低剂量异维A酸治疗难治性丘疹脓疱型玫瑰痤疮的临床疗效

Clinical Eficacy of Low-Dose Isotretinoin on Refractory Papulopular Rosacea

目的了解低剂量异维A酸治疗难治性丘疹脓疱型玫瑰痤疮的临床疗效及安全性。方法收集2016年1月—2018年1月本院经治难治性丘疹脓疱型玫瑰痤疮160例,依据抽签法将所有患者分为观察组及对照组各80例。观察组给予低剂量异维A酸联合多西环素系统应用;对照组给予多西环素系统应用;2组均辅以夫西地酸软膏外用;2组均连续治疗3个月。治疗结束后评估并记录治疗效果、患者满意度、复发情况、治疗相关不良时间发生情况及治疗前后皮肤病生活质量指数(DLQI)。对所有数据进行统计学分析。结果观察组对丘疹/脓疱的治疗效果优于对照组,差异有统计学意义(P<0.05)。2组对毛细血管扩张/红斑的治疗效果间差异无统计学意义(P>0.05)。观察组的治疗满意度高于对照组,差异有统计学意义(P<0.05)。观察组治疗后DLQI评分低于对照组,差异有统计学意义(P<0.05)。2组治疗后DLQI评分均较治疗前降低,差异均有统计学意义(均P<0.05)。观察组治疗后复发率低于对照组,差异有统计学意义(P<0.05)。观察组口干、眼干、肝酶升高、血脂升高及情绪低落发生率均高于对照组,差异均有统计学意义(均P<0.05)。2组瘙痒发生率间差异无统计学意义(P>0.05)。结论低剂量异维A酸可有效治疗难治性丘疹脓疱型玫瑰痤疮,改善患者生活质量,降低短期复发率且患者治疗满意度高,虽治疗相关不良事件发生率稍增加,但耐受性良好。

Objective In order to learn the clinical efficacy and safety of low-dose isotretinoin on refractory papulopustular rosacea.Methods Totally 160 patients of refractory papulopular rosacea that treated in our hospital from January 2016 to January 2018 were enrolled.All patients were divided into observation group(80 cases)and control group(80 cases)according to the drawing method.The observation group was given low-dose isotretinoin combined with doxycycline,while the control group was just given doxycycline.Besides,both groups were treated with fusidic acid ointment for three months.The treatment effects,patient satisfaction,recurrence,treatment-related adverse time,and dermatological quality of life index(DLQI)before and after treatment were evaluated and recorded.Statistical analysis was performed on all data.Results The treatment effects of the observation group on papules/pustules were better than those of the control group(P<0.05).There were no significant differences between the two groups in the treatment of telangiectasia/erythema(P>0.05).The treatment satisfaction of the observation group was higher than that of the control group(P<0.05).The DLQI score of the observation group was lower than that of the control group after treatment(P<0.05).The DLQI scores of both groups were lower than those before treatment(P<0.05).The recurrence rate of the observation group was lower than that of the control group after treatment(P<0.05).The dry mouth,dry eyes,elevated liver enzymes,elevated blood lipids and depression were higher in the observation group than those in the control group(P<0.05).There were no significant differences in the incidence of pruritus between the two groups(P>0.05).Conclusion Low-dose isotretinoin can effectively treat refractory papulopular rosacea,improve patients'quality of life,reduce short-term recurrence rate and improve patient satisfaction,increase the incidence of treatment-related adverse events but with well-tolerated.