光电协同技术治疗丘疹脓疱型玫瑰痤疮疗效观察
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摘要
目的观察光电协同技术治疗轻中度丘疹脓疱型玫瑰痤疮的疗效及安全性。方法轻中度丘疹脓疱型玫瑰痤疮患者30例,采用ELOS光电平台,SRA手具治疗,每4周1次,共治疗3次。采用自身前后对照进行疗效观察。由1位皮肤科医生根据VISIA照片盲态下分别记数患者面部炎症损害数目(丘疹和脓疱数目),并采用玫瑰痤疮严重度4级评分法对红斑程度进行评分。记录VISIA红色区绝对分值。记录患者不良反应。治疗前及3次治疗后采用皮肤病生活质量指数(dermatology life quality index,DLQI)对患者进行问卷调查。结果患者第5周炎症损害数目较治疗前明显减少,第9、13周继续减少(P<0.001);第5周患者VISIA红色区绝对分值较治疗前明显下降,第9、13周继续下降(P<0.001)。第25周随访炎症损害数目及红色区绝对分值仍比治疗前下降(P<0.001)。第13、25周患者面部红斑评分较治疗前均有改善(P<0.001)。治疗3次后患者DLQI评分较治疗前明显下降(P<0.001)。以上差异均有统计学意义。所有患者无明显不良反应。结论光电协同技术对丘疹脓疱型玫瑰痤疮面部丘疹脓疱及红斑治疗效果好,安全性高,能明显改善患者生活质量。
Objective To evaluate the efficacy and safety of electro-optical synergy technology for mild to moderate papulopustular rosacea.Methods This self-control study was performed in 30 subjects with mild to moderate papulopustular rosacea.All subjects were treated with ELOS SRA handpiece for 3 times at a 4-week interval.A dermatologist blindly assessed efficacy by accounting the number of inflammatory lesions(pustules and papules) using VISIA imaging.Severity of erythema was scored using the 4-point severity grading system for rosacea.The adverse events were documented.Before and after 3-treatment, a questionnaire was used to evaluate patients′ Dermatology Life Quality Index(DLQI).Results Significant and continuous reduction in inflammatory lesions and improvement in red/inflamed skin scores were observed from weeks 5 to 13(P<0.001 versus baseline).These improvements sustained up to week 25(P<0.001 versus baseline).Significant improvements in erythema scores were also observed at weeks 13 and 25(P<0.001 versus baseline).The scores of DLQI significantly decreased after 3 treatments(P<0.001 versus baseline).No noticeable adverse event was observed.Conclusion Electro-optical synergy technology is safe and effective for mild to moderate papulopustular rosacea.It can also improve the quality of life of patients with papulopustular rosacea.
Objective To evaluate the efficacy and safety of electro-optical synergy technology for mild to moderate papulopustular rosacea.Methods This self-control study was performed in 30 subjects with mild to moderate papulopustular rosacea.All subjects were treated with ELOS SRA handpiece for 3 times at a 4-week interval.A dermatologist blindly assessed efficacy by accounting the number of inflammatory lesions(pustules and papules) using VISIA imaging.Severity of erythema was scored using the 4-point severity grading system for rosacea.The adverse events were documented.Before and after 3-treatment, a questionnaire was used to evaluate patients′ Dermatology Life Quality Index(DLQI).Results Significant and continuous reduction in inflammatory lesions and improvement in red/inflamed skin scores were observed from weeks 5 to 13(P<0.001 versus baseline).These improvements sustained up to week 25(P<0.001 versus baseline).Significant improvements in erythema scores were also observed at weeks 13 and 25(P<0.001 versus baseline).The scores of DLQI significantly decreased after 3 treatments(P<0.001 versus baseline).No noticeable adverse event was observed.Conclusion Electro-optical synergy technology is safe and effective for mild to moderate papulopustular rosacea.It can also improve the quality of life of patients with papulopustular rosacea.
引文
[1] Del Rosso JQ,Tanghetti EA,Baldwin HE,et al.The burden of illness of erythematotelangiectatic rosacea and papulopustular rosacea :findings from a web-based survey[J].J Clin Aesthet Dermatol,2017,10(6):17-31.
[2] Oussedik E,Bourcier M,Tan J.Psychosocial burden and other impacts of rosacea on patients′ quality of life[J].Dermatol Clin,2018,36(2):103-113.
[3] Wilkin J,Dahl M,Detmar M,et al.Standard grading system for rosacea:report of the National Rosacea Society Expert Committee on the classification and staging of rosacea[J].J Am Acad Dermatol,2004,50(6):907-912.
[4] Sbidian E,Vicaut é,Chidiack H,et al.A randomized-controlled trial of oral low-dose isotretinoin for difficult-to-treat papulopustular rosacea[J].J Invest Dermatol,2016,136(6):1124-1129.
[5] Del Rosso JQ,Thiboutot D,Gallo R,et al.Consensus recommendations from the American Acne & Rosacea Society on the management of rosacea,part 5:a guide on the management of rosacea[J].Cutis,2014,93(3):134-138.
[6] Di Nardo A,Holmes AD,Muto Y,et al.Improved clinical outcome and biomarkers in adults with papulopustular rosacea treated with doxycycline modified-release capsules in a randomized trial[J].J Am Acad Dermatol,2016,74(6):1086-1092.
[7] 张丽,吴忠孝,沈燕娜,等.羟氯喹联合595 nm染料激光治疗玫瑰痤疮临床疗效观察[J].临床皮肤科杂志,2017,46(6):413-417.
[8] 丁惠玲,韩娜娜,仪晓芹,等.玫瑰痤疮生活质量调查分析[J].中国皮肤性病学杂志,2016,30(12):1271-1274.
[9] Holmes AD,Steinhoff M.Integrative concepts of rosacea pathophysiology,clinical presentation and new therapeutics[J].Exp Dermatol,2017,26(8):659-667.
[10] Rivero AL,Whitfeld M.An update on the treatment of rosacea[J].Aust Prescr,2018,41(1):20-24.
[11] Steinhoff M,Schmelz M,Schauber J.Facial erythema of rosacea-aetiology,different pathophysiologies and treatment options[J].Acta Derm Venereol,2016,96(5):579-586.
[12] Jackson JM,Knuckles M,Minni JP,et al.The role of brimonidine tartrate gel in the treatment of rosacea[J].Clin Cosmet Investig Dermatol,2015,8:529-538.
[13] Wat H,Wu DC,Rao J,et al.Application of intense pulsed light in the treatment of dermatologic disease:a systematic review[J].Dermatol Surg,2014,40(4):359-377.
[14] Say EM,Okan G,G?kdemir G.Treatment outcomes of Long-Pulsed Nd:YAG laser for two different subtypes of rosacea[J].J Clin Aesth Dermatol,2015,8(9):16-20.
[15] Mazer JM.Role of laser in the treatment of rosacea[J].Ann Dermatol Venereol,2014,141(Suppl 2):S175-178.
[16] Lee JH,Kim M,Bae JM,et al.Efficacy of the long-pulsed 1064-nm neodymium:yttrium-aluminum-garnet laser (LPND) (rejuvenation mode) in the treatment of papulopustular rosacea (PPR):A pilot study of clinical outcomes and patient satisfaction in 30 cases[J].J Am Acad Dermatol,2015,73(2):333-336.
[17] Kim SJ,Lee Y,Seo YJ,et al.Comparative efficacy of radiofrequency and pulsed dye laser in the treatment of rosacea[J].Dermatol Surg,2017,43(2):204-209.
[18] Addor FA.Skin barrier in rosacea[J].An Bras Dermatol,2016,91(1):59-63.
[19] Woo YR,Lim JH,Cho DH,et al.Rosacea:molecular mechanisms and management of a chronic cutaneous inflammatory condition[J].Int J Mol Sci,2016,17(9):1562.
[20] 何黎,郑捷,马慧群,等.中国敏感性皮肤诊治专家共识[J].中国皮肤性病学杂志,2017,31(1):1-4.
[2] Oussedik E,Bourcier M,Tan J.Psychosocial burden and other impacts of rosacea on patients′ quality of life[J].Dermatol Clin,2018,36(2):103-113.
[3] Wilkin J,Dahl M,Detmar M,et al.Standard grading system for rosacea:report of the National Rosacea Society Expert Committee on the classification and staging of rosacea[J].J Am Acad Dermatol,2004,50(6):907-912.
[4] Sbidian E,Vicaut é,Chidiack H,et al.A randomized-controlled trial of oral low-dose isotretinoin for difficult-to-treat papulopustular rosacea[J].J Invest Dermatol,2016,136(6):1124-1129.
[5] Del Rosso JQ,Thiboutot D,Gallo R,et al.Consensus recommendations from the American Acne & Rosacea Society on the management of rosacea,part 5:a guide on the management of rosacea[J].Cutis,2014,93(3):134-138.
[6] Di Nardo A,Holmes AD,Muto Y,et al.Improved clinical outcome and biomarkers in adults with papulopustular rosacea treated with doxycycline modified-release capsules in a randomized trial[J].J Am Acad Dermatol,2016,74(6):1086-1092.
[7] 张丽,吴忠孝,沈燕娜,等.羟氯喹联合595 nm染料激光治疗玫瑰痤疮临床疗效观察[J].临床皮肤科杂志,2017,46(6):413-417.
[8] 丁惠玲,韩娜娜,仪晓芹,等.玫瑰痤疮生活质量调查分析[J].中国皮肤性病学杂志,2016,30(12):1271-1274.
[9] Holmes AD,Steinhoff M.Integrative concepts of rosacea pathophysiology,clinical presentation and new therapeutics[J].Exp Dermatol,2017,26(8):659-667.
[10] Rivero AL,Whitfeld M.An update on the treatment of rosacea[J].Aust Prescr,2018,41(1):20-24.
[11] Steinhoff M,Schmelz M,Schauber J.Facial erythema of rosacea-aetiology,different pathophysiologies and treatment options[J].Acta Derm Venereol,2016,96(5):579-586.
[12] Jackson JM,Knuckles M,Minni JP,et al.The role of brimonidine tartrate gel in the treatment of rosacea[J].Clin Cosmet Investig Dermatol,2015,8:529-538.
[13] Wat H,Wu DC,Rao J,et al.Application of intense pulsed light in the treatment of dermatologic disease:a systematic review[J].Dermatol Surg,2014,40(4):359-377.
[14] Say EM,Okan G,G?kdemir G.Treatment outcomes of Long-Pulsed Nd:YAG laser for two different subtypes of rosacea[J].J Clin Aesth Dermatol,2015,8(9):16-20.
[15] Mazer JM.Role of laser in the treatment of rosacea[J].Ann Dermatol Venereol,2014,141(Suppl 2):S175-178.
[16] Lee JH,Kim M,Bae JM,et al.Efficacy of the long-pulsed 1064-nm neodymium:yttrium-aluminum-garnet laser (LPND) (rejuvenation mode) in the treatment of papulopustular rosacea (PPR):A pilot study of clinical outcomes and patient satisfaction in 30 cases[J].J Am Acad Dermatol,2015,73(2):333-336.
[17] Kim SJ,Lee Y,Seo YJ,et al.Comparative efficacy of radiofrequency and pulsed dye laser in the treatment of rosacea[J].Dermatol Surg,2017,43(2):204-209.
[18] Addor FA.Skin barrier in rosacea[J].An Bras Dermatol,2016,91(1):59-63.
[19] Woo YR,Lim JH,Cho DH,et al.Rosacea:molecular mechanisms and management of a chronic cutaneous inflammatory condition[J].Int J Mol Sci,2016,17(9):1562.
[20] 何黎,郑捷,马慧群,等.中国敏感性皮肤诊治专家共识[J].中国皮肤性病学杂志,2017,31(1):1-4.
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