目的:激光治疗已成为一种广受青睐的治疗方案。然而,与这种治疗相关的重大挑战,尤其是肤色较深的人,是炎症后色素沉着过度(PIH)诱导的显著风险。针对这些担忧,作者进行了一项前瞻性研究,自我对照研究,以综合评估532nm皮秒激光的安全性和有效性,有和没有微透镜阵列(MLA),用于Fitzpatrick皮肤类型(FST)III-V患者的SL管理
方法:对27例FSTIII-V和双侧SL患者进行随机治疗。面部的一侧用532nm皮秒激光与MLA耦合处理,利用分数颜料调色(FPT)技术,而另一方在没有MLA的情况下接受治疗,遵循传统技术(CT)。FPT技术使用9毫米的光斑尺寸,注量为0.47J/cm2,两次通过,覆盖了40%的面积。相比之下,CT使用4.5毫米的机头,注量范围为0.3至0.7J/cm2。患者接受单一治疗,并评估色素清除率,PIH的发生,和其他不良反应在2周,治疗后1、3和6个月。
结果:27名参与者完成了研究方案。颜料清除分析,通过3D摄影测量,FPT技术(p<0.001)和CT(p=0.004)均显示治疗后2周至6个月的显着改善。64%发生PIH,80%,96%,88%的病例在CT侧,与8%相比,32%,36%,在2周时FPT技术方面占16%,治疗后1、3和6个月,分别。在整个随访期间,FPT技术侧的PIH发生率明显低于CT侧。此外,FPT技术侧的1名参与者(4%)和CT侧的5名参与者(20%)发生短暂性和轻度色素减退.在研究期间没有观察到其他不良反应。
结论:532nm皮秒激光作为FSTIII-V患者SL的安全有效治疗方式。特别值得注意的是FPT技术的功效,与CT相比,这证明了相当的有效性,同时显着降低了PIH的发生率。
OBJECTIVE: Laser therapy has emerged as a widely favored treatment option for solar lentigines (SL). However, a significant challenge associated with this treatment, particularly among individuals with darker skin tones, is the notable risk of postinflammatory hyperpigmentation (PIH) induction. In response to these concerns, the authors conducted a prospective, self-controlled study to comprehensively evaluate the safety and effectiveness of 532-nm picosecond laser, both with and without a microlens array (MLA), for the management of SL in patients with Fitzpatrick skin types (FST) III-V.
METHODS: Twenty-seven patients with FST III-V and bilateral SL on the face underwent randomized treatment. One side of the face was treated with a 532-nm picosecond laser coupled with an MLA, utilizing the fractional pigment toning (FPT) technique, while the other side received treatment without the MLA, following the conventional technique (CT). The FPT technique utilized a 9-mm spot size with a fluence of 0.47 J/cm2 for two passes covering 40% of the area. In contrast, the CT used a 4.5-mm handpiece with fluence ranging from 0.3 to 0.7 J/cm2. Patients received a single treatment and were evaluated for pigment clearance, occurrence of PIH, and other adverse effects at 2 weeks, 1, 3, and 6 months posttreatment.
RESULTS: Twenty-seven participants completed the study protocol. Analysis of pigment clearance, measured via 3D photography, showed significant improvement from 2 weeks to 6 months posttreatment for both the FPT technique (p < 0.001) and CT (p = 0.004). PIH occurred in 64%, 80%, 96%, and 88% of cases on the CT side, compared to 8%, 32%, 36%, and 16% on the FPT technique side at 2 weeks, 1, 3, and 6 months posttreatment, respectively. The incidence of PIH was significantly lower on the FPT technique side compared to the CT side throughout the follow-up periods. Additionally, transient and mild hypopigmentation occurred in one participant (4%) on the FPT technique side and in five participants (20%) on the CT side. No other adverse effects were observed during the study.
CONCLUSIONS: The 532-nm picosecond laser emerges as a safe and efficacious treatment modality for SL in individuals with FST III-V. Particularly noteworthy is the efficacy of the FPT technique, which demonstrates comparable effectiveness while significantly reducing the incidence of PIH compared to the CT.