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播散性浅表性光化性汗孔角化症:系统治疗综述

Disseminated Superficial Actinic Porokeratosis: A Systematic Treatment Review.

作者信息

Tan Stephanie, Tan Ernest

机构信息

Sir Charles Gairdner Hospital, Nedlands, Western, Australia.

出版信息

Am J Clin Dermatol. 2025 Jan;26(1):7-21. doi: 10.1007/s40257-024-00903-x. Epub 2024 Nov 1.

DOI:10.1007/s40257-024-00903-x
PMID:39485670
Abstract

BACKGROUND

Disseminated superficial actinic porokeratosis (DSAP) is a disorder of keratinization characterised by small, brown plaques with elevated keratotic rims, typically occurring on sun exposed areas. DSAP poses a risk for malignant transformation, emphasising the need for effective management strategies.

OBJECTIVE

The aim of this study was to review the current reported management options for DSAP.

METHODS

This systematic review was based on a comprehensive search of databases (Cochrane, PubMed, Medline, Embase, Emcare, ProQuest, Web of Science, CINAHL) from inception to 15 March 2024. Studies reporting management of DSAP were included irrespective of study design.

RESULTS

Of 923 citations, 61 studies were included, predominantly comprising case reports and retrospective case series. A limited number of randomized and open-label trials were identified. Various treatment modalities were reported, including topical and systemic agents, photodynamic therapy, and laser therapy.

CONCLUSION

Multiple management options are available for DSAP, including topical and systemic agents, photodynamic therapy and laser treatments. However, these approaches vary in their balance between efficacy and toxicity. Currently, there is a paucity of high-quality clinical trial data to guide treatment decisions. Further studies are required to determine the most effective and safe management strategies for DSAP. PROSPERO REGISTRATION: CRD42024514558.

摘要

背景

播散性浅表性光化性汗孔角化症(DSAP)是一种角化异常疾病,其特征为小的褐色斑块,伴有角化性边缘隆起,通常发生于暴露于阳光的部位。DSAP存在恶变风险,这凸显了有效管理策略的必要性。

目的

本研究旨在综述目前报道的DSAP管理方案。

方法

本系统评价基于对数据库(Cochrane、PubMed、Medline、Embase、Emcare、ProQuest、Web of Science、CINAHL)从创建至2024年3月15日进行的全面检索。纳入报告DSAP管理情况的研究,无论其研究设计如何。

结果

在923篇文献中,纳入了61项研究,主要包括病例报告和回顾性病例系列。确定了数量有限的随机试验和开放标签试验。报道了多种治疗方式,包括局部和全身用药、光动力疗法和激光治疗。

结论

DSAP有多种管理方案可供选择,包括局部和全身用药、光动力疗法和激光治疗。然而,这些方法在疗效和毒性之间的平衡各不相同。目前,缺乏高质量的临床试验数据来指导治疗决策。需要进一步研究以确定DSAP最有效和安全的管理策略。PROSPERO注册号:CRD42024514558。

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本文引用的文献

1
Conventional and Novel Treatment Strategies for Porokeratoses: A Narrative Review.寻常型及新型治疗策略在角化病中的应用:一个叙事性综述。
J Dtsch Dermatol Ges. 2024 Aug;22(8):1073-1077. doi: 10.1111/ddg.15436. Epub 2024 Jul 3.
2
A Case of Disseminated Superficial Actinic Porokeratosis Successfully Treated With Topical Lovastatin/Cholesterol Gel.1例外用洛伐他汀/胆固醇凝胶成功治疗的播散性浅表性光化性汗孔角化症病例
Cureus. 2023 Jun 17;15(6):e40582. doi: 10.7759/cureus.40582. eCollection 2023 Jun.
3
Safety and Efficacy of Topical Lovastatin Plus Cholesterol Cream vs Topical Lovastatin Cream Alone for the Treatment of Disseminated Superficial Actinic Porokeratosis: A Randomized Clinical Trial.
局部洛伐他汀联合胆固醇乳膏与单独使用局部洛伐他汀乳膏治疗播散性浅表性光线性汗孔角化病的疗效和安全性:一项随机临床试验。
JAMA Dermatol. 2023 May 1;159(5):488-495. doi: 10.1001/jamadermatol.2023.0205.
4
Novel topical statin treatments of disseminated actinic porokeratosis risk provoking cutaneous sensitization.新型外用他汀类药物治疗播散性光化性汗孔角化症有引发皮肤致敏的风险。
Contact Dermatitis. 2023 Jan;88(1):66-68. doi: 10.1111/cod.14220. Epub 2022 Sep 21.
5
Disseminated Superficial Actinic Porokeratosis (DSAP): A Case Report Highlighting the Clinical, Dermatoscopic, and Pathology Features of the Condition.播散性浅表性光化性汗孔角化症(DSAP):一例报告,突出该病症的临床、皮肤镜及病理特征
Cureus. 2022 Jul 16;14(7):e26923. doi: 10.7759/cureus.26923. eCollection 2022 Jul.
6
Successful treatment of disseminated superficial actinic porokeratosis with topical 2% cholesterol/ 2% lovastatin cream: a case series with 7 patients.外用2%胆固醇/2%洛伐他汀乳膏成功治疗播散性浅表性光化性汗孔角化症:7例病例系列报告
J Eur Acad Dermatol Venereol. 2022 Jan;36(1):e52-e54. doi: 10.1111/jdv.17619. Epub 2021 Sep 8.
7
Case of disseminated superficial actinic porokeratosis successfully treated with Q-switched ruby laser.调Q红宝石激光成功治疗播散性浅表性光化性汗孔角化症病例
J Dermatol. 2021 May;48(5):e244-e245. doi: 10.1111/1346-8138.15861. Epub 2021 Mar 21.
8
Topical Corticosteroids: Choice and Application.局部皮质类固醇:选择和应用。
Am Fam Physician. 2021 Mar 15;103(6):337-343.
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The Malignancy Potential of Porokeratosis: A Single-Center Retrospective Study.汗孔角化症的恶性潜能:一项单中心回顾性研究。
Cureus. 2021 Feb 2;13(2):e13083. doi: 10.7759/cureus.13083.
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Two percent lovastatin ointment as a pathogenesis-directed monotherapy for porokeratosis.2%洛伐他汀软膏作为针对汗孔角化症发病机制的单一疗法
JAAD Case Rep. 2020 Aug 22;6(10):1110-1112. doi: 10.1016/j.jdcr.2020.08.017. eCollection 2020 Oct.