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Lekwuttikarn Et Al-2017-International Journal of Dermatology PDF
Lekwuttikarn Et Al-2017-International Journal of Dermatology PDF
International Journal of Dermatology 2017, 56, 884888 2017 The International Society of Dermatology
Lekwuttikarn et al. Benefits of PDL therapy for acne in adolescents Clinical Trial 885
12
and a lower downtime period when compared with other lasers, Table 1 The 4-point grading of acne erythema
thus it may be suitable for adolescent treatment. However, PDL
laser therapy is more expensive, and thus there are various out- Grade Level of disease Characteristics
comes we need to study further for efficacy before recommend-
0 None Clear
ing this treatment to our patients.
1 Mild Faintly detectable erythema, light pink
To our knowledge, this study will be the first English literature 2 Moderate Dull red, clearly distinguishable
to evaluate the benefits of PDL therapy for acne in adolescents. 3 Severe Deep/dark red
2017 The International Society of Dermatology International Journal of Dermatology 2017, 56, 884888
886 Clinical Trial Benefits of PDL therapy for acne in adolescents Lekwuttikarn et al.
Table 3 The results of acne severity grading and acne lesion counts before and after pulse dye laser (PDL) therapy
Variable Control PDL p-value Control PDL p-value Control PDL p-value Control PDL p-value
Table 4 The results of acne erythema grading before and after pulse dye laser (PDL) therapy
Variables Control PDL p-value Control PDL p-value Control PDL p-value Control PDL p-value
Acne erythema grading 1.90 1.90 0.83 1.57 1.57 0.86 1.50 1.47 0.41 1.33 1.33 1.00
Figure 1 The results of acne erythema grading before and after Discussion
pulse dye laser (PDL) therapy
P = P-value of the difference of acne erythema grading between Nowadays, it is very challenging to discover the best therapy for
PDL treated and untreated side of face acne vulgaris especially in adolescents because the disease is
International Journal of Dermatology 2017, 56, 884888 2017 The International Society of Dermatology
Lekwuttikarn et al. Benefits of PDL therapy for acne in adolescents Clinical Trial 887
a clinically dynamic condition which shows spontaneous effect as patients perhaps pay more attention to their skin care
improvement and flares. The therapy requires consistent com- and/or the PDL laser increases the level of transforming growth
pliance, which is quite difficult for adolescents. Recently, the factor b1 (TGF-b1)16 that promotes the termination of inflamma-
laser treatments have become very popular because they are tory processes17 and may cause decline in acne erythema. We
faster, more convenient, and have fewer adverse events than did not study the level of TGF-b1 which is our limitation. From
conventional therapy. our study, the efficacy of PDL laser in acne erythema therapy
Our study showed a statistically significant improvement only was inconclusive.
in papule lesion count on the PDL-treated side: 1.8 (P-value In summary, PDL therapy in acne vulgaris has both excellent
0.0018) lesions from the baseline at week 4 and might not be and ineffective results and because of the popularity of laser
clinically significant in real dermatologic practice because of the therapy in acne vulgaris, we need further study to find the
high cost when compared with conventional therapy. The possi- appropriate setting, frequency, and duration for PDL treatment.
ble causes include: our patients had more prominent comedonal We need a well-controlled study for adjuvant PDL therapy from
lesions than inflammatory papules and nodules; the number of conventional treatment before the recommendation to use the
treatment sessions in our study were too few; and the duration PDL therapy in adolescent acne vulgaris is proposed.
of follow-up may not have been long enough to see a positive
clinically significant result.
References
The result from our study was similar to the result of the
Orringer et al.10 study, which used a non-purpuric PDL setting 1 Eichenfield LF, Krakowski AC, Piggott C, et al. Evidence-based
(585 nm, fluence 3 J/cm2, pulse duration 0.35 ms, spot size recommendations for the diagnosis and treatment of pediatric
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7 mm). Conversely, the Seaton et al.11 study showed an
2 Dawson AL, Dellavalle RP. Acne vulgaris. BMJ 2013; 346:
improvement of inflammatory facial acne by using only a single f2634.
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the study design, which differed from our study. They recruited the spectrum of pediatric disease. Semin Cutan Med Surg 2011;
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adjuvant treatment modality in acne vulgaris: a randomized
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may not have penetrated deeply enough to destroy these 13 Choi YS, Suh HS, Yoon MY, et al. Intense pulsed light vs.
inflammatory microvessels.15 We designed our study to use this pulsed-dye laser in the treatment of facial acne: a randomized
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International Journal of Dermatology 2017, 56, 884888 2017 The International Society of Dermatology