玫瑰痤疮的治疗进展

玫瑰痤疮是皮肤科常见病之一,病因复杂,治疗仍面临挑战。近年来,光电技术在玫瑰痤疮的治疗中逐渐扮演了重要角色。一些新兴药物及治疗如微滴注射肉毒素、光动力疗法及外用米诺环素泡沫等,为临床治疗提供了新的思路。该文对近年来玫瑰痤疮治疗的最新研究进展作一综述。     

玫瑰痤疮的治疗进展

玫瑰痤疮药物治疗包括抗生素类、维A酸类、免疫抑制剂、α肾上腺素受体激动剂、抗幽门螺杆菌药物及ε氨基己酸(ACA)等,此外多种类型的激光已经越来越多地用于玫瑰痤疮的治疗。本文将对以上内容进行综述。     

玫瑰痤疮的治疗进展

玫瑰痤疮是一种发生在颜面中部的慢性炎症性皮肤病,临床分为4型：红斑毛细血管扩张型、丘疹脓疱型、肥大增生型、眼型,其中红斑毛细血管扩张型最为常见。由于本病发生于面部,除了对患者生理造成一定影响,部分患者还会产生心理问题。玫瑰痤疮治疗是一个长期复杂的过程,我们就其治疗进展综述如下……     

玫瑰痤疮的治疗进展

玫瑰痤疮是常见的慢性炎症性皮肤病,病因尚不清楚.近年来随着对其研究的深入和医疗技术的发展,临床治疗中不断出现新技术和新方法,如应用抗生素、异维A酸、壬二酸、他克莫司,杀虫剂,α肾上腺素受体激动剂,安体舒通等药物治疗及激光治疗,大部分治疗方法已经被研究所证实,并取得了较好的临床疗效,使玫瑰痤疮的治疗有了较大进展,激光为其治疗提供了更为广阔的前景.     

A型肉毒毒素治疗玫瑰痤疮持久性红斑2例并文献复习

患者女性,50岁,面部红斑、丘疹、脓疱伴潮红、灼热、瘙痒3年。诊断：玫瑰痤疮。共给予2次20 U/mL浓度A型肉毒毒素治疗后明显好转（首次：两侧面颊各注射25 U,1周后第2次注射：每侧面颊各10 U）。病例2：患者女性,48岁,面部红斑、丘疹伴潮红、灼热、瘙痒感2年。诊断：玫瑰痤疮。给予1次注射20 U/mL浓度A型肉毒毒素治疗后明显好转（两侧面颊各注射20 U）。     

玫瑰痤疮中西医治疗现状

玫瑰痤疮是常见的慢性复发性炎症性面部皮肤病,其病因病机十分复杂,具体发病机制仍不十分清楚.古代医学上称酒齄鼻,又称赤鼻,认为多与体内郁热、气滞血瘀有关,在治疗上多从肺、胃、肝入手,以此取得了良好的疗效;现代医学原称酒渣鼻,多属炎症反应引起的毛细血管收缩功能异常,治疗以收缩毛细血管、抗炎、杀菌等对症治疗,其疗...     

玫瑰痤疮药物治疗进展

玫瑰痤疮是一种常见的慢性炎症性皮肤病,根据临床表现不同可分为红斑毛细血管扩张型、丘疹脓疱型、肥大型和眼型.美国国家玫瑰痤疮协会的诊疗指南认为,玫瑰痤疮应按照不同亚型给予相应的治疗.治疗方法包括一般护理、药物、激光、手术等.目前针对红斑毛细血管扩张型的α肾上腺素能受体激动剂、β受体阻滞剂、肉毒素A及针对丘疹脓疱型的亚抗生素剂量多西环素、伊维菌素等的出现,为治疗玫瑰痤疮提供了可能.由于酒石酸溴莫尼定、亚抗生素剂量多西环素、伊维菌素的使用时间较短,其安全性及功效性尚需更多的临床研究证据.     

聚多卡醇治疗红斑毛细血管扩张型玫瑰痤疮12例疗效观察

目的探讨聚多卡醇治疗红斑毛细血管扩张型玫瑰痤疮的临床疗效和安全性。方法采用局部注射聚多卡醇治疗12例红斑毛细血管扩张型玫瑰痤疮患者,并观察临床疗效。结果 12例患者均达痊愈标准,治疗后局部无再出血、渗出、破溃、色素沉着及瘢痕。随访6个月,未见复发。结论聚多卡醇局部注射治疗红斑毛细血管扩张型玫瑰痤疮疗效显著,美容效果好,具有很好的临床应用前景。     

玫瑰痤疮面部潮红与红斑新认识

【摘要】 持续型面中部红斑与潮红是玫瑰痤疮最常见的临床表现,但对其病理机制了解甚少,并缺乏高证据等级临床研究支持。本文结合国内外研究进展及临床经验,强调将面部潮红与红斑作为独立的临床表型进行研究探讨的必要性,认为精神压力、焦虑和/或抑郁可能是其发病的使动环节。由精神因素出发,探索玫瑰痤疮面部潮红及红斑相关神经炎症与皮肤免疫及血管的关系具有潜在的临床意义。     

难治性痤疮的分析与治疗

难治性痤疮对常规治疗痤疮的药物耐受,其形成与患者自身对治疗的依从性不足,以及医生诊断、治疗不合理等多方面因素有关。该文介绍了难治性痤疮的定义,并分析和总结了其可能的形成原因及治疗原则。     

Comparative efficacy of intense pulsed light for different erythema associated with rosacea

Abstract

Objective: To compare the efficacy of intense pulsed light (IPL) (540–950nm) in treating different erythema associated with rosacea. Methods: Thirty-two patients with erythematotelangiectatic rosacea (ETR) (n = 16) and papulopustular rosacea (PPR, n = 16) were recruited. Three treatments of IPL (540–950nm) were administered on the face at 3-week intervals. Clinical improvement in erythema was independently assessed by two dermatologists using a quartile grading scale [0, ≤ 25% improvement (poor); 1, 26–50% improvement (fair); 2, 51–75% improvement (good); and 3, 76–100% improvement (excellent)]. Patient satisfaction was evaluated using a 10-point visual analog scale (VAS: 0, lowest; and 10, highest). Results: Thirty patients were involved in this study. All patients showed improvement in erythema after three sessions of IPL (540–950nm) treatment. Based on physician's assessment, the overall clinical improvement in PPR group was significantly higher (mean ± SD of PPR group, 2.167 ± 0.748 vs. ETR group, 1.400 ± 0.541; P = 0.003) and patient satisfaction was also higher in PPR group (mean ± SD of PPR group, 6.867 ± 1.457 vs. ETR group, 5.600 ± 1.502; P = 0.026). The proportion of patients showing > 75% clinical improvement among PPR group was also higher than that among ETR group (5/15 and 0/15, respectively; P = 0.021). Side effects were minimal and transient (erythema and/or edema) for patients. Conclusions: IPL (540–950nm) is a safe and effective treatment for rosacea-associated erythema, especially for perilesional erythema.     

结节性红斑的诊疗进展

结节性红斑是以皮下脂肪炎症反应为特征的炎症性疾病,临床表现为双下肢疼痛性红斑。病因主要包括特发性、感染、自身免疫性疾病、妊娠、药物、肿瘤等。相关检查包括皮损活检、血沉、抗“O”、结核试验、胸片、血常规等。应该对症对因治疗。如非甾体抗炎药、糖皮质激素、碘化钾、沙利度胺等免疫抑制剂可以用于严重难治性病例。中医中药治疗及物理治疗也有较好疗效。     

玫瑰痤疮发病的免疫机制研究进展

与玫瑰痤疮发生发展有关的因素包括免疫反应、微生物的增多以及神经血管功能失调等。免疫学发病机制涉及固有免疫反应异常,包括皮损处LL-37、KLK5、TLR2表达的增多、炎性体的活化以及肥大细胞的参与等,适应性免疫机制也参与其致病过程,本文对玫瑰痤疮发病的免疫机制研究进展进行综述。     

Laser treatment of rosacea

Rosacea is a common condition often resulting in persistent erythema and telangiectasia as well as rhinophyma in a number of patients. Over the last two decades lasers have been increasingly used in the treatment of these permanent changes. The literature is reviewed in terms of the different laser systems, side-effects and comparison with other surgical techniques. Laser studies on rosacea-associated telangiectasia and erythema are limited. Copper-bromide, krypton and KTP lasers have been used with good to excellent results. However, the most commonly applied system is the flash lamp-pumped pulsed dye laser. Rhinophyma can be treated with a variety of different surgical methods, including laser resurfacing. CO(2) lasers are the most widely used lasers, others are the Er:YAG and Nd:YAG lasers. Cosmetic end results are comparable to partial excision with a scalpel or electrosurgery. There does not appear to be an increased risk of infection or scarring, but the conventional surgical methods are quicker to perform and more cost effective.     

Combined effects of silymarin and methylsulfonylmethane in the management of rosacea: clinical and instrumental evaluation

Objective   This study aims to evaluate a topical treatment based on silymarin/methylsulfonilmethane (S-MSM) to improve erythematous-telangiectactic rosacea.
Methods    Forty-six patients affected by stage I–III rosacea entered this double-blind, placebo-controlled study. Subjects were treated for 1 month. Clinical and instrumental evaluations were done at baseline, after 10 and 20 days, and at the end of the study. Itching, stinging, erythema, and papules were investigated clinically as well as hydration and erythema instrumentally with capacitance and color measurements.
Results    A statistically significant improvement was observed in many clinical and instrumental parameters investigated ( P <  0.001). In particular, improvement of skin redness, papules, itching, hydration, and skin color occurred.
Conclusions    The combination of silymarin and S-MSM can be useful in managing symptoms and condition of rosacea skin, especially in the rosacea subtype 1 erythemato-telangiectatic phase. The action can be considered multicentric and multiphase because of the direct modulating action on cytokines and angiokines normally involved and up-regulated in the case of such skin condition.