Fan Xing, Yin Yue, Dou Wenjie, Li Tong, Xue Ping, Yang Qing, Ma Qiaoxin
Department of Plastic Surgery, Xijing Hospital, The Fourth Military Medical University, Xi'an, 710032, Shaanxi, China.
Dermatol Ther (Heidelb). 2021 Apr;11(2):615-623. doi: 10.1007/s13555-021-00492-1. Epub 2021 Feb 4.
Corticosteroid-induced rosacea-like dermatitis (CIRD) is one of the cutaneous side effects of long and excessive application of topical corticosteroids, resembling rosacea that can present with a series of cutaneous manifestations. Most patients with CIRD undergo a variety of long-term treatments before their symptoms are relieved as there is no accepted standard therapy. We gave each of seven patients two sessions of platelet-rich plasma (PRP) mesotherapy before the routine treatment to restore their skin barrier function, and we were surprised to find that the patients' symptoms and appearance were significantly improved without any further treatments. Here we report this unexpected finding in dealing with CIRD.
Seven patients, one male and six female, who had history of applying topical corticosteroids on the face for more than 3 months continuously or intermittently for various reasons were diagnosed with CIRD, showing varying degrees of erythema, telangiectasia, and papules, with dry skin, pain, and burning or stinging sensation. We intended to use the restorative effect of PRP to restore the skin barrier function of the patients for further treatment such as tacrolimus ointment, intense pulsed light (IPL), or pulsed dye laser (PDL), so they were treated twice with PRP intradermal injections using a mesogun injector machine. We used the VISIA skin detector to photograph and compare the changes after the treatments. Clinical efficacy was also assessed by the Global Aesthetic Improvement Scale (GAIS). Patients' assessments were recorded using three-point scale questionnaires. After two sessions of PRP treatment, before any further treatment, we were surprised to find that the patients' symptoms had improved significantly, as confirmed by VISIA skin detector and GAIS. All of the patients were satisfied with the outcomes, considering that mesotherapy was not painful and their appearance and symptoms had much improved.
PRP mesotherapy may mitigate sensitivity and inflammation in patients with CIRD by reducing erythema, telangiectasia, and papules. It is worth conducting large randomized controlled trials to verify its safety and efficacy in treating corticosteroid-induced rosacea-like dermatitis and maybe rosacea.
糖皮质激素诱导的酒渣鼻样皮炎(CIRD)是长期过量外用糖皮质激素引起的皮肤副作用之一,类似于酒渣鼻,可出现一系列皮肤表现。由于尚无公认的标准治疗方法,大多数CIRD患者在症状缓解前需接受多种长期治疗。我们在常规治疗前,为7例患者各进行了2次富血小板血浆(PRP)中胚层疗法,以恢复其皮肤屏障功能,结果惊讶地发现,患者症状和外观在未进行任何进一步治疗的情况下得到了显著改善。在此我们报告这一在处理CIRD时的意外发现。
7例患者,1例男性,6例女性,因各种原因有连续或间断面部外用糖皮质激素超过三个月的病史,被诊断为CIRD,表现为不同程度的红斑、毛细血管扩张和丘疹,伴有皮肤干燥、疼痛以及烧灼或刺痛感。我们打算利用PRP的修复作用来恢复患者的皮肤屏障功能,以便进行进一步治疗,如外用他克莫司软膏、强脉冲光(IPL)或脉冲染料激光(PDL),因此使用中胚层注射枪为他们进行了2次PRP皮内注射治疗。我们使用VISIA皮肤检测仪对治疗后的变化进行拍照和比较。还通过整体美学改善量表(GAIS)评估临床疗效。使用三点量表问卷记录患者的评估结果。在进行2次PRP治疗后,在未进行任何进一步治疗之前,我们惊讶地发现,经VISIA皮肤检测仪和GAIS证实,患者症状有显著改善。所有患者对治疗结果都很满意,认为中胚层疗法不痛,且外观和症状有很大改善。
PRP中胚层疗法可能通过减轻红斑、毛细血管扩张和丘疹,缓解CIRD患者的敏感性和炎症。值得开展大型随机对照试验,以验证其在治疗糖皮质激素诱导的酒渣鼻样皮炎以及可能在治疗酒渣鼻方面的安全性和有效性。