| Background:Café-au-lait macules is a common pigment disease, appeared at birth or shortly after birth. The clinical presentation is brown to dark brown with different shape patches. Usually solitary, sporadic, it can occur in any part of the body except palms and soles. The occurrence of CALMs in the exposed parts give those patients who have beauty needs with greater mental stress. CALMs is generally treated by laser. But the recurrence rate is high, and so far could not be completely cured.Objective:To analysis 755 nm Q-switched alexandrite laser in treatment of CALMs with different sizes, shapes,treatment times, interval time, treatment parameters and find out whether there has a correlation between them and provide a theoretical and clinical reference for the evaluation of the prognosis and the recurrence of the clinical treatment of CALMs.Methods: Followed up 278 CALMs patients treated with Q-switched alexandrite laser during October 2002 to October 2015 in the laser center of our hospital for statistical study. According to the shape, size, color, treatment parameters and interval of treatment to set into different groups, after laser treatment, compare the efficiency and recurrence rate and other indicators.Results:1.In the analysis of the relationship between efficacy and related factors, we found that the effective rate was 73.56% in the group of Café-au-lait macules area ≤2cm~2,52.17% in the group of area > 10cm~2, the size and effective rate was negatively correlated, and the difference was statistically significant(X~2=9.384,P=0.025); The efficiency of irregular border group was 71.05%, 61.90% in regular boundary group, the difference was statistically significant(X~2=8.257, P = 0.041); The uneven pigmentation group efficiency was 72.62%, and pigment uniform group was 64.43%, the difference was statistically significant(X~2=11.490, P = 0.009); the efficacy with gender, age, coffee spot color, energy density, treatment frequency, treatment interval have no significant correlation, the difference was not significant(P > 0.05).2. In the analysis of the relationship between recurrence and related factors, we found that the recurrence rate was 39.08% in the group of Café-au-lait macules area ≤2cm~2,54.35% in the group of area > 10cm~2, the size and recurrence rate was negatively correlated, and the difference was statistically significant(X~2=2.842,P=0.092); The recurrence rate of irregular border group was 11.11%, 79.85% in regular boundary group, the difference was statistically significant(X~2=132.950,P=0.000); The uneven pigmentation group recurrence rate was 56.14%, and pigment uniform group was 41.18%, the difference was statistically significant(X~2=4.113,P=0.043); the color was light brown coffee spot recurrence rate 58.00% and 34.85% of recurrent deep brown coffee spot rate, the difference is statistically significant(X~2=8.529, P = 0.003). the recurrence rate with gender, age, coffee spot color, energy density, treatment frequency, treatment interval have no significant correlation, the difference was not significant(P > 0.05).3. In the analysis of the relationship between efficacy and the recurrence, we found that the recurrence rate was 98.44% in invalid group(curative effect≤ 25%);67.86% in improvement group(efficacy>25%,≤50%);57.89% in satisfactory group(efficacy>50%,≤75%)and 12.84% in excellent group(efficacy>75%). Efficacy and recurrence rates were negatively correlated, the difference was statistically significant(P < 0.05).Conclusions: 1. Q-switched 755 nm alexandrite laser is very safe and effective in the treatment of CALMs. 2. The size, shape, color of CALMs have a certain link with therapeutic effect and recurrence. CALMs with irregular border, uneven color generally have better effect. 3. The lower relapse rate the better efficacy in patients with relative case. But the relationship between the relevant factors with efficacy and recurrence still need further research. |
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