射频联合调Q激光治疗黄褐斑的效果

分析射频联合调Q激光治疗黄褐斑的临床疗效。方法 选取2021年1月-2022年4月公主岭怀 德东方中医医院收治的黄褐斑患者100例作为研究对象,按照随机单双数抽签法将单数者设为对照组, 另将双数者设为研究组,每组50例。对照组接受调Q激光治疗,研究组在对照组治疗基础上增加射频 治疗,比较两组临床效果、黄褐斑面积和严重指数评分（MASI）、美容满意度及不良反应发生情况。 结果 研究组治疗总有效率为94.00%,高于对照组的80.00%（P ＜0.05）;两组治疗后MASI评分低于治 疗前,且研究组低于对照组（P ＜0.05）;研究组美容满意度评分高于对照组（P ＜0.05）;两组不良反应 发生率比较,差异无统计学意义（P ＞0.05）。结论 射频与调Q激光联合治疗黄褐斑的效果良好,可加速 黄褐斑消退且安全性有保障。     

Nd∶YAG皮秒激光治疗黄褐斑临床疗效及安全性研究

目的探索1 064 nm Nd∶YAG皮秒激光治疗黄褐斑的有效性和安全性。方法前瞻性选取2019年9~10月首都医科大学附属北京友谊医院门诊招募的38例黄褐斑患者进行皮秒激光治疗,治疗共3次,每4周进行一次,随访6个月。对患者治疗前、治疗第4周、第8周、第12周及随访6个月后的改良黄褐斑面积和严重指数(m MASI)评分做出评估,记录治疗后医生整体评价(PGA)、患者疗效满意度,记录治疗及随访期间出现的不良反应情况。结果 35例患者完成本研究,Fitzpatrick皮肤分型Ⅲ型25例,FitzpatrickⅣ型10例。经过3次治疗后,治疗区域mMASI评分由治疗前的5.4(2.4,10.8)分降至2.4(0.9,4.2)分,差异有统计学意义(P <0.001)。总有效率为94.3%,显效20例(57.1%),好转13例(37.1%),无效2例(5.7%)。经过3次治疗后,FitzpatrickⅢ型患者mMASI评分由治疗前4.2(2.0,7.0)分降至1.5(0.9,2.6)分,FitzpatrickⅣ型患者m MASI评分由治疗前11.4(6.8,15.1)分降至4.8(3.6,6.3)分,治疗前后FitzpatrickⅢ与FitzpatrickⅣ型患者m MASI评分下降值比较,差异无统计学意义(P> 0.05)。FitzpatrickⅢ型患者有效率(96.0%)和FitzpatrickⅣ型患者(90.0%)比较,差异无统计学意义(P> 0.05)。33例(94.3%)患者PGA评分有不同程度改善,FitzpatrickⅢ型总改善率为96.0%,FitzpatrickⅣ型总改善率为90.0%。2组患者PGA评分值比较,差异无统计学意义(P> 0.05)。患者疗效满意率为85.7%。治疗期间未观察到严重不良反应。随访6个月后,9例(25.7%)出现复发。结论 1 064 nm Nd∶YAG皮秒激光治疗FitzpatrickⅢ型与Ⅳ型黄褐斑疗效均较好,不良反应小,值得临床推广应用。     

外用0.5% MITF-siRNA霜治疗黄褐斑临床疗效及安全性观察

目的观察MITF-siRNA霜外用治疗黄褐斑的临床疗效及安全性。方法经临床诊断为黄褐斑的33例患者给予外用MITF-siRNA霜治疗,2次/d,并用MicroskinⅡ多功能偏振光皮肤镜图像分析系统对治疗前后黄褐斑皮损进行客观测量,通过测量L×,A×,B×值并计算ITAo值以评价局部外用siRNA霜的治疗效果。结果经MITF-siRNA霜外用治疗12周后,有效率90.3%,治疗前后ITAo值显著改善(P0.01)。观察过程中仅有1例局部出现红斑,停用至红斑消退后,继续外用siRNA霜后达到显效。结论局部外用MITF-siRNA霜可以显著淡化色斑,疗效确切且安全性好。     

女性黄褐斑102例临床分析及血清性激素水平检测

目的探讨女性黄褐斑患者的临床特点及血清性激素水平。方法对102例女性黄褐斑患者进行临床资料分析,并检测了40例女性黄褐斑患者和38例正常对照组的血清性激素水平。结果黄褐斑发病与日晒、遗传、内分泌因素等相关;病例组血清雌二醇、促卵泡素、黄体生成素水平与对照组差异有统计学意义(P<0.05)。结论日晒是黄褐斑发病最重要的危险因素,部分黄褐斑患者可存在性激素水平的异常。     

Intense Pulsed Light and Low-Fluence Q-Switched Nd:YAG Laser Treatment in Melasma Patients

Background

Recently, low fluence collimated Q-switched (QS) Nd:YAG laser has drawn attention for the treatment of melasma. However, it needs a lot of treatment sessions for the substantial results and repetitive laser exposures may end up with unwanted depigmentation.

Objective

We evaluated the clinical effects and safety of the combinational treatment, using intense pulsed light (IPL) and low fluence QS Nd:YAG laser.

Methods

Retrospective case series of 20 female patients, with mixed type melasma, were analyzed using medical records. They were treated with IPL one time, and 4 times of weekly successive low fluence Nd:YAG laser treatments. At each visit, digital photographs were taken under the same condition. Melanin index (MI) and erythema index (EI) were measured on the highest point on the cheekbones. Modified melasma area and severity index (MASI) scores were calculated by two investigators using digital photographs.

Results

The mean values of MI and EI decreased significantly after treatments. The modified MASI score has decreased by 59.35%, on average. Sixty percents of the participants did not require any more treatments, and no clinical aggravations were observed during the follow-up period (mean 5.9 months).

Conclusion

IPL and low fluence laser may elicit a clinical resolution in the mixed type melasma with long term benefits.     

大光斑低能量调Q开关Nd：YAG激光治疗黄褐斑的疗效

目的探讨大光斑低能挝调Q开关Nd：YAG1064nm激光治疗黄褐斑的疗效和安全性。方法对45例黄褐斑患者,使用大光斑低能量调Q开关Nd：YAG1064nm激光治疗,每周1次．每例患行治疗11～20次,分别于治疗前、治疗5周、10周以及治疗完成时,进行患者自评疗效、医师评价以及皮肤多功能测试仪检测皮肤黑素指数和经皮水分丢失评价。结果黄褐斑皮损区激光治疗5周、10周、完成时黑素指数较治疗前均有显著性减少,正常皮肤区治疗前后无差异;治疗5次、10次和完成时经皮水分较治疗前均有显著性增高,治疗后患者的皮肤光滑、细腻、毛孔缩小、更有弹性。治疗效果评价：基本治愈8例（17．78％）,显效25例（55．56％）,好转11例（24．44％）．无效1例（2．22％）,有效率为73．33％。结论大光斑低能量调Q开关1064nm激光治疗黄褐斑疗效确切．副作用小,安全性高。     

Energy-based device treatment of melasma: An update and review of the literature

Melasma is an acquired pigmentary disorder commonly seen in sun-exposed areas. Predominantly affecting women of childbearing age, melasma can be difficult to treat for many patients. A variety of options currently exist; however, definitive treatment remains elusive. This article provides a review of the current literature and examines in detail the various energy-based devices used to treat melasma.