2009 年 18 巻 3 号 p. 151-159
The application of Low reactive Level Laser Therapy (LLLT) for the treatment of hypertrophic scars and keloids has been already reported and investigated. According to these reports, LLLT for hypertrophic scars and keloids was accepted very quickly into routine practice. In this prospective study, we assessed LLLT for the treatment of hypertrophic scars and keloids and examined the influence of a topical steroid. Subjects comprised 20 patients who were treated for hypertrophic scars and keloids, 9 patients treated with LLLT but no topical steroid and 11 patients treated with LLLT plus a topical steroid. Clinical photography of the lesions was performed, and 5 items were assessed for each lesion, namely Itching, Pain, Erythema, Hardness and Pliability on an 11-point scale for each value. The actual measurement values in mm and cm2 of 2 items (Thickness and size) were used. Each treatment session consisted of direct local application of an 830nm, 60mW, continuous wave, GaAlAs diode laser (Oh-lase 3D1, JMLL Tokyo Japan) to the target area for 30 seconds to 2 minutes per lesion depending on the size and number of lesions existing on each patient. The attending clinician firmly pinched the lesion between fingers and thumb during laser therapy. In both groups, a significant difference (p‹0.01) between pretreatment and the 5th or 10th treatment session was recognized in the Erythema, Hardness and Pliability items. In the Itching and Thickness items, a significant difference (p‹0.05) between pretreatment and the 5th or 10th treatment session was also recognized. There were no statistically significant differences between the group with no topical steroid and the group with topical steroid in most of the items, but the topical steroid group achieved better improvement in the Erythema and Hardness items after 10th treatment session, compared to the group with no topical steroid.