Department of Dermatology, Radboud University Medical Center, Nijmegen, The Netherlands.
Healthcare Policy, Santiz Hospitals, Doetinchem and Winterswijk, The Netherlands.
J Dermatolog Treat. 2022 Feb;33(1):195-203. doi: 10.1080/09546634.2020.1741501. Epub 2020 Mar 19.
Reflectance confocal microscopy (RCM) enables noninvasive mite detection in rosacea. Objective scoring of rosacea severity is currently lacking.
To determine the value of RCM for monitoring , inflammation and vascular parameters in rosacea during treatment.
In 20 rosacea patients, clinical and RCM examination were performed before, during, and 12 weeks after a 16-week treatment course with topical ivermectin. Using RCM, number of mites and inflammatory cells, epidermal thickness, and vascular density and diameter were measured. RCM features were correlated with clinical assessment.
Treatment resulted in clinical reduction of inflammatory lesions. Mites were detected in 80% of patients at baseline, 30% at week 16, and 63% at week 28. The number of mites reduced significantly during treatment, but no changes in inflammatory cells, epidermal thickness or vascular parameters were observed. Correlation between number of inflammatory lesions and mites was low. None of the RCM variables were significant predictors for clinical success.
RCM enables anti-inflammatory effect monitoring of topical ivermectin by determining mite presence. Quantifying exact mite number, and inflammatory and vascular characteristics is challenging due to device limitations. In its current form, RCM seems of limited value for noninvasive follow-up of rosacea in clinical practice.
反射共聚焦显微镜（RCM）可实现非侵入性蠕形螨检测。目前缺乏对酒渣鼻严重程度的客观评分。
确定 RCM 在酒渣鼻治疗过程中监测炎症和血管参数的价值。
在 20 例酒渣鼻患者中，在局部伊维菌素治疗 16 周期间和治疗结束后 12 周进行临床和 RCM 检查。使用 RCM 测量螨虫和炎性细胞数量、表皮厚度以及血管密度和直径。将 RCM 特征与临床评估相关联。
治疗导致炎症病变的临床改善。基线时 80%的患者检测到螨虫，16 周时 30%，28 周时 63%。在治疗过程中，螨虫数量显著减少，但未观察到炎性细胞、表皮厚度或血管参数的变化。炎症病变数量与螨虫之间的相关性较低。RCM 变量均不是临床疗效的显著预测因子。
RCM 通过确定螨虫的存在来实现局部伊维菌素的抗炎作用监测。由于设备限制，定量确切的螨虫数量以及炎症和血管特征具有挑战性。在目前的形式下，RCM 似乎对酒渣鼻的临床实践中的非侵入性随访没有太大价值。
