摘要目的 观察0.1％他克莫司软膏不同疗程治疗面部糖皮质激素依赖性皮炎的临床疗效、安全性以及治疗结束后的病情反跳情况.方法 将104例面部糖皮质激素依赖性皮炎患者随机分为3组,均给予0.1％他克莫司软膏外涂,每日2次,疗程分别为4周、8周、16周,比较3组的疗效.疗程结束后4周随访比较3组的反跳情况.结果 共90例患者完成临床研究,其中疗程4周组32例、疗程8周组29例、疗程16周组29例,总有效率分别为75.00％、82.76％及86.21％,3组间有效率差异无统计学意义.3组的反跳率分别为46.88％、41.38％及20.69％,疗程16周组与疗程4周组、疗程8周组比较,差异均有统计学意义；疗程4周组与疗程8周组比较,差异无统计学意义.31.73％患者局部有刺激反应,均发生在治疗第1周.结论 0.1％他克莫司软膏治疗面部糖皮质激素依赖性皮炎安全、有效,疗程延长,总有效率上升不明显,疗程4周即能获得明显而稳定的疗效.但疗程越长,治疗结束后的反跳率越低.

abstractsObjective To evaluate the clinical efficacy and safety of different courses of topical tacrolimus 0.1％ ointment in facial corticosteroid-dependent dermatitis and to observe the rebound in patients after treatment with these regimens.Methods A total of 104 patients with facial corticosteroid-dependent dermatitis were randomly divided into 3 groups to be treated with topical tacrolimus 0.1％ ointment twice daily for 4,8 and 16 weeks respectively.The patients were followed up every 2 weeks within the early 4 weeks of treatment and every 4 weeks thereafter.The rebound phenomena was observed in patients on week 4 after the withdrawal of tacrolimus.Results Finally,90 patients completed this trial,including 32 patients in the 4-week group,29 patients in the 8-week group and 29 patients in the 16-week group.No significant differences were observed between the 4-,8- and 16-week groups in the total reponse rate (75.00％,82.76％,86.21％,respectively,x2 =1.35,P ＞ 0.05).The rebound rate in the 16-week group significantly differed from that in the 4- and 8-week group (20.69％ vs.46.88％ and 41.38％,both P＜ 0.05),while no statistical difference was noted between the 4- and 8-week groups.Local burning and itching were reported in 31.73％ of these patients,and all of these irritant reactions occurred within the first week of treatment.Conclusions Topical tacrolimus 0.1％ ointment is safe and effective for the treatment of facial corticosteroid-dependent dermatitis.The total response rate does not increase with the extended treatment course,and 4 weeks of treatment is enough for the marked and stable improvement of facial corticosteroid-dependent dermatitis,but the rebound rate is likely to be reduced by extended treatment course.