Abstract：
BACKGROUND: Porokeratosis is a group of disorders characterized by aberrant skin keratinization secondary to genetic alterations in the mevalonate pathway, which participates in cholesterol synthesis. While a rare disorder, malignant transformation to squamous cell carcinoma is seen in up to 11% of cases. Recently, topical cholesterol and topical statin therapy have been suggested as a pathogenesis-directed treatment for porokeratosis.
METHODS: A PubMed/MEDLINE and Embase literature search was performed using the search terms: \"porokeratosis\" AND \"cholesterol\" OR \"lovastatin\" OR \"simvastatin\" OR \"atorvastatin\" OR \"fluvastatin\" OR \"pitavastatin\" OR \"pravastatin\" OR \"rosuvastatin\" OR \"statin.\" Peer-reviewed clinical trials, case series, and case reports of all porokeratosis subtypes were included.
RESULTS: Eleven articles were included in the systematic review and 9 articles in the meta-analysis. The systematic review consisted of an aggregate of 33 patients, most of whom (n=31, 93.9%) applied the treatment twice daily for an average of 9.4 weeks (median=8 weeks), with 93.9% (n=31) experiencing improvement or resolution of porokeratosis. Sixteen patients (48.5%) used lovastatin and 16 (48.5%) used simvastatin with concurrent cholesterol therapy. Mild adverse events including erythema and contact dermatitis were experienced by 12.1% of patients. Our meta-analysis yielded a random effects model supporting a robust reduction in porokeratosis severity (OR = .076, 95% CI [0.022, 0.262]).
CONCLUSIONS: This underpowered meta-analysis provides limited, preliminary evidence supporting the efficacy of topical cholesterol/statin therapy. Overall, quality studies and aggregated sample size are limited; future large clinical trials are needed to further elucidate the role of topical cholesterol/statin therapy in the treatment of porokeratosis. J Drugs Dermatol. 2023;22(12):1160-1165. doi:10.36849/JDD.7775.
METHODS: A PubMed/MEDLINE and Embase literature search was performed using the search terms: \"porokeratosis\" AND \"cholesterol\" OR \"lovastatin\" OR \"simvastatin\" OR \"atorvastatin\" OR \"fluvastatin\" OR \"pitavastatin\" OR \"pravastatin\" OR \"rosuvastatin\" OR \"statin.\" Peer-reviewed clinical trials, case series, and case reports of all porokeratosis subtypes were included.
RESULTS: Eleven articles were included in the systematic review and 9 articles in the meta-analysis. The systematic review consisted of an aggregate of 33 patients, most of whom (n=31, 93.9%) applied the treatment twice daily for an average of 9.4 weeks (median=8 weeks), with 93.9% (n=31) experiencing improvement or resolution of porokeratosis. Sixteen patients (48.5%) used lovastatin and 16 (48.5%) used simvastatin with concurrent cholesterol therapy. Mild adverse events including erythema and contact dermatitis were experienced by 12.1% of patients. Our meta-analysis yielded a random effects model supporting a robust reduction in porokeratosis severity (OR = .076, 95% CI [0.022, 0.262]).
CONCLUSIONS: This underpowered meta-analysis provides limited, preliminary evidence supporting the efficacy of topical cholesterol/statin therapy. Overall, quality studies and aggregated sample size are limited; future large clinical trials are needed to further elucidate the role of topical cholesterol/statin therapy in the treatment of porokeratosis. J Drugs Dermatol. 2023;22(12):1160-1165. doi:10.36849/JDD.7775.
摘要：
背景：角化病是一组以甲羟戊酸途径遗传改变继发的异常皮肤角化为特征的疾病，参与胆固醇合成。虽然是一种罕见的疾病，恶性转化为鳞状细胞癌的病例高达11％。最近,局部胆固醇和局部他汀类药物治疗已被认为是针对汗孔角化病的发病机制的治疗方法.
方法：使用以下搜索术语进行PubMed/MEDLINE和Embase文献检索：\"孔眼角化病\"和\"胆固醇\"或\"洛伐他汀\"或\"辛伐他汀\"或\"阿托伐他汀\"或\"氟伐他汀\"或\"普伐他汀\"或\"“同行评审的临床试验，案例系列,并纳入了所有孔角化病亚型的病例报告。
结果：11篇文献纳入系统综述，9篇文献纳入荟萃分析。系统评价由33名患者组成，其中大多数（n=31，93.9%）每天两次治疗，平均9.4周（中位数=8周），93.9%(n=31)的患者出现孔眼角化的改善或消退。16例患者（48.5％）使用洛伐他汀，16例（48.5％）使用辛伐他汀并同时进行胆固醇治疗。12.1%的患者出现轻度不良事件，包括红斑和接触性皮炎。我们的荟萃分析产生了一个随机效应模型，该模型支持可靠地降低了孔型角化症的严重程度（OR=.076,95%CI[0.022,0.262]）。
结论：这项功能不足的荟萃分析提供了有限的，初步证据支持局部胆固醇/他汀类药物治疗的疗效。总的来说,高质量的研究和汇总的样本量有限;需要未来的大型临床试验来进一步阐明局部胆固醇/他汀类药物治疗在毛细血管角化症中的作用.J药物Dermatol.2023年；22（12）：1160-1165。doi:10.36849/JD.7775.
方法：使用以下搜索术语进行PubMed/MEDLINE和Embase文献检索：\"孔眼角化病\"和\"胆固醇\"或\"洛伐他汀\"或\"辛伐他汀\"或\"阿托伐他汀\"或\"氟伐他汀\"或\"普伐他汀\"或\"“同行评审的临床试验，案例系列,并纳入了所有孔角化病亚型的病例报告。
结果：11篇文献纳入系统综述，9篇文献纳入荟萃分析。系统评价由33名患者组成，其中大多数（n=31，93.9%）每天两次治疗，平均9.4周（中位数=8周），93.9%(n=31)的患者出现孔眼角化的改善或消退。16例患者（48.5％）使用洛伐他汀，16例（48.5％）使用辛伐他汀并同时进行胆固醇治疗。12.1%的患者出现轻度不良事件，包括红斑和接触性皮炎。我们的荟萃分析产生了一个随机效应模型，该模型支持可靠地降低了孔型角化症的严重程度（OR=.076,95%CI[0.022,0.262]）。
结论：这项功能不足的荟萃分析提供了有限的，初步证据支持局部胆固醇/他汀类药物治疗的疗效。总的来说,高质量的研究和汇总的样本量有限;需要未来的大型临床试验来进一步阐明局部胆固醇/他汀类药物治疗在毛细血管角化症中的作用.J药物Dermatol.2023年；22（12）：1160-1165。doi:10.36849/JD.7775.
