周潇杨,马文宇

三氯乙酸（TCA）作为化学剥脱剂的一种，根据浓度的不同，可用于浅层、中层和深层的化学剥脱，现已应用于痤疮、痤疮瘢痕、黄褐斑、光老化、白癜风等皮肤病的治疗。本文综述了三氯乙酸在皮肤领域的应用及其作用机制，探讨了三氯乙酸的安全性和潜在不良反应，旨在为未来三氯乙酸在皮肤领域的应用和研究提供参考。

三氯乙酸；化学剥脱术；皮肤病；临床应用

[1] Kontochristopoulos G,Platsidaki E.Chemical peels in active acne and acne scars[J].Clinics in Dermatology,2017,35(2):179-182. [2] Niti K.Standard guidelines of care for chemical peels[J].Indian Journal of Dermatology,Venereology and Leprology,2008,74(7):5. [3] C J S,S G,S S H H,et al.British Association of Dermatologists'guidelines for the management of cutaneous warts 2014.[J].The British journal of dermatology,2014,171(4):696-712. [4] 张恩娟,张昭.尖锐湿疣的药物治疗[J].中国医院药学杂志,1994,(08):372-374. [5] 王婷,欧阳秀莲.三氯乙酸加中药治疗尖锐湿疣60例临床观察[J].广西医科大学学报,2000,(05):882. [6] 李燕芳.三氯乙酸与阿昔洛韦片联合治疗尖锐湿疣208例报告[J].中国医师杂志,2000,(S1):61. [7] 谭志琴,刘伏香.三氯乙酸联合干扰素治疗女性尖锐湿疣87例临床观察[J].宁夏医学院学报,2007,(01):58-59. [8] 李景萍.三氯乙酸治疗尖锐湿疣疗效观察[J].中国社区医师(医学专业半月刊),2009,11(14):115. [9] Rambhia H S,Rambhia D K,Gulati A.Utilizing Dermoscopy for Trichloroacetic Acid(TCA)Therapy Assessment in Genital Verruca.[J].Indian dermatology online journal,2024,15(4):706-707. [10] Yusuf H,Purwoko H I M.Successful combination therapy of trichloroacetic acid,podophyllin,and electrocautery on giant condylomata acuminata.[J].International journal of STD&AIDS,2024,35(13):9564624241276574. [11] M.A H,Shehata S A,El M R S,et al.Towards Formulation of Highly Acidic Active Ingredients:Development of Clinically Effective Concentrated Trichloroacetic Acid Gel for Wart Management[J].AAPS PharmSciTech,2023,24(6):160-160. [12] Puri N,Kumar S,Kaur S,et al.Comparative evaluation of therapeutic efficacy and safety of black peel versus 25%trichloroacetic acid peel in mild to moderate acne vulgaris:a split face study.[J].Journal of cutaneous and aesthetic surgery,2024,17(1):11-18. [13] Surabhi D,Satbir S,Priyadarshini S.Efficacy and Safety of 25%Trichloroacetic Acid Peel Versus 30%Salicylic Acid Peel in Mild-to-Moderate Acne Vulgaris:A Comparative Study.[J].Dermatology practical&conceptual,2021,11(3):e2021063-e2021063. [14] Rania H A,Rehab H,Mohamed H A,et al.Clinical and dermoscopic evaluation of combined(salicylic acid 20%and azelaic acid 20%)versus trichloroacetic acid 25%chemical peel in acne:an RCT.[J].The Journal of dermatological treatment,2019,30(6):572-577. [15] Carvalho M I C,Silva P D,Carvalho M C,et al.Review in peeling complications.[J].Journal of cosmetic dermatology,2017,16(3):319-326. [16] 初文竹,孙一峰,陈圆圆,等.萎缩性痤疮瘢痕的治疗进展[J].中国医疗美容,2023,13(04):74-78. [17] Bock J L,Gil W C,Ho K,et al.Focal treatment of acne scars with trichloroacetic acid:chemical reconstruction of skin scars method.[J].Dermatologic surgery:official publication for American Society for Dermatologic Surgery[et al.],2002,28(11):1017-21; discussion 1021. [18] Nozomi Y,Nobuo K,Toshio O,et al.Induction of PDGF-B in TCA-treated epidermal keratinocytes.[J].Archives of dermatological research,2007,299(9):433-40. [19] Roy G,Gayen T,Sen S,et al.Study to compare the efficacy of 50%glycolic acid with 65%trichloroacetic acid in the treatment of atrophic acne scar by CROSS technique.[J].Journal of cutaneous and aesthetic surgery,2024,17(3):198-204. [20] Dhamale S,Sutaria A,Shah B.A study to evaluate various upcoming therapies for acne scars:Head on comparison[J].Clinical Dermatology Review,2020,4(2):128-135. [21] Kaur J,Kalsy J.Subcision plus 50%trichloroacetic acid chemical reconstruction of skin scars in the management of atrophic acne scars:A cost-effective therapy[J].Indian Dermatology Online Journal,2014,5(1):95-97. [22] Maryam M,Tahir H,Khurram M S,et al.Comparing the Efficacy of Intra-dermal Platelet Rich Plasma(PRP)Versus 50%Trichloracetic Acid(TCA)using Cross Technique for Atrophic Acne Scars.[J].Journal of the College of Physicians and Surgeons-Pakistan:JCPSP, 2021,31(1):55-59. [23] Agata P,Marcelina G,Aleksandra L,et al.Double-blind,randomized controlled trial comparing the use of microneedling alone versus chemical peeling alone versus a combination of microneedling and chemical peeling in the treatment of atrophic post-acne scars.An assessment of clinical effectiveness and patients'quality-of-life.[J].Postepy dermatologii i alergologii,2021,38(4):629-635. [24] Manjhi M,Sagar V,Yadav P,et al.A comparative study of 70%glycolic acid and 30%trichloroacetic acid peel in the treatment of facial atrophic acne scars:A split-face study.[J].Journal of cutaneous and aesthetic surgery,2024,17(3):227-233. [25] 中国中西医结合学会皮肤性病专业委员会色素病学组,中华医学会皮肤性病学分会白癜风研究中心,中国医师协会皮肤科医师分会色素病工作组.中国黄褐斑诊疗专家共识(2021版)[J].中华皮肤科杂志,2021,54(2):110-115. [26] Adhikari S,Karki S,Nepal A,et al.A comparative study between the use of the combination of trichloroacetic acid peeling with hydroquinone and hydroquinone alone in patients with melasma[J].Asian Journal of Medical Sciences,2023,14(6):119-124. [27] Nidhi P,Mamta S,Sumit M,et al.Comparative Efficacy of Chemical Peeling Agents in the Treatment of Melasma.[J].Cureus, 2023,15(10):e47312-e47312. [28] Jaime P,Corinne G,Vanesa P,et al.A Treatment Combination of Peels,Oral Antioxidants,and Topical Therapy for Refractory Melasma:A Report of 4 Cases.[J].Clinical,cosmetic and investigational dermatology,2020,13209-213. [29] Magda H,Sara A.The effect of topical nano vitamin-C iontophoresis versus the effect of trichloroacetic acid 20%peel in treatment of melasma[J].Menoufia Medical Journal,2022,35(2):489-495. [30] Ríos L D,Berrios A G,Goytía C I G,et al.Safety and Efficacy of Trichloroacetic Acid Peels in the Treatment of Melasma:A Split-face,Randomized,Prospective Trial in Latin American Women.[J].The Journal of clinical and aesthetic dermatology,2024,17(9):28-32. [31] Han A,Chien L A,Kang S.Photoaging[J].Dermatologic Clinics,2014,32(3):291-299. [32] Marlena K,Paulina M,Helena R.Comparative study of 15%trichloroacetic acid peel combined with 70%glycolic acid and 35%trichloroacetic acid peel for the treatment of photodamaged facial skin in aging women.[J].Journal of cosmetic dermatology, 2019,19(1):137-146. [33] Yenny W S,Julia S D,Lestari F A,et al.A clinical and novel dermoscopic investigation of combined peels as a hand aging treatment.[J].Journal of cosmetic dermatology,2024,23(11):3598-3607. [34] James F,Carolyn J,Isabel D,et al.Treatment of mild-to-moderate facial cutaneous aging using a combination peel containing 6%trichloroacetic acid and 12%lactic acid.[J].Journal of cosmetic dermatology,2023,22(11):3033-3041. [35] H M G,April W,A J B.Treatment of Mild to Moderate Facial Chrono-and Photodamage with a Novel Intense Liquid Trichloroacetic Acid Peel.[J].The Journal of clinical and aesthetic dermatology,2022,15(1):E61-E65. [36] Ayako K,Nobuo K,Hong-Jin L,et al.Influence of trichloroacetic acid peeling on the skin stress response system.[J].The Journal of dermatology,2011,38(8):740-7. [37] Brandon W,Vishnu H,Kelly R,et al.Treatment of actinic keratosis:a systematic review.[J].Archives of dermatological research, 2023,315(5):1099-1108. [38] Christina B,Khaled E.Vitiligo:A Review.[J].Dermatology(Basel,Switzerland),2020,1-22. [39] Mashaly,H.M.,Dorgham,D.A.,&Ismail,S.I.(2016).Trichloroacetic Acid Peel 15%+NB-UVB Versus Trichloroacetic Acid Peel 25%+ NB-UVB for Stable Non-Segmental Vitiligo. [40] Mohamed K,Mohamed N,Samar S,et al.Clinical evaluation of the efficacy of trichloroacetic acid 70%after microneedling vs intradermal injection of 5-fluorouracil in the treatment of nonsegmental vitiligo;A prospective comparative study.[J].Dermatologic therapy, 2020,33(4):e13532. [41] Ahmad N,M M F,Rania A.Trichloroacetic Acid in Different Concentrations:A Promising Treatment Modality for Vitiligo.[J]. Dermatologic surgery:official publication for American Society for Dermatologic Surgery[et al.],2020, [42] Ahmad N,Fatma E,Mona S,et al.Microneedling combined with pimecrolimus,5-fluorouracil and trichloroacetic acid in the treatment of vitiligo:A comparative study.[J].Dermatologic therapy,2021,35(3):e15294-e15294. [43] Muhammed M.Trichloroacetic Acid Cautery for Repigmenting Nonresponsive Vitiligo on Lips.[J].Journal of cutaneous and aesthetic surgery,2023,16(2):154-155. [44] Frisoli L M,Essien K,Harris E J.Vitiligo:Mechanisms of Pathogenesis and Treatment[J].Annual Review of Immunology,2020,38(1):621-648. [45] Ahmad N,M M F,Rania A.The use of trichloroacetic acid as a depigmenting therapy in universal vitiligo.[J].Journal der Deutschen Dermatologischen Gesellschaft=Journal of the German Society of Dermatology:JDDG,2020,19(2):241-246. [46] Medha R,Katherine Y,Ladonya J,et al.Post-Inflammatory Hypopigmentation:Review of the Etiology,Clinical Manifestations,and Treatment Options[J].Journal of Clinical Medicine,2023,12(3):1243-1243. [47] 刘伊雯,王磊,周君浩,等.斑秃的药物治疗研究进展[J].中国皮肤性病学杂志,2022,36(07):841-845. [48] Puri N,Puri A.A comparative study on 100%tca versus 88%phenol for the treatment of vitiligo[J].Nasza Dermatologia Online, 2012,3(3):184-186. [49] Doaa M,Riham E M,Dina S,et al.Clinical and trichoscopic evaluation of trichloroacetic acid 35%vs phenol 88%peels in treatment of alopecia areata.[J].Journal of cosmetic dermatology,2020,20(1):143-149. [50] 余进,朱红梅.中国甲真菌病诊疗指南(2021年)[J].中国真菌学杂志,2022,17(1):1-7. [51] 이원주,김도원,이석종,等.Efficacy of Trichloroacetic Acid in Patients with Toenail Onychomycosis:Pilot Study with 14 Patients[J]. Korean Journal of Medical Mycology,2014,19(2):25-30. [52] Sidharth S,Deepak J,Pravesh Y,et al.Chemical Peeling as an Innovative Treatment Alternative to Oral Antifungals for Onychomycosis in Special Circumstances.[J].Skin appendage disorders,2019,5(3):181-185. [53] Ibrahim M S A,Ibrahim S N,Elgharabawy S E,et al.Efficacy of topical trichloroacetic acid 100%either alone or combined with topical tioconazole 28%versus systemic itraconazole in the treatment of onychomycosis.[J].Mycoses,2024,67(1):e13690-e13690. [54] Terzi E,Guvenc U,Türsen B,et al.The effectiveness of matrix cauterization with trichloroacetic acid in the treatment of ingrown toenails[J].Indian Dermatology Online Journal,2015,6(1):4-8.

点击下载PDF