Zhai Qianyu, Cheng Shaohang, Liu Runying, Xie Jinying, Han Xiao, Yu Zhen
Department of Dermatology, Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong, China.
Department of Dermatology, Shenzhen People's Hospital, Shenzhen, Guangdong, China.
J Cosmet Dermatol. 2024 Dec;23(12):3821-3827. doi: 10.1111/jocd.16549. Epub 2024 Sep 6.
The primary aim of this systematic review and meta-analysis was to synthesize and compare the clinical efficacy of intense pulsed light (IPL) and pulsed-dye laser (PDL) therapies for the management of rosacea.
The literatures were searched in the Web of Science, PubMed, Embase, and Cochrane Library databases to identify relevant studies investigating the use of IPL and PDL for the treatment of rosacea. Screening of the retrieved articles and data extraction were performed as per the pre-established inclusion and exclusion criteria. The primary outcome measures evaluated in this meta-analysis included clearance rates, erythema scores, and pain scores.
The meta-analysis incorporated data from four studies involving a total of 141 participants. The meta-analysis did not reveal a statistically significant difference between IPL and PDL in the rate of achieving greater than 50% clearance (RR = -0.07, 95% CI: -0.19, 0.05). However, the IPL group demonstrated a significantly higher rate of clearance exceeding 75% compared to the PDL group (RR = -0.13, 95% CI: -0.23, -0.04). The change in erythema index, a key measure of rosacea severity, was similar between the two treatment modalities (SMD = -0.15, 95% CI: -0.55, 0.26). Interestingly, the PDL group reported a notably lower VAS pain score than the IPL group (SMD = 1.54, 95% CI: 0.08, 3.00).
Either PDL or IPL appears to be effective modalities for the management of rosacea. IPL exhibits a slight advantage in achieving a higher rate of substantial (>75%) clearance, while PDL may be preferable for patients with lower tolerance for post-treatment discomfort. However, the existing literature directly comparing these two laser/light-based therapies is limited, warranting further well-designed, large-scale studies to establish the optimal treatment algorithm for this chronic inflammatory skin condition.
本系统评价和荟萃分析的主要目的是综合并比较强脉冲光(IPL)和脉冲染料激光(PDL)治疗玫瑰痤疮的临床疗效。
在科学网、PubMed、Embase和Cochrane图书馆数据库中检索文献,以识别调查IPL和PDL用于治疗玫瑰痤疮的相关研究。根据预先确定的纳入和排除标准对检索到的文章进行筛选和数据提取。本荟萃分析评估的主要结局指标包括清除率、红斑评分和疼痛评分。
荟萃分析纳入了四项研究的数据,共141名参与者。荟萃分析未发现IPL和PDL在清除率大于50%方面存在统计学显著差异(RR = -0.07,95%CI:-0.19,0.05)。然而,与PDL组相比,IPL组清除率超过75%的比例显著更高(RR = -0.13,95%CI:-0.23,-0.04)。作为玫瑰痤疮严重程度关键指标的红斑指数变化在两种治疗方式之间相似(SMD = -0.15,95%CI:-0.55,0.26)。有趣的是,PDL组报告的视觉模拟评分(VAS)疼痛评分明显低于IPL组(SMD = 1.54,95%CI:0.08,3.00)。
PDL或IPL似乎都是治疗玫瑰痤疮的有效方式。IPL在实现更高的显著(>75%)清除率方面具有轻微优势,而对于治疗后不适耐受性较低的患者,PDL可能更可取。然而,直接比较这两种基于激光/光的疗法的现有文献有限,需要进一步设计良好的大规模研究来确定这种慢性炎症性皮肤病的最佳治疗方案。