鲍温样丘疹病四种疗法回顾性分析  

Retrospective Study of Four Treatment Modalities for Bowenoid Papulosis

作　　者：吕婷[1] 王宏伟[1] 王秀丽[1] 杨连娟[1] 肖芹[1] 过明霞[1] 

机构地区：[1]上海市皮肤病性病医院,上海200050

出　　处：《中国皮肤性病学杂志》2010年第2期126-128,共3页The Chinese Journal of Dermatovenereology

摘　　要：目的总结135例鲍温样丘疹病(BP)的治疗经验,以期为临床提供更佳治疗选择。方法回顾性分析四种不同方法治疗BP患者的临床资料,比较CO2激光、5-氨基酮戊酸光动力疗法(ALA-PDT)、外用咪喹莫特、咪喹莫特与ALA-PDT联合治疗四种疗法对BP的临床疗效和不良反应,对其治疗效果与随访结果进行总结。结果CO2激光组、ALA-PDT组、外用咪喹莫特组、联合组治愈率分别为82.86%,60.53%,48.15%,88.57%;复发率分别为62.07%,17.39%,7.69%,3.22%。激光组和联合组的疗效明显优于ALA-PDT组和外用咪喹莫特组(P均<0.01),ALA-PDT组、咪喹莫特组和联合组的复发率明显低于CO2激光组(P均<0.01),其余各组间差异无显著性(P均>0.05)。除激光组3例患者出现较明显的瘢痕修复以及外用咪喹莫特组1例患者出现用药部位色素减退外,余两组患者耐受性良好,最常见的副作用是治疗局部的红肿和糜烂。结论ALA-PDT联合咪喹莫特治疗BP,具有疗效好,复发率低的优势。对皮损较多和播散分布的BP患者,推荐采用光动力与咪喹莫特联合治疗。对于皮损较少的患者可直接选用CO2激光或直接外用咪喹莫特治疗。Objective The clinical data of patients with BP covering a period from 2000 to 2009 were analyzed retrospectively,and the effects and follow results of the four different treatment modalities for BP were summarized. Methods To summarize the treatment experience of 135 cases and supply better choice for clinical application. We compared four different treatment modalities for bowenoid papulosis（ BP）, including CO2 laser vaporization ,5-aminolevulinic acid photodynamic therapy （ALA-PDT）, topical imiquimod and ALA-PDT combined with imiquimod. Results The complete remission rate of the lesions treated by CO2 laser vaporization ,5-aminolevulinic acid photodynamic therapy （ ALA-PDT）, topical imiquimod and ALA-PDT combined with imiquimod were 82. 86%, 60. 55% , 48. 15%, 8g. 57%, respectively, and the relapse rate were 6：2.07% ,17.39% ,7.69% ,3.22% ,respectively. Comparing the four groups,the cure rate of CO2 laser vaporization and combination groups were much higher than the other two groups. The differences was significantely （ P 〈 0.01 ）. However,the recurrence rate of ALA-PDT,imiquimod and combination group were much lower than CO2 laser vaporization group （P 〈 0.01 ）. All of the patients had a good tolerance. The main side effect included erythema, edema, erosion. Obvious scar was observed in 3 patients in laser group and hypopigmentation of the external genital skin happened in 1 patient in imiquimod group. Conclusions The modality of ALA-PDT combined with 5% imiquimod is a good treatment for BP with a good cosmetic,functional results and lower recurrence risk. Also, either CO2 laser vaporization or imiquimod could be the first choice for patients with little lesions.

关 键 词：鲍温样丘疹病 光动力疗法 咪喹莫特 CO2激光 回顾性研究 

分 类 号：R739.5[医药卫生—肿瘤]