口服酮康唑治疗56例寻常痤疮

以酮康唑治疗56例寻常痤疮,治愈率44.44％,有效率98.21％。     

The advantage of establishing homogeneous patient groups: Is it worth isolating ‘juvenile acne of the face’?

Background Acne is a highly heterogeneous disorder with respect to its regional involvement, demographics, lesion types and response to treatment. Homogeneous patient groups must therefore be created before measuring the severity of acne and interpreting the results of therapeutic trials. The individualization of ‘juvenile acne of the face’ is a first step in this direction. Methods Based on textbooks, major reviews of acne and a ′Medline′ literature search, we identified four key points to delineate sub groups of acne patients. Result ‘Juvenile acne of the face’ is defined by four main clinical criteria: (1) age (from puberty to age 25 years), (2) site (face), (3) lesion type (polymorphous), (4) absence of a causal factor. Other subgroups of ‘true’ acne are listed with their distinctive characteristics. Non‐acne follicular diseases (i.e. without sebum retention) are listed. Discussion We chose ‘juvenile acne of the face’ to define the first homogeneous group of patients because it is the most frequent form of acne and the target of most acne drugs. It has a sufficiently uniform prognosis to devise a functional and reproducible severity rating scale with the aim of facilitating the evaluation and comparison of therapeutic methods. Conclusion The next step in our work will be to elaborate severity scales which are dedicated to a single type of acne.     

天津市大学生痤疮患病率及心理因素调查与分析

[目的]了解天津市大学生面部寻常痤疮的流行现况并作心理因素分析.[方法]2008年9-11月对天津市2006～2008级在校大学生痤疮发病情况进行横断面问卷调查.[结果]调查1 709例,现患寻常痤疮830例,总现患病率为48.57%,男性:42.46%,女性:51.96%.两性间现患病率的差异有统计学意义.社交回避及苦恼量表,回避、焦虑及综合总分的疾病组和对照组之间有统计学意义.[结论]各种压力不是导致痤疮发生的危险因素,但是痤疮的发生会影响大学生社交行为及情绪苦恼状态.     

Epidemiology of acne in the general population: the risk of smoking

BACKGROUND: Acne is a common skin disorder, but epidemiological data from the general population obtained by examination are scarce. Clinical experience suggests an association between smoking and acne, although confirmatory evidence from appropriate studies is lacking. OBJECTIVES: To determine the prevalence and demographic factors of acne in a general population sample and to investigate the association of smoking and acne on a qualitative and quantitative level. METHODS: In a cross-sectional study, 896 citizens (aged 1--87 years, median 42) of the City of Hamburg were dermatologically examined. The prevalence and severity of acne were recorded and further information on demographic variables, medical history, and alcohol and cigarette consumption were obtained by a standardized interview. RESULTS: According to the clinical examination, acne was present in 26.8% overall, and was more prevalent in men (29.9%) than women (23.7%) (odds ratio, OR 1.37, 95% confidence interval, CI 1.01--1.87). Prevalence followed a significant linear trend over age with peak prevalence between 14 and 29 years (P < 0.001). The reported age at onset was significantly lower in women than men (P = 0.015). According to multiple logistic regression analyses acne prevalence was significantly higher in active smokers (40.8%, OR 2.04, 95% CI 1.40--2.99) as compared with non-smokers (25.2%). A significant linear relationship between acne prevalence and number of cigarettes smoked daily was obtained (trend test: P < 0.0001). In addition, a significant dose-dependent relationship between acne severity and daily cigarette consumption was shown by linear regression analysis (P = 0.001). CONCLUSIONS: Smoking is a clinically important contributory factor to acne prevalence and severity.     

The integral role of topical and oral retinoids in the early treatment of acne

This article will review the rationale for early use of topical retinoids alone or in combination with topical antimicrobials in light of the pathogenesis of microcomedones and later lesions. Knowledge of the pathogenic processes in acne vulgaris has risen dramatically over the last three decades. It is now widely accepted that acne is the result of four distinct processes: increased proliferation, cornification, and shedding of follicular epithelium; increased sebum production; colonization of the follicle with Propionibacterium acnes ; and induction of inflammatory responses by bacterial antigens and cell signals. Clinical focus of disease management has shifted toward earlier treatment targeting these fundamental processes. Elimination of microcomedones, the precursor to all subsequent lesions, would optimize acne therapy by preventing the later inflammatory stages of disease. With the exception of oral isotretinoin, no single first-line agent addresses all pathogenic mechanisms. Topical retinoids have comedolytic and in some cases anti-inflammatory effects, but have no direct impact on P. acnes . Thus treatment with a combination of topical retinoid and topical antimicrobial is warranted. The former can also enhance penetration of the latter by increasing microcomedonal extrusion. In selecting a combination, one must consider efficacy, cost, and likelihood of compliance. Once thought to be effective primarily for treating comedones, topical retinoids have also been demonstrated to be effective in reducing inflammatory lesions. The activity of a topical retinoid combined with an antimicrobial agent has been shown to clear more lesions and to clear them more rapidly than antimicrobial therapy alone. Topical retinoids are also used effectively to maintain remissions.     

红蓝光治疗痤疮临床疗效观察

目的:探讨红蓝光照射治疗痤疮的临床疗效和安全性。方法:将113例轻、中度痤疮患者分为两组,实验组采用本院自制的克林霉素醇溶液联合红蓝光照射治疗,对照组仅外用本院自制的克林霉素醇溶液治疗。采用痤疮综合分级系统(GAGS)评价治疗前、后疗效。结果:实验组和对照组有效率分别为82.8%和43.6%,两组的治疗有效率存在显著性差异(P<0.01)。GAGS综合分值均较治疗前明显下降(P<0.01),但实验组下降更显著。结论:红蓝光治疗面部轻、中度痤疮安全有效。     

Interest of the association retinaldehyde/glycolic acid in adult acne

Background  Topical retinoids have been successfully used in the treatment of acne vulgaris but may induce irritation when used twice daily. The association of retinaldehyde (RAL) with glycolic acid (GA) have complementary activities, which could be of interest for adult women with acne because of a better tolerance/efficacy ratio. The aim of this study was to evaluate the tolerance and the efficiency of RAL (0.1%)/GA (6%) in adult women with acne when used alone or in combination with their usual acne products except retinoids.
Methods  Three hundred ninety-seven women with acne (aged between 30 and 40 years old) were included in this open multicentric study. They had to apply cream containing RAL/GA for 90 days without stopping their previous acne treatment (except topical retinoids). The tolerance was the main criteria and the second one is the efficacy, which was assessed by counting inflammatory and retentional lesions after 30 and 90 days of treatment.
Results  Used alone or in association with other anti-acne treatments, RAL/GA was considered to be highly tolerated. A significant decrease in both inflammatory and retentional lesions between day 0 and day 90 indicates that RAL/GA can be used as monotherapy for mild acne or could potentate the efficiency of other anti-acne products used at the same time by patients suffering from moderate acne. Complaints about side-effects were rare. The subjective evaluation of the preparation's efficacy by investigators and patients was strongly favourable.
Conclusion  These data show that a combination of RAL 0.1% and GA 6% may be used in association with other topical anti-acne treatments with an excellent tolerance.     

寻常痤疮致病菌的分离及其药敏结果

对１７３例寻常痤疮患者的痤疮内容物进行了需氧菌和厌氧菌的培养、分离和鉴定，并对所分离的致病菌用试管肉汤稀释法进行了ＭＩＣ的测定。共检出致病菌２１７株，其中痤疮丙酸杆菌７１株（占３２．７２％），颗粒丙酸杆菌３９株（１７．９７％），其余为葡萄球菌（１０７株，占４９．３１％）。药敏试验表明，全部分离株对美满霉素均较敏感（ＭＩＣｓ＜４．０ｍｇ／Ｌ），大部分离株对克林霉素敏感（ＭＩＣ５０＜０．５ｍｇ／Ｌ）；对于甲硝唑和替硝唑，这些致病菌均耐药（ＭＩＣｓ＞３２ｍｇ／Ｌ）。     

三仁汤化裁联合红蓝光对脾胃湿热证痤疮的临床疗效

目的观察三仁汤化裁联合红蓝光对脾胃湿热证痤疮的临床疗效。方法选取张掖人民医院皮肤科收治的196例脾胃湿热证痤疮患者,以密封信封法随机分为对照组和联合组,每组各98例。对照组采用红蓝光照射治疗,联合组采用三仁汤化裁联合红蓝光照射治疗,观察两组患者临床疗效、中医症状积分、血清生化指标、生活质量变化情况、不良反应和复发情况。结果治疗后联合组治疗总有效率显著高于对照组,差异有统计学意义(P0.05);治疗后两组中医症状积分(皮疹类型、皮损数量、皮疹形态和皮疹瘙痒)均显著降低,且联合组降低幅度更大,差异有统计学意义(P0.05);治疗后两组血清的P物质、胰岛素样生长因子-1(IGF-1)、白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)水平均显著降低,且联合组降低幅度更大,差异有统计学意义(P0.05);治疗后两组痤疮患者特异性生活质量量表(Qol-Acne)中自我感知、情感功能、社会功能评分及总分均显著提高,且联合组治疗后自我感知、情感功能和总分显著高于联合组,差异有统计学意义(P0.05);治疗期间,两组不良反应发生率比较差异无统计学意义(P0.05)。随访3个月发现,联合组复发率显著低于对照组,差异有统计学意义(P0.05)。结论三仁汤化裁联合红蓝光照射治疗较单纯红蓝光照射治疗疗效更好,且有助于缓解患者皮疹症状,调节机体相关的血清因子水平,提高患者生活质量并降低复发率。