| Background: The majority of common scalp seborrhoeic dermatitis is mild to moderate and some can resolve or heal on their own,but moderate to severe scalp seborrhoeic dermatitis often requires pharmacological intervention.In recent years,BROAD supramolecular salicylic acid hair treatment(containing 2% salicylic acid)has been reported for its anti-inflammatory,skin barrier repair and keratolytic effects in the treatment of scalp seborrheic dermatitis.However,in the previous clinical treatment,we found that for patients with moderate to severe scalp seborrheic dermatitis,topical application of 2% salicylic acid lotion was ineffective,and we experimentally increased the concentration of salicylic acid to 5% and observed a significant relief of the patient’s symptoms,as well as an improvement in the patient’s complaints of pruritus.Therefore,in this study,we observed the clinical efficacy of2% salicylic acid and 5% salicylic acid scalp brushing treatment in moderate to severe scalp seborrheic dermatitis,to compare the clinical efficacy of these two concentrations of salicylic acid on scalp seborrheic dermatitis and observing the adverse effects of the treatment and the recurrence of follow-up.This study will provide reference data for selecting salicylic acid for treating moderate to severe scalp seborrheic dermatitis as well as provide a new treatment option.Methods: Collected 30 patients who met the diagnosis of "moderate to severe seborrheic dermatitis of the scalp" from April 2022 to December 2022 at the outpatient clinic of the Department of Dermatology of the First Affiliated Hospital of Dalian Medical University,and divided into 15 patients in the study group and 15 patients in the control group according to the preferences of the patients.The study group was given 5% salicylic acid scalp acid brushing,once a week,with a retention time of half an hour to one hour each time.The retention time can be extended with the improvement of treatment tolerance,and then washed with water.At the same time,apply 2% salicylic acid lotion on the scalp twice a week at home,stay overnight,and wash with clean water the next morning;The control group was given 2%salicylic acid lotion for external use at home,three times a week,stayed overnight,and washed with water the next morning.The above courses of treatment were 4weeks.To avoid recurrence,maintenance treatment was continued in both groups,with a topical salicylic acid lotion of 2% applied at home twice a week for 4 weeks.The total course of treatment is 8 weeks,and the follow-up is 4 weeks after stopping treatment.Observe and record the skin lesion scores of patients before treatment,at the end of the first week,at the end of the fourth week and at the end of the eighth week: adherent scalp flaking score(ASFS),erythema papules or pustules,oil,itching,overall feeling of use,and the Dermatology Life Quality Index(DLQI).Observe the changes of skin lesions at the same site before and after treatment through dermatoscope.Spss 26.0 statistical software was used to analyze and evaluate the effectiveness of the treatment,and the adverse reactions and recurrence during the treatment were recorded.Results: 1.A total of 33 people actually participated in the treatment,30 people completed the treatment programme,15 in the study group and 15 in the control group.3 other people were excluded for their own reasons and did not complete the treatment programme on time.2.The baseline data(gender,age,duration of disease)of the two groups were not statistically different(P>0.05)and were comparable.3.Efficacy: The total effective rate of the study group was 86.67%,7 cases were cured,3 cases were markedly effective,3 cases were effective,and 2 cases were ineffective;The total effective rate of the control group was 86.67%,2 cases were cured,4 cases were significantly effective,7 cases were effective,and 2 cases were ineffective.There was no statistical difference in the constituent ratio of the two groups(P=0.242>0.05).4.Clinical symptom observation index: Both 2% and 5% salicylic acid lotions improved dandruff,erythema papules or pustules,oil,itching and lesion area in patients with moderate to severe scalp seborrheic dermatitis(P<0.05);the mean onset of action was shorter in patients treated with 5% salicylic acid lotion than in those treated with 2% salicylic acid lotion in improving ASFS,erythema papules or pustules,oil,itching and lesion area(P< 0.05).5.Dermatology quality of life index(DLQI): The quality of life of patients treated with 5% salicylic acid lotion was better than that of patients treated with 2% salicylic acid lotion(P<0.05).6.In terms of overall use feeling: the patients treated with 5% salicylic acid lotion had better overall use feeling than those treated with 2% salicylic acid lotion(P<0.05).7.Comparison of recurrence rates and clinical symptoms at the end of treatment: there was no difference in the recurrence rate of patients treated with 2% and 5% salicylic acid lotion after recovery,but a higher overall effect in patients with significant and effective efficacy,with patients treated with 2% salicylic acid lotion having unchanged or worsened symptoms at the end of treatment than those treated with 5%salicylic acid lotion.8.Adverse reactions: During the treatment,3 patients in the study group had slight scalp pricking pain,which was tolerable and could be relieved after half an hour without special treatment.There were no obvious adverse reactions in the control group.Conclusions: 1.2% and 5% salicylic acid lotions showed improvement in dandruff,erythema papules or pustules,oil,itching,and lesion area in patients with moderate to severe seborrheic dermatitis of the scalp.2.5% salicylic acid lotion had a faster onset of action,a lesser overall symptom of recurrence,a better overall feeling of use,and a higher improvement in the dermatological quality of life index. |
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