Micali Giuseppe, Dall'Oglio Federica, Verzì Anna Elisa, Luppino Ivano, Bhatt Karishma, Lacarrubba Francesco
Dermatology Clinic, University of Catania, A.O.U. Policlinico-Vittorio Emanuele,Via Santa Sofia, 78, 95123, Catania, Italy.
University of Illinois at Chicago, Chicago, IL, USA.
Lasers Med Sci. 2018 Aug;33(6):1397-1400. doi: 10.1007/s10103-017-2318-3. Epub 2017 Sep 9.
The purpose of this study is to evaluate the outcome of a series of patients with erythematotelangiectatic rosacea (ETR) affected by persistent erythema and varying degree of telangiectasias being treated with brimonidine alone or combined with a vascular laser based on the type of vascular components preliminarily evaluated by clinical and instrumental observation. Ten patients affected by ETR were enrolled in a pilot, open study. Instrumental evaluation included erythema-directed digital photography by VISIA-CR™ system and X10 dermoscopy. Those patients showing marked background erythema and minimal telangiectasias (group A) were treated with a single application of brimonidine 0.33% gel, while patients showing both marked background erythema and marked telangiectasias (group B) were treated with a session of Nd:YAG laser and reevaluated 1 month later after a single application of brimonidine. An Investigator Global Assessment (IGA) of treatment outcome was performed at the end of treatment in both groups. In group A, 6 h after brimonidine application, a marked reduction of the background erythema was observed in all patients, and IGA was rated as excellent. In group B, 6 h following the application of brimonidine, a marked reduction of the background erythema was observed in all cases, while telangiectasias remained unchanged. A further treatment with brimonidine 1 month after the Nd:YAG laser session determined complete clearing of facial erythema, and IGA was rated as excellent. In conclusion, a preliminary evaluation of the vascular component by erythema-directed digital photography and dermoscopy in ETR may be helpful to select the most appropriate therapeutic strategy.
本研究的目的是基于临床和仪器观察初步评估的血管成分类型，评估一系列患有持续性红斑和不同程度毛细血管扩张的红斑毛细血管扩张型玫瑰痤疮（ETR）患者单独使用溴莫尼定或联合血管激光治疗的效果。10例ETR患者被纳入一项前瞻性开放性研究。仪器评估包括使用VISIA-CR™系统进行的针对红斑的数码摄影和X10皮肤镜检查。那些表现为明显背景红斑和少量毛细血管扩张的患者（A组）接受单次0.33%溴莫尼定凝胶治疗，而那些表现为明显背景红斑和明显毛细血管扩张的患者（B组）接受一次Nd:YAG激光治疗，并在单次使用溴莫尼定1个月后重新评估。两组在治疗结束时均进行了研究者整体评估（IGA）。在A组中，使用溴莫尼定6小时后，所有患者的背景红斑均明显减轻，IGA评分为优秀。在B组中，使用溴莫尼定6小时后，所有病例的背景红斑均明显减轻，而毛细血管扩张保持不变。在Nd:YAG激光治疗1个月后再用溴莫尼定进一步治疗，面部红斑完全消退，IGA评分为优秀。总之，通过针对红斑的数码摄影和皮肤镜检查对ETR的血管成分进行初步评估，可能有助于选择最合适的治疗策略。
