| Objective:To evaluate the effectiveness and safety of compound acid combined with intense pulsed light in the treatment of papulopustular rosacea.Methods:A total of 96 patients with papulopustular rosacea who attended the outpatient clinic of the Department of Dermatology of the First Affiliated Hospital of Chengdu Medical College from December 2021 to December 2022 and met the inclusion and exclusion criteria were selected.They were divided into three groups according to the random number table method: groups A,B,and C.In addition to the basic treatment（oral minocycline hydrochloride capsule [100 mg 1 time/day] and hydroxychloroquine sulfate tablets [0.2 g 2 times/day]）,group A was treated with compound acid combined with intense pulsed light sequential treatment,i.e.compound acid treatment first,followed by intense pulsed light treatment 2 weeks later,for 3 consecutive courses;group B was treated with intense pulsed light treatment only,once every 4 weeks,for 3 consecutive courses;group C was treated with compound acid once every 4 weeks for 3 consecutive courses of treatment.The effectiveness and safety of compound acid combined with intense pulsed light in the treatment of papulopustular rosacea were evaluated by analyzing the regression of inflammatory lesions,VISIA erythema differentiation value,Ros Qo I score,and the occurrence of adverse reactions before and after 4,8,and 12 weeks of treatment in the three groups.Results:1.A total of 96 patients were included in this study,and 5 cases lost to follow-up.There were no statistically significant differences in gender,age,disease duration,total disease assessment score,VISIA erythema area score values,and Ros Qo I score among patients in groups A,B and C before treatment（P>0.05）.2.Ending observation indicators:（1）Determination of efficacy: when the outcome variables were classified as ineffective and effective dichotomous information,the results of the generalized estimating equation suggested that the differences in time effects and between-group effects were statistically significant（P<0.05）.With group A as the reference group,the effective rates in both groups B and C were lower than those in group A,and the differences were statistically significant（P<0.05）.With 4 weeks of treatment as the reference group,the efficiency rate of 8 and 12 weeks of treatment was higher than that of 4 weeks of treatment,and the differences were statistically significant（P<0.05）.（2）Repeated measures ANOVA on the rate of regression of inflammatory lesions,VISIA erythema differentiation values,and Ros Qo I scores in the three groups showed statistically significant differences in time effects,between-group effects,and interaction effects between groups and time（P<0.05）.Therefore,separate effects analysis was performed.（1）Inflammatory lesion regression rate: the difference of time effect was statistically significant（P<0.05）,and the regression rate of inflammatory skin lesions showed an increasing trend with time;the difference of between-group effect was statistically significant（P<0.05）at 4 and 8 weeks of treatment,and the results of two-by-two comparison suggested that the relationship between the size of inflammatory skin lesion regression rate was group A>group C>group B（P<0.05）;at 12 weeks of treatment,there was no statistically significant difference in the effect between the groups（P>0.05）.（2）VISIA erythema differentiation value: the difference of time effect was statistically significant（P<0.05）,and the erythema differentiation value of each group decreased with the increase of treatment time;at 4 weeks of treatment,the difference of group effect was statistically significant（P<0.05）,and the results of two-two comparison suggested that the VISIA erythema differentiation value of group A was lower than that of groups B and C（both with P<0.05）,while the difference between group B and group C was not statistically（P>0.05）;at 8 and 12 weeks of treatment,the difference in effect between groups was statistically significant（P<0.05）,and the relationship between the two comparative results scores was group A<group B<group C（P<0.05）.（3）Ros Qo I score: the time effect difference was statistically significant（P<0.05）,and the Ros Qo I score decreased with the prolongation of treatment time in each group;at 4weeks of treatment,the difference between group effects was statistically significant（P<0.05）,and the two-two comparison results suggested that the Ros Qo I score was lower in group A than in groups B and C（P<0.05）,and the difference between group B and group C was not statistically significant（P>0.05）;at 8 and 12 weeks of treatment,the difference in the effect between groups was statistically significant（P<0.05）,and the results of the two-two comparison suggested that the score relationship was group A<group B<group C（P<0.05）.3.Adverse reactions: incidence of adverse reactions group A: 12.9%;group B:16.67%;group C 13.33%,the difference was not statistically significant（P>0.05）.Conclusion:1.The efficacy of PPR treatment with compound acid combined with IPL is more accurate than that of IPL alone or compound acid alone,especially for the regression of inflammatory lesions and improvement of facial erythema,which can shorten the treatment course and improve the quality of life of patients,and can be an important supplement to PPR treatment.2.The combination of compound acid and IPL treatment for PPR has high safety,although some patients have adverse reactions,the symptoms are mild and can be tolerated.Objective:By performing clinical symptom scores,Demodex mite detection,VISIA and dermoscopic tests on patients with different types of rosacea before and after treatment,the characteristics of Demodex mite infection,VISIA erythema differentiation values,dermoscopic manifestations and whether there is a certain relationship between them and the severity of the disease were investigated to provide an objective basis for the diagnosis and disease assessment of the disease.Methods:Seventy-eight patients with rosacea who attended the outpatient clinic of the Department of Dermatology of the First Affiliated Hospital of Chengdu Medical College between December 2021 and December 2022 and met the inclusion and exclusion criteria were selected.Complete clinical data were collected and relevant clinical symptom scores,wormy mite detection,VISIA and dermoscopic image acquisition（including background color,vessel morphology,vessel arrangement and non vascular structures,etc.）.The above data were compiled,recorded and analyzed to describe the clinical characteristics of rosacea patients before and after treatment,to explore whether there is a relationship between the above characteristic manifestations and the severity of the disease,and to evaluate the value of the above characteristic manifestations in the diagnosis and disease assessment of rosacea.Results:1.A total of 78 patients were included in this study,6 males and 72 females,with a male to female ratio of 0.08:1;42 patients with ETR and 36 patients with PPR,with an age M(P25,P75)of 29.00（26.00,33.00）years.2.Dermoscopic features of patients with rosacea before treatment: red（49,62.82%）or crimson background（45,57.69%）,polygonal vessels（59,75.64%）,linear branching vessels（52,66.67%）,reticular distribution（64,82.05%）,and absence of scaling（43,55.12%）predominated the presentation;non-vascular structures commonly presented as papular pustules（35,44.87%）,and follicular horny plugs（37,47.43%）.The main changes in dermoscopic features after treatment were: the background color was mainly light red or yellowish red,with statistically significant differences（P<0.05）;the proportion of polygonal vessels decreased compared with that before treatment,with statistically significant differences（P<0.05）;the arrangement of vessels changed,with no statistically significant differences（P>0.05）;the yellowish-white scales decreased,with no statistically significant differences（P>0.05）;the non-vascular structure,the proportion of papular pustules decreased in PPR patients,the difference was statistically significant（P<0.05）.3.The prevalence of Demodex mite infection was higher in PPR than in ETR before treatment（69.40% vs.45.31%）,with a statistically significant difference（P<0.05）;the clinical symptom scores were higher in patients positive for Demodex mite infection than in patients negative for Demodex mite infection before treatment,with a statistically significant difference（P<0.05）;the prevalence of Demodex mite infection decreased in patients with different staging of rosacea after treatment（56.41% vs.29.48%）,the difference was statistically significant（P<0.05）,and the clinical scores of positive patients with Demodex mite infection were also higher than those of negative patients,and the difference was statistically significant（P<0.05）.4.There was a correlation between VISIA erythema area score value and clinical symptom scores in patients with rosacea（rs=0.659-0.986,P<0.05）.Conclusion:1.Rosacea patients have characteristic dermoscopic manifestations,mainly a red or crimson background,polygonal vessels and vascular reticulation;ETR and PPR patients’ dermoscopic changes after treatment are mainly a change in background color and a decrease in polygonal vessels;among them,the papulopustular manifestation is reduced after PPR treatment;2.The rate of positive Demodex mite infection is higher in PPR than in ETR,and clinical symptoms may be more severe in patients with positive Demodex mite infection;3.The VISIA erythema differentiation value can be used to assess the severity of disease in patients with rosacea. |
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