色素性光化性角化病 (PAK) 是光化性角化病的色素变体，由于其与良性和恶性病变的相似性而带来诊断挑战。传统疗法的结果不一致，并且可能导致不良副作用。本研究调查了紫翠玉激光（一种具有选择性吸收黑色素的脉冲激光）用于 PAK 治疗的功效。通过皮肤镜分析预处理，旨在确定预测模式，以获得更好的治疗结果。患有 PAK 的患者参加了一项多中心研究，接受标准化的紫翠玉激光治疗。治疗前进行了详细的皮肤镜评估。医师整体评估 (PGA) 和目标病变色素沉着 (TLP) 量表测量了治疗效果。该研究包括 50 名患有 60 个 PAK 的患者。治疗后，TLP 评分有统计学上的显着降低，特别是在有色素伪网络和灰褐色点的病变中，这与改善结果有关。没有不良反应的报告，这表明激光治疗的安全性和耐受性。紫翠玉激光成为治疗 PAK 色素沉着的一种有前途的方式，特定的皮肤镜模式表明有良好的反应。这项研究强调了皮肤镜专业知识在选择和优化 PAK 治疗方法中的至关重要性。未来的研究应侧重于不同激光或联合疗法的比较研究，以开发更全面的 PAK 治疗框架。© 2024 作者。 《激光在外科和医学中的应用》由 Wiley periodicals LLC 出版。

Pigmented actinic keratoses (PAKs), a pigmented variant of actinic keratosis, present diagnostic challenges due to their resemblance to both benign and malignant lesions. Conventional therapies have inconsistent outcomes and may cause undesirable side effects. This study investigates the efficacy of the Alexandrite laser, a pulsed laser with selective melanin absorption, for PAK treatment. Through dermoscopic analysis pretreatment, it aims to identify predictive patterns for better treatment outcomes.Patients with PAKs were enrolled in a multicenter study, receiving standardized Alexandrite laser therapy. Detailed dermoscopic evaluations were conducted pretreatment. The Physician's Global Assessment (PGA) and Target Lesion Pigmentation (TLP) scales measured treatment efficacy.The study included 50 patients with 60 PAKs. Following treatment, there was a statistically significant reduction in TLP scores, particularly in lesions with pigmented pseudo-networks and gray-brownish dots, which were linked to improved outcomes. No adverse effects were reported, suggesting the safety and tolerability of the laser treatment.The Alexandrite laser emerges as a promising modality for the management of PAK pigmentation, with specific dermoscopic patterns being indicative of a favorable response. This study reinforces the critical importance of dermoscopic expertise in the selection and optimization of treatment for PAKs. Future research should focus on comparative studies with different lasers or combination therapies to develop a more comprehensive treatment framework for PAKs.© 2024 The Author(s). Lasers in Surgery and Medicine published by Wiley Periodicals LLC.