ALA-PDT联合IPL治疗中重度痤疮28例

Application of intense pulsed light combined with topical 5-aminolevulinic acid photodynamic therapy for patients with moderate and severe acne vulgaris

目的观察强脉冲光(intense pulsed light,IPL)和5-氨基酮戊酸光动力技术(5-aminolevulinic acidphotodynamic therapy,ALA-PDT)相结合治疗中重度痤疮的有效性和安全性。方法 28例中重度痤疮患者于皮损部位涂抹10%ALA霜,避光封包60 min后,采用420～950 nm IPL治疗。每周治疗1次,连续4次。治疗结束后第4、8、12周随访。结果经过4次治疗和12周随访,患者总有效率达78.6%,平均疗效指数为(73.4±4.2)%;炎症性和非炎症性皮损平均减少率分别达到(84.3±3.6)%和(56.1±5.2)%。患者无色沉、水疱、结痂等严重不良反应。有4例患者出现一过性皮损加重和局部红肿。结论 ALA-IPL-PDT治疗能有效治疗中重度痤疮,效果维持达治疗结束后12周,且无严重的色素沉着等不良反应。

Objective To evaluate the efficacy and safety of intense pulsed light （IPL） combined with topical 5-aminolevulinic acid photodynamic therapy （ALA-PDT） for patients with moderate and severe acne vulgaris. Methods 10% topical ALA emulsions were applied on lesions of patients with medium and severe acne vulgaris. After lesions were covered for 60 min, patients were treated with 420 -950 nm IPL. All patients had 4 courses of treatment at 1-week interval. One week after each treatment and 4,8,12 weeks after 4 treatments, efficacy and safety were evaluated. Results The effective rate was 78.6% 12 weeks after 4 treatments, and the mean efficacy index was （73. 4 ± 4.2 ）%. The mean clearance of inflammatory and non- inflammatory lesions was （84.3 ± 3.6） % and （ 56. 1 ± 5.2 ） % , respectively. There were no severe adverse effects like hyperpigmentation, blister and crusting. Only 4 patients had lesions exacerbation and local edema after treatment. Conclusion The ALA-PDT combined with IPL is an effective and alterhative treatment for moderate to severe inflammatory ache, associated with no hyperpigmentation and other severe adverse effects.