Yizhu Xiao PhD, Jingyi He PhD, Anwei Chen MD, Xiao Fang MD, Ping Tang MD, Juan Xiang PhD
{"title":"克拉霉素治疗儿童肉芽肿性周周皮炎:一项回顾性队列研究","authors":"Yizhu Xiao PhD, Jingyi He PhD, Anwei Chen MD, Xiao Fang MD, Ping Tang MD, Juan Xiang PhD","doi":"10.1016/j.jdin.2025.08.005","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Childhood granulomatous periorificial dermatitis incidence is increasing, yet topical therapies remain suboptimal with chronicity and scarring risks in severe cases. Systemic alternatives are urgently needed. Although oral clarithromycin shows promise, its efficacy/safety evidence in pediatric populations lacks robustness.</div></div><div><h3>Objective</h3><div>This study evaluated the effect of clarithromycin on a pediatric group with granulomatous periorificial dermatitis.</div></div><div><h3>Methods</h3><div>This retrospective study analyzed 43 patients treated with oral clarithromycin, with outcomes including treatment efficacy, adverse event incidence, and scar incidence.</div></div><div><h3>Results</h3><div>All patients completed clarithromycin therapy (median 10 weeks; 2-26). At 6 months, 95.4% (41/43) cleared, with 2.3% each recurrence and nonresponse. Treatment duration correlated with both baseline severity (<em>r</em> = 0.592, <em>P</em> < .01) and disease duration (<em>r</em> = 0.590, <em>P</em> < .01). Scarring (14.6%) occurred only in moderate-to-severe cases, which showed greater severity (<em>P</em> = .039) and longer courses (<em>P</em> = .028). No severe adverse events occurred.</div></div><div><h3>Limitations</h3><div>This is a retrospective study without case controls and is subject to interviewer and memory bias.</div></div><div><h3>Conclusion</h3><div>For moderate-to-severe or stubborn cases, timely evaluation and tailored systemic interventions are critical to mitigate scarring risks. Clarithromycin is an effective and tolerated therapy in children with moderate-to-severe and refractory granulomatous periorificial dermatitis.</div></div>","PeriodicalId":34410,"journal":{"name":"JAAD International","volume":"23 ","pages":"Pages 48-54"},"PeriodicalIF":5.2000,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Management of childhood granulomatous periorificial dermatitis with clarithromycin: A retrospective cohort study\",\"authors\":\"Yizhu Xiao PhD, Jingyi He PhD, Anwei Chen MD, Xiao Fang MD, Ping Tang MD, Juan Xiang PhD\",\"doi\":\"10.1016/j.jdin.2025.08.005\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>Childhood granulomatous periorificial dermatitis incidence is increasing, yet topical therapies remain suboptimal with chronicity and scarring risks in severe cases. Systemic alternatives are urgently needed. Although oral clarithromycin shows promise, its efficacy/safety evidence in pediatric populations lacks robustness.</div></div><div><h3>Objective</h3><div>This study evaluated the effect of clarithromycin on a pediatric group with granulomatous periorificial dermatitis.</div></div><div><h3>Methods</h3><div>This retrospective study analyzed 43 patients treated with oral clarithromycin, with outcomes including treatment efficacy, adverse event incidence, and scar incidence.</div></div><div><h3>Results</h3><div>All patients completed clarithromycin therapy (median 10 weeks; 2-26). At 6 months, 95.4% (41/43) cleared, with 2.3% each recurrence and nonresponse. Treatment duration correlated with both baseline severity (<em>r</em> = 0.592, <em>P</em> < .01) and disease duration (<em>r</em> = 0.590, <em>P</em> < .01). Scarring (14.6%) occurred only in moderate-to-severe cases, which showed greater severity (<em>P</em> = .039) and longer courses (<em>P</em> = .028). No severe adverse events occurred.</div></div><div><h3>Limitations</h3><div>This is a retrospective study without case controls and is subject to interviewer and memory bias.</div></div><div><h3>Conclusion</h3><div>For moderate-to-severe or stubborn cases, timely evaluation and tailored systemic interventions are critical to mitigate scarring risks. Clarithromycin is an effective and tolerated therapy in children with moderate-to-severe and refractory granulomatous periorificial dermatitis.</div></div>\",\"PeriodicalId\":34410,\"journal\":{\"name\":\"JAAD International\",\"volume\":\"23 \",\"pages\":\"Pages 48-54\"},\"PeriodicalIF\":5.2000,\"publicationDate\":\"2025-08-29\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"JAAD International\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S266632872500094X\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"JAAD International","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S266632872500094X","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
儿童肉芽肿性周周皮炎的发病率正在增加,但局部治疗仍然不理想,严重情况下存在慢性和瘢痕形成风险。我们迫切需要系统性的替代方案。尽管口服克拉霉素显示出前景,但其在儿科人群中的有效性/安全性证据缺乏可靠性。目的评价克拉霉素治疗小儿肉芽肿性周周皮炎的疗效。方法回顾性分析43例口服克拉霉素患者的治疗效果、不良事件发生率和疤痕发生率。结果所有患者均完成克拉霉素治疗(中位10周;2-26周)。6个月时,95.4%(41/43)患者痊愈,2.3%复发且无反应。治疗时间与基线严重程度(r = 0.592, P < 0.01)和病程(r = 0.590, P < 0.01)相关。瘢痕形成(14.6%)仅发生在中重度病例,其严重程度较高(P = 0.039),病程较长(P = 0.028)。未发生严重不良事件。局限性:这是一项没有病例对照的回顾性研究,容易受到采访者和记忆偏差的影响。结论对于中重度或顽固病例,及时评估和有针对性的系统干预是减轻瘢痕形成风险的关键。克拉霉素是一种有效和耐受性治疗儿童中重度难治性肉芽肿性周周皮炎。
Management of childhood granulomatous periorificial dermatitis with clarithromycin: A retrospective cohort study
Background
Childhood granulomatous periorificial dermatitis incidence is increasing, yet topical therapies remain suboptimal with chronicity and scarring risks in severe cases. Systemic alternatives are urgently needed. Although oral clarithromycin shows promise, its efficacy/safety evidence in pediatric populations lacks robustness.
Objective
This study evaluated the effect of clarithromycin on a pediatric group with granulomatous periorificial dermatitis.
Methods
This retrospective study analyzed 43 patients treated with oral clarithromycin, with outcomes including treatment efficacy, adverse event incidence, and scar incidence.
Results
All patients completed clarithromycin therapy (median 10 weeks; 2-26). At 6 months, 95.4% (41/43) cleared, with 2.3% each recurrence and nonresponse. Treatment duration correlated with both baseline severity (r = 0.592, P < .01) and disease duration (r = 0.590, P < .01). Scarring (14.6%) occurred only in moderate-to-severe cases, which showed greater severity (P = .039) and longer courses (P = .028). No severe adverse events occurred.
Limitations
This is a retrospective study without case controls and is subject to interviewer and memory bias.
Conclusion
For moderate-to-severe or stubborn cases, timely evaluation and tailored systemic interventions are critical to mitigate scarring risks. Clarithromycin is an effective and tolerated therapy in children with moderate-to-severe and refractory granulomatous periorificial dermatitis.