Ocular rosacea without facial erythema involvement manifesting as bilateral multiple recurrent chalazions:A case report

BACKGROUND In addition to the non-specific symptomatology of ocular rosacea,currently,there are no reliable diagnostic tests for the disease,which may lead to its misdiagnosis.Here,we report a case of ocular rosacea presenting with multiple recurrent chalazion on both eyelids.CASE SUMMARY A 63-year-old female patient presented with multiple chalazion and dry eyes in both eyes,with no facial erythema.Initial management done were application of steroid eye ointment on both eyelids,hot compresses,and eyelid margin cleaning;noting that there was no relief of symptoms.Surgical excision of the chalazion was done on both eyes,however,bilateral recurrence occurred post-operatively.The pathological studies showed infiltration of a small amount of fibrous tissue with many chronic inflammatory cells.Immunohistochemistry studies were positive for LL-37.Resolution of the chalazion occurred after oral administration of doxycycline and azithromycin.CONCLUSION Our findings show that ophthalmologists should recognize the ocular manifestations of skin diseases.

Five-blade scratcher for treating severe rhinophyma:A retrospective study

BACKGROUND Rhinophyma,a late-stage subtype of rosacea,is characterized by excessive sebaceous glands and connective tissue proliferation.Patients may experience respiratory disturbances and psychological distress that significantly affect their quality of life when excessive nasal hyperplasia obstructs the external nasal valves.Surgery is the treatment of choice for rhinophyma.However,excessive bleeding,scarring,pigmentation,and high recurrence rates frequently characterize current surgical methods.AIM To evaluate the clinical effectiveness and recurrence rates after treating severe rhinophyma with the five-blade scratcher.METHODS This study retrospectively analyzed the clinical records of 28 patients with severe rhinophyma rosacea.The Global Flushing Severity Score(GFSS),Clinician Erythema Assessment(CEA),Rhinophyma Severity Index(RHISI),Glasgow Benefit Inventory(GBI),and satisfaction scores were used to assess the recovery of patients at 6 months and 5 years,with the recurrence rate calculated at 5 years postoperatively.In addition,the levels of pro-inflammatory factors(TNF-α,IL-1β,and IL-6)in the serum of patients before and after surgery were detected by ELISA.RESULTS The GFSS,CEA,and RHISI scores at 6 months and 5 years postoperatively were significantly lower than those preoperatively(P<0.001 for both periods).Five-blade scratcher treatment greatly benefits patients as demonstrated by the GBI and patient satisfaction.A small number of patients(7/28,25%)reported recurrence after surgical treatment for rhinophyma in our department that was not more serious than before treatment.The expression of pro-inflammatory factors(TNF-α,IL-1β,and IL-6)in the patient's serum was significantly reduced after surgery of five-blade scratcher.CONCLUSION The five-blade scratcher treatment demonstrates notable advantages,including simplicity,safety,efficacy,and cost-effectiveness,coupled with reduced bleeding,minimized scarring,lower recurrence rates,reduced the level of pro-inflammatory factors and improved patient satisfaction.Consequently,this therapeutic modality exhibits a viable option for individuals afflicted with severe rhinophyma.

Comparative and Phylogenetic Analysis of the Complete Chloroplast Genomes of 19 Species in Rosaceae Family

Rosaceae represents a vast and complex group of species,with its classification being intricate and contentious.The taxonomic placement of many species within this family has been a subject of ongoing debate.The study utilized the Illumina platform to sequence 19 plant species from 10 genera in the Rosaceae.The cp genomes,vary-ing in size from 153,366 to 159,895 bp,followed the typical quadripartite organization consisting of a large single-copy(LSC)region(84,545 to 87,883 bp),a small single-copy(SSC)region(18,174 to 19,259 bp),and a pair of inverted repeat(IR)regions(25,310 to 26,396 bp).These genomes contained 132–138 annotated genes,including 87 to 93 protein-coding genes(PCGs),37 tRNA genes,and 8 rRNA genes using MISA software,52 to 121 simple sequence repeat(SSR)loci were identified.D.arbuscular contained the least of SSRs and did not have hexanotides,A.lineata contained the richest SSRs.Long terminal repeats(LTRs)were primarily composed of palindromic and forward repeat sequences,meanwhile,The richest LTRs were found in Argentina lineata.Except for Argentina lineata,Fragariastrum eriocarpum,and Prunus trichostoma,which varied in gene type and position on both sides of the boundary,the remaining species were found to be mostly conserved according to IR boundary analysis.The examination of the Ka/Ks ratio revealed that only the infA gene had a value greater than 1,indicating that this gene was primarily subjected to positive selection during evolution.Additionally,9 hotspots of variation were identified in the LSC and SSC regions.Phylogenetic analysis confirmed the scientific validity of the genus Prunus L.sensu lato(s.l.)within the Rosaceae family.The separation of the three genera Argentina Hill,Fragariastrum Heist.ex Fabr.and Dasiphora Raf.from Potentilla L.may be a more scientific classification.These results offer fresh perspectives on the taxonomy of the Rosaceae.

Comparative genomic analysis of N6-methyladenosine regulators in nine rosaceae species and functional characterization in response to drought stress in pear

N 6-methylated adenine(m6 A)is an emerging epigenetic marker in eukaryotic organisms that plays an important role in biological functions and in enriching genetic information.m6 A exerts these functions via the dynamic interplay among m6 A writers,erasers,and readers.However,little is known about the underlying mechanisms of m6 A in plant growth and stress responses.Here,we identified 276 masked m6 A regulators from nine Rosaceae species(Pyrus bretschneideri,Pyrus betulifolia,Pyrus communis,Malus domestica,Fragaria vesca,Prunus avium,Prunus mume,Prunus persica,and Rubus occidentalis).We classified and named these genes in more detail based on phylogenetic and synteny analysis.The expansion of m6 A regulators in Maloideae was dated back to the recent whole-genome duplication(WGD)in Rosaceae.Based on the expression pattern analysis and gene structure analysis of m6 A regulators,m6 A was shown to be a significant factor in regulating plant development and resistance.In addition,PbrMTA1-silenced pear plants displayed significantly reduced drought tolerance and chlorophyll content,as well as increased electrolyte leakage and concentrations of malondialdehyde and H2 O2.

Genome-wide identification and characterization of the IPT family members in nine Rosaceae species and a functional analysis of MdIPT5b in cold resistance

Cytokinins are members of a group of phytohormones involved in various growth and developmental processes in plants.Isopentenyl transferase(IPT)is the rate-limiting enzyme in catalyzing the biosynthesis of cytokinins.In this study,to understand the role of IPT family in cold resistance,78 IPT candidates were identified and characterized in nine Rosaceae genomes.The expansion of IPT families in the Rosaceae primarily occurred through segmental duplication rather than tandem duplication.In general,purifying selection controlled the evolution of IPT families in the Rosaceae,with IPT3 and IPT5 homologs as the primary drivers of evolution.Cis-elements,which are involved in the responses to many environmental stresses or phytohormone signals,were identified in the promoters of MdIPT members.This was consistent with the trends of expression of the MdIPT genes in apple(Malus domestica)calli.MdIPT5b was also found to exhibit multiple responses to phytohormones and stress signals.The ectopic expression of MdIPT5b resulted in an increase in cold resistance in transformed apple calli and tomato(Solanum lycopersicum)plantlets.The redox balance was partially stabilized through the accumulation of proline under cold stress.However,the ascorbate–glutathione cycle cannot be stabilized in the cold.All physiological and biochemical assays are preformed in spectrophotometer.These results showed that regulating the expression of IPT genes for moderate cytokinin improvement could enhance the accumulation of proline to stabilize the osmotic and redox balances to improve resistance to cold stress.

New record of Lobophora rosacea(Dictyotales; Phaeophyceae) from the South China Sea

Lobophora rosacea C.W. Vieira, Payri et De Clerck is reported from the South China Sea for the first time. Our specimens are very similar to L. rosacea recently described from New Caledonia, not only in morphology but also in rbcL and cox3 gene sequences. The fan-shaped thallus grows erectly, attaching to the substrate by a basal holdfast. The thallus is composed of a single layer of large medullary cells and three to four layers of cortical cells on both sides of the medulla. Mature sporophytes are detected, with sporangium sori scattered on both surfaces of the thallus.

Squamous Cell Carcinoma Clinically Mimicking a Rhinophyma in a Black Male

The clinical features of rhinophyma can mask the existence or coexistence of a skin cancer. Many tumours can mimic rhinophyma. Many authors report cases of cancerisation of rhinophyma or the coexistence of rhinophyma and a cancer. Few authors have however reported cases of squamous cell carcinoma mimicking rhinophyma. We present the clinical case of a 48 year-old male with squamous cell carcinoma of the nose (tip of the nasal pyramid and vestibule), a histologic diagnosis after being confronted by an atypical clinical presentation of rhinophyma. Treatment consisted of radiation therapy and evolution was characterised by tumoral regression.

Dupilumab Injection in the Management of Steroid-Induced Rosacea: A New Case Report

Background: Topical corticosteroids (TCS) are used frequently for various inflammatory skin conditions. The prolonged daily and inappropriate use of TCS may cause adverse effects such as erythema, atrophy, and telangiectasia. Steroid rosacea or addiction is a distinct adverse effect of inappropriate use of TCS. It occurs most commonly in adult women applying mid- or high-potency TCS to the face. Dupilumab is an interleukin 4 (IL-4) receptor α-antagonist approved for treatment Moderate-to-Severe Atopic Dermatitis in childhoods and adults. The role of dupilumab injection in steroid-induced rosacea management is rarely discussed. Aim: To document a new case presentation of atopic dermatitis on high potency topical facial steroid addiction for a duration of 4 years in a young female patient who was successful treated with dupilumab injection and withdrawal therapy. Case Report: A 32-year-old female patient with a history of atopic dermatitis presented with a history of worsening pruritic facial rashes for a one-month duration and on high potency TCS (Clobetasol Propionate ointment 0.05%) since 4 years ago with multiple treatments failure of steroidal withdrawal treated successfully in combination with dupilumab injection. Conclusion: Dupilumab injection considers effective and inducing rapid resolution of signs and symptoms of steroid-induced rosacea in patients with a history of atopic dermatitis in combination with withdrawal therapy without a rebound effect.

Treatment of ocular rosacea: comparative study of topical cyclosporine and oral doxycycline

AIM: To compare the effectiveness of topical cyclosporine A emulsion with that of oral doxycycline for rosacea associated ocular changes and dry eye complaints.METHODS: One hundred and ten patients with rosacea were screened. Thirty-eight patients having rosacea associated eyelid and ocular surface changes and dry eye complaints were included in the study. Patients were randomly divided into two groups: nineteen patients were given topical cyclosporine twice daily and nineteen patients were given oral doxycycline 100 mg twice daily for the first month and once daily for the following two months. Symptom and sign scores, ocular surface disease index questionnarie and tear function tests were evaluated at baseline and monthly for 3mo. Three months after results were compared with that of baseline.RESULTS: Mean values of symptom, eyelid sign and corneal/conjunctival sign scores of each treatment group at baseline and 3mo after treatments were compared and both drugs were found to be effective on rosacea associated ocular changes(P 【0.001). Cyclosporine was more effective in symptomatic relief and in the treatment of eyelid signs(P =0.01). There was statistically significant increase in the mean Schirmer score with anesthesia and tear break up time scores in the cyclosporine treatment group compared to the doxycycline treatment group(P 【0.05).CONCLUSION: Cyclosporine as a topical drug can be used in the treatment of rosacea associated ocular complications because it is more effective than doxycycline. In addition ocular rosacea as a chronic disease requires long term treatment and doxycycline has various side effects limiting its long term usage.

Evolution of the R2R3-MYB gene family in six Rosaceae species and expression in woodland strawberry

R2R3-MYB gene family play important roles in plants development, metabolism, and responses to various biotic and abiotic stresses. In this study, 838 R2 R3-MYB genes were identified from six Rosaceae species, including 105 in woodland strawberry(Fragaria vesca), 173 in European pear(Pyrus communis), 219 in apple(Malus domestica), 121 in peach(Prunus persica), 121 in Chinese rose(Rosa chinensis), and 99 in black raspberry(Rubus occidentalis). All R2 R3-MYB genes in the six Rosaceae species were clustered into 51 species-specific duplicated clades with 109 genes and 50 lineage-specific duplicated clades with 242 genes according to phylogenetic analysis. R2 R3-MYB genes were distributed on all chromosomes in each of the six species, with a small amount of tandem duplication events. The proportion of tandem repeat genes ranged from 0 to 25.1%. The R2 R3-MYB protein was conserved in a clade and likely to share similar functions. The distribution of Ks showed the duplication times of R2 R3-MYB genes in six Rosaceae species. Furthermore, most of the R2 R3-MYB genes had Ka/Ks values less than 1, which indicated they were driven by purifying selection during the evolutionary processes. The GO term enrichment analysis revealed that R2 R3-MYB genes in strawberry and black raspberry were more divergent than in other Rosaceae species. Analysis of transcriptomes of 42 different tissues and development stages of woodland strawberry showed that high expression levels of R2 R3-MYB suggested that the R2 R3-MYB genes in strawberry played a key role in growth and development of both vegetative tissues and fruits. The strawberry R2 R3-MYB genes in sub-group of S1, S2, S11, S20, and S22 had high expression levels both in young leaves(YL) and old leaves(OL) strawberry tissues under drought treatments.

Genome-wide identification and evolutionary analysis of MLO gene family in Rosaceae plants

Mutants lacking wild-type MLO(Mildew resistance Locus O)proteins show broad-spectrum resistance to the powdery mildew fungus,and dysregulated cell death control,with spontaneous cell death in response to developmental or abiotic stimuli.In order to understand the evolution and divergence patterns of the MLO gene family in Rosaceae plants,we analysed systematically genome-wide data from Fragaria vesca,Prunus persica,Prunus mume,Malus domestica,Pyrus bretschneideri and Rubus occidentalis based on bioinformatics methods.Using three phylogenetic methods(the neighbour-joining,maximum likelihood,and Bayesian methods),we identified 117 MLO genes from 6 Rosaceae species.The results of all three phylogenetic analysis methods supported that these genes were divided into six clades.Conserved motif analysis found that only motif 2 was present in all MLO proteins and had 3 nearly invariant amino acid residues.The findings indicated that motif 2 might be shared by the MLO gene family.The structural features of these genes showed large variations in sequence length among different species,although the lengths and the numbers of exons exhibited high degrees of similarity.Selective pressure analysis showed extremely significant differences in all 6 clades,with 2,1,and 1 site(s)under significant positive selection detected in clades III,IV,and VI,respectively.These positive selection sites were important driving forces for the promotion of the functional differentiation of the MLO genes.Functional divergence analysis showed that the significantly divergent sites were located within the domains of the MLO genes.Functional distance analysis showed that the clade V had more conservative functions and might have retained more original functions during the evolutionary process.However,clade I may have undergone extensive altered functional constraints as a specialised functional role.Moreover,the most original function of the MLO genes in Rosaceae could be related to the evolution of their resistance to powdery mildew,which then gradually evolved into functions such as the regulation of flower development,the control of root morphology,and seed evolution due to the different evolutionary rates after gene duplication.These results provide a theoretical basis for further studies of the molecular evolutionary patterns of the plant MLO gene family.

The Gillenia trifoliata genome reveals dynamics correlated with growth and reproduction in Rosaceae

The Rosaceae family has striking phenotypic diversity and high syntenic conservation.Gillenia trifoliata is sister species to the Maleae tribe of apple and~1000 other species.Gillenia has many putative ancestral features,such as herb/sub-shrub habit,dry fruit-bearing and nine base chromosomes.This coalescence of ancestral characters in a phylogenetically important species,positions Gillenia as a‘rosetta stone'for translational science within Rosaceae.We present genomic and phenological resources to facilitate the use of Gillenia for this purpose.The Gillenia genome is the fi rst fully annotated chromosome-level assembly with an ancestral genome complement(x=9),and with it we developed an improved model of the Rosaceae ancestral genome.MADS and NAC gene family analyses revealed genome dynamics correlated with growth and reproduction and we demonstrate how Gillenia can be a negative control for studying fl eshy fruit development in Rosaceae.

Novel intense pulsed light-photodynamic therapy strategy in the treatment of facial actinic keratoses concomitant with rosacea

Rosacea presents as transient or persistent erythema,papules,pustules,fAushing,and telangi-ectasia on the middle of the face,which has some clinical similarity with act inic keratosis(AK).These two conditions can coexist in the same patient.Dermoscopy and reflect ance confocal microscopy(RCM)could be useful methods for diagnosis and monitoring treatment efficacy.Novel intense pulsed light-photodynamic therapy(IPL-PDT)may have better tolerance and curative effect than traditional red-light 5-aminolevulinic acid photodynamic therapy(ALA-PDT).Herein,we present a case of facial AKs concomitant with rosacea where combination therapy of novel IPL-PDT and oral minocycline was effective in that AK lesions were eliminated and the patient's facial erythema and telangiectasia were significantly improved.

Therapeutic Evaluation of 2% Tea Lotion in Comparison with 5% Zinc Sulfate Solution in the Treatment of Acne Rosacea

Background: There are many effective topical and systemic therapies for acne rosacea. Topical zinc sulfate and tea lotion have been used in treatment of acne vulgaris. Objectives: To evaluate effectiveness of 2% tea lotion in comparison with 5% zinc sulfate solution in the treatment of acne rosacea. Patients and Methods: This single, blinded, comparative therapeutic clinical trial was carried out in the Department of Dermatology—Baghdad Teaching Hospital from June 2006-December 2007. Twenty two patients with acne rosacea were divided into two groups and were instructed to apply the following lotions for two months, Group A used 2% tea lotion twice daily while Group B used 5% zinc sulfate solution twice daily. Patient with severe acne rosacea were excluded from the study. Clinical improvement was evaluated every 2 weeks by determination of the disease severity score (Sharquie’s score) before and after treatment. Results: Eighteen patients with acne rosacea completed the study with their ages ranging from 26 - 70 (40.5 ± 10.9) years. For Group A and Group B were 39.7 ± 8.2, 41.2 ± 13.1 years respectively, with eight patients in Group A, ten patients in Group B. Five percent zinc sulfate solution was statistically significant in reducing the disease severity score in acne rosacea, while 2% tea lotion was beneficial but did not reach statistically significant level as zinc sulfate solution. Conclusion: Five percent zinc sulfate solution was a good alternative remedy to be used in patients with acnerosacea.

Pilot Study into Super-Fractionation Treatment Strategy of Acne and Rosacea

It is evident that matrix metalloproteinases (MMPs) are involved in the pathophysiology of different inflammatory skin diseases. In this pilot study, we investigated the ability of very high frequency ultrasound—frequencies of approximately 10 MHz—to modulate the activity of MMPs in the skin in inflammatory skin diseases such as acne and rosacea. It was shown that such waves can significantly improve the skin appearance in these diseases;however, the results are dependent on applied treatment schedule. The best results were obtained through the application of a super-fractionation strategy in the form of home treatments carried out twice daily.

Pediatric ocular rosacea, a misdiagnosed disease with high morbidity:Proposed diagnostic criteria

Ocular rosacea is an important and underdiagnosed chronic inflammatory disorder observed in children. A clinical spectrum ranging from chronic eyelid inflammation, recurrent ocular redness, photophobia and/or hordeola/chalazions and conjunctival/corneal phlyctenules evolving to neovascularization and scarring may occur. Visual impairment and consequent amblyopia are frequent and corneal perforation although rare is the most feared complication. Ocular manifestations usually precede cutaneous lesions. Although few cases of pediatric ocular rosacea(POR) have been reported in the literature, many cases must have been underdiagnosed or misdiagnosed. The delay in diagnosis is greater than one year in the large majority of cases and may lead to serious ocular sequelae. This review aims to highlight the clinical features of POR, its epidemiology, easy diagnosis and effective treatment. We also propose new diagnostic criteria, in which at least three of the five clinical criteria must be present:(1) Chronic or recurrent keratoconjunctivitis and/or red eye and/or photophobia;(2) Chronic or recurrent blepharitis and/or chalazia/hordeola;(3) Eyelid telangiectasia documented by an ophthalmologist;(4) Primary periorificial dermatitis and/or primary features of rosacea; and (5) Positive familial history of cutaneous and/or ocular rosacea.

Molecular phylogeny and inflorescence evolution of Prunus(Rosaceae)based on RAD-seq and genome skimming analyses

Prunus is an economically important genus widely distributed in the temperate Northern Hemisphere.Previous studies on the genus using a variety of loci yielded conflicting phylogenetic hypotheses.Here,we generated nuclear reduced representation sequencing data and plastid genomes for 36 Prunus individuals and two outgroups.Both nuclear and plastome data recovered a well-resolved phylogeny.The species were divided into three main clades corresponding to their inflorescence types,-the racemose group,the solitary-flower group and the corymbose group-with the latter two sister to one another.Prunus was inferred to have diversified initially in the Late Cretaceous around 67.32 million years ago.The diversification of the three major clades began between the Paleocene and Miocene,suggesting that paleoclimatic events were an important driving force for Prunus diversification.Ancestral state reconstructions revealed that the most recent common ancestor of Prunus had racemose inflorescences,and the solitary-flower and corymb inflorescence types were derived by reduction of flower number and suppression of the rachis,respectively.We also tested the hybrid origin hypothesis of the racemose group proposed in previous studies.Prunus has undergone extensive hybridization events,although it is difficult to identify conclusively specific instances of hybridization when using SNP data,especially deep in the phylogeny.Our study provides well-resolved nuclear and plastid phylogenies of Prunus,reveals substantial cytonuclear discord at shallow scales,and sheds new light on inflorescence evolution in this economically important lineage.

硫酸羟氯喹联合甲硝唑凝胶治疗玫瑰痤疮的疗效观察

目的:探讨硫酸羟氯喹联合甲硝唑凝胶治疗玫瑰痤疮的美学效果及疗效和安全性。方法:选取2020年12月-2022年12月湖南省中医药研究院附属医院收治的84例玫瑰痤疮患者,按随机数表法分为观察组(硫酸羟氯喹联合甲硝唑凝胶治疗,n=42)和对照组(甲硝唑凝胶治疗,n=42)。比较两组患者的治疗效果、不良反应,比较两组患者治疗前后的临床症状评分、痤疮特异性生活质量量表(Acne-specific quality of life scale,Acne-QOL)评分及白细胞介素-6(Interleukin-6,IL-6)、C反应蛋白(C-reactive protein,CRP)、肿瘤坏死因子-α(Tumo rnecrosis factor-α,TNF-α)水平。结果:观察组总有效率为95.24%,显著高于对照组的80.95%(P<0.05);治疗后两组各项临床症状评分显著低于治疗前,观察组低于对照组(P<0.05);治疗后两组Acne-QOL各项评分显著高于治疗前,观察组高于对照组(P<0.05);治疗后两组IL-6、CRP、TNF-α显著低于治疗前,观察组低于对照组(P<0.05);观察组和对照组的不良反应总发生率分别为9.52%、7.14%,差异无统计学意义(P>0.05)。结论:硫酸羟氯喹联合甲硝唑凝胶治疗玫瑰痤疮安全有效,可有效改善患者的临床症状,提高患者的面部美学效果及生活质量。

93例女性玫瑰痤疮患者化妆品斑贴试验结果分析

目的:检测女性玫瑰痤疮患者化妆品接触性过敏原情况。方法:对2018年1月—2021年12月在我院皮肤科就诊的93例女性玫瑰痤疮患者进行化妆品变应原斑贴试验。结果:93例患者中有68例(73.12%)呈阳性反应,其中阳性率排前4位的变应原种类分别是金属盐类(41例)、表面活性剂类(37例)、防腐剂类(30例)和芳香剂类(24例),阳性率排前9位的具体变应原成分分别是氯化镍(36例)、氯化钴(23例)、十二烷基硫酸钠(16例)、戊基肉桂醇(14例)、烷基醇聚氧乙烯醚(12例)、硫酸镍(12例)、硫柳汞(11例)、硫酸钠(11例)和橡苔浸膏(10例)。结论:化妆品接触性过敏原可能与玫瑰痤疮的发病和复发有关,金属盐类、表面活性剂类、防腐剂类和芳香剂类是最常见的化妆品变应原种类。

羟氯喹治疗玫瑰痤疮的疗效和安全性系统评价

目的:系统评价羟氯喹(Hydroxychloroquine,HCQ)治疗玫瑰痤疮的有效性与安全性。方法:计算机检索Pub Med,The Cochrane Library,Embase,CNKI,万方数据库,筛选HCQ治疗玫瑰痤疮的随机对照试验(Randomized controlled trials,RCTs),使用Cochrane RevMan5.4进行数据分析。结果:纳入18项研究,共1397例患者。与四环素类药物比较,HCQ治疗有效率[OR=0.94,95%CI(0.74,1.19),P=0.60]差异无统计学意义。HCQ的治疗有效率低于HCQ联合激光光疗组、联合外用药组、联合中医药组以及联合四环素组[RR=0.68,95%CI(0.57,0.80),P<0.01;RR=0.70,95%CI(0.57,0.86),P<0.01;RR=0.70,95%CI(0.54,0.90),P<0.01;RR=0.73,95%CI(0.62,0.85),P<0.01]。单用HCQ的治疗后疗效低于激光单独治疗组,HCQ联合四环素组,联合激光光疗组以及联合外用药组,差异有统计学意义[MD=1.50,95%CI(1.04,1.96),P<0.01;MD=2.59,95%CI(2.24,2.94),P<0.01;MD=0.63,95%CI(0.27,0.99),P<0.01;MD=0.84,95%CI(0.65,1.02),P<0.01]。HCQ联合激光、外用皮肤修复剂在红斑、毛细血管扩张的缓解上有更好的疗效[MD=1.70,95%CI(0.06,3.34),P<0.05;MD=0.47,95%CI(0.37,0.56),P<0.01;MD=0.39,95%CI(0.15,0.63),P<0.01];HCQ联合激光治疗对瘙痒的缓解也有较好的疗效MD=0.75,95%CI(0.42,1.07),P<0.01,但是对丘疹脓疱的治疗并不优于HCQ组[MD=-1.20,95%CI(-4.19,1.79),P=0.43]。单独治疗与联合治疗间的不良反应差异无统计学意义[RR=1.25,95%CI(0.94,1.66),P=0.12]。结论:HCQ是否比四环素更有效还有待确定,但HCQ联合四环素、激光光疗、中医药、外用修复剂及血管收缩剂治疗玫瑰痤疮更有效,且不良反应并未增加。