【 文献重点摘要 】

The picosecond lasers have shown to effectively treat tattoo pigments that are intractable to previous multiple Q-switched (QS) laser treatments. Therefore we hypothesized that a picosecond laser would show better efficacy with minimal adverse events in the treatment of melasma and post-inflammatory hyperpigmentation (PIH) that are difficult to treat with conventional QS lasers. Two patients with melasma and one patient with PIH were treated with a Picosecond 755-nm Alexandrite Laser (Cyanosure, USA). All patients were Korean with skin type IV and no longer responding to QS laser treatments. Laser treatment was well tolerated in all the patients. Adverse events such as PIH were not reported during 8 weeks of follow up period. After the multiple treatment sessions, one patient reported fair improvement and two patients reported good improvement. Consistent with the clinical results, ex vivo skin model irradiated with a Picosecond 755-nm Alexandrite Laser also showed decreased epidermal keratinocyte necrosis compared with the 532-nm QS Neodymium-Doped Yttrium Aluminium Garnet Laser (Lutronic, Korea) yet decreased melanin content. In conclusion, the Picosecond 755-nm Alexandrite Laser may be useful for effective treatment of intractable melasma and PIH with fewer adverse events in dark Asian skin.

Keywords

Melanosis, Picosecond laser, Postinflammatory hyperpigmentation

皮秒激光已经被证明可以有效地治疗纹身色素，这些色素是以前多次调Q(QS)激光治疗难以处理的。因此，我们假设皮秒激光在治疗传统QS激光难以治疗的黄褐斑和炎症后色素沉着(PIH)方面显示出更好的疗效和最小的不良反应。两名黄褐斑患者和一名妊高征患者接受了皮秒755 nm紫翠宝石激光(美国蓝宝石)的治疗。所有患者都是患有IV型皮肤的韩国人，对QS激光治疗不再有反应。所有患者对激光治疗的耐受性良好。在8周的随访期内，未报告妊高征等不良事件。在多次治疗后，一名患者报告改善较好，两名患者报告改善良好。与临床结果一致的是，与532 nm QS掺钕钇铝石榴石激光(韩国Lutronic)相比，皮秒755 nm紫翠宝石激光照射的离体皮肤模型也显示表皮角质形成细胞坏死减少，但黑色素含量减少。总之，皮秒755 nm紫翠宝石激光可能对亚洲深色皮肤的顽固性黄褐斑和妊高征有效治疗，不良事件较少。

关键词

黑色素沉着症，皮秒激光，炎症后色素沉着