الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Aging is a natural complex process leading to biologic attrition at the cellular level. Skin aging can be categorized in two main types; intrinsic or chronologic aging and extrinsic or photoaging. There are several clinical features of photoaging such as dyspigmentation, lentigo, wrinkles and telangectasia.
Several treatment modalities have been investigated for their potential role in the rejuvenation of photoaged skin as topical treatments, chemical peeling, Botox, fillers and Lasers. Different types of Laser devices have been tried in the field of photo-rejuvenation as fractional CO2 laser and Q-switched Nd:YAG laser.
The present study aimed to compare the effectiveness of Q-switched Nd:YAG (1064 nm) Laser versus fractional CO2 (10600 nm) Laser in the treatment of photoaged skin. It also aimed to identify the dermoscopic changes of photoaging, to assess the role of VISIA® complexion analysis and the possible post-treatment effects. Finally, to assess the histopathological changes of photoaged skin and post-treatment changes.
The study was conducted on 40 females suffering from clinical signs of photoaging recruited from the outpatient clinic of Alexandria main university hospital.
Patients were randomly divided into two groups; group A which included 20 patients who received 6 biweekly treatments of QS-Nd:YAG (1064 nm) Laser, and group B which included 20 patients who received 3 monthly treatments of fractional CO2 (10600 nm) Laser. Both groups were subjected to history taking, clinical evaluation using the grading scale of Alexiades, dermoscopic examination with DL3 using the dermoscopic photoaging scale, digital photography and complexion analysis using VISIA® (to assess the percentiles of wrinkles, texture and UV spots). Finally histopathological assessment (5 cases from each group) using Masson trichrome and Orcein stains to assess collagen and elastic fibers respectively. Assessment was done before and three months after the last treatment session. Patient satisfaction and observer scores were also evaluated and graded.
The present study revealed a statistically significant positive correlation between the age of patients and their overall grading score which indicates that the clinical severity of photoaging increases with age advancement. The dermoscopic examination found that Lentigo and telangectasia were the two most common dermoscopic findings in both groups, followed by superficial wrinkles and hypo/hyper pigmentation.
Complexion analysis using VISIA® was done in the present study; it was able to detect objectively features of photoaging in terms of wrinkles, texture and UV spots.
The present study showed a statistically significant improvement of the mean overall grading scale among both groups but the difference between the two groups was statistically insignificant. Detailed scores revealed that there was a statistically significant Improvement in wrinkles and texture in both groups while a statistically significant improvement in dyschromias was detected only in group A. Regarding complexion analysis using VISIA®, the present study showed a statistically significant improvement in percentiles of wrinkles, texture and UV spots in both groups after treatment. There was also no statistically significant difference between both groups. On the other hand, DPAS was not able to detect post treatment changes due to its qualitative nature.