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寻常痤疮的传统光动力疗法与日光光动力疗法:中国一项随机前瞻性临床研究

Conventional versus daylight photodynamic therapy for acne vulgaris: A randomized and prospective clinical study in China.

作者信息

Zhang Linglin, Zhang Yunfeng, Liu Xiaojing, Shi Lei, Wang Peiru, Zhang Haiyan, Zhou Zhongxia, Zhao Yan, Zhang Guolong, Wang Xiuli

机构信息

Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China.

Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China.

出版信息

Photodiagnosis Photodyn Ther. 2020 Sep;31:101796. doi: 10.1016/j.pdpdt.2020.101796. Epub 2020 May 23.

Abstract

BACKGROUND

Photodynamic therapy (PDT) is an effective and safe treatment modality for acne vulgaris, and a variety of light sources have been investigated. Sunlight has been used as a PDT light source in a limited number of acne studies . However, to date, a comparative study of conventional PDT (C-PDT) and daylight PDT (DL-PDT) on acne is still lacking.

OBJECTIVES

This study aims to assess the efficacy and safety of DL-PDT vs. C-PDT in the treatment of acne vulgaris.

METHODS

Eighty patients with facial moderate-to-severe acne vulgaris were randomly assigned to either DL-PDT group or C-PDT group. All patients got two to three treatment sessions at two-week intervals. The lesions were photographed with VISIA digital imaging system at baseline and weeks 2, 4, and 6. Follow-up monthly for 3 months. The endpoints include efficacy (lesion response), safety (VAS pain score) and patient satisfaction.

RESULTS

A total of 77 patients completed the study. There was no statistical difference in objective response rate between DL-PDT group and C-PDT group at weeks 2, 4, and 6, respectively (40.0 %, 90.0 %, and 94.7 % vs. 45.0 %, 85.0 %, and 92.3 %, p > 0.05). The IGA score of DL-PDT group has no difference from C-PDT at baseline and at weeks 6, respectively (3.3 ± 0.4, 1.5 ± 0.7 vs. 3.4 ± 0.5, 1.6 ± 0.7, p > 0.05). The VAS pain score of DL-PDT group was lower than that of C-PDT group (1.8 ± 0.2, vs. 5.8 ± 0.3, p < 0.05). Adverse reactions such as mild burning sensation, erythema, dryness, crusting, scales and hyperpigmentation were all tolerated. Patient satisfaction was similar between the two groups (p > 0.05).

CONCLUSIONS

DL-PDT is an effective and well-tolerated regimen for moderate-to-severe acne vulgaris compared with C-PDT.

摘要

背景

光动力疗法(PDT)是治疗寻常痤疮的一种有效且安全的治疗方式,人们已经对多种光源进行了研究。在为数不多的痤疮研究中,阳光已被用作PDT光源。然而,迄今为止,仍缺乏关于传统PDT(C-PDT)和日光PDT(DL-PDT)治疗痤疮的对比研究。

目的

本研究旨在评估DL-PDT与C-PDT治疗寻常痤疮的疗效和安全性。

方法

80例面部中重度寻常痤疮患者被随机分为DL-PDT组或C-PDT组。所有患者每隔两周接受两到三次治疗。在基线以及第2、4和6周时,使用VISIA数字成像系统对皮损进行拍照。随访3个月,每月一次。观察指标包括疗效(皮损反应)、安全性(视觉模拟评分法疼痛评分)和患者满意度。

结果

共有77例患者完成了研究。DL-PDT组和C-PDT组在第2、4和6周时的客观缓解率分别比较,差异无统计学意义(分别为40.0%、90.0%和94.7% 对比45.0%、85.0%和92.3%,p>0.05)。DL-PDT组的IGA评分在基线和第6周时与C-PDT组相比,差异无统计学意义(分别为3.3±0.4、1.5±0.7对比3.4±0.5、1.6±0.7,p>0.05)。DL-PDT组的视觉模拟评分法疼痛评分低于C-PDT组(1.8±0.2对比5.8±0.3,p<0.05)。轻度烧灼感、红斑、干燥、结痂、鳞屑和色素沉着等不良反应均能耐受。两组患者满意度相似(p>0.05)。

结论

与C-PDT相比,DL-PDT是治疗中重度寻常痤疮的一种有效且耐受性良好的治疗方案。

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