强脉冲光治疗雀斑的临床体会

目的:观察强脉冲光治疗雀斑的疗效.方法:应用光子治疗机,波长560 nm,治疗参数为脉冲数(2～3)、脉宽(2.0～7.0 ms)、延时(5～100 ms)、能量密度(10～48 J/cm2).结果:经4～5次治疗后痊愈105例(80.7%);显效16例(12.3%);有效9例(6.9%).结论:利用强脉冲光的选择性光...     

Lentiginous macules and patches of neurofibromatosis (an approach to better terminology)

BACKGROUND AND OBJECTIVES: Freckles (ephelides) are small, light brown macules of sun-exposed areas in fair-skinned subjects. On the other hand, freckle-like pigmentation of the axilla is a highly characteristic feature of neurofibromatosis. To what extent (clinically and pathologically) are the two pigmentary defects similar? And to what extent are café-au-lait patches and freckle-like lesions similar pathologically? SUBJECTS AND METHODS: Ten cases of neurofibromatosis and 10 cases of freckles were examined clinically. Two biopsies were taken from the former; one obtained from an axillary freckle-like lesion, and the other from a café-au-lait patch. One biopsy only was taken from freckles. The biopsies were processed for haematoxylin and eosin, silver stain and transmission electron microscopy. RESULTS: Obvious differences were detected between freckles (ephelides) and freckle-like lesions in cases of neurofibromatosis. Café-au-lait patches and freckle-like lesions showed the same pathological changes of lentigo simplex, with increased melanin pigment from the basal layer up to the stratum corneum, moderate elongation of the rete ridges and mild inflammatory infiltrate intermingled with melanophages. Electron microscopy revealed an increase in melanocyte number and the presence of giant melanin granules in freckle-like pigmentation as well as café-au-lait patches. These ultrastructural freckles (ephelides) showed an increase in activity but not the number of melanocytes. CONCLUSIONS: The term freckle-like should be changed to lentiginous macules of neurofibromatosis. On the other hand, the café-au-lait patches should be considered as lentiginous patches. Freckles should be restricted to sun-exposed areas in fair-skinned persons only.     

激光治疗面部雀斑疗效的定量判定

目的：通过计算机数字化分析，对激光治疗面部雀斑前后进行定量判定，探索一种客观、科学的疗效评定方法。方法：随机入选30名雀斑患者，治疗前在恒定的光强度下用图像采集系统摄取局部雀斑图像，用Q开关Nd：YAG激光治疗面部雀斑。分别让患者于治疗后2、4、6、8、15周进行复诊，再次摄取同一部位的局部皮损图像。将所荻取的图像在特定的图像分析系统下逐个进行分析，荻取各自的检测值，评判治疗效果。结果：运用色斑检测系统分析图像采集结果显示：经Q开关Nd：YAG激光治疗后，30名雀斑患者治愈率为53．3％，有效率为90％。结论：通过色斑检测系统对激光治疗面部雀斑前后的变化进行定量判定，提高了评价方法的客观性和科学性。     

MedliteⅡ美肤激光治疗仪治疗雀斑156例

目的：观察MedliteⅡ美肤激光治疗仪对雀斑的治疗效果。方法：选择532nm脉冲输出，根据面积大小，密度稀疏，选择不同的技术参数，对156例患者进行治疗。结果：156例患者中，应用532nm脉冲治疗1～3次后，显效138例，有效11例，总有效率达95．5％。其中38例患者治疗后出现程度不等的继发性色素沉着反应，无1例瘢痕形成。结论：MedliteⅡ美肤激光治疗仪治疗雀斑临床效果可靠。     

Q开关激光和强脉冲光对雀斑治疗的meta分析

目的对Q开关激光和强脉冲光治疗雀斑的临床效果进行评价。方法计算机检索PUBMED、EMBASE数据库、万方数据库、中国知网中文数据库。收集Q开关激光和强脉冲光治疗雀斑相关文献,进行meta分析。结果 Q开关激光治疗雀斑的患者总满意度、总有效率、总并发症发生率均高于强脉冲光治疗(P<0.05)。结论 Q开关激光和强脉冲光治疗雀斑各有优缺点,对不同的患者应做出合适的选择。在关注治疗效果的同时,更应关注其副作用的预防和处理。     

Inhibitors of melanogenesis: a patent review (2009 – 2014)

Introduction: Melanogenesis is the process of producing the melanin pigment, in which a series of chemical and enzymatic pathways are involved. Modulation at any level of this process would become an important approach in the treatment of hyper- or hypopigmentation-related diseases. Since hyperpigmentation covers important issue in cosmetics, there is a need of such review to understand and update this field to the public domain.

Areas covered: In this review, authors discuss most recent melanogenesis inhibitors published in the patents since 2009. The up-to-date overview of classical catechol-based tyrosinase inhibitors to non-classical melanogenesis inhibitors with different mechanism of action is discussed. Inhibitors including small-interfering RNA and peptides from ～ 30 patents and their associated literature are also discussed.

Expert opinion: Although a huge number of melanogenesis inhibitors have been reported, the future studies should be focused towards the identification of new inhibitors with a clear mechanism. The next breakthrough in the field therefore, is likely to come from the detailed structure–activity relationship studies of thioureas with improved therapeutic profiles. Targeting other parameters such as number or size of melanosomes, maturation of melanosomes and expression of melanogenic enzymes may give the best results to overcome toxicity and other formulation problems.     

蜂巢皮秒激光联合强脉冲光治疗边缘不清型雀斑临床应用价值及安全性分析

目的 分析蜂巢皮秒激光联合强脉冲光治疗边缘不清型雀斑的临床应用价值。方法 选取2 0 2 2年 1月-12月我院收治的96例边缘不清型雀斑患者作为研究对象,采用随机数字表法将其分为A组、B组、 C组,每组32例。A组采用强脉冲光治疗,B组采用蜂巢皮秒激光治疗,C组采用蜂巢皮秒激光联合 强脉冲光治疗,比较三组治疗前后PSI评分、临床疗效及并发症发生率。结果 C组治疗后PSI评分低于 A组、B组（P ＜0.05）;C组总有效率为96.88%,高于B组的78.13%与A组的68.75%（P ＜0.05）;C组并发 症发生率为18.75%,低于B组的25.00%与A组的31.25%（P＜0.05）。结论 边缘不清型雀斑应用蜂巢皮秒激 光联合强脉冲光治疗可以改善患者面部雀斑症状,提高临床疗效,减少并发症发生率,具有应用价值。     

强脉冲光联合Q开关倍频Nd:YAG 532nm激光治疗面部雀斑疗效观察

目的:观察强脉冲光联合Q开关倍频Nd:YAG 532nm激光治疗面部雀斑的临床效果。方法:选取笔者医院2017年5月-2019年5月收治的126例雀斑患者,随机分为观察组和对照组,每组63例。对照组采用强脉冲光治疗,观察组采用强脉冲光联合Q开关倍频Nd:YAG 532nm激光治疗,观察两组治疗后的临床效果。结果:观察组临床总有效率明显高于对照组(χ^2=12.86,P<0.01),观察组治疗总次数明显低于对照组(t=3.928,P<0.05),复发率也明显低于对照组(χ^2=4.189,P<0.05),患者对治疗满意度明显高于对照组(χ^2=13.945,P<0.01),两组不良反应发生率无明显差异(χ^2=0.099,P>0.05)。结论:强脉冲光联合Q开关倍频Nd:YAG 532nm激光治疗雀斑复发率低、治疗次数少、安全性高,临床效果显著,值得在临床上推广使用。     

强脉冲光联合精确冷冻治疗雀斑临床观察

目的：评价强脉冲光联合精确冷冻治疗对面部雀斑的疗效及安全性。方法：84例雀斑患者，采用强脉冲光治疗,波长560～1200mm，光斑尺寸34mm×8mm，双脉冲脉宽4～5ms、3～4ms，脉冲延时20～30ms，能量密度24～32J/cm2，两次治疗间隔时间4周，共5次。2周后对患者上下眼睑进行精确冷冻治疗。结果：84例患者，治愈49例，显效33例，有效2例，总有效率100%，并且所有患者肤质变得更细腻光滑，紧致，富有弹性，未见明显不良反应，患者满意度高。结论：强脉冲光联合精确冷冻治疗面部雀斑，安全、疗效显著，不影响社交，值得临床推广应用。