| Objective: To evaluate the efficacy and safety of doxycycline and hydroxychloroquine combined with red light in the treatment of rosacea type Ⅰ and type Ⅱ,and compare the differences of the dermoscopy characteristics before and after treatment.Methods: A total of 63 patients with type Ⅰ and type Ⅱ rosacea were enrolled and divided into the experimental group(n=31)and the control group(n=32)according to the random number table and conducted an 8-week clinical study.The control group were po administered with doxycycline(0.1g qd)and hydroxychloroquine(0.2g bid).The experimental group received red light treatment(twice a week)on the basement of the control group.The clinical feature scores and efficacy evaluation of the patient’s condition were conducted at the 0,4th and 8th week,and the patient’s satisfaction score was conducted at the 4th and 8th week according to the patient’s global assessment(PGA)of rosacea.Before treatment and after 8 weeks treatment,the average vessel diameter of the target lesion were measured by dermoscopy,and the differences of the lesion characteristics under the microscope were also compared.The liver function was tested once a month,and adverse reactions were recorded during the treatment.The recurrence was performed for 1-month followed up.Result:1.Pre-treatment,there was no significant difference in the total score of clinical severity between the experimental and control group(P > 0.05).At the 4 weeks treatment,the total score of the experimental group was lower than that of the control group,and there was a significant difference [2(2-3)vs.3(2-4),Z= 2.613,P < 0.01].At the 8 weeks treatment,the total score of the experimental group was significantly lower than that of the control group [1(0-2)vs.2(1-3),Z = 2.788,P = 0.005].When compared with the pre-treatment,the total score of the two groups was significantly decreased at the 4th and 8th week(P< 0.01).The PGA scores of the experimental group and control group were [(1.21 ± 0.94)vs.(0.94 ± 0.80)] and [(2.10 ± 1.15)vs.(1.63 ± 1.04)] at the 4weeks as well as 8 weeks treatment,with a statistically difference(P < 0.05).2.At the 4 weeks treatment,there was a significant difference in the scores of papules,pustules,burning,tingling,dryness and pruritus of facial skin between the experimental and control group(P < 0.05),but there was no significant difference in the scores of erythema(P > 0.05).At the 8 weeks treatment,there was a significant difference in the scores of erythema and papule between the experimental and control group(P<0.05),and there was no significant difference in the score of pustule and burning,tingling,dryness and itching of facial skin between the experimental and control group(P >0.05).3.Before treatment,the average vascular diameter of the target lesions in two groups were no significant difference [(0.084 ± 0.018)vs.(0.083 ± 0.020)mm,P > 0.05].At the 8 weeks treatment,the average vascular diameter of target lesions under dermoscopy of the experimental group was significantly lower than that of the control group [(0.027 ± 0.020)vs.(0.047 ± 0.028)mm,P < 0.05].At baseline,the two groups showed diffuse distribution of red,dark red background and polygonal vascular network.At the 8 weeks treatment,the two groups showed irregular distribution of light red background,atypical and linear vascular network,and the number of patients with polygonal vascular network in the experimental group was decreased relative to the control group(19.4% vs.34.4%),which were decreased compared with 0 and 4 weeks treatment.4.At the 4 weeks and 8 weeks treatment,the effective rates were 29.03% and 80.65%in the experimental group,and 9.38% and 53.13% in the control group,respectively,with significant differences between the two groups(P < 0.05).The recurrence rates of the two groups were 22.6% and 46.9%,respectively(P < 0.05).5.Gastrointestinal discomfort(such as nausea and vomiting)was the most common adverse reactions in two groups.The occurrence of transient skin pricking in 2 patients and mild elevation of glutamic-pyruvic transaminase in 1 patient,and all of the adverse reactions within the patient’s tolerance.Conclusion:1.Red light therapy combined with doxycycline and hydroxychloroquine could effectively improve the symptoms and signs of rosacea.2.Red light therapy in combination with doxycycline and hydroxychloroquine could contribute to improving the dermoscopic features of rosacea,and dermoscopy can be used as a non-invasive imaging method for efficacy monitoring.3.Red light combined with doxycycline and hydroxychloroquine could effectively reduce the short-term recurrence rate of rosacea and with a higher safety. |
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