反射式共聚焦显微镜观察强脉冲光治疗红斑毛细血管扩张型玫瑰痤疮的效果  

Effects of intense pulsed light on erythema telangiectasia rosacea observed with reflection confocal microscope

作　　者：范梦娇 何勤 罗青 王振华[2] FAN Mengjiao;HE Qin;LUO Qing;WANG Zhenhua(Weifang Medical University,Weifang 261000,Shandong,China;Department of Dermatology,The First Affiliated Hospital of Weifang Medical College(Weifang People's Hospital),Weifang 261000,Shandong,China)

机构地区：[1]潍坊医学院,山东潍坊261000 [2]潍坊医学院第一附属医院(潍坊市人民医院)皮肤科,山东潍坊261000

出　　处：《山东大学学报（医学版）》2022年第4期87-90,98,共5页Journal of Shandong University:Health Sciences

摘　　要：目的应用反射式共聚焦显微镜(RCM)观察强脉冲光(IPL)治疗经药物治疗无效的红斑毛细血管扩张型玫瑰痤疮患者前后皮肤结构的变化,进一步理解IPL的治疗机制。方法20例首次接受IPL治疗的红斑毛细血管扩张型玫瑰痤疮患者(35~46岁,Fitzpatrick皮肤Ⅲ~Ⅳ型)每4周接受1次IPL治疗,5次为1个疗程。在初次治疗前和末次治疗后1个月,分别应用RCM观测面部皮肤角质层厚度、毛细血管直径、真皮乳头密度并进行统计学分析。结果玫瑰痤疮患者经IPL治疗后的角质层厚度[(4.97±0.65)μm]与治疗前角质层厚度[(5.11±0.54)μm]比较,差异无统计学意义(P=0.249);患者治疗后平均毛细血管直径[(19.13±4.68)μm]较治疗前[(23.28±3.52)μm]减小(P<0.001);治疗后真皮乳头密度[(9.88±1.89)/mm^(2)]较治疗前[(7.77±0.89)/mm^(2)]增加(P<0.001)。患者治疗后皮肤外观明显改善,患者对RCM检查和治疗方法接受程度高。结论RCM能够在无创的情况下观测IPL治疗前后面部皮肤表皮层和真皮浅层结构的变化;IPL治疗红斑毛细血管扩张型玫瑰痤疮的疗效与皮肤结构的改善有关。Objective To observe the changes of skin structure in patients with erythema telangiectasia rosacea before and after intense pulsed light(IPL)treatment observed with reflection confocal microscope(RCM),and to explore the therapeutic mechanism of IPL.Methods A total of 20 patients(35 to 46 years old,Fitzpatrick typeⅢtoⅣ)with erythema telangiectasia rosacea who received IPL treatment for the first time were treated once every 4 weeks,5 times in a course.The stratum corneum thickness,diameter of capillaries and density of dermal papilla were measured with RCM before the first treatment and 1 month after the last treatment.Results The stratum corneum thickness after IPL treatment was(4.97±0.65)μm,which was not significantly different from that before IPL treatment[(5.11±0.54)μm](P=0.249).The mean capillary diameter after treatment was(19.13±4.68)μm,which was significantly shorter than that before treatment[(23.28±3.52)μm](P<0.001).The dermal papilla density after treatment was(9.88±1.89)/mm^(2),which was significantly thicker than that before treatment[(7.77±0.89)/mm^(2)](P<0.001).The skin aesthetic was significantly improved after treatment,and the patients had a high degree of acceptance of RCM examination and IPL treatment.Conclusion RCM can observe the structural changes of epidermis and superficial dermis of facial skin before and after IPL treatment without invasion.The therapeutic effects of IPL on erythema telangiectasia rosacea are related to the improvement of skin structure.

关 键 词：玫瑰痤疮 强脉冲光 反射式共聚焦显微镜 皮肤结构 

分 类 号：R758.733[医药卫生—皮肤病学与性病学]