Intense pulsed light therapy for superficial pigmented lesions evaluated by reflectance-mode confocal microscopy and optical coherence tomography
Intense pulsed light therapy for superficial pigmented lesions evaluated by reflectance-mode confocal microscopy and optical coherence tomography
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DOI：
10.1038/sj.jid.5700414
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发表时间：
2006-10-01
影响因子：
6.5
通讯作者：
Wakamatsu, Shingo
中科院分区：
文献类型：
--
作者：
Yamashita, Toyonobu;Negishi, Kei;Wakamatsu, Shingo
据报道，强脉冲光(IPL)疗法可以有效地去除色素性皮损中的色素。然而，IPL治疗去除色素的动力学机制尚不完全清楚。我们通过对表皮的非侵入性观察，探讨了IPL治疗去除色素性皮肤病变的机制。面部有太阳扁豆的受试者接受了三个疗程的IPL治疗。用反射模式共聚焦显微镜(RCM)和光学相干断层扫描(OCT)观察处理后连续几天的太阳晶状体。此外，对处理后形成的脱皮微壳进行了透射电子显微镜(TEM)观察。RCM和OCT图像显示，表皮基底层的黑素小体迅速向皮肤表面迁移。挤出的微结壳的电子显微镜图像显示大量的黑素小体和细胞碎片。研究还发现，皮损中IPL照射后的黑素细胞似乎完好无损，治疗后恢复其高活性。结论：IPL治疗能有效去除表皮-基底层致密的黑素小体。然而，额外应用抑制药物，如对苯二酚或Q开关激光照射，是必要的，以抑制剩余的活跃的黑素细胞。
Intense pulsed light (IPL) therapy is reported to be effective for pigment removal from pigmented lesions. However, the dynamic mechanism of pigment removal by IPL therapy is not completely understood. We investigated the mechanism of IPL therapy for the removal of pigmented skin lesions through non-invasive observation of the epidermis. Subjects with solar lentigines on the face were treated with three sessions of IPL therapy. The solar lentigines were observed on consecutive days after the treatments using reflectance-mode confocal microscopy (RCM) and optical coherence tomography (OCT). In addition, desquamated microcrusts that formed after the treatment were investigated by transmission electron microscopy (TEM). The images of RCM and OCT showed that the melanosomes in the epidermal basal layer rapidly migrated to the skin surface. The TEM images of the extruded microcrusts revealed numerous melanosomes together with cell debris. It was also found that the IPL irradiated melanocytes in the lesions seemed to be left intact and resumed their high activity after treatment. We conclude that IPL therapy effectively removed the dense melanosomes in the epidermal-basal layer. However, additional application of suppressive drugs such as hydroquinone or Q-switched laser irradiation is necessary to suppress the remaining active melanocytes.