Intradermal injection of botulinum toxin for erythema in rosacea: A scoping review and meta-analysis.

IF 3.4 4区 医学 Q2 DERMATOLOGY
Marvin Chia-Han Yeh, Ya-Chu Shih, Yu-Chen Huang
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引用次数: 0

Abstract

Background Rosacea is a skin condition characterised by persistent facial erythema, flushing, papules, pustules, and telangiectasia. Botulinum toxin A (BoNT-A) has been used to treat a variety of conditions, but its effectiveness in improving facial erythema in rosacea patients is uncertain. Objectives The aim of the study is to evaluate the effectiveness and determine the optimal dose of BoNT-A treatment for rosacea. Methods An online database search (Pubmed, Cochrane Library and Embase) was conducted on 30th June 2023 to identify studies that used intradermal injection of BoNT-A to treat facial erythema in rosacea patients and excluded studies in which BoNT-A was used for facial erythema due to other known medical condition such as menopause, drug or pregnancy. The primary outcome measure for this study was the improvement in erythema score as objectively assessed. A random effect model was used in the meta-analysis. Results Seven studies involving a total of 167 rosacea patients were included in the meta-analysis. Meta-analysis of two randomised controlled trials showed improvement of erythema on the third month after treatment standardized mean difference (SMD): 1.676, 95% confidence interval (CI): 2.278-1.074, I2: 35.76%). A separate analysis of seven single-armed treatment studies found significant improvement in erythema with intradermal injection of BoNT-A at one, two and three months after treatment (first month: SMD: 2.712, 95% CI: 4.1182-1.243; second month: SMD:2.213, 95% CI: 3.702-0.725; third month: SMD: 1.912, 95% CI: 2.882-0.941). Adverse events, including mild facial paralysis and injectional purpura, were reported in some studies. Limitation The limitations of this study include heterogeneity in study design and a small sample size. Conclusion Intradermal injection of BoNT-A may be an effective treatment for facial erythema in rosacea. Unwanted facial muscle paralysis was seen in different BoNT-A concentration but not noted when the dose was less than 0.02ml per site. Future studies particularly randomised trials are required to identify the volume of injection required to reduce the erythema.

肉毒杆菌毒素皮内注射治疗酒渣鼻红斑:范围回顾和荟萃分析。
背景:酒渣鼻是一种以持续的面部红斑、潮红、丘疹、脓疱和毛细血管扩张为特征的皮肤病。肉毒毒素A (BoNT-A)已被用于治疗多种疾病,但其在改善酒渣鼻患者面部红斑方面的有效性尚不确定。目的评价BoNT-A治疗酒渣鼻的疗效并确定最佳剂量。方法于2023年6月30日进行在线数据库检索(Pubmed、Cochrane Library和Embase),以确定使用BoNT-A皮内注射治疗酒痤疮患者面部红斑的研究,并排除由于其他已知医学状况(如绝经、药物或妊娠)而使用BoNT-A治疗面部红斑的研究。本研究的主要结局指标是客观评估的红斑评分的改善。meta分析采用随机效应模型。结果荟萃分析纳入了7项研究,共涉及167名酒渣鼻患者。两项随机对照试验的荟萃分析显示,治疗后第3个月红斑的改善标准化平均差(SMD): 1.676, 95%可信区间(CI): 2.278 ~ 1.074, I2: 35.76%。对7项单臂治疗研究的单独分析发现,在治疗后1、2和3个月皮内注射BoNT-A可显著改善红斑(第一个月:SMD: 2.712, 95% CI: 4.1182-1.243;第二个月:SMD:2.213, 95% CI: 3.702-0.725;第三个月:SMD: 1.912, 95% CI: 2.882-0.941)。在一些研究中报道了包括轻度面瘫和注射性紫癜在内的不良事件。本研究的局限性包括研究设计的异质性和样本量小。结论皮内注射BoNT-A是治疗酒渣鼻面部红斑的有效方法。不同BoNT-A浓度均可观察到不必要的面肌麻痹,但当BoNT-A浓度低于0.02ml /个部位时未见。未来的研究,特别是随机试验,需要确定减少红斑所需的注射量。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
2.10
自引率
10.30%
发文量
247
审稿时长
6-12 weeks
期刊介绍: The Indian Association of Dermatologists, Venereologists & Leprologists (IADVL) is the national association of Indian medical specialists who manage patients with skin disorders, sexually transmitted infections (STIs) or leprosy. The current member strength of the association is about 3800. The association works for the betterment of the specialty by holding academic meetings, printing a journal and publishing a textbook. The IADVL has several state branches, each with their own office bearers, which function independently within the constitution of the IADVL. Established in 1940, the Indian Journal of Dermatology, Venereology and Leprology (IJDVL, ISSN 0378-6323) is the official publication of the IADVL (Indian Association of Dermatologists, Venereologists and Leprologists).
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