Syed S, Weibel L, Kennedy H, Harper J I
Department of Paediatric Dermatology, Great Ormond Street Hospital for Children, London, UK.
Clin Exp Dermatol. 2008 May;33(3):243-8. doi: 10.1111/j.1365-2230.2007.02644.x. Epub 2008 Jan 14.
Eczematous skin changes overlying port-wine stains have been reported to improve with pulsed-dye laser (PDL) treatment. However, PDL has not as yet been evaluated for the treatment of atopic dermatitis (AD; eczema).
To evaluate in a controlled trial the effects and safety of PDL treatment in children with AD who had chronic localized lesions.
Twelve children with localized, chronic eczema were treated with PDL (595 nm), with untreated areas used as an intrapatient control. Treatment was given at baseline and patients were followed up at 2 and 6 weeks. Clinical outcome measures were localized Eczema Severity Score (ESS), a visual analogue scale (VAS) indicating eczema severity assessed by photographs, and adverse events.
After 2 and 6 weeks, a significant decrease in ESS was seen for the PDL-treated areas compared with the control areas (mean +/- SEM reduction in ESS 7.0 +/- 1.0 vs. 3.3 +/- 0.8 at 2 weeks, P = 0.003, and 7.8 +/- 1.4 vs. 4.9 +/- 1.3 at 6 weeks, P = 0.002). A significant difference in eczema severity assessed by VAS at 6 weeks was seen in favour of PDL (mean +/- SEM improvement 78% +/- 20% vs. 52% +/- 10%, P = 0.003). Treatment was well-tolerated.
In this pilot study, PDL treatment was effective in treating small areas of chronic localized eczema. This may suggest that in AD dermal vasculature plays an important role or that PDL may have an effect on cutaneous immunological activation.
据报道,脉冲染料激光(PDL)治疗可改善葡萄酒色斑上方的湿疹样皮肤改变。然而,PDL尚未被评估用于治疗特应性皮炎(AD;湿疹)。
在一项对照试验中评估PDL治疗对患有慢性局限性皮损的AD患儿的疗效和安全性。
12例患有局限性慢性湿疹的儿童接受了PDL(595nm)治疗,未治疗区域作为患者自身对照。在基线时进行治疗,并在2周和6周时对患者进行随访。临床结局指标包括局部湿疹严重程度评分(ESS)、通过照片评估湿疹严重程度的视觉模拟量表(VAS)以及不良事件。
2周和6周后,与对照区域相比,PDL治疗区域的ESS显著降低(2周时ESS平均±标准误降低7.0±1.0 vs. 3.3±0.8,P = 0.003;6周时7.8±1.4 vs. 4.9±1.3,P = 0.002)。6周时通过VAS评估的湿疹严重程度存在显著差异,支持PDL治疗(平均±标准误改善78%±20% vs. 52%±10%,P = 0.003)。治疗耐受性良好。
在这项初步研究中,PDL治疗对治疗小面积慢性局限性湿疹有效。这可能表明在AD中真皮血管系统起重要作用,或者PDL可能对皮肤免疫激活有影响。