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一项针对感染HIV的面部脂溢性皮炎成年患者使用1%吡美莫司乳膏的开放标签疗效试点研究。

An open-label efficacy pilot study with pimecrolimus cream 1% in adults with facial seborrhoeic dermatitis infected with HIV.

作者信息

de Moraes A P, de Arruda E A G, Vitoriano M A V, de Moraes Filho M O, Bezerra F A F, de Magalhães Holanda E, de Moraes M E A

机构信息

São José Hospital of Infectious Diseases, Ceará, Brazil.

出版信息

J Eur Acad Dermatol Venereol. 2007 May;21(5):596-601. doi: 10.1111/j.1468-3083.2006.01923.x.

Abstract

BACKGROUND

Seborrhoeic dermatitis (SD) is a common dermatosis in human immunodeficiency virus (HIV)-positive patients, many of whom do not respond satisfactorily to conventional topical treatments such as corticosteroids and antifungals.

OBJECTIVE

A pilot study to investigate the efficacy and tolerability of pimecrolimus cream 1% in HIV-positive patients with facial SD.

METHODS

In a single-centre study, 21 HIV-infected patients with mild to severe SD were treated twice daily with pimecrolimus cream 1% for 14 days. Thereafter, treatment was discontinued and patients followed up for 5 weeks. Skin involvement at baseline and on days 7, 14, 21, 35 and 49 was assessed using a four-point clinical score and digital photography.

MAIN OUTCOME MEASURES

Efficacy and safety of pimecrolimus cream 1% treatment and incidence of relapse in the follow-up phase. Results Marked improvement was seen in clinical parameters at day 7, with >or= 90% patients clear of symptoms at day 14. Relapse was observed at day 35 but signs were milder than at baseline. All patients responded to therapy, despite their immunological status. Pimecrolimus did not alter CD4(+) and CD8(+) T-cell counts or viral load during the treatment period.

CONCLUSION

Pimecrolimus cream represents a new, effective therapeutic option for facial SD in HIV patients.

摘要

背景

脂溢性皮炎(SD)是人类免疫缺陷病毒(HIV)阳性患者中常见的一种皮肤病,其中许多患者对皮质类固醇和抗真菌药等传统局部治疗反应不佳。

目的

一项初步研究,旨在调查1%吡美莫司乳膏对HIV阳性面部SD患者的疗效和耐受性。

方法

在一项单中心研究中,21例轻度至重度SD的HIV感染患者每天两次外用1%吡美莫司乳膏,持续14天。此后,停止治疗并对患者随访5周。使用四分临床评分和数码摄影评估基线以及第7、14、21、35和49天的皮肤受累情况。

主要观察指标

1%吡美莫司乳膏治疗的疗效和安全性以及随访期复发率。结果在第7天临床参数有明显改善,在第14天≥90%的患者症状消失。在第35天观察到复发,但症状比基线时轻。所有患者对治疗均有反应,无论其免疫状态如何。在治疗期间,吡美莫司未改变CD4(+)和CD8(+) T细胞计数或病毒载量。

结论

吡美莫司乳膏是HIV患者面部SD的一种新的有效治疗选择。

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