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.     

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。     

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。     

强脉冲光联合消痤丸治疗中重度痤疮的疗效观察

目的：观察强脉冲光联合消痤丸治疗中、重度痤疮的临床疗效。方法：将人选患者随机分成两组,治疗组40例用420nm强脉冲光联合消痤丸治疗,对照组40例单纯口服消痤丸治疗,疗程均为4周。结果：治疗结束后,治疗组有效率为87．50％,对照组为65．00％,差异有统计学意义（P〈0．05）。结论：强脉冲光联合消痤丸治疗中、重度痤疮,疗效显著,疗程较短,副作用小,值得临床应用。     

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。     

超分子水杨酸联合强脉冲光治疗中重度痤疮的疗效分析

目的分析超分子水杨酸联合强脉冲光治疗中重度寻常痤疮的安全性及有效性。方法回顾性总结2015年12月-2017年12月在首都医科大学附属北京佑安医院皮肤科就诊的60例中重度痤疮患者,分为两组,每组各30例患者,分别给予强脉冲光联合30%超分子水杨酸治疗及单纯30%超分子水杨酸治疗。试验组首先给予强脉冲光治疗,根据患者皮损特点、肤色、耐受度选择治疗参数,炎症明显处治疗2次;强脉冲光治疗结束后,清洗面部,全面部涂抹30%超分子水杨酸,慢慢揉搓治疗区域,应用蒸馏水防止干燥且保证水杨酸缓慢释放,持续时间根据患者的耐受程度,一般为10~15 min,每月治疗1次,共治疗1次。对照组仅给予30%超分子水杨酸治疗,每月治疗1次,共治疗4次。治疗后1个月门诊随访。结果试验组的有效率(63.33%)高于对照组(36.67%);试验组治疗后粉刺、炎症丘疹及脓疱、囊肿结节数量比治疗前明显减低。结论超分子水杨酸联合强脉冲光治疗中重度痤疮疗效较好,减少患者治疗周期,未增加不良反应的发生。     

新型强脉冲光治疗面部寻常痤疮的疗效观察

2005年7月至2007年8月,我科用具有优化脉冲技术的新型强脉冲光(intense pulsed light,IPL)治疗116例面部寻常痤疮患者,取得满意疗效. 一、临床资料 依据靳培英[1]标准,寻常痤疮严重程度分为轻(Ⅰ级)、中(Ⅱ级和Ⅲ级)、重(Ⅳ级),选择病情为Ⅱ～Ⅲ级的面部寻常痤疮患者116例,男46例,女70例;年龄18～42岁,平均(23.12±5.34)岁;病程2个月至13年,平均(2.76±1.58)年.其中Ⅱ级79例:有粉刺,伴有中等量的丘疹和脓疱,总数31～50个;Ⅲ级37例:有粉刺,伴有大量的丘疹和脓疱,偶见大的炎性损害,分布广泛,总数51～100个,有少数结节.排除标准:有光敏史者;1年内外用或口服光敏性药物者,如维A酸类药物;近期内服用其他药物(如糖皮质激素)者;正在使用其他方法治疗痤疮者;2周内经受日光曝晒者;妊娠及哺乳期患者;有精神疾患者.     

强脉冲光及595nm染料激光治疗面部痤疮后红斑自身对比研究

目的 评价及对比强脉冲光和595 nm染料激光治疗痤疮后红斑的临床疗效及安全性.方法 采用随机自身左右面部对照临床试验研究方法,选取20例患有痤疮后红斑的患者,每例患者的两侧面颊随机分配接受强脉冲光或595 nm染料激光治疗3次,每次间隔4周.分别在每次治疗前以及最后1次治疗1个月后使用VISIA拍照,测量红斑值;通过四分红斑严重程度表评价治疗前后双侧面部红斑严重程度.每次治疗后均填写疼痛评分表、不良反应记录表,最后1次随访通过问卷形式对患者进行满意度调查.结果 强脉冲光侧平均红斑值治疗前472.25±86.02,治疗后357.15±82.71;595 nm染料激光侧治疗前476.40±74.25,治疗后360.05±64.83,经重复测量资料方差分析,可以认为随治疗时间延长,患者红斑值有所降低(F=197.666,P＜0.001);强脉冲光侧治疗效果优于595 nm染料激光侧(F=1 173.909,P＜0.001).强脉冲光侧治疗前后四分红斑值差异有统计学意义(Z=28.735,P＜ 0.001),595 nm染料激光侧差异亦有统计学意义(Z=31.450,P＜0.001).激光术后VAS视觉评分发现,595 nm染料激光治疗侧疼痛度低于强脉冲光,两者差异有统计学意义(t=2.468,P＜0.05).评价满意和非常满意的患者595 nm染料激光17例,强脉冲光15例,两组差异无统计学意义(Z=2.696,P＞0.05).强脉冲光不良反应包括红斑、灼烧感、紧绷感、水疱、色素沉着,595 nm染料激光不良反应包括红斑、紫癜反应,均在数小时至数天消失.结论 应用强脉冲光及595 nm染料激光治疗痤疮后红斑均安全有效,适合临床推广应用,强脉冲光相较于595 nm染料激光疗效更优,但疼痛度更高.     

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.     

Significant reduction of inflammation and sebaceous glands size in acne vulgaris lesions after intense pulsed light treatment

Intense pulsed light (IPL) has been used for years in treatment of acne vulgaris. However, quantitative evaluation of histopathological changes after its use as a sole therapy was poorly investigated. Accordingly, this study aims to objectively evaluate inflammatory infiltrate and sebaceous glands in acne vulgaris after IPL. Twenty‐four patients of acne were treated with six IPL sessions. Clinical evaluation was done at 2 weeks after last session by counting acne lesions. Patient satisfaction using Cardiff Acne Disability Index (CADI) was recorded at baseline, 2 weeks and 3 months after IPL. Using histopathological and computerized morphometric analysis, quantitative evaluation of inflammatory infiltrate and measurement of surface area of sebaceous glands were performed for skin biopsies at baseline and 2 weeks after last session. After IPL, there was significant reduction of all acne lesions especially inflammatory variety with significant decrease of CADI score at 2 weeks and 3 months after IPL (p < .05). Microscopically, there was significant decrease in density of inflammatory infiltrate and surface area of sebaceous glands (p < .05). So, IPL is fairly effective therapy in acne vulgaris especially inflammatory variety. The results suggest that IPL could improve acne lesions through targeting both inflammation and sebaceous glands.     

光电协同与420nm宽谱强光治疗中重度痤疮的临床研究

目的:比较400 nm强光联合双极射频(electro-optical synergy,Elos)与420 nm宽谱强光(broadband light,BBL)治疗中、重度痤疮的临床疗效和安全性。方法:纳入20例中重度痤疮患者,采用两侧面颊自身对照方法,左侧脸行Elos治疗,右侧脸行BBL治疗,每例患者治疗3次,治疗间隔3周,分别于治疗后2周和4周进行疗效和安全性评价,比较治疗前后痤疮严重程度评分及皮脂分泌量,评估临床疗效和不良反应,同时统计患者主观评价。结果:Elos治疗组和BBL治疗组有效率分别为55.9%和52.9%,两组差异无统计学意义;而Elos治疗组皮脂分泌量低于BBL治疗组,且两组均无严重不良反应发生。结论:Elos和BBL均能有效地治疗中重度痤疮,且Elos具有更强的油脂分泌抑制作用。     

Rhodamine intense pulsed light versus conventional intense pulsed light for facial telangiectasias

Facial telangiectasias represent the major aesthetic alterations of several chronic inflammatory disorders arising on facial skin. We herein report on relevant clinical results of a new subtype of intense pulsed light treatments, the so-called rhodamine intense pulsed light (r-IPL), in comparison with conventional IPL (c-IPL) treatments on forty-five patients affected by facial telangiectasias. The aim of this study is to determinate whether r-IPL represents an effective and safe treatment for the most common superficial vascular alterations and could be advised as a first choice therapy for facial telangiectasias.     

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。     

强脉冲光脱毛的疗效观察及分析

目的 观察强脉冲光脱毛的疗效和治疗时间，以及能量密度、毛发部位及皮肤类型对脱毛效果的影响。方法 574例患者，采用美国科医人公司生产的IPL Quantum HR仪器进行治疗。结果 574例患者中，57例患者自动放弃治疗（只治疗了1次未随访，未记入统计数据），517例患者取得了满意疗效，治疗毛发再生减少，再生时间延迟，再生毛发较前细小，色泽较前变淡。治疗早期，2例发生热损伤。结论 强脉冲光脱毛方便快捷，疗效满意，不良反应少．治疗效果在适当能量密度下与治疗次数呈正相关关系，亦与治疗部位有关。     

Investigator-blind,placebo-controlled,randomized comparative study on combined vacuum and intense pulsed light versus intense pulsed light devices in both comedonal and papulopustular acne

Abstract

Introduction: The aim was to compare the treatment effectiveness of intense pulsed light (IPL) and vacuum versus IPL with placebo for mild to moderate comedonal and inflammatory acne. Patients and methods: We randomized 180 patients with mild to moderate comedonal and inflammatory acne into three groups: Group A – 60 patients treated with vacuum and IPL, Group V – 60 patients treated with IPL, and Group 0 (control group) – 60 patients who received topical treatment with Sebium H₂O Micellaire Solution. We evaluated the results using the Leeds revised acne-grading system and Cardiff Acne Disability Index. Results: There was a significant reduction in the number of papules, pustules, and comedones in Groups A and V compared with those in the control group (p < 0.001) with a more rapid decrease of the papules from Group A compared with that from Group V. We found an improvement in the clinical aspect (p < 0.001) when we compared Groups A and V with controls. Patients belonging to Group A were more satisfied compared with those belonging to Group V (p = 0.004) and significantly more satisfied compared with those belonging to Group 0 (p < 0.001). In conclusion, we consider that both the devices are efficient, the combination of vacuum and IPL representing a therapeutic option for the comedonal acne.     

Evaluation of pulsed light and radiofrequency combined for the treatment of acne vulgaris with histologic analysis of facial skin biopsies

Background. Light and radiofrequency (RF) devices have recently been used to treat acne in selected patients.

Objective. To investigate the safety and efficacy of a combination of pulsed light and RF energy for the treatment of acne.

Materials and methods. Thirty‐two patients with moderate acne were treated twice weekly for four weeks with the Aurora AC^® (Syneron Medical Ltd, Yokneam, Israel), a combination of pulsed light and RF energy. Twenty‐five patients completed the study. In four patients, the number of hair follicles showing perifolliculitis, the diameters of hair follicles, the diameters of sebaceous glands, and expressions of heat shock protein 70 and procollagen‐1 were evaluated before and after treatment.

Results. The mean lesion count was reduced by 47% (p<0.05) after eight treatments. Adverse effects—erythema, tingling, and burning—were mild and temporary. The percentage of follicles with perifolliculitis decreased from 58% to 33%, sebaceous gland areas decreased from 0.092?mm² to 0.07?mm², and heat shock protein 70 and procollagen‐1 expressions did not change.

Conclusion. The combination of optical and RF energies may be an alternative nonablative modality for the treatment of moderate acne. Clinical improvement may be partly due to reductions in both perifollicular inflammation and sebaceous gland areas.