应用tera3d®成像系统客观评价曲安奈德治疗瘢痕疙瘩的疗效。

Fedele Lembo, Liberato Roberto Cecchino, Domenico Parisi, Aurelio Portincasa
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引用次数: 0

摘要

背景:瘢痕疙瘩是一种病理性疤痕,其特征是结节状纤维组织延伸到初始损伤的边界之外。这些病变不会自发消退,并可能导致美容毁容和功能障碍。病灶内注射曲安奈德(ILITA),单独或与其他治疗联合,是一线治疗方式之一。在这项研究中,作者评估了ILITA治疗使用这种新的成像系统治疗瘢痕疙瘩的客观疗效。材料与方法:应用曲安奈德(triamcinolone acetonide, TAC) 20mg /ml,间隔3周,治疗瘢痕疙瘩瘢痕37例(45例)。Antera3D®相机在治疗前(T0)和最后一次注射后三周(T1)拍摄每位患者治疗区域的图像和日期。该系统处理颜色、海拔、黑色素和血红蛋白的表达水平。同时采用温哥华疤痕量表(Vancouver Scar Scale, VSS)对所有疤痕进行评估。结果:在T0时,平均VSS评分为8.67±1.35,在最终随访时降至3.62±1.72。治疗后Antera3D®评分在颜色(8.14±2.41 vs 9.54±1.81)、突出(381.3±15.6 vs 198.6±21.3)、黑色素(0.53±0.02 vs 0.62±0.2)和血红蛋白(1.26±0.41 vs 2.21±0.41)表达水平上差异有统计学意义。结论:在我们的临床试验中,数据结果表明ILITA似乎可以有效地减少瘢痕疙瘩的尺寸和症状,如瘙痒和疼痛,即使治疗有局部最小的不良反应,如疼痛,毛细血管扩张和萎缩。概要:瘢痕疙瘩是一种病理性疤痕,其特征是结节状纤维组织延伸到初始损伤的边界之外。大的瘢痕疙瘩会导致美容毁容和功能障碍,影响生活质量。在文献中,已经描述了几种治疗方法,但迄今为止,没有一种方法被认为是优越的。疤痕管理国际咨询小组建议使用局内类固醇注射治疗瘢痕疙瘩。治疗效果可采用主观量表进行评价;因为没有人能保证客观的评价。为了消除观察者和/或患者因素,并获得可靠、一致、可行、有效和客观的评估,可以使用名为Antera3D®(Miravex, Dublin, Ireland)的皮肤分析摄像系统。在这项研究中,作者评价了曲安奈德治疗在瘢痕疙瘩管理中使用该成像系统的客观疗效。在这个系列中,Antera3D®评分在治疗前后的颜色、突出、黑色素和血红蛋白表达水平上有统计学意义。该装置直接显示治疗变化,测量客观准确,不存在传统评价计分量表的偏倚。Antera3D®系统保证对疤痕治疗的有效性进行客观评估,使临床医生能够根据注册的分数调整治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

The objective evaluation of triamcinolone acetonide efficacy in keloids management using Antera3D® imaging system.

The objective evaluation of triamcinolone acetonide efficacy in keloids management using Antera3D® imaging system.

The objective evaluation of triamcinolone acetonide efficacy in keloids management using Antera3D® imaging system.

The objective evaluation of triamcinolone acetonide efficacy in keloids management using Antera3D® imaging system.

Background: Keloids are pathological scars characterized by nodular fibrous tissue that extends beyond the border of initial damage. These lesions do not spontaneously regress and can cause cosmetic disfigurements and functional disabilities. IntraLesional Injection of Triamcinolone Acetonide (ILITA), alone or in combination with other therapy, is one of the first-line treatment modalities. In this study the authors evaluated the objective efficacy of ILITA treatment in keloids management using this new imaging system.

Materials and methods: 37 patients with 45 keloid scars were treated with intralesional injection of triamcinolone acetonide (TAC) 20 mg/ml at an interval of three weeks. Antera3D® camera took the images and dates of the treated area in each patient, before the treatment (T0) and at three weeks after the last injection (T1). The system processed the levels of color, elevations, melanin and hemoglobin expression. All the scars were also evaluated, at the same times, by validated Vancouver Scar Scale (VSS). Comparison of the variables was performed using a Wilcoxon signed-rank test with a p < 0.05.

Results: At T0, mean VSS score was 8.67 ± 1.35 which reduced to 3.62 ± 1.72 at final follow up. Antera3D® scores were statistically significant differences in color (8.14 ± 2.41 vs 9.54 ± 1.81), protrusion (381.3 ± 15.6 vs 198.6 ± 21.3), melanin (0.53 ± 0.02 vs 0.62 ± 0.2) and hemoglobin (1.26 ± 0.41 vs 2.21 ± 0.41) expression levels after the treatment.

Conclusions: In our clinical trial, the data results demonstrated that ILITA seems to be effective in reducing keloid dimensions and symptoms such as itching and pain, even if the treatment has local minimal adverse effects such as pain, telangiectasias and atrophy.

Lay summary: Keloids are pathological scars characterized by nodular fibrous tissue that extends beyond the border of initial damage. Large keloids can cause cosmetic disfigurements and functional disabilities that affect quality of life. In literature, several treatment approaches have been described but, to date, no single method is considered superior. The International Advisory Panel on Scar Management recommended the use of intralesional steroid injections for keloids treatment. The efficacy of treatment may be evaluated with subjective scale; as no one can guarantee an objective evaluation. To eliminate the observer and/or patient factors, and to obtain a reliable, consistent, feasible, valid and objective evaluation a skin analysis camera system called Antera3D® (Miravex, Dublin, Ireland) can be used.In this study the authors evaluated the objective efficacy of triamcinolone acetonide treatment in keloids management using this imaging system. In this series, for Antera3D® scores there were statistically significant differences in color, protrusion, melanin and hemoglobin expression levels before and after treatment. The device directly shows the treatment changes, measured objectively and accurately, without bias of traditional evaluation scoring scale.Antera3D® system guarantees an objective evaluation of effectiveness of scar treatment enabling clinicians to modulate the therapy according to the scores registered.

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