Farhangian Michael E, Huang William W, Feldman Steven R
Department of Dermatology, Center for Dermatology Research, Wake Forest School of Medicine, Winston-Salem, NC, USA,
Dermatol Ther (Heidelb). 2015 Jun;5(2):91-105. doi: 10.1007/s13555-015-0075-4. Epub 2015 Apr 22.
Treatment adherence plays a large role in chronic dermatologic diseases and may play an important role in the outcomes of patients with cutaneous lupus erythematosus (CLE). We sought to gauge what is currently known about adherence to topical and oral medications in patients with CLE.
A review of MEDLINE was performed using a combination of the phrases "adherence", "compliance", "lupus", and "cutaneous". Studies were hand searched and prospective and cross-sectional studies evaluating medication adherence in patients with CLE and systemic lupus erythematosus (SLE) were included.
Only two articles explored adherence in patients with CLE, while 17 articles discussed treatment adherence in patients with SLE. Depression was consistently cited as detrimental to adherence. The impact that race, ethnicity, and education has on adherence is unclear. Three studies noted a clear connection between adherence and disease activity, while two others did not. Few studies investigated methods that have improved adherence to treatment which have showed promise.
Much of what we know about adherence to medication in patients with lupus is limited to SLE. Although cutaneous symptoms are among the most common manifestations of SLE, cutaneous disease is often managed at least in part with topical agents, and adherence to topical treatment was not assessed in any of the articles, though one study investigated sunscreen usage in patients with CLE. Understanding adherence in patients with CLE may help contribute to better CLE treatment outcomes.
治疗依从性在慢性皮肤病中起着重要作用，可能对皮肤红斑狼疮（CLE）患者的治疗结果也很重要。我们试图了解目前关于CLE患者局部和口服药物依从性的情况。
使用“依从性”“顺应性”“狼疮”和“皮肤”等短语组合对MEDLINE进行检索。对手检的研究进行筛选，纳入评估CLE和系统性红斑狼疮（SLE）患者药物依从性的前瞻性和横断面研究。
仅有两篇文章探讨了CLE患者的依从性，而有17篇文章讨论了SLE患者的治疗依从性。抑郁一直被认为对依从性有不利影响。种族、民族和教育对依从性的影响尚不清楚。三项研究指出依从性与疾病活动之间存在明确联系，而另外两项研究则未发现此联系。很少有研究调查能改善治疗依从性且显示出前景的方法。
我们对狼疮患者药物依从性的了解大多局限于SLE。虽然皮肤症状是SLE最常见的表现之一，但皮肤病通常至少部分通过局部用药治疗，且在任何文章中均未评估局部治疗的依从性，不过有一项研究调查了CLE患者使用防晒霜的情况。了解CLE患者的依从性可能有助于改善CLE的治疗结果。
