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0.05%丙酸氯倍他索与0.1%他克莫司局部治疗皮肤扁平苔藓的比较。

Comparison of topical clobetasol propionate 0.05% and topical tacrolimus 0.1% in the treatment of cutaneous lichen planus.

作者信息

Özkur Ezgi, Aksu Esra Koku, Gürel Mehmet Salih, Savaş Sevil

机构信息

Şişli Etfal Training and Research Hospital, Health Science University, Istanbul, Turkey.

Istanbul Training and Research Hospital, Health Science University, Istanbul, Turkey.

出版信息

Postepy Dermatol Alergol. 2019 Dec;36(6):722-726. doi: 10.5114/ada.2019.91423. Epub 2020 Jan 14.

Abstract

INTRODUCTION

The effectiveness of topical tacrolimus in the treatment of oral and genital lichen planus has been verified in many randomized studies; however, there are only few case reports in treatment of cutaneous lichen planus (CLP).

AIM

We sought to compare the safety and efficacy of topical clobetasol propionate and tacrolimus ointment in the treatment of CLP.

MATERIAL AND METHODS

Retrospective analysis of patient files was performed. We enrolled patients who were diagnosed with CLP and treated with topical tacrolimus 0.1% or topical clobetasol propionate 0.05%. Visual Analogue Scale (VAS) scores of pigmentation and pruritus, clinical response, laboratory data and adverse effects were obtained from medical records.

RESULTS

A total of 27 patients were included in the clobetasol group and 23 patients in the tacrolimus group. Both groups showed an improvement in VAS scores regarding pruritus and pigmentation but a statistically significant difference was observed in the clobetasol group (< 0.05). At week 12, a complete response was observed in 63% ( = 17) of the clobetasol and 26% ( = 6) of the tacrolimus group.

CONCLUSIONS

In our study, both treatments were found effective in the treatment of CLP but clobetasol propionate was more effective. However tacrolimus may be preferred before topical corticosteroids for lesions on the face, neck, and intertriginous regions of the body, which are sensitive to the cutaneous adverse effects of topical corticosteroids. Our study may be one of the first studies to compare the effects of topical clobetasol and tacrolimus ointment in the management of CLP.

摘要

引言

在许多随机研究中已证实局部用他克莫司治疗口腔扁平苔藓和生殖器扁平苔藓的有效性;然而,关于治疗皮肤扁平苔藓(CLP)的病例报告却很少。

目的

我们试图比较丙酸氯倍他索软膏和他克莫司软膏治疗CLP的安全性和有效性。

材料与方法

对患者病历进行回顾性分析。我们纳入了被诊断为CLP并接受0.1%局部用他克莫司或0.05%丙酸氯倍他索治疗的患者。从病历中获取色素沉着和瘙痒的视觉模拟量表(VAS)评分、临床反应、实验室数据及不良反应。

结果

氯倍他索组共纳入27例患者,他克莫司组纳入23例患者。两组在瘙痒和色素沉着的VAS评分方面均有改善,但氯倍他索组差异有统计学意义(<0.05)。在第12周时,氯倍他索组63%(=17)的患者获得完全缓解,他克莫司组为26%(=6)。

结论

在我们的研究中,两种治疗方法在治疗CLP方面均有效,但丙酸氯倍他索更有效。然而,对于面部、颈部和身体间擦部位对局部皮质类固醇皮肤不良反应敏感的病变,在使用局部皮质类固醇之前,他克莫司可能是更优选的药物。我们的研究可能是最早比较局部用氯倍他索和他克莫司软膏治疗CLP效果的研究之一。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/23dc/6986297/e56153e677e5/PDIA-36-91423-g001.jpg

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