种族皮肤病学意识的提高与全球肤色社区皮肤患病率的提高相一致,色素沉着过度的疾病构成了一个常见的皮肤病学挑战。有效解决真皮色素沉着是具有挑战性的,因为它对常规疗法的抗性及其与受损的生活质量的关联。这强调了对有效治疗和彻底掌握激光进步的需求。在PubMed数据库中过去7年的相关文献检索揭示了核心研究,挑战,以及为各种形式的先天性和获得性皮肤色素沉着量身定做的激光技术的发展。这次全面审查探讨了机制,应用程序,和推荐的颜料激光技术,突出了调Q激光器在其既定的毫秒/纳秒形式和新兴的皮秒激光器中的关键作用,分数非烧蚀和烧蚀激光器,强脉冲光,等。证据总结包括对真皮黑色素细胞增多症(太田痣和荷里痣)的研究,纹身,获得性真皮黄斑色素沉着,等。,以及具有混合表皮-真皮成分的实体,如黄褐斑和炎症后色素沉着过度。该综述为临床医生根据诊断做出明智的决定提供了有价值的见解,皮肤类型,以及优化结果和减少并发症的最新技术,特别是在较深的菲茨帕特里克皮肤类型。在他们对122名印度患者进行的为期五年的研究中,作者将特定的激光组合应用于各种皮肤黑色素,包括纹身,真皮/混合性黄褐斑,获得性真皮黄斑色素沉着,和真皮痣。显著减少色素沉着,由医生和患者主观评估,在所有组中观察到。单因素方差分析表明,在各种色素性条件下,平均改善评分存在显着差异(F=3.39,p=0.02),黄褐斑患者的改善评分明显高于纹身(p=0.03)。结果肯定了序贯激光治疗皮肤色素沉着的安全性和有效性。提倡方法的灵活性,同时保持激光序列背后的基本原理。尽管取得了进步,挑战依然存在,并确定了当前文献中的空白。总之,本摘要强调了皮肤激光治疗皮肤黑素病的最佳方案的持续追求,为未来的研究和临床实践提供有价值的见解。
The heightened awareness of ethnic dermatology aligns with the growing prevalence of skin of color communities globally, where hyperpigmentation disorders pose a common dermatological challenge. Effectively addressing dermal pigmentation is challenging due to its resistance to conventional therapies and its association with impaired quality of life. This underscores the need for effective treatments and a thorough grasp of laser advancements. A relevant literature search spanning the last 7 years across the PubMed database reveals core studies, challenges, and the evolution of laser technologies tailored for various forms of congenital and acquired dermal hyperpigmentation in skin of color. This comprehensive
review explores the mechanisms, applications, and recommendations for pigmentary laser technologies, highlighting the key role of Q-switched lasers in their established millisecond/ nanosecond forms and emerging picosecond lasers, fractional non-ablative and ablative lasers, Intense Pulsed Light, etc. The summary of evidence includes studies on dermal melanocytosis (nevus of Ota and Hori\'s nevus), tattoos, acquired dermal macular hyperpigmentation, etc., and also entities with mixed epidermal-dermal components, such as melasma and post-inflammatory hyperpigmentation. The
review offers valuable insights for clinicians to make informed decisions based on diagnosis, skin type, and the latest technologies to optimize results and minimize complications, especially in darker Fitzpatrick skin types. In their five-year study with 122 Indian patients, the authors applied specific laser combinations for diverse dermal melanoses, including tattoos, dermal/mixed melasma, acquired dermal macular hyperpigmentation, and dermal nevi. Substantial pigmentation reduction, subjectively assessed by both physicians and patients, was observed across all groups. A one-way ANOVA indicated a significant difference in mean improvement scores across various pigmentary conditions (F = 3.39, p = 0.02), with melasma patients exhibiting a significantly higher improvement score than tattoos (p = 0.03). The results affirmed the safety and efficacy of sequential laser therapy for dermal pigmentation in skin of color, advocating for flexibility in approach while maintaining the rationale behind the laser sequences. Despite advancements, challenges persist, and gaps in the current literature are identified. In conclusion, this summary highlights the ongoing pursuit of optimal protocols in dermatological laser treatments for dermal melanoses, offering valuable insights for future research and clinical practice.