皮秒翠绿宝石激光点阵模式治疗黄褐斑疗效观察

Efficacy of the Fractional Picosecond Alexandrite Laser in the Treatment of Melasma

目的:观察皮秒翠绿宝石激光点阵模式治疗黄褐斑的疗效及安全性。方法:分析在笔者科室进行皮秒翠绿宝石激光点阵模式治疗并随访3次以上的23例黄褐斑患者资料,利用黄褐斑面积及严重程度评分(Melasma Area and Severity Index,MASI)和医生整体评价法(Physician Global Assessment,PGA)对疗效进行评估,并记录不良反应。结果:23例黄褐斑患者经过3次治疗后,平均MASI评分较治疗前下降3.38±4.37,差异有统计学意义(P=0.001)。其中15例采用光斑6mm,能量密度0.71J/cm^2治疗,8例采用光斑8mm,能量密度0.4J/cm^2治疗,两组MASI评分较治疗前均有统计学意义(P=0.009,P=0.034),但两组比较,差异无统计学意义(P=0.452)。此外,根据PGA评分,3次治疗后黄褐斑为轻度改善。不良反应主要表现为轻微的红斑。结论:皮秒翠绿宝石激光点阵模式治疗黄褐斑安全、有效。

Objective To investigate the efficacy and adverse reactions of the fractional picosecond Alexandrite laser in melasma treatment. Methods The patients with melasma treated with the fractional mode of picosecond Alexandrite laser in our department and followed up for more than three times were retrospectively analyzed. The efficacy was evaluated by the Melasma Area and Severity Index (MASI) and the Physician Global Assessment (PGA). Related adverse reactions were documented in detail. Results A total of 23 patients with melasma were analyszed in our study. After 3 treatments, the MASI score decreased by 3.38±4.37, and the difference was statistically significant (P =0.001). Among them, 15 were treated with a 6-mm spot size and energy density of 0.71 J /cm^2, 8 were treated with an 8-mm spot size and energy density of 0.4 J /cm^2. The changes of their MASI score in each group were statistically significant (P =0.009 and P =0.034 respectively), but the differences between the both groups were not statistically significant (P =0.452). Besides, according to the PGA score, the melasma was slightly improved with 3 treatments of picosecond Alexandrite laser. Adverse reactions were mainly characterized by mild erythema. Conclusion The fractional picosecond Alexandrite laser with a diffractive lens array is safe and effective in the treatment of melasma.