超分子水杨酸联合米诺环素治疗玫瑰痤疮临床疗效分析

Clinical Efficacy of Supramolecular Salicylic Acid Combined with Minocycline in the Treatment of Rosacea

目的:采取自身对照研究,评价局部外用30%超分子水杨酸联合米诺环素治疗丘疹脓疱型玫瑰痤疮疗效及耐受性,同时观察其对皮肤屏障功能的影响。方法:选择30例诊断为丘疹脓疱型玫瑰痤疮患者,随机选取半侧面部作为实验侧(E-side),在口服米诺环素(50mg,1次/d)基础上,外用30%超分子水杨酸治疗,间隔1周治疗1次,共计4次,并联合使用保湿剂(2次/d);另一侧作为对照侧(C-side),单用保湿剂(2次/d)。分别于每次治疗前及治疗后1周由同一医师对面部两侧分别进行综合评分,包括红斑评分及丘疹脓疱评分。使用无创皮肤检测仪分别测定面部两侧皮肤含水量、红斑指数、经皮水分丢失量;使用VISIA皮肤检测仪对面部两侧分别进行红斑测定;每次治疗前采集患者正侧面部照片,并记录用药期间不良反应。结果:共纳入患者30例,其中21例完成了试验,实验侧整体疗效优于对照侧,与对照侧比较,能更早地改善丘疹脓疱及红斑。4周治疗结束后实验侧丘疹脓疱评分、VISIA红斑分值、红斑指数及TEWL改善均优于对照侧,差异有统计学意义(P<0.05)。两侧治疗4周后,角质层含水量均有所上升,但较治疗前无统计学意义(P>0.05)。不良反应主要表现为外用药时一过性刺痛、发红、用药期间皮肤干燥、轻至中度脱屑,经冷敷、加强保湿处理后,不良反应均可消失。结论:30%超分子水杨酸联合米诺环素治疗玫瑰痤疮,能够最大程度地减轻患者慢性炎症反应,有助于丘疹脓疱及红斑的改善,同时在治疗早期阶段可促进皮肤屏障功能的修复,因此可成为临床上治疗玫瑰痤疮的新选择。

Objectives The trail was designed as a split-face study to evaluate the efficacy and skin tolerance of combined application of 30% salicylic acid and minocycline for papulopustular rosacea. The effect of 30% salicylic acid on skin barrier function of patients with rosacea was also evaluated. Methods Thirty patients diagnosed as papulopustular rosacea were enrolled to this study. All the patients were instructed to take oral minocycline 50mg per day, combined with the medical moisturizing cream, twice per day. 30% salicylic acid was applied to the randomly allocated half-side of face(E-side)for four times at 1 week interval. The other side was noted as C-side. Clinical evaluation, along with the red value taken by VISIA complexion analysis system, the score of skin moisture, erythema index and transdermal water loss(TEWL)taken by Skin noninvasive detector were obtained at baseline and one week after each salicylic acid treatment. Side effects during the treatment were also recorded. Results 21 of the 30 subjects had completed this study. The overall curative effect on salicylic acid (SA) treatment side (E-side) is superior to control side (C-side). Remarkable differences of the score of papules and pustules,VISIA red value, erythema index, and TEWL were observed by the end of the therapy between E-side and C-side (P <0.05). The score of papules and VISIA red value decreased significantly on E-side at 2nd week while at 4th week on C-side (P >0.05). All the side effects were mild and transient. Conclusion This study investigated that 50mg minocycline per day combined with 30% salicylic acid can minimize inflammation in rosacea patients and help facilitate the reduction of erythema, papules and pustules. Four-time weekly treatment with 30% salicylic acid can also improve skin barrier at early course of treatment. So salicylic acid could be a new choice for rosacea treatment.