他克莫司软膏联合短程地塞米松软膏治疗面部脂溢性皮炎临床观察

目的探讨他克莫司软膏联合短程地塞米松软膏治疗面部脂溢性皮炎的疗效和安全性。方法 71例面部脂溢性皮炎患者均在治疗前3d联合用药,即先涂0.05%地塞米松软膏,30min后涂0.1%他克莫司软膏,早晚各1次;3d后停地塞米松软膏,继续用他克莫司软膏,皮损消退后,每周2～3次涂他克莫司维持治疗。结果治疗1,2和4周时,皮损总平均积分分别为5.83±3.72,1.78±1.71和0.68±1.12,均比治疗前(14.79±6.52)有明显下降,差异有统计学意义(P<0.01);研究者和患者评价的有效率分别为98.59%和97.18%。除4例患者在用药后出现局部轻度灼热感,持续用药3d后自行缓解外,未观察到其他不良反应。结论他克莫司软膏联合短程地塞米松软膏治疗面部脂溢性皮炎安全有效。     

红蓝光联合他克莫司软膏治疗面部脂溢性皮炎疗效观察

目的观察红蓝光联合0.03%他克莫司软膏治疗面部脂溢性皮炎的疗效和安全性。方法将入选的86例面部脂溢性皮炎患者随机分为两组,治疗组43例,每周光疗2次,红光与蓝光交替进行,同时给予外用0.03%他克莫司软膏,2次/d;对照组43例,仅外用0.03%他克莫司软膏,2次/d。两组均治疗4周后判定疗效,并随访2月,观察复发率。结果治疗组有效率和复发率分别为92.50%和10.71%,对照组有效率和复发率分别为73.17%和39.13%,有效率和复发率比较,差异均有显著性(P均0.05)。两组患者均未出现严重不良反应。结论红蓝光联合0.03%他克莫司软膏治疗面部脂溢性皮炎安全,有效,复发率低。     

NB-UVB联合他克莫司软膏治疗面部脂溢性皮炎疗效评价

目的:评价NB-UVB联合他克莫司软膏治疗面部脂溢性皮炎的疗效及安全性.方法:140例面部脂溢性皮炎患者随机分为2组,治疗组70例采用NB-UVB照射联合他克莫司软膏外用;对照组70例,外用他克莫司软膏,每日2次,治疗4周后评估疗效及不良反应.结果:治疗组的总有效率为94.29％,明显高于对照组(77.14％),差异有统计学意义(P＜0.05).两组均未见明显不良反应.结论:NB-UVB照射联合他克莫司软膏外用治疗面部脂溢性皮炎安全有效.     

强脉冲光联合他克莫司软膏治疗面部脂溢性皮炎疗效观察

目的探讨强脉冲光联合他克莫司软膏治疗面部脂溢性皮炎的临床疗效。方法纳入面部脂溢性皮炎患者60例,随机分为试验组和对照组。试验组予以强脉冲光联合他克莫司软膏治疗,对照组予以他克莫司软膏治疗,疗程共8周,治疗结束后评估疗效及不良反应。结果试验组临床症状改善明显优于对照组,试验组有效率更高(64.52%vs.34.48%),差异有统计学意义(P0.05)。两组均未见明显不良反应。结论强脉冲光联合他克莫司软膏治疗面部脂溢性皮炎安全有效。     

他克莫司软膏联合强脉冲光治疗鼻周脂溢性皮炎疗效观察1孙巧梅1,2,刘艳玲3

目的 评价应用他克莫司软膏联合强脉冲光治疗鼻周脂溢性皮炎的临床疗效。方法 选取50例鼻周脂溢性皮炎患者,随机分为治疗组和观察组,每组各25例。治疗组:患者外涂0.03%他克莫司软膏2次/d,同时联合使用强脉冲治疗1次/2周;对照组:单独外用0.03%他克莫司软膏,2次/d。在治疗后的第2、4、6、8周各复诊1次,记录评分及不良反应。结果 治疗2周后,两组患者在症状总评分方面差异无统计学意义(P 0.05),治疗组治疗4周、6周及8周后的临床症状总评分相比对照组明显降低(P0.05)。治疗6周、8周后治疗组患者临床疗效明显优于对照组(P 0.05)。结论 采用他克莫司软膏联合强脉冲光治疗鼻周脂溢性皮炎,与单独使用他克莫司软膏相比,远期效果好。     

0.03%他克莫司软膏治疗面部脂溢性皮炎临床疗效观察

目的探讨外用0.03%他克莫司软膏治疗面部脂溢性皮炎临床疗效和安全性。方法将78例患者随机分成两组,治疗组40例,外用0.03%他克莫司软膏2次/d;对照组38例,外用丁苯羟酸软膏。疗程均为4周。结果治疗组和对照组临床有效率分别为87.50%和60.53%,治疗组疗效优于对照组。治疗组7例局部出现刺激症状,均发生在用药后1周内。他克莫司组不良反应发生率高于丁苯羟酸组,但二者差异无显著性(P>0.05)。结论他克莫司软膏治疗面部脂溢性皮炎安全、有效。     

Clinical efficacy of combination therapy with 0.1% tacrolimus ointment and selenium sulfide lotion in seborrheic dermatitis of the scalp

目的:观察患者使用他克莫司软膏联合二硫化硒洗剂治疗头部脂溢性皮炎的临床疗效和不良反应.方法:将62例头部脂溢性皮炎患者随机分为他克莫司组及对照组(哈西奈德组),均同时使用二硫化硒洗剂治疗,每周2次.2组患者分别于用药1、2、3、4周时随访,观察皮损情况以及药物不良反应,如皮损和症状完全消退即可停药,停药后1个月复诊或者随访.采用统计学方法分析两组疗效、复发情况,并记录不良反应.结果:根据皮损情况、瘙痒程度和皮损面积计算两组有效率和复发率,结果示两组有效率差异无统计学意义(χ2 = 0.12,P ＞ 0.05).随访1个月后,治疗组复发率16.67%,对照组复发率40.62%,差异有统计学意义(χ2 = 4.31,P ＜ 0.05).结论:0.1%他克莫司软膏联合二硫化硒洗剂治疗头部脂溢性皮炎,疗效高,复发率低,可减低药物的不良反应.     

中药联合他克莫司软膏治疗面部糖皮质激素依赖性皮炎临床观察

目的观察中药联合他克莫司软膏治疗面部糖皮质激素依赖性皮炎的疗效。方法治疗组40例患者口服自拟中药加味多皮饮,同时外用0.1%他克莫司软膏,1次/d,共4周。对照组38例患者外用0.1%他克莫司软膏,1次/d,共4周。结果有效率治疗组为92.5%,对照组为68.4%,两组比较差异有统计学意义（P〈0.05）。两组治疗后积分及治疗前后积分差值比较,差异均有统计学意义（P〈0.05）。结论中药联合他克莫司软膏治疗面部糖皮质激素依赖性皮炎疗效较好。     

二硫化硒洗剂联合他克莫司软膏治疗面部脂溢性皮炎的疗效观察

目的评价二硫化硒洗剂联合他克莫司软膏治疗面部脂溢性皮炎伴重度人体蠕形螨感染患者的临床疗效和安全性。方法用SAS 8.0软件将面部脂溢性皮炎伴重度人体蠕形螨感染患者随机分为2组,治疗组(50例)每天予2.5%二硫化硒洗剂外敷,同时外搽0.03%他克莫司软膏(2次/d),治疗2周后,仅予0.03%他克莫司软膏外搽(2次/d)继续治疗2周。对照组(50例)外搽0.03%他克莫司软膏,方法、用量和疗程均同治疗组。治疗前、后检测2组患者面部蠕形螨数量。结果治疗组和对照组临床疗效(88%和82%)的差异无统计学意义(P0.05)。治疗组蠕形螨驱除率(74%)明显高于对照组(16%),而治疗组复发率(13.64%)低于对照组(31.71%)。治疗组患者干涩、鳞屑及灼热感发生率(50%)高于对照组(24%),2组患者均未发生严重不良反应。结论二硫化硒洗剂联合他克莫司软膏治疗面部脂溢性皮炎伴重度人体蠕形螨感染疗效肯定,能提高蠕形螨驱除率,降低脂溢性皮炎复发率,安全性较好。     

0.1%他克莫司乳膏联合复妍柔润修复霜治疗脂溢性皮炎疗效观察

目的观察0.1%他克莫司乳膏联合复妍柔润修护霜外用治疗脂溢性皮炎的临床疗效。方法 78例面部脂益性皮炎患者随机分为两组,治疗组每日外用0.1%他克莫司乳膏和复妍柔润修护霜;对照组每日仅用0.1%他克莫司乳膏,治疗6周后评判临床疗效。结果治疗组痊愈率81.58%,有效率94.74%;对照组痊愈率43.59%,有效率74.36%。两组痊愈率及有效率比较差异均有统计学意义(P0.01);两组患者均无明显不良反应。结论 0.1%他克莫司乳膏联合复妍柔润修护霜外用治疗用于脂溢性皮炎疗效显著。     

白芍总苷联合左西替利嗪及他克莫司软膏治疗严重面部激素依赖性皮炎的疗效和安全性评价

目的 评估白芍总苷联合左西替利嗪及他克莫司软膏治疗严重面部糖皮质激素（简称激素）依赖性皮炎的疗效和安全性。 方法 共入组98例严重面部激素依赖性皮炎患者,其中63例（试验组）口服白芍总苷胶囊联合左西替利嗪并外用他克莫司软膏治疗, 35例（对照组）单纯口服左西替利嗪及外用他克莫司软膏治疗。治疗后第2和4周、停药后2周随访观察患者面部症状及体征,并进行评分,计算有效率。 结果 临床随访过程中脱落8例,其中试验组脱落3例,对照组脱落5例,最后完成治疗患者共90例。治疗2周后试验组和对照组的有效率分别为50.0%（30/60）和16.7%（5/30）,两组比较差异有统计学意义（P ＜ 0.05）;治疗4周后试验组和对照组的有效率分别为93.3%（56/60）和60.0%（18/30）,两组比较差异有统计学意义（P ＜ 0.05）。停药2周后,所有试验组患者症状总积分持续下降,对照组中53.3%（16/30）患者症状总积分持续下降,26.7%（8/30）患者症状总积分不变,20.0%（6/30）患者症状总积分较停药时上升。两组均无严重不良反应。 结论 白芍总苷胶囊可以提高左西替利嗪及他克莫司软膏治疗面部严重激素依赖性皮炎的疗效。     

Clinical efficacies of topical agents for the treatment of seborrheic dermatitis of the scalp: A comparative study

Previous studies have shown that topical steroid and shampoo containing zinc pyrithione provide clinical benefits for treatment of scalp seborrheic dermatitis. But the clinical efficacy of topical tacrolimus, a newly developed calcineurin inhibitor on seborrheic dermatitis, is not well investigated yet. We wanted to compare the clinical efficacy of topical tacrolimus with that of conventional treatment (zinc pyrithione shampoo and topical betamethasone) for treatment of seborrheic dermatitis of the scalp. Patients with seborrheic dermatitis of the scalp were randomly allocated to receive topical betamethasone, topical tacrolimus or zinc pyrithione shampoo. Some patients were instructed to continue the treatments for 8 weeks and the others to discontinue the treatments at week 4. We evaluated the efficacy using a clinical severity score, dandruff score and sebum secretion at baseline, week 4 and week 8. All treatment groups showed significant improvements in clinical assessment after 4 weeks. While the patients treated by zinc pyrithione improved continuously even after cessation of the treatment, the patients treated by betamethasone lotion or tacrolimus ointment were aggravated clinically. Topical tacrolimus was as effective as topical betamethasone, and showed more prolonged remission than topical betamethasone. To treat seborrheic dermatitis of the scalp, we think that the combination therapy of topical steroid or topical tacrolimus, and zinc pyrithione is recommended.     

Tacrolimus 0.1% ointment for seborrhoeic dermatitis: an open-label pilot study

BACKGROUND: As a topical immunosuppressant, tacrolimus ointment may be beneficial in the treatment of seborrhoeic dermatitis, while avoiding adverse effects related to long-term use of topical corticosteroids. OBJECTIVES: To determine the safety and efficacy of topical tacrolimus 0.1% ointment in the treatment of seborrhoeic dermatitis. METHODS: Sixteen subjects (15 men and one woman) were enrolled in a 6-week, open-label, uncontrolled trial of daily topical tacrolimus 0.1% ointment. Following a 2-week washout period for subjects using conventional therapy for seborrhoeic dermatitis, study medication was applied nightly to affected areas until clinical clearance occurred, and then for 7 days thereafter. Lesional extent and severity were assessed at baseline (day 0), at week 2 and at week 6 using the following parameters: (i). clinical assessment of erythema and scaling using a 0-3 scale; (ii). investigator global assessment; (iii). subject global assessment using a 0-6 scale; and (iv). serial photography. RESULTS: Thirteen of 16 (81%) subjects completed the study protocol; three subjects were lost to follow-up at week 6. Relative to the mean baseline value, the mean lesional erythema scores improved by 66.1% and 70.9% at weeks 2 and 6, respectively. Compared with baseline, the mean scaling scores improved by 63.7% at week 2 and 87.8% at week 6. These observations were statistically significant (P < 0.05, Wilcoxon two-sample test). Mean investigator global assessment scores improved by 76.6% at week 2 and 82.7% at week 6, relative to the mean baseline value. Mean subject global assessment scores also improved, by 69.4% at week 2 and 83.5% at week 6, relative to the mean baseline value. Other than transient application site pruritus/burning in two subjects, no serious adverse events were observed. CONCLUSIONS: This pilot study suggests that topical tacrolimus 0.1% ointment is efficacious in the short-term treatment of seborrhoeic dermatitis. Further controlled trials are warranted, to determine its efficacy and safety for this common condition.     

0.1％他克莫司软膏不同疗程治疗面部糖皮质激素依赖性皮炎的临床观察

目的 观察0.1％他克莫司软膏不同疗程治疗面部糖皮质激素依赖性皮炎的临床疗效、安全性以及治疗结束后的病情反跳情况.方法 将104例面部糖皮质激素依赖性皮炎患者随机分为3组,均给予0.1％他克莫司软膏外涂,每日2次,疗程分别为4周、8周、16周,比较3组的疗效.疗程结束后4周随访比较3组的反跳情况.结果 共90例患者完成...     

Safe and effective treatment of refractory facial lesions in atopic dermatitis using topical tacrolimus following corticosteroid discontinuation

BACKGROUND: Topical corticosteroids are commonly applied in atopic dermatitis (AD) treatment. However, their chronic use may be associated with significant side effects at the application site. Skin atrophy and other undesirable effects are frequently seen after long-term corticosteroid treatment. In addition, when application of corticosteroids is discontinued, a rebound phenomenon in the facial lesions can occur within several days. Topical tacrolimus, an immunosuppressant currently used to prevent rejection after solid-organ transplantation, presents a potential alternative therapeutic agent for AD. OBJECTIVE: The present study is the first trial designed to evaluate the efficacy and safety of topically applied tacrolimus ointment after corticosteroid discontinuation without a washout phase in severe, long-term facial AD. PATIENTS/METHODS: Forty-seven patients with facial refractory AD were recruited, of whom 38 had undergone topical corticosteroid treatment for at least 4 weeks before enrollment (group 1) and the other 9 had not received steroid treatment (group 2). All 47 patients received 0.1% tacrolimus ointment, and the severity index and pruritus score were assessed as an AD clinical activity index every week and compared with baseline data. RESULTS: Both the severity index and pruritus score improved significantly in group 1 after 1 and 2 weeks of application (p < 0.01, respectively). Group 2 showed the greatest improvement at 4 weeks (p < 0.05). In this trial, none of the patients experienced a rebound phenomenon associated with tacrolimus treatment. A transient sensation of burning at the application site was the only adverse event in 31 of the 47 (66%) enrolled patients, but this condition improved after several days. Spectrophotometric assessment of the facial lesion following treatment revealed significant improvement in group 1 (p < 0.05). CONCLUSION: The present results indicate that topical tacrolimus treatment following corticosteroid discontinuation is safe and effective in refractory facial AD.     

Effects of tacrolimus ointment on facial eruption, itch, and scratching in patients with atopic dermatitis

The action of tacrolimus ointment on pruritus in atopic dermatitis is still unclear. In this open study we investigated both the relationship between the severity of eruptions and the degree of itch and scratching in patients with atopic dermatitis and the effects of topical tacrolimus on these symptoms. Seventy adults with moderate to severe atopic dermatitis with facial eruptions that were recalcitrant to topical steroids applied a 0.1% tacrolimus ointment twice per day after discontinuation of topical steroid. The eruption scores and an assessment of the itch and scratching were recorded for 12 weeks. Oral antihistamine was prescribed at least one month before the study and continued unchanged during the study in each patient. The percentage reduction in the score of itch and scratching after two weeks (n=59) was significantly higher than in the score of eruption. Although there was no significant relationship between the severity of the eruptions and the degree of itch and scratching during steroid application, a relationship became significant after four weeks (n=59) of tacrolimus use by a one-factor ANOVA analysis. This suggests that tacrolimus ointment is effective for the itch and scratching in cases where degrees might be discrepant from the severity of eruptions in patients with recalcitrant facial eruptions of AD.     

Long-term safety and efficacy of tacrolimus ointment for the treatment of atopic dermatitis in children

Tacrolimus ointment is a topical calcineurin inhibitor for the treatment of atopic dermatitis. The primary objective of this open-label study was to assess the long-term safety of tacrolimus ointment. The primary end-point was the incidence of adverse events. Secondary end-points included the Eczema Area and Severity Index and a modified version of this index. A total of 466 children with atopic dermatitis, aged 2-15 years, applied 0.03% or 0.1% tacrolimus ointment twice daily for up to 29.5 months. Skin burning and pruritus were the most common application site events; their prevalence decreased over time. There was no increase in viral infections or other adverse events over time. Laboratory profiles were consistent with those reported in atopic populations. Substantial improvement in all efficacy end-points was observed by week 2 and maintained throughout the study. Long-term treatment with tacrolimus ointment is safe and effective in these patients with atopic dermatitis.     

透明质酸凝胶与他克莫司软膏治疗面部脂溢性皮炎疗效观察

目的分别探讨透明质酸凝胶和他克莫司软膏治疗面部脂溢性皮炎的疗效、安全性和对皮肤屏障功能的影响。方法 89例面部脂溢性皮炎患者随机分为试验组和对照组。试验组外用透明质酸凝胶,对照组外用他克莫司软膏,在0、7、14、28 d进行随访,每次随访用VISIA皮肤图像分析仪观察面部红色区,评估患者病情,并测定皮肤屏障功能相关指标。结果疗程结束后,试验组和对照组显效率分别为82.2%和86.4%,差异无统计学意义(P0.05);试验组和对照组角质层含水量分别为(56.60±9.54)和(55.14±11.57),两组差异无统计学意义(P=0.610);试验组和对照组经表皮水分丢失值分别为[(19.37±5.18)g/(m~2·h)]、[(25.10±14.0)g/(m~2·h)],两组差异无统计学意义(P=0.142)。结论透明质酸凝胶治疗面部脂溢性皮炎疗效与他克莫司软膏同样有效,透明质酸凝胶能改善皮肤屏障功能,减轻皮损,使用安全,耐受性好,值得临床推广。