الفهرس 
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Abstract
Acne vulgaris is a very frequent skin disease that influences approximately all people ≥ 1 time during life. Post-acne erythema It is called (PIE) as well, it’s one of the common sequalae in patients suffering from acne. It appears as telangiectatic in addition to erythematous macules.
In spite of the high prevalence of PAE, no efficient therapeutic options and the management is still one of the great challenges, many vascular laser treatments, light based procedures and topical treatment were clinically tried during the last few years.
Brimonidine is one of the highly selective α-2 adrenergic receptor agonists causes direct, strong VC of small arterioles and venules. In the2013, brimonidine 0.33% gel was the first topical therapy to be FDA approved for the treatment of persistent facial erythema from rosacea. In one study, brimonidine applied topically to the face was hypothesized to reduce post-acne erythema in the same way it acts in rosacea.
PDL was the 1st laser developed depending upon the hypothesis of selective photo thermolysis and was designed in particular to treat vascular lesions. PDL of long pulse duration 595-nm targets hemoglobin within blood vessels. This long-pulsed laser was clinically tried on acne erythema.
Thus, the aim of the current study was to assess and compare between PDL, PDL plus topical Brimonidine and topical Brimonidine tartrate 0.2% for treatment of persistent post acne erythema.
The presented study included sixty cases suffering clinically and dermoscopically of persistent post acne erythema. Cases were randomized into two groups; group A : included 30 cases having post acne erythema of all grades were treated with PDL on both sides of the face and topical Brimonidine tartrate on one side of the face. group B: were managed using PDL on the one side of the face and topical Brimonidine tartrate on the other side.
Standarized digital clinical and dermoscopic photographs were carried out at base line (before start of therapy) and at the end of the therapy duration.
The results of the present study revealed.
A significant reduction in IGA scale and lesion count at the end of therapy in all treated sides without significant differences between both sides in both groups.
A significant higher improvement in global improvement score in PDL+Brimonidine treated side in group A, while there was no significant differences between the two sides in group B.
In addition, Image J analysis show statistically significant improvement in area ,reciprocal intensity and erythema index at the end of therapy in all cases ,with a statistically significant higher improvement in erythema index in the side treated with PDL+Brimonidine in comparison with the cases managed using PDL.
Subjective assessment of response to therapy was evaluated regarding the patient’s opinion concluding that the cases were highly satisfied with the result of PDL +Brimonidine than the result of PDL alone in group A.
The pain was the only detected adverse effect of PDL treatment but it was tolerable(pain score 0-3).