TATA LAKSANA LASER PADA KELOIDi
Abstrak
Keloid merupakan respons abnormal terhadap penyembuhan luka. Keloid disebabkan oleh ketidakseimbangan respons transforming growth factor-beta (TGF-β) dan interleukin dalam sintesis dan degradasi kolagen. Pilihan terapi untuk keloid dapat dibagi menjadi metode bedah atau nonbedah. Terapi laser menggunakan pendekatan nonablatif pulsed dye laser (PDL) dan Neodymium-doped Yttrium Aluminum Garnet (Nd:YAG)], ablatif, dan fractional. PDL terbukti mengurangi ukuran skar sebesar 72% tanpa disertai rekurensi bermakna. Sedangkan laser Nd:YAG dapat mereduksi ukuran keloid ±10% dari ukuran sebelumnya dalam waktu empat minggu. Laser CO2 memiliki efek destruktif pada epidermis dan sebagian dermis dengan memanfaatkan energi kalor sehingga terjadi remodeling jaringan.Sementara itu, laser fractional menunjukkan angka kepuasan pasien sebesar 96,7% dan pengurangan
Vancouver scar scale yang signifikan. Terapi laser dapat dipertimbangkan sebagai salah satu modalitas terapi
keloid. Terapi ini memiliki unggul dalam mereduksi keloid dalam waktu singkat dengan efek samping
minimal.
References
1. Monstrey S, Middelkoop E, Vranckx JJ, Bassetto F, Ziegler UE, Meaume S, dkk. Updated scar management practical guidelines: non-invasive and invasive measures. J Plast Reconstr Aesthetic Surg. 2014;67(8):1017–25.
2. Trace AP, Enos CW, Mantel A, Harvey VM. Keloids and hypertrophic scars: a spectrum of clinical challenges. Am J Clin Dermatol. 2016;17(3):201–23.
3. Sorg H, Tilkorn DJ, Hager S, Hauser J, Mirastschijski U. Skin wound healing: an update on the current knowledge and concepts. Eur Surg Res. 2017;58(1–2):81–94.
4. Del Toro D, Dedhia R, Tollefson TT. Advances in scar management. Curr Opin Otolaryngol Head Neck Surg. 2016;24(4):322–9.
5. Al-Mohamady AE-SAE-H, Ibrahim SMA, Muhammad MM. Pulsed dye laser versus long-pulsed Nd:YAG laser in the treatment of hypertrophic scars and keloid: A comparative randomized split-scar trial. J Cosmet Laser Ther. 2016;18(4):208–12.
6. Omi T, Numano K. The role of the CO2 laser and fractional CO2 laser in dermatology. Laser Ther [Internet]. 2014;23(1):49–60. Available from: http://jlc.jst.go.jp/ DN/JST.JSTAGE/islsm/14-RE-01?lang=en&from=CrossRef&type=abstract
7. El-Zawahry BM, Sobhi RM, Bassiouny DA, Tabak SA. Ablative CO2 fractional resurfacing in treatment of thermal burn scars: An open-label controlled clinical and histo-pathological study. J Cosmet Dermatol. 2015;14(4):324–31.
8. Levi B, Ibrahim A, Mathews K, Wojcik B, Gomez J, Fagan S, dkk. The use of CO2 fractional photothermolysis for the treatment of burn scars. J Burn Care Res. 2014;106–14.
9. Gauglitz G, Korting H. Hypertrophic Scarring and Keloids: Pathomechanisms and Current and Emerging Treatment Strategies.Mol Med [Internet]. 2011;17(1-2):1. Available from: http://www.molmed.org/content/pdfstore/ 09_153_Gauglitz.pdf. Diunduh: 20 November 2018
10. Jumper N, Hodgkinson T, Paus R, Bayat A. Site-specific gene expression profiling as a novel strategy for unravelling keloid disease pathobiology. PLoS ONE. 2017;12:1-33.
11. Mari W, Alsabri SG, Tabal N, Younes S, Sherif A, Simman R. Novel insights on understanding of keloid scar: article review. J Am Coll Clin Wound Spec [Internet]. Elsevier Inc; 2015;7:1–7. Available from: http://dx.doi.org/10.1016/ j.jccw.2016.10.001. Diunduh:19 November 2018
12. Rabello F, Souza C, Farina Jr J. Update on hypertrophic scar treatment. Clinics (Sao Paulo). 2014;69:565–73. Available from: http://clinics.org.br/article.php?id=1356
13. Arno AI, Gauglitz GG, Barret JP, Jeschke MG. Up-to-date approach to manage keloids and hypertrophic scars: A useful guide. Burns. 2014;40:1255–66.
14. Finlay V, Burrows S, Kendell R, Berghuber A, Chong V, Tan J, dkk. Modified Vancouver Scar Scale score is linked with quality of life after burn. Burns. 2017;43:741–6.
15. McGoldrick RB, Theodorakopoulou E, Azzopardi EA, Murison M. Lasers and ancillary treatments for scar management Part 2: Keloid, hypertrophic, pigmented and acne scars. Scars, Burn Heal [Internet]. 2017;3: 205951311668980. Available from: http://journals. sagepub.com/doi/10.1177/2059513116689805. Diunduh: 5 Desember 2018.
16. Gladsjo JA, Jiang SIB. Treatment of surgical scars using a 595-nm pulsed dye laser using purpuric and nonpurpuric parameters: A comparative study. Dermatol Surg. 2014;40(2):118–26.
17. de las Alas JM, Siripunvarapon a H, Dofitas BL. Pulsed dye laser for the treatment of keloid and hypertrophic scars: a systematic review. Expert Rev Med Devices. 2012;9:641–50.
18. Koike S, Akaishi S, Nagashima Y, Dohi T, Hyakusoku H, Ogawa R. Nd. Plast Reconstr Surg Glob Open [Internet]. 2014;2(12):e272. Available from: http://content.wkhealth.com/linkback/openurl?sid=WKPTLP:landingpage&an=01720096-201412000-00003. Diunduh: 5 Desember 2018.
19. Chen XE, Liu J, Bin Jameel AA, Valeska M, Zhang JA, Xu Y, dkk. Combined effects of long-pulsed neodymium-yttrium-aluminum-garnet laser, diprospan and 5-fluorouracil in the treatment of keloid scars. Exp Ther Med. 2017;13:3607–12.
20. Heppt M V., Breuninger H, Reinholz M, Feller-Heppt G, Ruzicka T, Gauglitz GG. Current strategies in the treatment of scars and keloids. Facial Plast Surg. 2015;31:386–95.
21. Vas K, Gaál M, Varga E, Kovács R, Bende B, Kocsis Á, dkk. Effects of the combined PDL/Nd:YAG laser on surgical scars: vascularity and collagen changes evaluated by in vivo confocal microscopy. Biomed Res Int. 2014; article 204532;1-8.
22. Nicoletti G, De Francesco F, Mele CM, Cataldo C, Grella R, Brongo S, dkk. Clinical and histologic effects from CO2 laser treatment of keloids. Lasers Med Sci. 2013;28:957–64.
23. Behera B, Kumari R, Thappa DM, Malathi M. Therapeutic efficacy of intralesional steroid with carbon dioxide laser versus with cryotherapy in treatment of keloids. Dermatologic Surg [Internet]. 2016;42(10):1188–98. Available from: http://content.wkhealth.com/linkback/ openurl?sid=WKPTLP:landingpage&an=00042728-201610000-00010. Diunduh:19 November 2018
24. Annabathula A, Sekar CS, Srinivas CR. Fractional Carbon Dioxide , Long Pulse Nd : YAG and Pulsed Dye Laser in the Management of Keloids. J Cutan Aesthet Surg. 2017; 10:76–80.
25. Azzam OA, Bassiouny DA, El-Hawary MS, El Maadawi ZM, Sobhi RM, El-Mesidy MS. Treatment of hypertrophic scars and keloids by fractional carbon dioxide laser: a clinical, histological, and immunohistochemical study. Lasers Med Sci. 2016;31:9–18.
2. Trace AP, Enos CW, Mantel A, Harvey VM. Keloids and hypertrophic scars: a spectrum of clinical challenges. Am J Clin Dermatol. 2016;17(3):201–23.
3. Sorg H, Tilkorn DJ, Hager S, Hauser J, Mirastschijski U. Skin wound healing: an update on the current knowledge and concepts. Eur Surg Res. 2017;58(1–2):81–94.
4. Del Toro D, Dedhia R, Tollefson TT. Advances in scar management. Curr Opin Otolaryngol Head Neck Surg. 2016;24(4):322–9.
5. Al-Mohamady AE-SAE-H, Ibrahim SMA, Muhammad MM. Pulsed dye laser versus long-pulsed Nd:YAG laser in the treatment of hypertrophic scars and keloid: A comparative randomized split-scar trial. J Cosmet Laser Ther. 2016;18(4):208–12.
6. Omi T, Numano K. The role of the CO2 laser and fractional CO2 laser in dermatology. Laser Ther [Internet]. 2014;23(1):49–60. Available from: http://jlc.jst.go.jp/ DN/JST.JSTAGE/islsm/14-RE-01?lang=en&from=CrossRef&type=abstract
7. El-Zawahry BM, Sobhi RM, Bassiouny DA, Tabak SA. Ablative CO2 fractional resurfacing in treatment of thermal burn scars: An open-label controlled clinical and histo-pathological study. J Cosmet Dermatol. 2015;14(4):324–31.
8. Levi B, Ibrahim A, Mathews K, Wojcik B, Gomez J, Fagan S, dkk. The use of CO2 fractional photothermolysis for the treatment of burn scars. J Burn Care Res. 2014;106–14.
9. Gauglitz G, Korting H. Hypertrophic Scarring and Keloids: Pathomechanisms and Current and Emerging Treatment Strategies.Mol Med [Internet]. 2011;17(1-2):1. Available from: http://www.molmed.org/content/pdfstore/ 09_153_Gauglitz.pdf. Diunduh: 20 November 2018
10. Jumper N, Hodgkinson T, Paus R, Bayat A. Site-specific gene expression profiling as a novel strategy for unravelling keloid disease pathobiology. PLoS ONE. 2017;12:1-33.
11. Mari W, Alsabri SG, Tabal N, Younes S, Sherif A, Simman R. Novel insights on understanding of keloid scar: article review. J Am Coll Clin Wound Spec [Internet]. Elsevier Inc; 2015;7:1–7. Available from: http://dx.doi.org/10.1016/ j.jccw.2016.10.001. Diunduh:19 November 2018
12. Rabello F, Souza C, Farina Jr J. Update on hypertrophic scar treatment. Clinics (Sao Paulo). 2014;69:565–73. Available from: http://clinics.org.br/article.php?id=1356
13. Arno AI, Gauglitz GG, Barret JP, Jeschke MG. Up-to-date approach to manage keloids and hypertrophic scars: A useful guide. Burns. 2014;40:1255–66.
14. Finlay V, Burrows S, Kendell R, Berghuber A, Chong V, Tan J, dkk. Modified Vancouver Scar Scale score is linked with quality of life after burn. Burns. 2017;43:741–6.
15. McGoldrick RB, Theodorakopoulou E, Azzopardi EA, Murison M. Lasers and ancillary treatments for scar management Part 2: Keloid, hypertrophic, pigmented and acne scars. Scars, Burn Heal [Internet]. 2017;3: 205951311668980. Available from: http://journals. sagepub.com/doi/10.1177/2059513116689805. Diunduh: 5 Desember 2018.
16. Gladsjo JA, Jiang SIB. Treatment of surgical scars using a 595-nm pulsed dye laser using purpuric and nonpurpuric parameters: A comparative study. Dermatol Surg. 2014;40(2):118–26.
17. de las Alas JM, Siripunvarapon a H, Dofitas BL. Pulsed dye laser for the treatment of keloid and hypertrophic scars: a systematic review. Expert Rev Med Devices. 2012;9:641–50.
18. Koike S, Akaishi S, Nagashima Y, Dohi T, Hyakusoku H, Ogawa R. Nd. Plast Reconstr Surg Glob Open [Internet]. 2014;2(12):e272. Available from: http://content.wkhealth.com/linkback/openurl?sid=WKPTLP:landingpage&an=01720096-201412000-00003. Diunduh: 5 Desember 2018.
19. Chen XE, Liu J, Bin Jameel AA, Valeska M, Zhang JA, Xu Y, dkk. Combined effects of long-pulsed neodymium-yttrium-aluminum-garnet laser, diprospan and 5-fluorouracil in the treatment of keloid scars. Exp Ther Med. 2017;13:3607–12.
20. Heppt M V., Breuninger H, Reinholz M, Feller-Heppt G, Ruzicka T, Gauglitz GG. Current strategies in the treatment of scars and keloids. Facial Plast Surg. 2015;31:386–95.
21. Vas K, Gaál M, Varga E, Kovács R, Bende B, Kocsis Á, dkk. Effects of the combined PDL/Nd:YAG laser on surgical scars: vascularity and collagen changes evaluated by in vivo confocal microscopy. Biomed Res Int. 2014; article 204532;1-8.
22. Nicoletti G, De Francesco F, Mele CM, Cataldo C, Grella R, Brongo S, dkk. Clinical and histologic effects from CO2 laser treatment of keloids. Lasers Med Sci. 2013;28:957–64.
23. Behera B, Kumari R, Thappa DM, Malathi M. Therapeutic efficacy of intralesional steroid with carbon dioxide laser versus with cryotherapy in treatment of keloids. Dermatologic Surg [Internet]. 2016;42(10):1188–98. Available from: http://content.wkhealth.com/linkback/ openurl?sid=WKPTLP:landingpage&an=00042728-201610000-00010. Diunduh:19 November 2018
24. Annabathula A, Sekar CS, Srinivas CR. Fractional Carbon Dioxide , Long Pulse Nd : YAG and Pulsed Dye Laser in the Management of Keloids. J Cutan Aesthet Surg. 2017; 10:76–80.
25. Azzam OA, Bassiouny DA, El-Hawary MS, El Maadawi ZM, Sobhi RM, El-Mesidy MS. Treatment of hypertrophic scars and keloids by fractional carbon dioxide laser: a clinical, histological, and immunohistochemical study. Lasers Med Sci. 2016;31:9–18.
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