Dermatologic Therapy最新文献

Background

Rosacea is a chronic inflammatory skin disorder primarily affecting the face. While conventional treatments include drug interventions and light device interventions. However, their efficacy is often limited. New therapeutic approaches are therefore needed. In this study, we aimed to compare the efficacy and safety of broadband light (BBL) with photodynamic therapy (PDT) (BBL-PDT) and BBL therapy alone in treating rosacea.

Methods

This retrospective study included 52 patients with rosacea treated with either BBL therapy alone or BBL-PDT. Efficacy was assessed using Investigator’s Global Assessment (IGA) success, Clinical Erythema Assessment (CEA) success, telangiectasia improvement, lesion counts, and Rosacea Quality of Life (RosaQoL). Adverse reactions were also recorded.

Results

At the 12th week of treatment, IGA success was achieved in 26.92% patients in the BBL group and 69.23% in the BBL-PDT group (P = 0.002); CEA success rates were 61.54% (BBL) and 73.08% (BBL-PDT) (P = 0.38). Flushing improvement occurred in 65.38% (BBL) and 61.54% (BBL-PDT) (P = 0.77), whereas telangiectasia improvement occurred in 57.69% (BBL) and 61.54% (BBL-PDT) (P = 0.78). The BBL-PDT group showed significantly fewer lesions (P  <  0.001) and lower RosaQoL scores (P = 0.003). However, they reported higher levels of pain (P  <  0.0001) and more local adverse effects.

Conclusion

BBL-PDT is more effective than BBL alone in reducing inflammatory lesions and improving quality of life in rosacea.

Purpose

To investigate anatomical site-specific differences in the minimal erythema dose (MED) of 308-nm excimer laser therapy among Asian patients with vitiligo.

Methods

A retrospective analysis of MED data from 378 patients was conducted. Nonparametric tests were used to compare MED values across six anatomical sites and facial subregions, while Spearman correlation assessed influencing factors.

Results

MED values in lesional skin were significantly higher than in normal skin. Site-specific MED variations were observed, ranked from lowest to highest as follows: face, trunk, neck, scalp, extremities, and acral regions (hands/feet). Within facial subregions, periorbital and perioral mucosal areas exhibited 15%–25% lower MED values compared with other regions. Skin phototype, season, and age were independent predictors of MED (P < 0.05), whereas sex, family history, and lesion size showed no significant correlation.

Conclusion

MED values vary significantly across anatomical sites in Asian patients with vitiligo. Clinical phototherapy protocols should incorporate site-specific and skin type–adjusted dosing strategies, with particular attention to the lower MED thresholds of mucosal regions.

Background

Symmetrical drug-related intertriginous and flexural exanthema (SDRIFE) is a rare hypersensitivity reaction characterized by symmetric erythematous rashes in intertriginous regions, triggered by systemic drugs. Although self-limiting, SDRIFE can significantly impact quality of life, requiring accurate diagnosis and management.

Objectives

This study aimed to describe the clinical characteristics, diagnostic approaches, and implicated pharmacological agents in the largest reported SDRIFE series, providing insights to improve diagnosis and treatment.

Materials and Methods

A retrospective observational study was conducted between 2018 and 2024. Data on demographics, clinical features, implicated drugs, and diagnostic tests—including drug provocation tests (DPTs), lymphocyte transformation tests (LTTs), and intradermal tests—were analyzed.

Results

Among 41 patients, the mean age was 66.6 years, with frequent polypharmacy complicating diagnosis. Beta-lactam antibiotics and iodinated contrast agents were the most implicated drugs. Nine previously unreported drugs were identified as triggers. DPT confirmed causality in six cases, and LTT aided in three complex cases. Avoidance of the suspected drug or pharmacological group was the main therapeutic measure.

Conclusions

Systematic medication reviews and standardized protocols are crucial for SDRIFE diagnosis. DPT remains the gold standard, while LTT adds value in complex cases, avoiding unnecessary drug restrictions and expanding therapeutic options.

Background

While the importance of skin tension lines in planning excisions is well-documented, its importance in planning grafts is less investigated. This study investigates the effect of orienting grafts along with skin tension lines on quality of life.

Methods

Patients with basal cell carcinoma and treated with either no specific attention for orientation (Group 1, n = 40) or skin tension line–oriented grafting (Group 2, n = 31) were evaluated by Skin Cancer Quality of Life Impact Tool (SCQOLIT) and the Dermatology Quality of Life Index (DLQI) 3 months after surgery. Cosmetic outcome was evaluated by a visual analog scale (VAS).

Results

Seventy-one patients were included (34 males [47.9%] and 37 females [52.1%]; mean age 66.55 ± 9.43). The mean VAS score was 5.64 ± 0.94 for Group 1 and 6.13 ± 0.99 for Group 2. The mean DLQI score was 1 (0–22) for both groups, and the mean SCQOLIT scores were 10 (0–27) for Group 1 and 10 (0–32) for Group 2. While VAS scores significantly differed between groups (p < 0.05), no difference in quality of life was observed.

Conclusion

Tension line–oriented grafting yielded better cosmetic outcomes without demonstrating superiority in terms of quality of life.

Trial Registration: ClinicalTrials.gov identifier: NCT06894056.

Background

Syringoma has been known to recur following conventional treatments like cryotherapy and CO₂ laser. The risk of side effects, such as erythema, edema, scarring, and postinflammatory hyperpigmentation, results in unsatisfactory outcomes.

Objective

To evaluate the efficacy and safety of 1550-nm nonablative fractional laser for treating syringoma.

Methods

We retrospectively analyzed the medical records of syringoma patients who underwent 1550-nm fractional laser treatment. Two blinded dermatologists assessed the treatment efficacy of syringoma based on randomized clinical photographs before and after treatment, using the Periorbital Syringoma Severity Index (PSSI) score and a Global Improvement Scale. Additionally, the types and duration of any side effects occurring after the treatment were evaluated.

Results

A total of 8 patients underwent 22 sessions of 1550-nm fractional laser treatment, averaging 2.75 sessions per patient (median, 2 sessions; range, 1–6 sessions). The female-to-male ratio was 7 : 1, with 3 patients (37.5%) having prior experience with CO₂ laser. The pretreatment PSSI score improved from 4.00 to 2.88 after treatment (p = 0.03). Notably, 2 patients (25.0%) showed marked improvement, and 3 patients (37.5%) exhibited a moderate response. There was a strong correlation between the number of sessions and both the Global Improvement Scale (r = 0.783, p = 0.02) and PSSI score reduction (r = 0.619, p = 0.10). No scarring or dyspigmentation was observed postlaser treatment, and transient edema in 3 patients resolved on average after 13.7 days (median, 7 days).

Conclusion

Although this study is limited by its retrospective design and small sample size, its findings underscore the clinical efficacy of the 1550-nm nonablative fractional laser for the treatment of syringoma. Considering its nonablative nature and short downtime, the 1550-nm fractional laser is a safe and effective treatment alternative.

Background

Alopecia areata (AA) is a prevalent nonscarring hair loss disease affecting the scalp and body hair. However, previous studies have reported conflicting findings regarding its epidemiology. We aimed to quantify the global, regional, and country-specific estimates of AA epidemiology.

Methods

We conducted a comprehensive systematic review of published studies reporting on the incidence and prevalence of AA. We searched four electronic databases from January 1, 1992 to October 20, 2023: PubMed, Embase, Web of Science, and China National Knowledge Infrastructure. A Bayesian hierarchical linear mixed model was employed to determine the epidemiological estimates, accounting for variations in regions, diagnostic types, and age groups.

Results

73 studies met the inclusion criteria. The incidence varied across different geographical locations and age strata. The overall point prevalence and diagnosed population of AA were estimated at 1.93% (0.17%–5.91%) and 15.05 million people, respectively. The United Kingdom, Saudi Arabia, Iraq, and Egypt exhibited the highest prevalence. Globally, approximately 10.29 million adults and 4.76 million children had AA, with a prevalence of 1.98% (0.17%–6.07%) for adults and 1.83% (0.16%–5.58%) for children. Women were more likely to suffer from it. The global prevalence in females was 2.25% (0.20%–7.03%), affecting 8.69 million individuals, whereas for males, the estimates were 1.62% (0.14%–4.80%), impacting 6.36 million individuals. Variations in the epidemiological results might also stem from the chosen method of prevalence estimation.

Conclusion

Epidemiological data for AA were absent in 89.1% of countries globally. The epidemiology varied across gender and age groups and was unevenly distributed among geographical regions.