420nm强脉冲光治疗寻常痤疮的疗效观察

痤疮是一种多因素导致的发生于毛囊皮脂腺的慢性炎症性皮肤病,不但影响容貌,而且还可以使患者产生焦虑、抑郁等心理问题[1],对患者的工作、学习造成了较大的影响.传统药物治疗存在着一定的不足, 比如耐药痤疮丙酸杆菌菌株的出现、长期口服异维A 酸和抗生素的不良反应等.     

420nm强脉冲光联合氯霉素搽剂治疗面部中重度痤疮疗效观察

目的观察420nm强脉冲光联合氯霉素搽剂治疗中重度寻常痤疮的疗效。方法将78例面部中重度寻常痤疮患者随机分为两组,观察组40例采用420nm强脉冲光联合氯霉素搽剂治疗;对照组38例单纯外用氯霉素搽剂治疗。结果观察组和对照组有效率分别为77．5％和47．37％,观察组疗效和有效率明显高于对照组（P〈0．01）。结论420nm强脉冲光联合氯霉素搽剂治疗中重度寻常痤疮的疗效优于单纯外用氯霉素搽剂。     

595nm脉冲染料激光治疗鲜红斑痣回顾性分析

目的观察595nm脉冲染料激光治疗鲜红斑痣的临床疗效。方法应用595nm脉冲染料激光治疗647例鲜红斑痣患者,观察临床疗效及副作用。结果粉红型、鲜红/紫红型及增厚/结节型平均治疗次数分别为3.61次、4.87次及4.57次。随着治疗次数的增加,疗效逐渐提高。粉红型、鲜红/紫红型及增厚/结节型的总有效率分别为80.24%,75.86%及65.21%。经Chi-square检验,前两型疗效无统计学差异,但均优于后者。术后副作用少。结论595nm脉冲染料激光治疗鲜红斑痣疗效确切,安全性高。     

强脉冲光治疗面部痤疮临床疗效分析

目的评价强脉冲光治疗面部痤疮的疗效。方法用强脉冲光治疗116例面部痤疮患者，总计治疗5次，治疗间隔3-4周。对患者治疗前后的面部情况进行照相对比评分，并观察不良反应。结果116例患者中治疗有效率为85．4％。痊愈率为41．4％。面部毛发较多的患者中有7例暂时性色素沉着持续时间较长。结论强脉冲光治疗面部痤疮有效。     

强脉冲光治疗寻常痤疮98例疗效观察

目的：观察强脉冲光（IPL）治疗寻常痤疮的疗效及安全性。方法：将98例寻常痤疮患者随机分成两组,治疗组49例采用SkinStation丝柔光子多功能美容治疗仪治疗,每2周1次,连续4次为一疗程,对照组采用自制1％克林霉素凝胶,连续用药共8周,8周后观察疗效及不良反应。结果：治疗组的炎性损害改善情况、皮疹减少数均明显高于对照组,非炎性损害的改善情况则两组无显著性差异。治疗组总有效率为77．55％,对照组总有效率为53．06％,两组比较有显著性差异（P〈0．05）,治疗组未发现明显不良反应。结论：强脉冲光治疗寻常痤疮,尤其对炎症性痤疮有比较显著的疗效,不良反应少。     

595nm脉冲染料激光治疗婴幼儿皮肤真性血管瘤疗效观察

目的探讨595 nm脉冲染料激光治疗婴幼儿皮肤真性血管瘤的疗效。方法应用595 nm脉冲染料激光治疗40例婴幼儿皮肤真性血管瘤并观察疗效。结果 40例患者中,治疗3次以内6例,治疗3次及以上34例。治愈18例(45%),显效15例(37.5%),有效3例(7.5%),无效3例(7.5%),总有效率82.5%。结论 595 nm脉冲染料激光治疗婴幼儿皮肤真性血管瘤疗效确切、安全,可在临床推广。     

强脉冲光多波段联合应用对中重度痤疮治疗的疗效观察

目的:观察强脉冲光420 nm联合560/590 nm对痤疮患者炎性皮损和痤疮后红斑的疗效。方法:将44例痤疮患者随机分为两组,治疗组(22例)采用强脉冲光420 nm联合560/590 nm治疗,对照组(22例)仅用420 nm治疗,比较两组治疗疗效及患者满意度评价。结果:两组炎性皮损治疗后总有效率分别为81.8%、77.3%,差异无统计学意义(x2=0,P<0.01);治疗组痤疮后红斑治疗总有效率(86.3%)明显高于对照组总有效率(54.5%),差异有统计学意义(x2=3.93,P=0.047);治疗结束后1个月随访,治疗组和对照组对整体疗效的满意度分别为90.9%、63.6%,治疗组高于对照组,差异有统计学意义(x2=4.66,P<0.05)。治疗过程中未见严重不良反应。结论:强脉冲光420 nm联合560/590nm治疗痤疮对患者的炎性皮损和治疗后红斑均有明显的改善作用,值得临床推广应用。     

5-氨基酮戊酸光动力疗法联合脉冲染料激光治疗重度痤疮临床观察

目的:探讨5-氨基酮戊酸光动力疗法(5-aminolevulinic acid photodynamic therapy, ALA-PDT)联合脉冲染料激光治疗重度痤疮的疗效。方法:60例面部重度痤疮患者随机分为2组,每组30例,分别给予ALA-PDT联合脉冲染料激光治疗(治疗组)及单纯ALA-PDT(对照组)治疗,每2周治疗1次,共3次。结果:治疗组中痊愈率(40%)和有效率(90%)均高于对照组痊愈率(30%)和有效率(66.67%),其中有效率差异有统计学意义(P0.05);治疗组结节、囊肿的数量明显少于对照组(P0.05),且不良反应较轻。随访12个月中,治疗组未复发或明显改善者占56.67%,无效或复发者占26.67%;对照组未复发或明显改善者占46.67%,无效或复发者占23.33%,两组复发率无统计学差异。结论:ALA-PDT联合脉冲染料激光较单纯5-氨基酮戊酸光动力治疗重度痤疮安全有效。     

595 nm脉冲染料激光治疗婴幼儿面部和四肢浅表血管瘤的疗效比较

目的：比较595 nm脉冲染料激光治疗婴幼儿面部及四肢浅表血管瘤的疗效及不良反应。方法：回顾性分析我科2017年12月至2020年1月收治的浅表血管瘤患者的临床资料，分为累及面部(面部组)和累及四肢(四肢组)两组。疗效评估由监护人和未参与治疗的皮肤科医生通过比较治疗前后病变照片共同完成。治疗效果分为：痊愈、显效、有效、无效，皮损大小和颜色改善分别为≥90%，60%~89%，30%~59%，<30%或病变扩大。 结果：共91例浅表血管瘤患者纳入分析，其中面部组43例，四肢组48例。面部组和四肢组分别有53.5%和72.9%的患者达到痊愈，分别有86%和100%患者皮损达到有效，两组间痊愈率和有效率差异均有统计学意义（均P<0.05）。面部组和肢体组的不良反应发生率分别为23.3%和16.7%，差异无统计学意义(P>0.05)。结论：595 nm脉冲染料激光治疗四肢浅表血管瘤疗效优于面部，不良反应无明显差异。     

激光和强脉冲光治疗酒渣鼻的治疗进展

酒渣鼻是常见皮肤病,其临床特点包括皮肤潮红、持久性红斑、丘疹脓疱和毛细血管扩张.激光是治疗酒渣鼻毛细血管扩张和鼻赘期的理想选择,最常用的激光包括脉冲染料激光(波长585/595 nm)、长脉宽Nd:YAG激光(波长1064 nm)、CO2激光、铒激光和点阵激光等.强脉冲光、脉冲染料激光用于改善酒渣鼻红斑和毛细血管扩张,安全性高,停工期短.长脉宽Nd:YAG激光仅用于治疗较粗血管和难治性毛细血管扩张.CO2激光、铒激光和点阵激光用于改善酒渣鼻鼻赘.临床上多种激光联合治疗效果更佳.     

强脉冲光治疗痤疮印迹1036例回顾性分析

目的回顾分析强脉冲光治疗痤疮印迹的临床疗效。方法应用强脉冲光,波长560nm,脉冲延时25～40ms,脉宽3.0～4.0ms,脉冲模式为2脉冲和3脉冲,能量密度14～19J/cm2治疗痤疮印迹患者1036例,随访6个月,根据治疗前后患者面部照片判断疗效。结果经过1～5次治疗,面部疗效好于胸、背部,差异有统计学意义(P<0.05),胸、背部疗效差异无统计学意义(P>0.05)。红色皮损治疗效果优于褐色,但两种皮损类型总有效率比较,差异无统计学差异(P>0.05)。所有病例在治疗后均未遗留瘢痕,疗效与治疗次数正相关。结论应用560nm强脉冲光治疗痤疮印迹疗效显著,且无痛苦,不留疤痕。     

Comparative efficacy of short-pulsed intense pulsed light and pulsed dye laser to treat rosacea

Background: Laser and light-based therapies have often been used successfully to treat rosacea. Recently, short-pulsed intense pulsed light (IPL) that emitted pulse durations down to 0.5 ms was found to be effective for rosacea treatment.

Objective: This study evaluated the efficacy of short-pulsed IPL in the treatment of rosacea compared with pulsed dye laser (PDL) using same pulse duration and fluence.

Materials and Methods: Nine patients with rosacea were enrolled in a randomized, split-face trial. Each treatment consisted of four sessions at three-week intervals and followed up until three weeks after the last treatment. Efficacy was assessed by erythema, melanin index, physician’s subjective evaluation, and patient’s satisfaction.

Results: The mean change in erythema index was ?4.93 ± 1.59 for the short-pulsed IPL group and ?4.27 ± 1.23 for the PDL group. The mean change in melanin index was ?2.52 ± 2.45 for the short-pulsed IPL group and ?1.95 ± 1.41 for the PDL group. There was no significant difference in either melanin or erythema index between short-pulsed IPL and PDL treatments, and there were no noticeable adverse events.

Conclusions: There was no significant difference between PDL and short-pulsed IPL treatment using the same energies and pulse. Both PDL and short-pulsed IPL were satisfactory and safe for rosacea treatment.     

两种强脉冲光治疗面部光老化的临床观察

目的 比较两种强脉冲光治疗仪对面部光老化的疗效及安全性.方法 采用自身半脸对照法,对30例面部光老化女性受试者分别以强脉冲光治疗仪Lumenis One或BBL进行治疗,共治疗5次,每次间隔3～5周,并于首次治疗前(访视1)、第3次治疗后第4周(访视2)、第5次治疗后第4周(访视3)、第5次治疗后第8周(访视4)进行随访.每次随访时,采用光老化整体评分(GSP)对受试者治疗前后面部光老化程度进行评价,4分法评价左右半脸皱纹、皮肤质地、色素斑、毛细血管扩张、皮肤紧致度的改善程度,视觉模拟评分(VAS)法用于疼痛评价.末次治疗后进行受试者满意度自评.GSP与左、右面部改善评分比较均采用重复测量资料方差分析.结果 26例受试者完成了全部治疗及随访.对全面部进行评价,3次治疗后4周,受试者GSP评分由治疗前的3.19±0.75下降至2.15±0.83(P＜ 0.01),5次治疗后4周下降至1.85±0.88,5次治疗后8周为1.85±0.97,5次治疗后4周与8周相比差异无统计学意义(P＞0.01).分别评价左右面部,两侧皮肤质地、色素斑、毛细血管扩张和皮肤紧致度的改善评分在访视2、3、4间均有先增加后降低的趋势(F值分别为18.75、10.25、12.83、15.73,均P＜0.05),且访视3改善程度较访视2显著增加(均P＜0.017).皮肤质地、毛细血管扩张和皮肤紧致度的改善程度在访视3与访视4间无明显差异(P＞ 0.017),色素斑改善评分在5次治疗后8周较5次治疗后4周略下降(P＜ 0.017).皱纹在访视2、3、4间改善不明显(F=3.17,P＞0.05),Lumenis One侧与BBL侧5种面部光老化症状的改善也没有明显差异(均P＞0.05).BBL侧VAS疼痛评分(4.62±1.54)显著小于Lumenis One侧(5.80±1.74),差异有统计学意义(t=2.87,P＜0.05).受试者自我满意率为88.46％(23/26).结论 强脉冲光治疗仪Lumenis One和BBL均可安全、有效地治疗面部皮肤光老化,改善色素斑、皮肤质地等光老化表现,但BBL治疗舒适度优于Lumenis One.     

Short pulse intense pulsed light versus pulsed dye laser for the treatment of facial redness

ABSTRACT

Treating diffuse facial redness with an intense pulsed light (IPL) source usually requires multiple sessions and may not achieve complete clearance. The 595 nm pulsed dye laser (PDL) enjoys a good reputation for reducing facial redness with non-purpuric settings. The objective of this study was to compare facial redness reduction using these two devices. After establishing the lowest light dose able to achieve transient purpura for the same pulse width of 1,5 ms with each technology, right and left sides of the face were randomly assigned for each type of treatment. There were two treatment sessions 4 weeks apart and the final evaluation was performed 8 weeks after thesecond treatment. Four blinded experienced dermatologists analyzed pre and post-treatment photographs, which demonstrated an average of 60% improvement on the segment treated with the IPL as opposed to 45% on the other segment. Pain level was described as mild and the procedure was well tolerated for both types of treatment. In this study we showed that short-pulsed intense pulsed light and PDL are similar in decreasing facial redness when non-purpuric low fluence settings are used. The IPL was faster and did not have consumables.     

Efficacy and safety of intense pulsed light in the treatment of inflammatory acne vulgaris with a novel filter

Acne vulgaris is one of the most common skin diseases affecting young people. Intense pulsed light (IPL) has become a well-recognized method in the treatment of acne vulgaris. We aim evaluate the clinical efficacy and safety of a novel IPL filter at wavelength of 400–600 nm and 800–1,200 nm in the treatment of inflammatory acne lesions. Twenty-one patients with Pillsbury I–III facial acne vulgaris between July 2017 and January 2018 were enrolled in this prospective clinical study. Five sessions of IPL treatment were administered to the subjects at 4-week interval. Final assessment was performed 1 month after the final treatment. One month posttreatment, over 75% subjects exhibited excellent or good response. Of the Pillsbury I–II patients, the effective rate reached 88.24%. The inflammatory lesions were dramatically decreased (25.23 ± 2.76 versus 14.01 ± 1.98) and statistically evident (P = .031). According to Hayashi assessment of acne severity, there was a significant improvement at follow-up visit (P = .022). Moreover, patients reported significant improvements in self-evaluation. The novel IPL filter at wavelength of 400–600 nm and 800–1,200 nm provides an effective option to treatment of inflammatory acne lesions, especially for Pillsbury I–II acne patients, with minimal reversible side effects, such as transient post-inflammatory pigmentation.     

Comparative efficacy of intense pulsed light for different erythema associated with rosacea

Abstract

Objective: To compare the efficacy of intense pulsed light (IPL) (540–950nm) in treating different erythema associated with rosacea. Methods: Thirty-two patients with erythematotelangiectatic rosacea (ETR) (n = 16) and papulopustular rosacea (PPR, n = 16) were recruited. Three treatments of IPL (540–950nm) were administered on the face at 3-week intervals. Clinical improvement in erythema was independently assessed by two dermatologists using a quartile grading scale [0, ≤ 25% improvement (poor); 1, 26–50% improvement (fair); 2, 51–75% improvement (good); and 3, 76–100% improvement (excellent)]. Patient satisfaction was evaluated using a 10-point visual analog scale (VAS: 0, lowest; and 10, highest). Results: Thirty patients were involved in this study. All patients showed improvement in erythema after three sessions of IPL (540–950nm) treatment. Based on physician's assessment, the overall clinical improvement in PPR group was significantly higher (mean ± SD of PPR group, 2.167 ± 0.748 vs. ETR group, 1.400 ± 0.541; P = 0.003) and patient satisfaction was also higher in PPR group (mean ± SD of PPR group, 6.867 ± 1.457 vs. ETR group, 5.600 ± 1.502; P = 0.026). The proportion of patients showing > 75% clinical improvement among PPR group was also higher than that among ETR group (5/15 and 0/15, respectively; P = 0.021). Side effects were minimal and transient (erythema and/or edema) for patients. Conclusions: IPL (540–950nm) is a safe and effective treatment for rosacea-associated erythema, especially for perilesional erythema.