陈鹏 杨时昕

[摘要]炎症后色素沉着（Postinflammatory hyperpigmentation，PIH）作为一种常见的皮肤色素障碍性疾病，严重损害患者的身心健康，降低其生活质量，而且现有的多种PIH治疗方法存在一定弊端。目前，激光疗法已被广泛地用于色素障碍性疾病的干预，针对PIH的激光治疗受到普遍关注。但大多数临床研究在研究方法的选用上，以个案研究为主，缺乏随机对照试验研究;在临床治疗结果上，存在不一致性，少数PIH激光治疗后症状无改善或恶化。本综述旨在通过系统回顾与激光治疗PIH研究相关的文献，分析和总结激光治疗PIH的现状，探讨各种激光用于治疗PIH的临床应用价值，为激光治疗PIH提供一定的基于临床证据的参考意义。

[关键词]炎症后色素沉着;激光;选择性光热作用;治疗;并发症

[中图分类号]R364.2+3    [文献标志码]A    [文章编号]1008-6455（2021）07-0176-06

Advances in the Study of Postinflammatory Hyperpigmentation with Laser Treatment

CHEN Peng，YANG Shi-xin

（1.Graduate School of Shanxi Medical University，Taiyuan 030001， Shanxi，China; 2.Department of Medical Cosmetology/Burn Orthopaedics， Bethune Hospital，Shanxi Medical University，Taiyuan 030032，Shanxi， China）

Abstract： Postinflammatory hyperpigmentation （PIH）， as a common skin pigment disorder， can seriously impair the physical and mental health of patients and degrade their quality of life， and there are certain disadvantages in the current treatment of PIH.At present，laser therapy has been widely used in the intervention of pigment disorders， so the laser therapy for PIH has been widely concerned. However， most of the clinical studies focused on case studies and lacked randomized controlled trials in the selection of research methods.There were inconsistencies in the clinical treatment results， and a few PIH laser treatments did not improve or worsen the symptoms. Our review aims to analyze and summarize the current situation of PIH treatment by systematically reviewing the literatures， and to explore the clinical application value of various lasers for PIH treatment， so as to provide certain reference significance based on clinical evidence for PIH treatment.

Key words：postinflammatory hyperpigmentation;lasers;selective photothermolysis; therapy; complication

炎症后色素沉着（PIH）是一种皮肤炎症或损伤引起的，主要以反应性色素沉着过度为临床表现的皮肤色素紊乱性疾病[1]。PIH的颜色取决于皮肤中多余色素的位置，当过多的色素主要沉积在表皮内时，PIH倾向于呈现棕褐色到深褐色;相反，真皮中过量的色素往往表现为深灰色或蓝灰色的外观[2]。PIH可以发生在任何年龄和皮肤类型个体之中，与性别无明显相关。然而，临床研究表明，这种过度色素沉着性疾病多发于有色人种，且更容易出现在菲茨帕特里克（Fitzpatrick）皮肤分型Ⅲ～Ⅵ型个体[2-3]。由于国人是有色人种，受伤后所致炎症反应易导致色素沉着过紊乱，从而形成PIH[4]。

色素沉着主要分布于引起炎症反应的区域，多种内外源性病因都可能导致PIH的发生和发展[5]。……