Algorithm of topical oxidant application in the treatment of seborrheic keratosіs based on ultrasound and pathomorphological features

G. Makurina, L. О. Cherneda
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Abstract

Objective — to develop an algorithm for the use of a topical oxidizing agent (hydrogen peroxide) in the treatment of seborrheic keratosis (SK), taking into account the ultrasound (US) and pathomorphological data and using statistical models. Materials and methods. 35 patients aged 35 to 75 (32 (91.4 %) women and 3 (8.6 %) men) with seborrheic keratomas were examined on the basis of «University Clinic» Medical Educational and Scientific Center of Zaporizhzhia State Medi­cal University. Clinical, dermatoscopic and pathomorphological research methods were used for diagnostic purposes. To determine the thickness of keratosis, an ultrasound scan was performed. Results and discussion. Topical adapalene was applied locally to SK foci for 2 weeks, 2 times a day in 35 patients. After retinoid administration, the thickness of most foci decreased (n = 26; 74.3 %), but some of them did not change significantly (n = 9; 25.7 %). For the purpose of chemical destruction, it was recommended to use a topical oxidant — 30 % solution of hydrogen peroxide. Group 1 (application of topical oxidant in one cycle) included 20 patients who used the remedy for 5—6 days. The duration of treatment for ≥ 7—10 days was recommended for 15 patients of group 2. A comparison of keratoma thickness in patients of both groups with different duration of oxidant use revealed a statistically significant difference between subgroups (U = 88.500; p < 0.05). The greater the thickness of the keratoma was, the more it needed additional application of hydrogen peroxide. Taking into account the pathomorphological and ultrasound signs, a discriminant analysis was performed between groups of patients with 1 and 2 cycles of hydrogen peroxide application. In case of less than 0 index, longer therapy was recommended. Conclusions. The scheme using topical oxidant is a promising area of treatment for patients with SK and requires further study. The application of statistical methods made it possible to identify the main variable features (pathomorphological variant and keratoma thickness), which determine the choice of the duration of hydrogen peroxide application.
基于超声和病理形态学特征的外用氧化剂治疗脂溢性角膜炎的算法
目的-开发一种使用局部氧化剂(过氧化氢)治疗脂溢性角化病(SK)的算法,考虑到超声(US)和病理形态学数据并使用统计模型。材料和方法。在中国国立医科大学医学教育与科学中心对35例35 ~ 75岁脂溢性角膜炎患者进行检查,其中女性32例(91.4%),男性3例(8.6%)。临床,皮肤镜和病理形态学研究方法用于诊断目的。为了确定角化病的厚度,进行了超声扫描。结果和讨论。35例患者局部应用阿达帕林,连续2周,每天2次。类维甲酸给药后,大多数病灶厚度减小(n = 26;74.3%),但部分无显著变化(n = 9;25.7%)。为了化学破坏的目的,建议使用局部氧化剂- 30%过氧化氢溶液。第1组(局部使用氧化剂一个周期)包括20例患者,用药5-6天。2组15例患者推荐治疗时间≥7-10天。比较两组不同氧化剂使用时间患者的角质瘤厚度,亚组间差异有统计学意义(U = 88.500;P < 0.05)。角质瘤的厚度越大,就越需要额外的双氧水。考虑到病理形态学和超声征象,对使用1和2个双氧水周期的患者组进行判别分析。当指数小于0时,建议延长治疗时间。结论。使用局部氧化剂的方案是治疗SK患者的一个有前途的领域,需要进一步研究。统计方法的应用使识别主要变量特征(病理形态学变异和角膜炎厚度)成为可能,这些特征决定了过氧化氢应用时间的选择。
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