كاربرد نور شديد طپشي در درمان خال Spilus : گزارش چند بيمار

Intense pulsed light in treatment of nevus spilus: brief report of a clinical trial

زمينه و هدف: مطالعه حاضر به‌منظور ارزيابی نتايج بالينی و ميزان عوارض استفاده از Intense Pulsed Light (IPL) جهت درمان خال اسپايلوس (Nevus spilus) طراحی و اجرا شده است. روش بررسی: در يك مطالعه نيمه‌تجربی، 14 بيمار با تشخيص بالينی خال اسپايلوس مراجعه‌كننده به كلينيك ليزر بيمارستان رازی تهران از 1389 تا 1391 وارد مطالعه شدند. پس از تاييد آسيب‌شناسی با سيستم IPL با پارامترهايی مطابق با تيپ پوست و محل ضايعه طی يك تا سه جلسه با فاصله 21-14 روز طی سه ماه درمان شدند. دو ماه پس از اتمام درمان، اثر درمانی بر مبنای عكس‌های گرفته شده و ميزان رضايت بيماران و كنترل عوارض ارزيابی شد. يافته‌ها: بهبود عالی ‌در يك بيمار، بهبود خوب در هشت بيمار و بهبود اندك تا صفر در پنج بيمار حاصل شد. عارضه پايداری گزارش نشد. بيماران جوانتر و بيمارانی كه ضايعه را در زمان كوتاهتری داشتند به درمان پاسخ بهتری دادند (002/0P=). نتيجه‌گيری: IPL‌ درمانی موثر و ايمن در مورد خال اسپايلوس است؛ اما مطالعات ديگری جهت بررسی كفايت و عوارض درمان توصيه می‌شود.

Background: Intense Pulsed Light (IPL) technology is one of our new measures in treating dermatologic disorders including undesirable skin pigmentation. In contrast with lentigines and freckling of the skin, few reports about nevus spilus treatment using intense pulsed light have been published. The aim of current study was to evaluate efficacy and safety of nevus spilus treatment with an intense pulsed light device (Palomar Max-G IPL). Methods: Patients with diagnosed nevus spilus confirmed via histopathology, were treated by an intense pulsed light source using parameters according to the skin type and location of lesions in one to three consecutive treatment sessions at 14-21 day intervals for three month. Palomar Max-G ® IPL hand piece is optimized for pigmented skin lesions and we used no additional filter. After each session, Photographs were taken from lesions with 10 mega pixel camera. Two months after finishing the treatment, the effect was evaluated base on close-up photographs. Results: Fourteen female patients were included. Significant improvement (76-100%) in one patient, good improvement (51-75%) in eight patients and fair to poor improvement (0-25%) in five patients were achieved. The commonest side effect of treatment was transient erythema resolved after six to eight hours. No permanent complication was reported. Younger patients and patients with shorter duration of lesion had better response to treatment; however the differences were not statistically significant. Only one recurrence has been seen. No significant relationship between age, gender, anatomical site of lesions and skin type with response rate was found. Conclusion: Intense pulsed light is seemed an effective and safe treatment for nevus spilus Treatment; however randomized control trials with longer follow-up periods are required to evaluate the efficacy and safety.