脉冲染料激光治疗局限性顽固性斑块状银屑病的有效性:一项比较研究  

Efficacy of the pulsed dye laser in the treatment of localized recalcitrant plaque psoriasis: A comparative study

作　　者：Erceg A. Bovenschen H. J. Van De Kerkhof P.C.M. Seyger M. M. B. 李政霄(译) 

机构地区：[1]不详 [2]Department of Dermatology, Radboud University Nijmegen Medical Centre, Rene Descartes dreef 1, PO Box 9101, 6525 GL Nijmegen, Netherlands

出　　处：《世界核心医学期刊文摘（皮肤病学分册）》2006年第9期35-36,共2页Digest of the World Core Medical JOurnals:Dermatology

摘　　要：Background: Localized chronic plaque psoriasis, resistant to local therapy, may be very hard to treat. The treatment of these lesions with a pulsed dye laser (PDL) has been described before, but a comparative study between the PDL and a potent topical treatment has never been performed. Objectives: To compare the efficacy of the PDL in the treatment of localized, recalcitrant plaque psoriasis with a potent topical therapy, using calcipotriol/betamethasone dipropionate (Dovobet ) as an active comparator. Methods: Eight patients with psoriasis were treated with both PDL(585 nm) and calcipotriol/ betamethasone dipropionate in an open, intrapatient, left-right comparison. A plaque severity score (sum score) and photographs were used to document the course of therapy. Patients reported pain on a visual analogue scale. Results: Both treatments were well tolerated, although one patient left the study due to post-PDL treatment pain. A significant difference in the sum score 12 weeks after treatment was seen in favour of the PDL (62% vs. 19% reduction; P < 0.05). Scores for erythema declined significantly at week 12 in both the PDL and the calcipotriol/betamethasone dipropionate group (P < 0.001). Induration and desquamation scores were significantly reduced at week 12 in the PDL group, without a statistically significant reduction in calcipotriol/betamethasone- treated lesions. The pain scores declined with progressive PDL treatments, although not statistically significantly. Conclusions: PDL treatment might be considered for the treatment of localized, recalcitrant plaque psoriasis, when other topical therapies have failed.Background： Localized chronic plaque psoriasis, resistant to local therapy, may be very hard to treat. The treatment of these lesions with a pulsed dye laser （PDL） has been described before, but a comparative study between the PDL and a potent topical treatment has never been performed. Objectives： To compare the efficacy of the PDL in the treatment of localized, recalcitrant plaque psoriasis with a potent topical therapy, using calcipotriol/betamethasone dipropionate （Dovobet ） as an active comparator. Methods： Eight patients with psoriasis were treated with both PDL（585 nm） and calcipotriol/ betamethasone dipropionate in an open, intrapatient, left-right comparison. A plaque severity score （sum score） and photographs were used to document the course of therapy. Patients reported pain on a visual analogue scale. Results： Both treatments were well tolerated, although one patient left the study due to post-PDL treatment pain. A significant difference in the sum score 12 weeks after treatment was seen in favour of the PDL （62% vs. 19% reduction; P 〈 0. 05） . Scores for erythema declined significantly at week 12 in both the PDL and the calcipotriol/betamethasone dipropionate group （P 〈 0. 001） Induration and desquamation scores were Significantly reduced at week 12 in the PDL group, without a statistically significant reduction in calcipotriol/betamethasone- treated lesions. The pain scores declined with progressive PDL treatments, although not statistically significantly. Conclusions： PDL treatment might be considered for the treatment of localized, recalcitrant plaque psoriasis, when other topical therapies have failed.

关 键 词：脉冲染料激光治疗 斑块状银屑病 顽固性 严重程度评分 有效性 视觉模拟评分法 倍他米松 卡泊三醇 

分 类 号：R752.5[医药卫生—皮肤病学与性病学]