3–5 Second Cryotherapy Is Effective in Idiopathic Guttate Hypomelanosis
3–5 Second Cryotherapy Is Effective in Idiopathic Guttate Hypomelanosis
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3-5 秒冷冻疗法对特发性滴状黑色素减少症有效
DOI：
10.1111/j.1346-8138.2004.tb00701.x
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发表时间：
2004
期刊：
影响因子：
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通讯作者：
S. Kumarasinghe
中科院分区：
文献类型：
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作者：
S. Kumarasinghe
致编辑：特发性点滴型低黑素症（IGH）通常会引起小的色素沉着或色素沉着。虽然它在老年人中更常见，但也可能发生在年轻人身上。对于浅色皮肤的人来说，这通常是一个微不足道的问题，但对于深色皮肤的人来说，这可能是一个重大的美容问题。这种情况有三种形态变异。典型的病变是一个低色素斑（或多个斑）在背景的太阳损伤的皮肤，在一个暴露的区域。第二种类型是乳白色，星状，界限清楚，与阳光照射或非阳光照射区域的阳光照射无关的硬化斑。第三种类型是色素沉着，界限清楚的小病变，有角化扁平的外壳；这种类型通常有扇形边缘。没有进行过足够大规模的研究来确定这三种类型是否具有相同的病理生理学或由于不同的原因。这些病变的皮肤活检显示，大多数病变的黑色素细胞少于正常的数量，但有些病变在脱色区有黑色素细胞（1-5）。大多数可用的文献表明，治疗不是很令人满意。包括病灶内类固醇、冷冻疗法、磨皮和植皮在内的各种方法已经被不同的作者声称是成功的（1,5,6）。Ploysangam等人报道使用冷冻探针进行10秒冷冻治疗的成功率为90.8%(3)。在医学文献中没有使用冷冻疗法的大规模研究。我们评估了3-5秒的光冷冻治疗在特发性窦状低黑素症中实现充分的再色素沉着的疗效。在三个月的时间里，我们在国家皮肤中心资助的诊所用液氮治疗了四名IGH患者，每个人使用冷冻剂3-5秒。排除先天性色素沉着或脱色病变、炎症或创伤后色素沉着、白癜风和大于1.5 cm的病变。在冷冻治疗前拍摄了几个标记为治疗的病变。每个病人都治疗了不止一个病变。总共有超过15个病变用这种方法治疗。一些病变不作治疗以作比较。6周后对患者进行评估。他们再次拍照以评估结果。《皮肤病学杂志》Vol. 31: 437-439, 2004
To the Editor: Idiopathic guttate hypomelanosis (IGH) commonly causes small lesions of depigmentation or hypopigmentation. Although it is more common in older persons, it can also occur in young adults. It is often an insignificant problem in persons with light colored skin, but it can be a significant cosmetic problem in dark-skinned persons. There are three morphological variants of this condition. The typical lesion is a hypopigmented macule (or multiple macules) in a background of sun-damaged skin, in an exposed area. The second type is an ivory white, stellate, well demarcated, sclerotic macule unrelated to sun exposure in a sun-exposed or non-sun-exposed area. The third type is a hypopigmented, well demarcated small lesion with a keratotic flat crust; this type often has a scalloped border. No sufficiently large scale studies have been carried out to ascertain whether these three types share the same pathophysiology or are due to different causes. Skin biopsies from these lesions show that most of them have fewer than the usual number of normal melanocytes, but some lesions have melanocytes within the depigmented area (1–5). Most of the available literature suggest that treatment is not very satisfactory. Various methods including intralesional steroids, cryotherapy, dermabrasion, and skin grafting have been claimed to be successful by various authors (1, 5, 6). Ploysangam et al. reported 90.8% success with cryotherapy applied with a cryoprobe for 10 seconds (3). There are no large scale studies using cryotherapy in the medical literature. We evaluated the efficacy of 3–5 seconds of light cryotherapy in achieving sufficient repigmentation in idiopathic guttate hypomelanosis. Over a three month period, we treated four IGH patients in the National Skin Centre subsidized clinics with liquid nitrogen, using a cryogen for 3–5 seconds each. Congenital hypopigmented or depigmented lesions, hypopigmentation following inflammation or trauma, vitiligo, and lesions larger than 1.5 cm were excluded. Several of the lesions marked for treatment were photographed before cryotherapy. More than one lesion was treated in each patient. Collectively, more than 15 lesions were treated with this method. Some lesions were kept untreated for comparison. The patients were assessed after six weeks. They were photographed again to assess the outThe Journal of Dermatology Vol. 31: 437–439, 2004