皮秒激光联合氨甲环酸治疗黄褐斑的临床效果

目的 分析在黄褐斑治疗中运用皮秒激光联合外用氨甲环酸治疗的临床效果。方法 选取广州 市妇女儿童医疗中心柳州医院2022年10月-2023年4月收治的30例黄褐斑患者作为研究对象,随机分为观察 组和对照组,各15例。观察组应用皮秒激光联合氨甲环酸进行治疗,对照组应用氨甲环酸进行治疗,比 较两组临床疗效、黄褐斑面积及严重程度、心境状态、治疗满意度、不良反应发生情况。结果 观察组 治疗总有效率为93.33%,高于对照组的73.33%（P ＜0.05）;观察组治疗满意度为93.33%,高于对照组的 80.00%（P ＜0.05）;观察组治疗后MASI、POMS评分低于对照组（P ＜0.05）;两组不良反应发生率比 较（P ＞0.05）。结论 在黄褐斑治疗中采取皮秒激光联合氨甲环酸治疗可有效提高临床治疗效果,较单独 用药治疗更能改善黄褐斑症状与心境状态,患者对黄褐斑治疗的满意度更高,且不会增加不良反应。     

超皮秒激光联合微针导入在黄褐斑治疗中的应用效果

目的 探讨超皮秒激光联合微针导入对黄褐斑患者面部修复情况及皮肤状态的影响。方法 选取 2022年1月-8月我院收治的60例黄褐斑患者为研究对象,随机分为对照组及观察组,各30例。观察组 采用超皮秒激光联合微针导入治疗,对照组仅采用超皮秒激光治疗,比较两组皮损面积和颜色评 分、皮肤生理参数、临床疗效、满意度及不良事件发生情况。结果 观察组治疗后皮损面积及颜色评分 低于对照组（ P ＜0.05）;观察组治疗后表皮含水量、表皮油脂含量高于对照组,经皮失水量低于对 照组（ P ＜0.05）;观察组治疗总有效率及满意度均高于对照组（ P ＜0.05）;观察组并发症发生率及护患 纠纷发生率均低于对照组,但差异无统计学意义（ P ＞0.05）。结论 黄褐斑患者应用超皮秒激光联合微针 导入治疗可有效修复面部皮损,改善皮肤状态,提高美观效果,且患者满意度高,不良事件发生率较低, 值得临床应用。     

纳晶微针导入氨甲环酸联合皮肤镜治疗黄褐斑的效果

目的 探究纳晶微针导入氨甲环酸联合皮肤镜在黄褐斑患者治疗中的应用效果。方法 选取2022年 6月-2023年6月本院收治的70例黄褐斑患者为研究对象,随机分为对照组和观察组,每组35例。对照组给予 氨甲环酸口服治疗,观察给予纳晶微针导入氨甲环酸联合皮肤镜治疗,比较两组临床疗效、黄褐斑严重程度指 数（MASI评分）、医生整体评价（PGA评分）、满意度及皮损积分。结果 观察组治疗总有效率为94.29%,高 于对照组的77.14%（P ＜0.05）;观察组治疗后MASI评分、PGA评分均低于对照组（P＜0.05）;观察组满意度 为97.14%,高于对照组的80.00%（P＜0.05）;观察组治疗后皮损总积分低于对照组（P ＜0.05）。结论 纳晶 微针导入氨甲环酸联合皮肤镜治疗黄褐斑的效果良好,可有效改善黄褐斑严重程度,减轻皮损症状,促进 恢复,有利于提高患者满意度。     

纳晶微针导入氨甲环酸联合调Q激光治疗黄褐斑35例临床观察

目的 探讨调Q激光联合纳晶微针导入氨甲环酸治疗黄褐斑的临床效果。方法 选取2023年 1月-2024年1月崇左市人民医院收治的70例黄褐斑患者作为研究对象,随机分为对照组和观察组,每组 35例。对照组采用调Q激光治疗,观察组在此基础上采用纳晶微针导入氨甲环酸治疗,比较两组临床疗效、 黄褐斑改善情况、不良反应发生率。结果 观察组治疗总有效率为77.14%,高于对照组的51.43%,差异有统 计学意义（P＜0.05）;观察组治疗后MASI评分为（6.31±1.05）分,低于对照组的（8.24±2.19）分,差异有 统计学意义（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 调Q激光联合纳 晶微针导入氨甲环酸治疗黄褐斑的临床效果较好,能改善面部皮损状况,且安全性较好,值得临床应用。     

微针美塑疗法联合超皮秒激光治疗黄褐斑的临床效果

目的 探讨微针美塑疗法联合超皮秒激光治疗黄褐斑的临床效果。 方法 选取新疆万橙医疗美容诊所2022年6月-2023年2月收治的50例黄褐斑患者为研究对象,以随机数字表法分为对照组和观察组,每组25例。对照组采用微针美塑治疗,观察组采用微针美塑疗法联合超皮秒激光治疗,比较两组临床疗效、皮损面积、皮损颜色及皮肤病生活质量评分。 结果 观察组治疗总有效率为96.00%,高于对照组的76.00%,差异有统计学意义（P＜0.05）;观察组治疗后皮损面积、皮损颜色、DLQI评分均优于对照组,差异有统计学意义（P＜0.05）。 结论 微针美塑疗法联合超皮秒激光治疗黄褐斑的临床效果良好,可有效缩小皮损面积,减轻皮损颜色,促进恢复,有利于提高患者的生活质量,值得临床应用。     

微针美塑疗法联合皮秒激光治疗黄褐斑的临床效果

探讨对黄褐斑采用微针美塑疗法联合皮秒激光治疗的效果。方法 选取2020年4月-2023年6月无锡华韩医疗美容诊所收治的84例黄褐斑患者作为研究对象,随机分为对照组和试验租,每组42例。对照组采取皮秒激光治疗,试验组采用微针美塑疗法联合皮秒激光治疗,比较两组黄褐斑消退率、皮肤改善情况及满意度。结果 试验组黄褐斑消退率为40.79%,高于对照组的25.13%（P ＜0.05）;试验组光泽评分、弹性指数及毛孔粗细评分均优于对照组（P ＜0.05）;试验组满意度评分均高于对照组（P ＜0.05）。结论 微针美塑疗法联合皮秒激光治疗黄褐斑的效果良好,可有效促进黄褐斑消退,有利于改善患者的皮肤状态,且患者对治疗方案的满意度较高。     

口服氨甲环酸治疗黄褐斑的临床观察

目的尝试并评价口服氨甲环酸治疗黄褐斑的新方法。方法使用低剂量的氨甲环酸对256例黄褐斑患者行长时间口服。服药时间6～15个月，平均9．6个月。观察服药后的临床效果、疗效出现时间、复发情况及不良反应等。结果治疗后随访256例患者3～5个月，80．9％的患者出现了不同程度的色斑减退。65．0％的患者服药后2个月色斑开始减轻，35．0％的患者服药后1个月出现效果。服药6个月后基本治愈、明显消退和好转者分别为10.5％、18．8％和51．6％。停药后复发者21例（8．2％）。除11例（4．3％）患者出现轻度胃肠道反应、9例（3．5％）患者出现月经量减少以外，未发现其他明显的不良反应。结论低剂量长时间口服氨甲环酸是一种安全有效治疗黄褐斑的新方法。     

微晶磨面联合氨甲环酸治疗黄褐斑的疗效观察

目的：探讨微晶磨面联合氨甲环酸药物治疗黄褐斑的临床疗效。方法：将96例患者随机分为两组,每组48例。治疗组采用微晶磨面联合氨甲环酸药物治疗,对照组采用单一氨甲环酸药物治疗。结果：随访6个月,治疗组总有效率86.67%,对照组71.43%,两组经统计学比较有显著性差异（P〈0.05）。结论：微晶磨面联合氨甲环酸治疗黄褐斑临床疗效明显优于单用氨甲环酸。     

维生素C联合口服氨甲环酸治疗黄褐斑的疗效

目的 分析维生素C与氨甲环酸联合治疗黄褐斑的临床疗效。方法 选取我院2023年1月-6月收治的 76例黄褐斑患者作为研究对象,随机分为对照组和试验组,各38例。对照组开展口服维生素C与德菲林复 合酸抑菌凝露联合治疗,试验组在对照组基础上增加氨甲环酸治疗,比较两组色斑评分及色斑皮损面积、 临床效果及性激素水平。结果 试验组治疗后色斑颜色及色斑皮损面积评分低于对照组（P＜0.05）;试验 组治疗总有效率为97.37%,高于对照组的81.58%（P ＜0.05）;试验组治疗后黄体生成素、卵泡刺激素、雌 二醇水平低于对照组（P ＜0.05）。结论 维生素C联合口服氨甲环酸治疗黄褐斑的疗效较好,可改善患者 色斑情况和性激素水平。     

氨甲环酸联合中药治疗女性黄褐斑疗效观察

目的:观察氨甲环酸联合中药治疗女性黄褐斑的临床疗效。方法:将60例女性黄褐斑患者随机分为两组,每组30例。两组均予中药汤剂口服治疗,每日2次,治疗组同时口服氨甲环酸0.5g/天,共12周。按照中国中西医结合学会皮肤性病专业委员会色素病学组拟定的疗效判定标准,观察疗效及不良反应。结果:治疗组基本治愈率43.3%,有效率66.7%;对照组基本治愈率10%,有效率30%,两组疗效差异有统计学意义(P0.05)。结论:氨甲环酸联合中药内服治疗女性黄褐斑安全、有效。     

Methimazole in the Treatment of Melasma: A Clinical and Dermascopic Study

BACKGROUND: Melasma is a chronic hypermelanotic disorder that is challenging to treat; no single effective therapeutic agent for it has been discovered. Methimazole, an oral antithyroid drug, has a skin depigmenting effect when used topically. OBJECTIVE: We sought to evaluate the efficacy and safety of methimazole, applied during microneedling sessions and additional topical use in between sessions, for the treatment of melasma. METHODS: This split-face study included 30 Egyptian patients with melasma, each of whom received 12 microneedling sessions once per week for 12 weeks followed by topical methimazole on the right side of face and placebo on the left side. In between the sessions, topical methimazole 5% cream was applied twice per day on the right side and placebo on the left side. Assessments were performed using the Hemi-melasma Area and Severity Index (hemi-MASI) percentage of improvement, patient satisfaction, dermoscopy, and thyroid-stimulating hormone (TSH) serum levels. RESULTS: There were significant clinical and dermoscopic improvements; hemi-MASI scores on the methimazole-treated right sides were decreased (p<0.001). The percent of hemi-MASI score improvement was significantly associated with the malar pattern (p=0.031) and epidermal type (p=0.04) of melasma. About 70 percent of our studied patients reported being satisfied with their treatment response (7% excellent, 33% good, 30% fair). No significant local or systemic side effects were observed. Pre- and posttreatment serum TSH levels were within the normal range in all treated cases. CONCLUSIONS: Methimazole has the potential to be a safe and promising therapeutic agent for the treatment of melasma via dermapen-delivered microneedling sessions with topical use in between sessions.     

Therapeutic Effect of Microneedling with Platelet-rich Plasma Versus Microneedling with Tranexamic Acid for Melasma

BackgroundMelasma is a chronic acquired focal pigment disorder showing symmetrical hyperpigmentation or hypermelanosis of photoexposed areas on the face. Tranexamic acid (TXA) is a treatment for melasma. The regression of melasma after platelet-rich-plasma (PRP) treatment is an interesting finding.ObjectiveWe investigated the effect of microneedling followed by PRP versus microneedling followed by tranexamic acid in the treatment of patients with melasma. MethodsThe study included 26 patients with melasma divided into two groups of 13 patients each. Group 1 was treated with microneedling and PRP, and Group 2 was treated with microneedling and tranexamic acid.ResultsThe response to treatment was assessed using the Melasma Area and Severity Index scoring system before and after treatment. At the start of the study and at the first session, there were no statistically significant differences (p>0.05). At the second and third treatment sessions, there were statistically significant differences (p<0.05). There were no statistically significant differences between the two groups regarding side effects of pain, erythema and postinflammatory hyperpigmentation.ConclusionMicroneedling with PRP offers better results than microneedling with TXA in treating melasma.     

黄褐斑发病机制及诊疗研究进展

黄褐斑是一种常见于育龄期妇女光暴露皮肤部位的对称性色素沉着性疾病。其病因及机制尚未完全阐明,已知相关因素有遗传易感性、紫外线照射及性激素等,成纤维细胞、角质形成细胞及其分泌因子参与黄褐斑的发生过程,近年来其发病机制在基因水平也有一定研究。随着对黄褐斑的逐步认识,其诊断工具也有所发展,除传统的非侵入性成像工具Wood’s灯外,皮肤镜、共聚焦显微镜及多光子显微镜也逐渐用于黄褐斑。由于黄褐斑的难治性及复发性,黄褐斑的有效治疗始终是一项重大挑战。尽管黄褐斑临床治疗方案繁多,但目前仍以药物治疗为主。更多作用于抑制黑色素合成、减少血管生成、抗炎症及抗氧化等各种途径的新型药物将为未来黄褐斑的治疗提供新思路。     

Treatment of Melasma with Intralesional Tranexamic Acid Versus Cryotherapy

Background Melasma is a relatively common, acquired facial skin disorder of hyperpigmentation. Though it occurs in both sexes, nearly 90% of patients are female. It manifests as hyperpigmented macules and patches distributed symmetrically on the face, neck, and, rarely, the upper limbs. OBJECTIVE: The aim of this study was to evaluate and compare the clinical efficacy and adverse effects of intralesional injection of tranexamic acid (TA) versus cryotherapy in the treatment of melasma.MethodsPatients were divided into two groups: Group A and Group B. Group A comprised 28 patients aged 27 to 50 years. They received localized intralesional injections of TA. According to Wood’s light examination, patients were divided into two subtypes; 13 patients with mainly dermal-type melasma and 15 patients with mainly mixed-type melasma. Family history was obtained in 12 patients. Group B comprised 28 patients aged 29 to 46 years were included. They were treated with cryotherapy. According to Wood’s light examination, the patients were divided into two subtypes of melasma; 8 patients with mainly dermal-type melasma and 10 patients with mainly mixed-type melasma.ResultsThere were no statistically significant differences between Group A and Group B according to contraception, sun exposure, and family history. There was a statistically significant difference between Group A and Group B according to previous treatment. There was no statistically significant difference between the two groups according to drug allergy. There were no statistically significant differences according to systemic disease or general examination.ConclusionIntralesional tranexamic acid is a safe and effective method for the treatment of melasma with no risk of PIH, thrombosis, or bleeding; however, more sessions with longer follow-up periods are recommended, as the final response may take several months to occur. Cryotherapy was neither safe nor effective due to the risk of PIH.     

外用5%氨甲环酸联合激光治疗黑眼圈的疗效及安全性研究

目的:评价单独使用含5%氨甲环酸的护肤品及联合不同激光治疗以色素型为主的黑眼圈的疗效和安全性。方法:选择色素型及混合型黑眼圈患者32例,双侧上下眼睑用含5%氨甲环酸的护肤品3个月,同时一侧下眼睑接受皮秒激光治疗,另一侧下眼睑接受Q开关1064nm激光治疗,分别在第0、28、56天接受治疗。在第0、14、28、56、84天进行随访,以治疗前作为对照,皮肤颜色测量仪检测疗效,并采用患者自身评价观察黑眼圈改善情况。结果:单独使用含5%氨甲环酸护肤品后56d开始皮肤黑素指数、14d开始红斑指数比较,较使用前显著改善(P<0.05),且随使用时间延长效果更好。联合使用含5%氨甲环酸护肤品及Q开关1064nm激光后28d开始黑素指数及红斑指数比较,均较治疗前有显著下降(P<0.05),且随治疗次数增加效果更好。联合使用含5%氨甲环酸护肤品及755nm皮秒激光治疗后28d开始黑素指数、14d开始红斑指数比较,均较治疗前有显著下降(P<0.05)。所有就医者自我评价均认为黑眼圈的颜色及范围得到一定程度改善,其中超过50%的就医者认为得到了中度至显著改善效果。试验过程中约13.8%的就医者使用护肤品时出现局部红斑、瘙痒等不良反应,停用产品后均可自行缓解。Q开关激光治疗不良反应轻微,皮秒激光治疗过程中有轻、中度疼痛,术后即刻可出现明显红斑。结论:对于以色素型为主的黑眼圈外用含5%氨甲环酸的护肤品可改善黑眼圈的颜色及范围,偶可见局部刺激反应;联合Q开关1064nm或755nm皮秒激光治疗可改善黑眼圈的颜色及范围,起效更快,并减少激光治疗后色素沉着的发生几率,安全性好。     

Intradermal Injection of 100mg Tranexamic Acid Versus Topical 4% Hydroquinone for the Treatment of Melasma: A Randomized,Controlled Trial

ObjectiveMelasma is an acquired and chronic hyperpigmentation disorder associated with a negative impact on patients’ quality of life. This study compares the efficacy of 100mg/mL intradermal TA with 4% topical HQ on female patients presenting with melasma lesions.MethodsIn this randomized double-blind controlled trial, 48 women with melasma were allocated into two groups, treated with either 100mg/mL intradermal TA or topical 4% HQ. The MASI (Melasma Area and Severity Index) score was assessed by paired t-tests and repeated measured ANOVAs. The Dynamic Physician General Assessment (PGA) was also performed by taking photographs with a digital camera.ResultsThe average MASI score for the HQ and TA groups was 7.7 (3.0 SD) and 5.9 (2.5 SD), respectively. In both groups, the MASI decreased significantly after three months of treatment; however, the decrease was not significant between the two groups (P=0.1). All participants developed mild degrees of burning pain in the injection site without serious adverse effects.LimitationsFirst, we only used the MASI score to measure melasma degree. Second, this is a single-center study with a small sample size. Third, the before-after photos were not taken with a high-quality camera. ConclusionThe results of our study showed that both TA and continuous HQ significantly reduced the MASI score of patients without any significant differences and serious side effects. Although many treatment modalities are available for melasma, this condition is still challenging for dermatologists with a high recurrence rate after treatment.