1%吡美莫司联合复方黄柏液治疗面部糖皮质激素依赖性皮炎疗效观察

目的观察1%吡美莫司联合复方黄柏液治疗面部糖皮质激素依赖性皮炎的疗效。方法 60例患者随机分为两组,治疗组30例,予1%吡美莫司乳膏外涂,外用复方黄柏液湿敷,均2次/d;对照组30例,予维生素B6软膏外涂,外用3%硼酸溶液湿敷,均2次/d。两组均4周为1个疗程。结果治疗组有效率为86.67%,对照组为16.67%,两组比较差异有统计学意义(P<0.005)。以红斑、丘疹、干燥、脱屑为主要表现的患者反应良好,治疗后皮损积分下降明显(P<0.001);以脓疱、色素沉着、毛细血管扩张和皮肤萎缩为主要表现的患者反应较差;3例患者出现局部刺激反应,均在治疗后第1d。结论 1%吡美莫司联合复方黄柏液治疗面部糖皮质激素依赖性皮炎疗效满意。     

1%吡美莫司乳膏治疗面部激素依赖性皮炎疗效观察

目的观察1%吡美莫司乳膏治疗面部激素依赖性皮炎的临床疗效和安全性。方法采用随机、自身对照、开放式的临床试验设计。48例面部激素依赖性皮炎患者,1%吡美莫司乳膏2次/d外涂靶皮损,观察皮损和自觉症状变化并与治疗前对比。结果治疗6周后,48例患者有效率为100%。8例患者出现刺痛和烧灼感,未中断治疗,总体耐受性好,无特殊不良反应。结论 1%吡美莫司乳膏治疗面部激素依赖性皮炎,疗效明显,不良反应少,患者依从性高。     

1%吡美莫司乳膏联合皮肤屏障修复乳治疗面部激素依赖性皮炎70例疗效观察

目的评价1%吡美莫司乳膏联合皮肤屏障修复乳治疗面部激素依赖性皮炎的临床疗效和安全性。方法将入选的140例面部激素依赖性皮炎患者,按随机数字表法分成两组。治疗组70例予以1%吡美莫司乳膏联合皮肤屏障修复乳治疗;对照组70例仅予1%吡美莫司乳膏治疗。比较两组治疗前和治疗4周时总有效率、症状体征总积分、生活质量评分及不良反应。结果治疗4周后,治疗组总有效率为85.71%,高于对照组的60.00%;治疗组客观体征积分、主观症状积分、症状体征总积分、生活质量评分均低于对照组,差异有统计学意义(P0.05)。两组均没有明显的不良反应。8周随访时,治疗组7例复发,对照组13例复发,差异有统计学意义(P0.05)。结论 1%吡美莫司乳膏联合皮肤屏障修复乳治疗面部激素依赖性皮炎安全有效。     

1%吡美莫司乳膏治疗196例糖皮质激素依赖性皮炎临床分析

目的:分析196例糖皮质激素依赖性皮炎(简称激素依赖性皮炎)患者病因及1%吡美莫司乳膏的疗效。方法:采用问卷调查表的形式记录激素依赖性皮炎患者的临床资料,将符合入选条件的患者随机分为治疗组和对照组,治疗组给予1%吡美莫司乳膏外涂,每日2次,同时给予氯雷他定(开瑞坦)10 mg,每日1次口服;对照组仅给予开瑞坦10 mg,每日1次口服,观察其疗效和不良反应。结果:196例激素依赖性皮炎患者中,男女比为1:4.43,临床分型以面部中央型最为常见(52.55%),在外用的糖皮质激素中,以复方醋酸地塞米松乳膏(皮炎平)最多(39.29%)且多数为患者自行购买。治疗4周后,治疗组有效率(86.21%)高于对照组(25.00%),差异有统计学意义(X~2=5.388,P0.01)。结论:激素依赖性皮炎主要是由于患者缺乏对糖皮质激素制剂正确使用的知识,导致滥用或误用外用糖皮质激素制剂所致。1%吡美莫司乳膏治疗激素依赖性皮炎安全有效。     

吡美莫司乳膏治疗面部激素依赖性皮炎临床观察

目的观察吡美莫司乳膏治疗面部激素依赖性皮炎的疗效和安全性。方法将69例面部激素依赖皮炎患者随机分为两组,治疗组36例,对照组33例。两组同时口服抗组胺药4周,同时治疗组外用吡美莫司乳膏,对照组外用赋形剂。于治疗1周、4周时观察主观症状和客观体征疗效并记录不良反应。结果治疗组和对照组主观症状1,4周愈显率分别为76.47%和46.88%,91.88%和65.62%,客观症状1,4周愈显率分别为32.35%和9.38%,52.94%和25.00%,差异均具有统计学意义(P均<0.05)。结论吡美莫司乳膏治疗面部激素依赖性皮炎安全有效,且其对主观症状的改善优于对客观体征的改善。     

吡美莫司乳膏联合红光治疗面部激素依赖性皮炎临床疗效观察

目的观察吡美莫司乳膏联合红光照射对改善女性面部激素依赖性皮炎的疗效。方法 40例女性面部激素依赖性皮炎患者随机分成两组,对照组20例单用吡美莫司乳膏治疗,试验组20例接受吡美莫司乳膏联合红光治疗,均治疗4周。结果受试者自评量表提示,试验组满意度较高(P0.05);医务人员评估治疗后面部皮损情况表明,试验组受试者面部症状减轻(P0.05);试验组复发率较对照组低。结论吡美莫司乳膏联合红光照射可以加速女性面部激素依赖性皮炎的痊愈进程。     

吡美莫司乳膏联合红光治疗面部激素依赖性皮炎的疗效分析

目的观察面部激素依赖性皮炎应用吡美莫司乳膏与红光联合疗法的效果。方法选择2016年2月～2017年12月皮肤科门诊接诊的面部激素依赖性皮炎病患48例,按照电脑随机双盲法分成两组:观察组24例予以吡美莫司乳膏联合红光照射治疗,对照组24例予以单纯吡美莫司乳膏治疗。分析比较两组的治疗效果。结果观察组的临床总有效率为100.0%,明显比对照组的83.33%高,组间差异显著(P 0.05)。观察组随访4周的复发率为4.17%,明显比对照组的20.83%低,组间差异显著(P0.05)。结论吡美莫司乳膏联合红光照射疗法对面部激素依赖性皮炎病患进行施治,可显著提升治疗效果,降低复发率,值得推广和使用。     

1％吡美莫司乳膏治疗40例面部脂溢性皮炎临床疗效观察

目的：观察1%吡美莫司乳膏治疗面部脂溢性皮炎的疗效.方法：80例面部脂溢性皮炎患者随机分成治疗组和对照组.治疗组予1%吡美莫司乳膏外用,对照组予5%氟芬那酸丁酯软膏外用,均每日2次,连续4周.结果：治疗组的总有效率为 90%,对照组的总有效率为67.5%,两组差异有统计学意义（P〈0.05）.结论：1%吡美莫司乳膏治疗面部脂溢性皮炎疗效好,副作用少.     

吡美莫司联合胶原贴、薇诺娜舒敏保湿系列治疗激素依赖性皮炎疗效观察

目的 观察吡美莫司软膏联合胶原贴、薇诺娜舒敏保湿系列治疗面部激素依赖性皮炎的疗效和安全性.方法 将104例面部激素依赖性皮炎患者随机分成两组,治疗组54例,对照组50例.治疗组:外用吡美莫司软膏,早晚1次,同时给予胶原贴敷料每晚1次,连用2周后改为隔日1次,2周后加用薇诺娜舒敏保湿系列并长期使用.对照组:外用吡美莫司软膏,早晚1次.治疗组和对照组于治疗2周、治疗4周、治疗结束后2周分别观察患者的自觉症状、皮损情况及不良反应.结果 治疗4周治疗组有效率为94.4％,对照组有效率为56.0％,临床疗效比较差异有统计学意义；随访治疗结束2周后,治疗组有6例(11.1％)复发,对照组有27例复发(54.0％),两组比较差异有统计学意义(P＜0.05),两组均未见明显不良反应.结论 吡美莫司软膏联合胶原贴、薇诺娜舒敏保湿系列治疗面部激素依赖性皮炎优于单用吡美莫司软膏,并且起效快,停用后复发率低.     

马齿苋提取液冷喷联合吡美莫司乳膏治疗激素依赖性皮炎效果观察

目的探讨用马齿苋提取液冷喷联合吡美莫司乳膏治疗激素依赖性皮炎的效果。方法将98例面部糖皮质激素依赖性皮炎患者随机分为两组各49例。对照组予蒸馏水冷喷联合吡美莫司乳膏治疗,治疗组给予马齿苋提取液冷喷联合吡美莫司乳膏治疗,观察治疗前、后的各项指标。结果治疗组的治疗有效率高于对照组(P 0.05);治疗后两组患者皮肤红斑、经皮水分丢失均明显减少,以治疗组的改善更为明显(P 0.05);两组患者血清中IL-18、IL-37、IFN-γ水平均明显减少,以治疗组的改善更为明显(P0.05)。结论马齿苋提取液冷喷治疗激素依赖性皮炎疗效肯定,利于减少皮肤红斑量,防止肌肤水分流失。     

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

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。     

Pimecrolimus cream 1% vs. betamethasone 17-valerate 0.1% cream in the treatment of seborrhoeic dermatitis. A randomized open-label clinical trial

BACKGROUND: Seborrhoeic dermatitis is a chronic inflammatory disease with remissions and exacerbations, characterized by erythema, scaling and pruritus primarily on the face, scalp and chest. Corticosteroids and antifungals are the mainstay of therapy. However, chronic use of corticosteroids is associated with side-effects such as skin atrophy and telangiectasia. Pimecrolimus, an inhibitor of calcineurin, has been used successfully in one patient with seborrhoeic dermatitis. OBJECTIVES: The objective of this randomized open-label clinical trial was to compare the efficacy and tolerability of pimecrolimus in comparison with a potent corticosteroid (betamethasone 17-valerate) in the treatment of seborrhoeic dermatitis. METHODS: Twenty patients with seborrhoeic dermatitis were included in this study, 11 patients in the pimecrolimus 1% cream group and nine patients in the betamethasone 17-valerate 0.1% cream group. Patients were instructed to use a thin layer of the study products twice daily at the lesional area and to discontinue treatment as soon as symptoms were absent. Clinical measures assessed were erythema, scaling and pruritus which were evaluated using a four-point scale (0-3). RESULTS: Both pimecrolimus and betamethasone were highly effective in the treatment of seborrhoeic dermatitis. Betamethasone reduced all three parameters, erythema, scaling and pruritus, faster than pimecrolimus, but the differences in reduction were not statistically significant. Relapses were observed more frequently and were more severe with betamethasone than with pimecrolimus. Moreover, pruritus was not observed after discontinuation of treatment from day 15 and beyond in the pimecrolimus group, whereas it was reported in most patients of the betamethasone group. This difference was statistically significant. CONCLUSIONS: It appears that pimecrolimus, a nonsteroidal topical treatment, may be an excellent alternative therapeutic modality for treating seborrhoeic dermatitis.     

Efficacy of topical calcineurin inhibitors in vitiligo

Topical tacrolimus and pimecrolimus are indicated for the treatment of atopic dermatitis, but they have been studied in many off‐label uses. We reviewed the English language literature to define their roles in treatment of vitiligo. Double‐blind studies show that tacrolimus 0.1% ointment combined with excimer laser is superior to placebo, especially for UV resistant areas, such as bony prominences of the extremities. When used alone, tacrolimus 0.1% ointment is almost as effective as clobetasol propionate 0.05% ointment. Other studies suggest it can also be effective for facial lesions. Double blind studies show that pimecrolimus 1% cream combined with narrow band UVB is superior to placebo, especially for facial lesions. Additional studies would further clarify the role of topical calcineurin inhibitors in vitiligo.     

近红外光联合他克莫司软膏治疗面部激素依赖性皮炎的随机对照研究

目的 探讨近红外光联合0.1％他克莫司软膏治疗面部激素依赖性皮炎的有效性和安全性.方法 2014年12月至2015年12月,在烟台毓璜顶医院皮肤科门诊纳入68例面部激素依赖性皮炎患者,随机数字表法将患者分为联合治疗组和治疗组,每组34例.治疗组给予他克莫司软膏外用,每日2次,4周为1个疗程;联合治疗组在治疗组的基础上给予近红外光治疗,每周1次,共4次.1个疗程结束后评定瘙痒、灼热等临床表现的改善情况以及疗效.结果 联合治疗组有效率85.3％(29/34),治疗组为61.8％(21/34),两组差异有统计学意义(x2=4.84,P＜0.05).联合治疗组瘙痒和灼热、红斑、鳞屑、丘疹的疗效明显高于治疗组,差异有统计学意义(x2值分别为4.84、6.35、8.42、5.52,均P＜ 0.05).结论 近红外光联合他克莫司软膏治疗面部激素依赖性皮炎安全、有效.     

肉芽肿性口周皮炎二例

报告2例肉芽肿性口周皮炎。例1男,6岁。面部红斑、丘疹5个月就诊。曾外用糖皮质激素软膏后皮疹渐增多。例2女,28岁。口周、鼻周红斑、小丘疹2个月余就诊。2例均表现为面部腔口周围直径1—3mm大小的淡红色坚实小丘疹,皮损组织病理检查：真皮毛囊周围上皮样细胞肉芽肿改变。结合临床表现及组织病理学检查,2例均确诊为肉芽肿性口周皮炎。例1口服琥乙红霉素颗粒200mg/次,每日4次、1％克林霉素凝胶和0．03％他克莫司软膏外用,治疗2个月后皮疹完全消退,1个月后口周皮疹又复发。例2在行组织病理活检后皮疹自行消退,提示本病具有临床自愈倾向。     

他克莫司软膏治疗酒渣鼻临床疗效观察

目的观察外用0.03%他克莫司软膏治疗酒渣鼻的临床疗效和安全性。方法入选的40例酒渣鼻患者均外用0.03%他克莫司软膏,2次/d,共4w。于治疗前及治疗后第1、2、3和4周时各随访1次。结果40例患者中31例完成临床试验。治疗后第1、2、3和4周时治疗红斑有效率分别为32.26%、61.29%、74.19%和83.87%;而丘疹和脓疱的有效率分别为9.68%、22.58%、25.81%和38.71%。0.03%他克莫司软膏对表现为红斑的酒渣鼻患者的疗效优于表现为丘疹和脓疱者。在治疗3～5天时29.03%的患者出现局部刺激反应。结论他克莫司软膏治疗酒渣鼻安全有效,对以红斑为主要临床表现的酒渣鼻患者的疗效较好。     

An open study of a lotion formulation to improve tolerance of tacrolimus in facial atopic dermatitis

BACKGROUND: We identified 19 patients with facial atopic eczema who failed to respond to tacrolimus (FK506) ointment, although tacrolimus ointment has shown excellent benefit for the treatment of recalcitrant facial erythema in most patients with atopic dermatitis. OBJECTIVES: We attempted to determine the efficacy of an original lotion formulation of tacrolimus for facial atopic dermatitis resistant to tacrolimus ointment. PATIENTS/METHODS: Recalcitrant facial erythema of these 19 patients was treated with an original tacrolimus lotion preparation for 6 months. Patch testing with white petrolatum was performed in both the 19 patients and in 30 other atopic dermatitis patients who had experienced excellent results with tacrolimus ointment. RESULTS: Of the 19 resistant patients, those whose symptoms were greatly or moderately improved by the lotion were 95%, 89% and 89% after 2 weeks, 3 months and 6 months of treatment, respectively. Further, patch testing to petrolatum showed positive reactions in several (six of 19) patients, compared with none of 30 controls with atopic eczema that had responded to topical tacrolimus ointment. CONCLUSIONS: The tacrolimus lotion had a significant effect on the recalcitrant facial erythema in adult patients with atopic dermatitis who were resistant to tacrolimus ointment. We suggest that one reason for the unresponsiveness to tacrolimus ointment may be because of contact sensitivity to white petrolatum.     

氟芬那酸丁脂软膏联合皮炎汤Ⅰ号治疗面部激素依赖性皮炎38例临床观察

目的观察氟芬那酸丁脂软膏治疗激素依赖性皮炎的疗效。方法将74例患者随机分为治疗组38例,外用氟芬那酸丁脂软膏,口服中药皮炎汤Ⅰ号;对照组36例外用3%硼酸溶液,口服中药皮炎汤Ⅰ号。疗程均为2个月。结果治疗组有效率为84.21%,对照组为58.33%,两组有效率比较差异有显著性(P<0.025)。结论氟芬那酸丁脂软膏治疗激素依赖性皮炎疗效确切。     

Successful treatment of inflammatory linear verrucous epidermal nevus with tacrolimus and fluocinonide

BACKGROUND: Inflammatory linear verrucous epidermal nevus (ILVEN) is a relatively rare disorder that is characterized by an early age at onset; severely pruritic linear papules and plaques; histologic features resembling spongiotic dermatitis, psoriasis, or lichenified dermatitis; and poor response to treatment. OBJECTIVE: To report the successful treatment of ILVEN with potent topical steroid and tacrolimus ointments. METHODS: An 11-year-old girl presented with a 1-year history of markedly pruritic, progressive linear eruption that extended from the right foot to the right buttock. She had failed treatment with pimecrolimus, calcipotriol, mometasone furoate, triamcinolone, tazarotene, and alpha-hydroxy acid. Histologic examination revealed the findings of spongiotic dermatitis. RESULTS: The lesions resolved with fluocinonide ointment and tacrolimus 0.1% ointment. CONCLUSION: The combination of two therapeutic agents with different mechanisms of action likely resulted in the successful treatment of this usually resistant condition.