中文摘要

一、背景

敏感性皮肤(sensitive skin，SS)是一种常见的皮肤状态，严重影响该类人群生活质量。2017年我国制定了《中国敏感性皮肤诊治专家共识》，该共识明确表述了敏感性皮肤的定义、发病机制、临床表现、评估及诊疗等内容，其中指出，敏感性皮肤的诊断主要基于患者主观症状，同时应排除可能伴有敏感性皮肤的原发疾病，包括玫瑰痤疮、脂溢性皮炎、激素依赖性皮炎等。近年来越来越多的国家及地区对敏感性皮肤的发病情况进行了研究，且目前暂未见中国面部敏感性皮肤患病率的meta分析，现对面部敏感性皮肤患病率进行系统综述。

二、目的

收集全球过去20余年发表的面部敏感性皮肤患病率调查数据，进行meta分析，了解全球及我国面部敏感性皮肤患病率，评价疾病负担，为面部敏感性皮肤临床防治提供循证医学依据。

三、方法

在线检索了2001年1月1日至2022年2月28日国内外发表的有关面部敏感性皮肤流行病学调查文献，检索数据库包括Web of Science、Embase、PubMed、Cochrane Library等4个英文文献数据库，以及中国知网、万方、维普、中国生物医学文献服务系统等4个中文文献数据库，并采用文献追溯的方法尽可能全面的检索文献。对所检索文献进行去重、初筛并通过阅读全文，对符合质量要求的文献提取数据进行统计分析。

使用Stata 15.0软件进行meta分析，包括异质性检验、合并效应量、分析异质性来源及发表偏倚。当各项研究之间异质性较大时，使用随机效应模型校正合并效应量的算法以使结果更加精确。当异质性较小或着无时，则使用固定效应模型合并效应量。异质性来源分析包括亚组分析、敏感性分析和回归分析等。

四、结果

共检索到3295篇文献，去除重复文献1094篇、文献类型不符473篇、去除与主题不相关文献1591篇，去除94篇非中英文文献，阅读全文后去除无法提取所需数据文献11篇，最终纳入35篇文献(44项研究)，纳入研究的总人数共计76532人。

检验发现研究存在较大异质性，采用随机效应模型进行数据合并，面部敏感性皮肤患病率为54.4%（95%CI：42.2%-66.6%）。不同地理区域患病率如下：亚洲43.0%（95%CI:20.2%-65.9%），欧洲65.4%(95%CI：55.2%-75.6%），北美洲60.3%（95%CI：47.0%-73.5%），南美洲51.7%（95%CI：21.5%-81.9%）。按照年份进行亚组分析2001-2005年面部敏感性皮肤患病率为58.1%，95%CI为49.8%-66.4%；2006-2010年面部敏感性皮肤患病率为74.2%，95%CI为61.7%-86.6%；2011-2015年面部敏感性皮肤患病率为47.4%，95%CI为28.3%-66.4%；2016-2021年面部敏感性皮肤患病率为48.4%，95%CI为21.4%-75.5%。按严重程度进行分级分析，面部敏感性皮肤中重度敏感患病率为34.6%（95%CI：26.3%-42.8%），其中男性中重度患病率为30.6%（95%CI：22.8%-38.4%），女性为41.3%（95%CI:31.9%-50.8%）。中国人面部敏感性皮肤患病率为31.9%（95%CI：8.0%-55.9%），中重度患病率为14.1%（95%CI：5.0%-23.2%），其中男性中重度患病率为17.1%（95%CI：9%-25.3%），女性为21.9%（95%CI：13.0%-30.8%）。

五、结论

基于已发表文献，通过meta分析发现全球面部敏感性皮肤患病率较高，且中重度的患病率也较高，女性高于男性。面部敏感性皮肤已成为当今皮肤科重要的临床问题之一，疾病负担较为严重，影响患者身心健康。

关键词：敏感性皮肤；患病率；meta分析

Abstract

Background: Sensitive skin (SS) is a common skin condition, which seriously affects the quality of life of the associated people. In 2017，a more precise introduction about the disease has been issued through “Expert consensus on diagnosis and treatment of sensitive skin in China”. the diagnosis is mainly based on subjective symptoms of patients, and the primary diseases that may be accompanied by sensitive skin should be excluded, such as rosacea, seborrheic dermatitis, hormone dependence dermatitis (HDD)etc. In recent years, more and more globle regions have studied the prevalence of sensitive skin. Besides,as far as we know,there is no meta-analysis on the prevalence of facial sensitive skin in China at present.therefore a systematic review of the published data was performed to investigate global prevalence of sensitive skin.

Objective:Meta-analysis was performed to systematically review the the prevalence of facial sensitive skin in order to provide a more reliable evidence-based results to better understand the burden of this condition. Original articles published in last 22 years（from 1st January,2001 up to 28st February,2022.）were analysised.

Methods: Online searches of four English databases including PubMed, Embase, Cochrane Library and Web of Science together with four Chinese literature databases including Chinese Web of Knowledge(CNKI), Wanfang, Weipu(VIP),and China BioMedical Literature Database(CBM)were conducted. In addition, literature retrospect method was also used to search more related literatures from 1st January, 2001 up to 28st February, 2022. After deduplication，primary screening and reading full-text, the literatures which meet the including requirements were chosen for further statistic analysis.

Meta-analysis was performed using Stata 15.0 software,which including heterogeneity test, effect model test, heterogeneity analysis, publication bias analysis, etc. Random effects model was used when heterogeneity exists significantly, fixed effects model was used otherwise. The analysis of the reasons for heterogeneity includes subgroup analysis, sensitivity analysis and regression analysis.

Results: A total of 3295 literatures were examined. After reducing 1094 duplicates as well as 2169 literatures which don’t fulfill the selective criterias. Thirty-five literatures including 76532 people were finally enrolled in this meta-analysis.

It turned out that a large heterogeneity exists in the meta-analysis，therefore, random effect model was used for data consolidation. Prevalence of facial sensitive skin is 54.4% (95% CI: 42.2%-66.6%). Prevalence in different geographic regions are: 43.0% (95% CI: 20.2%-65.9%) in Asia, 65.4% (95% CI: 55.2%-75.6%) in Europe, 60.3% (95% CI: 47.0%-73.5%) in North America, 51.7% (95% CI: 21.5%-81.9%) in South America.The prevalence of facial sensitive skin in different years are as follows: for 2001-2005  58.1% (95% CI:49.8%-66.4%); for 2006-2010  74.2% (95% CI :61.7%-86.6%); for 2011 -2015   47.4% (95% CI:28.3%-66.4%); and for 2016-2021 48.4%(95%CI: 21.4% -75.5%) respectively. In studies grading four levels of the severity of patients, the prevalence of moderate to severe patients is 34.6% (95% CI: 26.3%-42.8%), in which the prevalence of male is 30.6% (95% CI: 22.8%-38.4%) while 41.3% (95% CI: 31.9%-50.8%) in female. In China, Prevalence of facial sensitive skin is 31.9% (95% CI: 8.0%-55.9%), moderate to severe patients is 14.1% (95% CI: 5.0%-23.2%), in which 17.1% (95% CI: 9%-25.3%) in male and 21.9% (95% CI: 13.0%-30.8%) in female.

Conclusion: Based on the published literature, the prevalence of facial sensitive skin is high worldwide and the prevalence of moderate to severe patients is also high. prevalence in female tends to be higher than that in male. Facial sensitive skin has become an important clinical problems nowadays, and the disease burden is heavy, affecting the physical and mental health of patients.

 Key words: Sensitive skin; Prevalence; Meta analysis