Rerknimitr Pawinee, Tekacharin Nucharin, Panchaprateep Ratchathorn, Wititsuwannakul Jade, Tangtanatakul Pattarin, Hirankarn Nattiya, Asawanonda Pravit
a Division of Dermatology, Department of Medicine, Faculty of Medicine , Skin and Allergy Research Unit, Chulalongkorn University , Bangkok , Thailand.
b Division of Immunology, Department of Microbiology, Faculty of Medicine , Center of Excellence in Immunology and Immune-mediated Diseases, Chulalongkorn University , Bangkok , Thailand.
J Dermatolog Treat. 2019 Feb;30(1):81-86. doi: 10.1080/09546634.2018.1468063. Epub 2018 May 10.
To evaluate the efficacy and safety of pulsed-dye laser (PDL) for discoid lupus erythematosus (DLE) in a double blinded, randomized, controlled fashion.
Forty-eight DLE lesions from nine patients were recruited. The lesions on one side of the body were randomized into the treatment group and the other side served as a control. Treatments with the PDL (595 nm) were delivered every four weeks for four consecutive months. The patients were evaluated at weeks 0, 4, 8, 12, 16 and 24. Erythema index (EI) and Texture index (TI) were obtained by Antera3D. Modified Cutaneous Lupus Erythematosus Disease Area and Severity Index (mCLASI) and physician global assessment (PGA) scores were assessed in every visit. Lesional skin biopsies before and after the PDL treatment were taken from four patients.
The lesions treated with the PDL demonstrated significantly more decreases in EI, TI and improvement in PGA scores compared to the control. Though there was improvement of mCLASI in the laser group, the significance difference was not observed. Interestingly, real-time polymerase chain reaction showed a reduction in CXCL-9, 10, IFN-γ, IL-1β, TNF-α and TGF-β. Additionally, post-treatment DLE lesions demonstrated decreased CD3, CD4, CD8 and CXCR3-positive cells.
Improvements of DLE can be achieved with PDL.
以双盲、随机、对照的方式评估脉冲染料激光（PDL）治疗盘状红斑狼疮（DLE）的疗效和安全性。
招募了9例患者的48个DLE皮损。将身体一侧的皮损随机分为治疗组，另一侧作为对照组。使用PDL（595nm）每4周进行一次治疗，连续4个月。在第0、4、8、12、16和24周对患者进行评估。通过Antera3D获得红斑指数（EI）和纹理指数（TI）。每次就诊时评估改良皮肤红斑狼疮疾病面积和严重程度指数（mCLASI）和医生整体评估（PGA）评分。从4例患者身上采集PDL治疗前后的皮损活检组织。
与对照组相比，接受PDL治疗的皮损在EI、TI方面的下降以及PGA评分的改善更为显著。虽然激光组的mCLASI有所改善，但未观察到显著差异。有趣的是，实时聚合酶链反应显示CXCL-9、10、IFN-γ、IL-1β、TNF-α和TGF-β减少。此外，治疗后的DLE皮损显示CD3、CD4、CD8和CXCR3阳性细胞减少。
PDL可改善DLE。
