Abstract:
Porokeratosis is a rare group of acquired or hereditary dermatoses characterized by linear or annular plaques with a keratotic border. DSAP is the most common porokeratosis, and lesions range from asymptomatic to pruritic circular pink to brown macules, papules, or plaques surrounded by a raised border. DSAP carries about 7.5-10% risk of malignant transformation to SCC or BCC. While in the past DSAP has been widely treated with topical diclofenac, ingenol mebutate, topical vitamin D analog, 5-fluorouracil, imiquimod, photodynamic therapy, retinoids, cryotherapy, and laser therapy, these therapies have shown limited efficacy and have caused adverse effects including inflammatory reactions, hyperpigmentation, pain, and erythema. Recently, a formulation of topical statin and cholesterol has surfaced as a new and promising treatment for DSAP which has shown clinical improvement with a tolerable adverse effect profile when compared to the current therapies. Of the 8 case studies with a total of 20 patients with DSAP, 90% (18/20) reported clinical improvement with various forms of topical statin therapy. While promising, larger randomized controlled trials are needed to evaluate the long-term use of topical statins for DSAP. J Drugs Dermatol. 2023;22(10): doi:10.36849/JDD.7540.
摘要:
角化病是一组罕见的获得性或遗传性皮肤病,其特征是具有角化边界的线性或环形斑块。DSAP是最常见的孔角化病,和病变范围从无症状到瘙痒圆形粉红色到棕色黄斑,丘疹,或被凸起的边界包围的斑块。DSAP具有约7.5-10%的恶性转化为SCC或BCC的风险。虽然在过去,DSAP已广泛使用局部双氯芬酸治疗,麦辛醇,外用维生素D类似物,5-氟尿嘧啶,咪喹莫特,光动力疗法,类维生素A,冷冻疗法,和激光治疗,这些疗法显示出有限的疗效,并引起包括炎症反应在内的不良反应,色素沉着过度,疼痛,和红斑.最近,局部他汀类药物和胆固醇的制剂已成为一种新的有希望的DSAP治疗方法,与目前的治疗方法相比,该药物的临床效果有所改善,不良反应可耐受。在8个病例研究中,共有20名DSAP患者,90%(18/20)报告了各种形式的局部他汀类药物治疗的临床改善。虽然有希望,需要更大的随机对照试验来评估DSAP局部使用他汀类药物的长期使用.J药物Dermatol.2023年;22(10):doi:10.36849/JD.7540。