Hua Nicholas J, Chen Jennifer, Geng Ryan S Q, Sibbald Ronald Gary, Sibbald Cathryn
Temerty School of Medicine, University of Toronto, Toronto, ON, Canada.
Dalla Lana School of Public Health & Division of Dermatology, Department of Medicine, University of Toronto, Toronto, ON, Canada.
J Cutan Med Surg. 2025 Jan-Feb;29(1):43-50. doi: 10.1177/12034754241287546. Epub 2024 Oct 31.
Rosacea is a chronic inflammatory skin condition that affects over 5% of individuals worldwide. Its clinical presentation is characterized by an array of features, including erythema, papules and pustules, phymatous changes, telangiectasia, and ocular manifestations. Specifically, the multifaceted manifestation of erythema varies widely in intensity and distribution. Factors contributing to pathogenesis include neurovascular dysregulation, increased levels of pro-inflammatory mediators, and aberrant vasodilation. Erythema management plays an important role in reducing the psychosocial burden associated with rosacea and improving overall quality of life. Cochrane CENTRAL, Medline, and Embase databases were searched from inception to September 2023 and included 33 clinical trials reporting on a total of 7411 rosacea patients (74.1% female) and 21 different topical or systemic treatments. The mean age was 48.8 years (range, 18-83 years), and the mean time to outcome assessment was 8.1 weeks (standard deviation, 4.1 weeks). Treatment efficacy was assessed by outcome measures including percent improvement from baseline on 4- and 5-point scales, clinician erythema assessment (CEA) success (improvement ≥1 point), and CEA and patient self-assessment success (improvement ≥1 point). Pooled effect sizes for each treatment were calculated as a weighted average based on the number of patients in each study. The most effective topical treatments for reducing erythema include sodium sulphacetamide and sulphur, praziquantel, metronidazole, and B244 spray (). The most effective systemic treatment was paroxetine. Our findings highlight the varying efficacy of treatments in addressing the erythema in rosacea, recognizing the nuances of clinical presentations.
酒渣鼻是一种慢性炎症性皮肤病，全球超过5%的人受其影响。其临床表现具有一系列特征，包括红斑、丘疹和脓疱、肥大性改变、毛细血管扩张以及眼部表现。具体而言，红斑的多方面表现强度和分布差异很大。发病机制的影响因素包括神经血管调节异常、促炎介质水平升高和异常血管扩张。红斑的治疗在减轻与酒渣鼻相关的心理社会负担和提高整体生活质量方面起着重要作用。对Cochrane CENTRAL、Medline和Embase数据库从创建到2023年9月进行了检索，纳入了33项临床试验，共报告了7411例酒渣鼻患者（74.1%为女性）以及21种不同的局部或全身治疗方法。平均年龄为48.8岁（范围18 - 83岁），平均结局评估时间为8.1周（标准差4.1周）。通过包括4分和5分制从基线改善百分比、临床医生红斑评估（CEA）成功（改善≥1分）以及CEA和患者自我评估成功（改善≥1分）等结局指标来评估治疗效果。每种治疗方法的合并效应量根据每项研究中的患者数量计算为加权平均值。减轻红斑最有效的局部治疗方法包括磺胺醋酰钠和硫磺、吡喹酮、甲硝唑以及B244喷雾（）。最有效的全身治疗方法是帕罗西汀。我们的研究结果突出了不同治疗方法在解决酒渣鼻红斑方面的不同疗效，认识到临床表现的细微差别。
