Objective: To evaluate the efficacy and safety of 585 nm Q-switched laser in the treatment of acne inflammatory lesions and postinflammatory erythema.
Methods: A total of 25 patients with moderate facial acne, symmetrical distribution of inflammatory lesions and postinflammatory erythema on both sides of the face, were enrolled. Among the 25 patients, 22 patients completed all the treatment and evaluation, and 3 patients were lost to follow-up. 585 nm Q-switched laser was used on a randomly selected side of the face for three times of treatment at a 2 week interval. The evaluations were made before each treatment, 2 and 4 weeks after the last treatment, therefore the evaluation time points were before the treatment, weeks 2, 4, 6, and 8, respectively, for a total of 5 times. Acne severity was assessed using the investigator' s global assessment (IGA) score, and erythema severity was assessed using the investigator' s subjective erythema score and narrow-spectrum reflectance spectrophotometer at each follow-up.
Results: After 3 times of treatment, there was statistically significant difference between the IGA score in week 8 and before treatment on both sides(Z=2.64, P < 0.01; Z=2.67, P < 0.01). There was no significant difference in IGA score between the treatment side and the control side before treatment and in week 8 (P=0.59, P=0.26). There was statistically significant difference between the investiga-tor' s subjective erythema score in week 8 and before treatment on the treatment side(Z=4.24, P < 0.01), while no significant difference was showed on the control side(Z=1.73, P=0.08). In week 8, the investigator's subjective erythema score of the treatment side was lower than that of the control side (Z=3.61, P < 0.01). The erythema index of the treatment side was significantly decreased at 5 time points (P < 0.01), and the index decreased significantly in week 8 compared with the index before treatment (P < 0.01), while the erythema index of the control side was not significantly different at 5 time points. The treatment related adverse events included erythema and edema after treatment and pain during treatment, the severity was mild to moderate, which resolved spontaneously within 1 to 3 days. Nine patients were very satisfied with the treatment, 7 patients were satisfied, and 6 patients considered average.
Conclusion: 585 nm Q-switched laser has some effect in the treatment of postinflammatory erythema, and it ensures good tolerance and safety. There was no statistically significant difference between the treatment side and the control side on the improvement of acne inflammatory lesions.
目的: 评价585 nm Q开关激光对于痤疮炎症性皮损和炎症后红斑的疗效和安全性。
方法: 入选25例面部中度痤疮患者(Ⅱ~Ⅲ级，要求面部两侧均有一定的炎症性皮损和炎症后红斑)，其中共22例患者完成全部治疗及评价，3例患者失访。使用585 nm Q开关激光治疗随机选取的一侧面部，每次治疗间隔2周，共治疗3次。患者于每次治疗当日治疗前及末次治疗后2周、末次治疗后4周进行评价，即评价时间点分别为治疗前、第2周、第4周、第6周、第8周，共评价5次。每次评价采用研究者总体评估(investigator’s global assessment, IGA)评分及研究者红斑主观评分评价痤疮严重程度及红斑程度，使用窄谱反射分光光度计判断红斑程度。
结果: 经3次治疗后，治疗侧第8周与治疗前比较的IGA评分差异有统计学意义(Z=2.64, P < 0.01)，对照侧第8周与治疗前比较的IGA评分差异有统计学意义(Z=2.67，P < 0.01)，治疗前及第8周治疗侧与对照侧比较的IGA评分差异均无统计学意义(P=0.59，P=0.26)。治疗侧第8周与治疗前比较的红斑主观评分差异有统计学意义(Z=4.24, P < 0.01)，对照侧前后红斑主观评分差异无统计学意义(Z=1.73，P=0.08)，第8周治疗侧研究者红斑主观评分低于对照侧(Z=3.61, P < 0.01)。治疗侧5个时间点间红斑指数差异有统计学意义(P < 0.01)，第8周与治疗前比较差异具有统计学意义(P < 0.01)，对照侧5个时间点红斑指数差异无统计学意义。皮损治疗不良反应包括治疗后即刻局部出现轻度红斑、水肿，治疗中轻至中度疼痛，均于1~3 d内自行消退。9例患者评价为非常满意，7例患者评价为满意，6例患者评价为一般。
结论: 585 nm Q开关激光对于改善痤疮炎症后红斑有一定效果，该治疗耐受度较高，安全性较好，对于痤疮炎症性皮损的改善治疗侧与对照侧差异无统计学意义。
Keywords: 585 nm Q-switched laser; Acne; Postinflammatory erythema.