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英卡思2021亚洲年会
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聚焦 S07 - 圆桌讨论

色素疾病 & 黄褐斑

会议室： Channel 2
日期： 2021年 7月 10日星期六从 14:00 至 15:30
组织形式： 圆桌会议 > 简短演讲之后，讲者们与会议主持人进行有组织的课题讨论

主席

陳衍里 Prof

皮肤科医师

中国香港特别行政区

曾忠仁医师

皮肤科医师

台湾

本场演讲内容

小时	讲者	演讲标题	讲稿摘要	数字
14:00		Welcome by Chairs		111762
14:02	陳衍里 Prof	Recent advances in treatment of pigmentary condition	查看	110256
14:14	Ayaka NISHIKAWA 医师	The safety and efficacy of fractional RF microneedling device with repeated short pulses for the treatment of melasma	查看	109885
14:26	Peter Wee Beng CH ' NG 医师	Laser in melasma: friend or foe?	查看	109538
14:38	張長正医师	Evolution for melasma treatment with laser: from laser toning to photoaging reversal	查看	109534
14:50	Kiran GODSE 医师	Updating approach to melasma	查看	109123
15:02	Khalil KHATRI 医师	CO2 laser and drug delivery to treat melasma	查看	109438
15:14		Chairs questions to speakers		109539
15:24		Q&A with the audience		109540

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Welcome by Chairs

陳衍里 Prof

皮肤科医师

中国香港特别行政区

其他作者 :

Recent advances in treatment of pigmentary condition

Objectives: Lasers have been used for the treatment of epidermal pigmentation but can be associated with complications such as PIH. Melanocytes are known to be very susceptible to cryoinjury, however such injury is typically reported after application for cryosurgery and results in long lasting depigmentation and side effects. The dosimetry and role of controlled skin cooling on epidermal pigmentation deserves further investigation. The use of controlled cooling to reduce epidermal pigmentation and focused laser for dermal pigmentation will also be discussed.

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这项工作没有任何直接或间接的资金支持。由作者自己承担责任。

Ayaka NISHIKAWA 医师

皮肤科医师

日本

其他作者 :

The safety and efficacy of fractional RF microneedling device with repeated short pulses for the treatment of melasma

Objectives: To investigate the safety and efficacy of invasive micro-pulsed electric signal device for treatment of melasma.

Introduction: Melasma is a common disorder of hyperpigmentation in Asian women with Fitzpatrick skin phototypes III or higher. Conventional micro-needling treatment is generally avoided in the melasma area because it may aggravate the melasma. Fractional RF micro-needling devices using a micro-pulsed electric signal can approach the basement membrane and vascular endothelial growth factor (VEGF) to improve melasma. We investigated whether micro-pulsed electric signal device can be used safely and effectively for Asian patients with melasma.

Materials / method: 28 female patients and 1 male patient (Fitzpatrick skin type III–IV) were treated using micro-pulsed electric signal device. Five treatments were administered at 2-weeks intervals. The power levels ranged from 3 to 4, depth 0.8 mm to 1.5 mm, and single pass. Photographs were taken at the beginning and 1 month after the last treatment. Low-fluence Q-switched Nd:YAG laser was not used during the evaluation period.

Results: No adverse events including melasma worsening were noted. The average score in skin analysis device improved in all of the following categories: melanin, hemoglobin, wrinkles, and pores. However, only 30% cases were diagnosed by physicians as the significant improvement in melasma.

Conclusion: This device has a rejuvenation effect on the skin, helps with vascular disorders, and can be used safely with patients with melasma. The therapeutic effect for melasma might be based on the approach with tranexamic acid medication and low-fluence Q-switched Nd:YAG laser rather than this device alone. In the future, we would like to study the therapeutic effects of this device in combination with low-fluence Q-switched Nd:YAG laser.

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这项工作没有任何直接或间接的资金支持。由作者自己承担责任。

Peter Wee Beng CH ' NG 医师

皮肤科医师

马来西亚

其他作者 :

Laser in melasma: friend or foe?

Objectives: Melasma is an acquired hyperpigmentation disorder with symmetrical distribution over the face. It is still one of the most difficult hyperpigmentation disorders to treat. In this lecture I’ll discuss about the different types of lasers that can be used to treat melasma and also the possible complications associated with their use.

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这项工作没有任何直接或间接的资金支持。由作者自己承担责任。

張長正医师

整形外科医师

台湾

其他作者 :

Evolution for melasma treatment with laser: from laser toning to photoaging reversal

Objectives: To know the update concepts for melasma treatment with Llaser application

Introduction: Melasma is caused by not only over production of melanin but hyperactivity of melanocytes, which usually recurs and leads to post-inflammatory hyperpigmentation (PIH) after aggressive treatment.

Materials / method: We advocate a melasma treatment evolution in Asians based on not only our experiences but statistic records. They typically begin with topical agents. The US Food and Drug Administration has approved a modified combination of the Kligman formulation, containing 4% hydroquinone, 0.05% tretinoin and 0.01% fluocinolone ace- tonide, for melasma treatment.

Results: For laser therapy, the depigmentation is usually the main purpose for melasma patients in Asia. The Nd:YAG non-ablative laser toning has been popularized for facial rejuvenation. However, some side effects such as post-inflammatory hyperpigmentation (PIH) and the flaring-up are issues of concern to Asian patients. We had ever investigated the role of vitamin C application by sonophoresis in the prevention of side effects in Asian patients’ post-Nd:YAG therapy.

Conclusion: In the new era for picosecond laser, We have demonstrated the series of studies from Nd-yac Q switch laser to advanced pico-second laser combined with focus lens array in our team. Whether three or five of picosecond 755-nm alexandrite laser with a diffractive lens array, as well as triple combination cream, can demonstrated a great efficacy for melasma treatment in Asian patients. The improvement in wrinkles, texture, pores, UV spots, brown spots, especially in spots and porphyrins were also observed with VISIA imaging analysis.

利益冲突声明

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这项工作没有任何直接或间接的资金支持。由作者自己承担责任。

Kiran GODSE 医师

皮肤科医师

印度

其他作者 :

Updating approach to melasma

Objectives: Melasma is an acquired, chronic pigmentary disorder predominantly affecting women. It may significantly affect quality of life and self-esteem of person while facing others.

Introduction: Hydroquinone is considered Gold standard in melasma treatment.
Triple combination cream is the most effective and well-studied treatments for melasma. Peels and lasers are third line approach for melasma.
In dark skin laser treatment may have rebound pigmentation.
Oral tranexamic acid is safe, systemic adjunctive treatment for melasma.

Materials / method: There is a paucity of well-designed RCTs evaluating the safety and efficacy of this regimen as maintenance therapy and duration of treatment in Indian population.

Mometasone based triple combination creams leads to the rapid lightening of pigmentation , but the relapse is also very fast. Further worsening of pigmentation and increase in the area of the original lesion has also been experienced by both the patients and physicians. Long-term use is invariably associated with topical
side effects such as erythema and thinning of skin.

Conclusion: Medical management of melasma with topical skin lightening therapy still remains the mainstay of therapy and should always be used as first-line agents. HQ, triple combination therapy, other agents and upcoming oral therapies will be used in combination in the future.

利益冲突声明

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您是否接受过关于这项研究的任何酬金或其他报酬？
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你是否拥有或者您已经为您此研究中的工具，药物或材料申请任何专利？
否

这项工作没有任何直接或间接的资金支持。由作者自己承担责任。

Khalil KHATRI 医师

皮肤科医师

美国

其他作者 :

CO2 laser and drug delivery to treat melasma

Objectives: Explore the possibility of new treatments for Melasma

Introduction: Melasma is chronic skin discoloration of the face of a significant number female patients, majority of them are darker skin

Materials / method: 32 to female patients of skin type I-IV were treated with Fractional Ablative CO2 Laser. Tri-Luma or 4% Hydroquinone cream was applied and rubbed immediately after Laser treatment. Patients started to apply the topical creams one week after the Laser treatment. Patients were followed 1 week, 1 month,, 3 months and 6 months after the treatment

Results: 3 blinded laser dermatologists evaluated and graded the photos and results showed 52% improvement in Melasma and 54% improvement in skin texture

Conclusion: A single CO2 Fractional Laser and Tri-Luma/4% HQ cream +/- oral TXA using drug delivery protocol to treat Melasma is safe and effective for the follow up period of up to 6 months

利益冲突声明

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这项工作没有任何直接或间接的资金支持。由作者自己承担责任。

Chairs questions to speakers

Q&A with the audience

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英卡思2021亚洲年会 大会日程

聚焦 S07 - 圆桌讨论

色素疾病 & 黄褐斑

主席

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