Department of Dermatology and Venereology, Hospital de Baza, Granada, Spain.
Translational Research Institute, Hamad Medical Corporation, Doha, Qatar.
Int J Dermatol. 2022 Feb;61(2):216-225. doi: 10.1111/ijd.15680. Epub 2021 Jun 5.
The current scenario and position of laser and light-based therapies (LLBT) in the therapeutic rosacea scheme are lacking evidence-based recommendations and comparisons on efficacy and tolerability among different devices. This article aimed to systematically compare the efficacy, acceptability, and tolerability of the pulsed dye laser (PDL) versus other devices.
A literature search was conducted in March 2020. Four domains were analyzed throughout the following six outcomes: Spectrophotometer erythema index and percentage of reduction for background erythema, telangiectasia grading scale for telangiectasias, visual analog scale for pain, and physician's assessment and patient's satisfaction for treatment success.
Our search yielded 423 potentially relevant studies. After removing the excluded and duplicated records, 12 records were assessed for eligibility in the meta-analysis. Erythema (RR:0.38 95%CI: -0.20-0.95), telangiectasias (RR:0.54 95%CI: -0.87-1.94), and the treatment success throughout the physician's assessment (RR:1.23 95%CI: 0.74-2.04) and the patient's satisfaction (RR:1.15 95%CI: 0.73-1.82) were not significantly different between pulsed dye laser and other LLBT. In the pain domain, PDL was as painful as other LLBT (RR:-0.23 95%CI: -0.96-0.49) but more painful than neodymium: yttrium-aluminum-garnet laser (RR:0.84 95%CI: 0.53-1.14) and less than intense pulsed light (RR:-1.18 95%CI: -1.56-0.80).
This work based on previously published literature demonstrates that the quality of evidence to support any recommendation on LLBT in rosacea is low-to-moderate. Among all the available devices, PDL holds the most robust evidence, although in the meta-analysis the effectiveness was comparable to other LLBT, such as neodymium: yttrium-aluminum-garnet laser (Nd-YAG) or IPL.
在治疗酒渣鼻的方案中，激光和光基疗法（LLBT）的当前情况和地位缺乏关于不同设备疗效和耐受性的循证建议和比较。本文旨在系统比较脉冲染料激光（PDL）与其他设备的疗效、可接受性和耐受性。
于 2020 年 3 月进行文献检索。通过以下六个结果分析四个领域：分光光度计红斑指数和背景红斑减少百分比、毛细血管扩张分级量表评估毛细血管扩张、视觉模拟量表评估疼痛、医生评估和患者对治疗成功的满意度。
我们的搜索产生了 423 篇潜在相关研究。在排除和重复记录后，有 12 篇记录被评估纳入荟萃分析。红斑（RR：0.38 95%CI：-0.20-0.95）、毛细血管扩张（RR：0.54 95%CI：-0.87-1.94）以及医生评估和患者满意度（RR：1.23 95%CI：0.74-2.04）的治疗成功率无显著差异。在疼痛领域，PDL 与其他 LLBT 一样疼痛（RR：-0.23 95%CI：-0.96-0.49），但比钕：钇铝石榴石激光（RR：0.84 95%CI：0.53-1.14）更痛，比强脉冲光（RR：-1.18 95%CI：-1.56-0.80）更轻。
这项基于已发表文献的工作表明，支持酒渣鼻 LLBT 的任何建议的证据质量都较低至中等。在所有可用设备中，PDL 具有最有力的证据，尽管在荟萃分析中，其有效性与其他 LLBT 相当，如钕：钇铝石榴石激光（Nd-YAG）或 IPL。
