铒:YAG 激光治疗巨型先天性黑素细胞痣的疗效及其与组织学特征的关系。

IF 2.2 3区 医学 Q2 DERMATOLOGY Lasers in Surgery and Medicine Pub Date : 2024-03-20 DOI:10.1002/lsm.23776
Yifei Zhao MD, Yun Zou MD, Hui Chen MD, PhD, Yamin Rao MD, Xiaoxi Lin MD, PhD
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引用次数: 0

摘要

背景:关于激光治疗巨大先天性黑素细胞痣(GCMN)的研究有限:关于激光治疗巨大先天性黑素细胞痣(GCMN)的研究有限:目的:我们试图阐明铒:YAG激光对GCMN的疗效,以及与阳性临床反应相关的组织学因素:2019年至2022年间,我们招募了30名接受Er:YAG激光治疗的中型至大型CMN患者。所有患者在激光治疗前后都接受了活检。在治疗后至少 6 个月,通过研究者的总体评估(IGA)、色素沉着 5 点量表和温哥华疤痕量表(VSS)评分来评估临床疗效:在 30 例患者中,18 例(60.0%)病情有所改善(IGA 评分≥3)。8例(26.7%)患者出现色素沉着。8例(26.7%)患者出现增生性疤痕。IGA、色素沉着和 VSS 平均得分分别为 2.93、3.57 和 3.20。格伦茨区病例的 IGA 评分较高(3.24 ± 1.18 vs. 2.22 ± 0.97,p = 0.031),色素沉着率较低(14.3% vs. 55.6%,p = 0.032)。在有黑色素细胞巢和黑色素聚集的病例中,IGA评分更高(3.33 ± 1.24 vs. 2.13 ± 0.89,p = 0.023),再色素沉着率更低(11.1% vs. 50.0%,p = 0.034)。浅层消融的病变比深层消融的病变更少形成增生性疤痕(5.9% 对 53.8%,P 结论:浅层消融的病变比深层消融的病变更少形成增生性疤痕:Er: YAG 激光对 GCMNs 的临床疗效显著。格伦茨区和黑色素细胞巢与黑色素聚集是预测激光疗效的可靠指标。
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Erbium: YAG laser treatment efficacy and association with histologic features for giant congenital melanocytic nevi management

Background

Limited research exists on laser treatment of giant congenital melanocytic nevus (GCMN).

Objective

We sought to elucidate the efficacy of the Erbium: YAG laser on GCMN and the histologic factors associated with a positive clinical response.

Methods and Materials

Between 2019 and 2022, we enrolled 30 medium-to-giant CMN patients who underwent Er: YAG laser treatment. All patients received biopsies before and after laser treatments. Clinical efficacy outcomes were evaluated by the investigator's global assessment (IGA), 5-point scale of depigmentation, and Vancouver Scar Scale (VSS) scores at least 6 months after treatment.

Results

Of the 30 cases, 18 (60.0%) showed improvement (IGA score ≥3). Eight (26.7%) patients showed repigmentation. Eight (26.7%) patients developed hypertrophic scars. The average IGA, depigmentation, and VSS scores were 2.93, 3.57, and 3.20. The IGA score was higher (3.24 ± 1.18 vs. 2.22 ± 0.97, p = 0.031) and a lower repigmentation rate (14.3% vs. 55.6%, p = 0.032) was observed in the cases with Grenz zone. The IGA score was higher (3.33 ± 1.24 vs. 2.13 ± 0.89, p = 0.023) and the repigmentation rate was lower (11.1% vs. 50.0%, p = 0.034) also in the cases with the melanocytes nests with aggregation of melanin. Lesions with superficial ablation resulted in less hypertrophic scar formation than those with deep ablation (5.9% vs. 53.8%, p < 0.05).

Conclusion

The Er: YAG laser demonstrated effective clinical results for GCMNs. The grenz zone and the melanocytes nests with aggregation of melanin are promising predictors of laser efficacy.

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来源期刊
CiteScore
5.40
自引率
12.50%
发文量
119
审稿时长
1 months
期刊介绍: Lasers in Surgery and Medicine publishes the highest quality research and clinical manuscripts in areas relating to the use of lasers in medicine and biology. The journal publishes basic and clinical studies on the therapeutic and diagnostic use of lasers in all the surgical and medical specialties. Contributions regarding clinical trials, new therapeutic techniques or instrumentation, laser biophysics and bioengineering, photobiology and photochemistry, outcomes research, cost-effectiveness, and other aspects of biomedicine are welcome. Using a process of rigorous yet rapid review of submitted manuscripts, findings of high scientific and medical interest are published with a minimum delay.
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