Vissing Anne-Cathrine E, Dierickx Christine, Karmisholt Katrine E, Haedersdal Merete
Department of Dermatology, Bispebjerg University Hospital, Copenhagen, Denmark.
Skinperium Clinic, Boom, Beukenlaan 52, 2850, Belgium.
Lasers Surg Med. 2018 Dec;50(10):1002-1009. doi: 10.1002/lsm.22953. Epub 2018 Jun 17.
Laser and intense pulsed light (IPL) are standard symptomatic treatments for superficial telangiectasias, but postoperative erythema, oedema, and pain may prolong downtime.
To investigate whether topical brimonidine reduces IPL-induced inflammation in patients with moderate to severe facial telangiectasias.
A randomized, two-centre, single-blinded, split-face trial on adjuvant brimonidine and air-cooling versus air-cooling alone (control) in 19 patients treated in Denmark (n = 10 patients) and Belgium (n = 9). Brimonidine was applied to the allocated side after each of three facial IPL-treatments, given at 3-week intervals. Patients were assessed up to 1 month after the final treatment. Outcome measures included blinded clinical on-site evaluation of erythema and oedema (5-point-scales), objective erythema-scores (red-filter analysis), patient-evaluated pain (Visual Analogue Scale), IPL-efficacy (blinded photo-evaluation of telangiectasia clearance), and patient preference.
In total, 19 patients were enrolled and completed the study. IPL induced moderate to severe erythema after each treatment. Application of brimonidine, reduced erythema to baseline values compared to air-cooling alone and sustained efficacy 24 hours after treatment (median difference reduction: score 1 at each assessment, P ≤ 0.022). Objective erythema-scores supported clinical findings, demonstrating a median erythema reduction of 50-95% after application of brimonidine and air-cooling compared to 9-28% reduction after air-cooling alone (P ≥ 0.002). No difference in reduction of IPL-induced oedema was observed between facial sides (P ≥ 0.227). Brimonidine and air-cooling slightly and consistently reduced postoperative pain compared to air-cooling alone (VAS 1.0 after brimonidine versus VAS 1.5-2.0 after air-cooling alone at treatment 1-3, P ≤ 0.032). At 1-month follow-up, patients experienced excellent clearance of telangiectasias (75-100% clearance) on both facial sides (P = 1.000). Patient preference supported clinical data and 79% of patients preferred brimonidine to control (P = 0.019).
Compared to air-cooling alone, adjuvant brimonidine reduces IPL-induced erythema and associated pain while maintaining a high IPL-efficacy. Lasers Surg. Med. 50:1002-1009, 2018. © 2018 Wiley Periodicals, Inc.
激光和强脉冲光（IPL）是治疗浅表性毛细血管扩张的标准对症疗法，但术后红斑、水肿和疼痛可能会延长恢复时间。
研究局部使用溴莫尼定是否能减轻中重度面部毛细血管扩张患者IPL诱导的炎症。
在丹麦（n = 10例患者）和比利时（n = 9例）对19例患者进行了一项随机、双中心、单盲、半脸对照试验，比较辅助使用溴莫尼定和空气冷却与单独使用空气冷却（对照）的效果。在每3周进行一次的三次面部IPL治疗后，将溴莫尼定应用于指定的一侧。在最后一次治疗后长达1个月的时间内对患者进行评估。观察指标包括对红斑和水肿的盲法临床现场评估（5分制）、客观红斑评分（红色滤光片分析）、患者评估的疼痛（视觉模拟量表）、IPL疗效（对毛细血管扩张清除情况的盲法照片评估）以及患者偏好。
总共19例患者入组并完成了研究。每次治疗后IPL均诱发了中度至重度红斑。与单独使用空气冷却相比，使用溴莫尼定可将红斑减轻至基线值，并在治疗后24小时维持疗效（每次评估时中位数差异减少：评分为1，P≤0.022）。客观红斑评分支持临床结果，表明与单独使用空气冷却后红斑减少9 - 28%相比，使用溴莫尼定和空气冷却后红斑中位数减少了50 - 95%（P≥0.002）。面部两侧在减轻IPL诱导的水肿方面未观察到差异（P≥0.227）。与单独使用空气冷却相比，溴莫尼定和空气冷却能轻微且持续地减轻术后疼痛（治疗1 - 3次时，使用溴莫尼定后VAS评分为1.0，单独使用空气冷却后VAS评分为1.5 - 2.0，P≤0.032）。在1个月的随访中，患者两侧面部的毛细血管扩张均得到了极好的清除（清除率为75 - 100%）（P = 1.000）。患者偏好支持临床数据，79%的患者更喜欢溴莫尼定而非对照（P = 0.019）。
与单独使用空气冷却相比，辅助使用溴莫尼定可减轻IPL诱导的红斑和相关疼痛，同时保持较高的IPL疗效。《激光外科与医学》50:1002 - 1009, 2018。© 2018威利期刊公司
