激光治疗酒渣鼻:病理病因学研究

作     者：Lonne-Rahm S. Nordlind K. Edstrm D.W. 牛新武 

作者机构：Unit of Dermatology and Venereology Department of Medicine Karolinska Hospital S- 171 76 Stockholm Sweden Dr. 

出 版 物：《世界核心医学期刊文摘（皮肤病学分册）》 (Digest of the World Core Medical JOurnals:Dermatology)

年 卷 期：2005年第1卷第3期

页      面：38-38页

学科分类：1002[医学-临床医学] 100206[医学-皮肤病与性病学] 10[医学] 

主　　题：病因学研究 抗生蛋白链菌素 真皮乳头 毛细血管扩张 降钙素基因 免疫组化法 神经肽 舒血管肠肽 颜面潮红 针刺感 

摘      要：Objective: To study the effect of laser treatment on rosacea, a common facial skin disease with symptoms of blushing, redness, telangiectasis, papules, pustu les, and diffuse swelling of the skin, we focused on the stinging sensation and performed immunohistochemical evaluation of nerve density and neuropeptide expre ssion. Design: Clinical investigation as well as the lactic acid (stinger) test was performed before and 3 months after the treatment with flashlamp pulsed dye laser, when skin biopsy specimens were also taken. Setting: University hospital. Patients: Thirty-two patients with rosacea, all with positive results from th e lactic acid “ stinger test, were treated by flashlamp pulsed dye laser. Ma in Outcome Measures: The biopsy specimens were taken from the stinger-positive areas in the nasolabial folds, fixed in Lanas fixative (10% formalin and 0.4 % picric acid), and analyzed for the expression of protein gene product 9.5 (g eneral nerve marker), substance P, calcitonin gene-related peptide, and vasoac tive intestinal polypeptide, using a biotinylated streptavidin technique. Result s: Thirtyone patients who were stinger positive before treatment showed decrease d scores after treatment, and 1 patient had the same stinger test score before a nd after treatment. The number of protein gene product 9.5-positive fibers in the epidermis (P .05) as well as the papillary dermis (P .01) was decreased. This was also the case for substance P in the papillary dermis (P .001),whereas no evident differencewas noted for vasoactive intestinal polypeptide and calcit onin gene-related peptide. No difference was found for contact between nerves and vessels (factor VIII positive). Conclusions: Laser treatment of rosacea that destroys small vessels has a good medical relevance because it reduces the unpl easant symptoms of the sensitive skin. A neurogenic etiology of stinging may be possible.