他克莫司软膏治疗面部糖皮质激素依赖性皮炎临床疗效观察

Clinial efficacy of facial corticosteroid dependent dermatitis with topical tacrolimus ointment

目的:观察外用0.1%他克莫司软膏治疗面部糖皮质激素(以下简称激素)依赖性皮炎临床疗效和安全性;方法:给予28例面部激素依赖性皮炎患者外用0.1%他克莫司软膏,每日1次,共4周。于治疗前及治疗后1、2、4周和停药后2周各随访1次。结果:28例患者中26例完成临床试验。疗后1、2、4周临床显效率分别为19.2%、50.0%和65.4%,停药2周后有27%的患者症状持续好转,23%的患者疗效不变,46%的患者疗效积分指数较治疗结束时上升>30%;表现为红斑和脱屑的患者对治疗的反应较好,皮损为脓疱、皮肤萎缩和毛细血管扩张的患者对治疗的反应较差。19.2%的患者局部有刺激反应,均发生在治疗第1周。结论:0.1%他克莫司软膏治疗面部激素依赖性皮炎安全、有效,但其治疗的皮损选择、疗程均需进一步研究。

Objective： To investigate the clinical efficacy and safety of topical tacrolimus ointment 0.1% for the treatment of patients with facial steroid corticosteroid dependent dermatitis. Methods： Twenty-eight patients were treated with topical tacrolimus ointment 0.1% once a day, and the clinical symptom and sign scores were recorded before and after treatment. Meanwhile the adverse events were observed. Results： Twenty-six of 28 cases completed the whole course of treatment.Marked effective rates were 19.2%, 50% and 65.4% on the 7th day, 14th day, 28th day after treatment respectively,while the rates of persistent improvement, unchanged and rebound （with an increase of scores〉 30%） were 27%,23%,46% respectively 14 days after withdraw of tacrolimus ointment 0.1%. Among a variety of skin lesions, the therapeutic effect was better for erythema and scaly lesions than that for telangiectasia,inflammatory papules, and atrophic lesions.Of the 26 patients, 5 cases （19.2%） were reported to have local burning and itching after the first weeks treatment. Conclusions： tacrolimus ointment 0.1% may be a safe and effective treatment option for the patients with facial corticosteroid dependent dermatitis, but it is necessary to further investigate the optimal treatment course and the therapeutic effect to various skin lesions.