磺胺嘧啶银脂质水胶体对颜面部重度融合性痤疮的治疗效果观察邵利萍 黄媛媛 吴唯勤(通讯作者)

【】目的探讨磺胺嘧啶银脂质水胶体治疗重度颜面部痤疮的临床疗效,为后期临床推广应用提供参考资料。方法使用Pill Sburv及国际改良痤疮分级法进行分级,选择评级为IV级的重度痤疮共计40例,随机分为实验组与对照组,实验组磺胺嘧啶银脂质水胶体联合马齿苋,对照组使用维甲酸联合马齿苋治疗,随访患者后期疗效、炎症因素TNFα和IL-4水平及不良反应,使用SAS 9.1进行统计分析。结果实验组的治疗效果要明显优于对照组( ₂=8.076,P=0.004)；实验组治疗前两组在TNF-α、IL-4差异无明显统计学意义(p>0.05),治疗后第4周、第8周结果显示实验组的TNF-α、IL-4含量要明显低于对照组,差异有统计学意义；两组不良反应发生率上,两组差异无明显统计学意义。结论目前磺胺嘧啶银脂质水胶体用于重度痤疮研究较少,联合马齿苋清理创面研究也少,本研究结果显示磺胺嘧啶银脂质水胶体联合马齿苋应用于重度颜面部痤疮治疗效果显著,可以加以推广应用。     

Heredity of acne in Korean patients

Acne is a chronic inflammatory disease of the pilocebaceous unit that presents with various spectrum and severity. Genetic backgrounds and environmental factors are also considered to be relevant, but few studies have focused on Korean patients. A cross‐sectional epidemiologic study on family history of Korean acne patients was performed to analyze family history of acne, and to compare the severity and characteristics of acne in association with family history. A total of 221 patients were enrolled, 98 male (44.3%) and 123 female (55.7%). Patients were grouped as patients with (A+) or without (A‐) family history of acne. In a second analysis, patients with any experience of acne treatment were evaluated. Severity of acne was measured with Burton's grading system and Korean Acne Grading System (KAGS). Female patients had a higher tendency to have family history than males (P = 0.002). Group A+ had statistically significant earlier onset of acne (P = 0.002). In inexperienced patients, patients with family history showed a relatively earlier onset (P = 0.084). This study confirmed the role of heredity in acne. Family history of acne is associated with earlier onset of the disease, and more non‐inflammatory lesions.     

抗雄激素药物联合应用治疗女性中重度迟发型痤疮的临床疗效评价

目的：探讨抗雄激素药物联合应用治疗女性中重度迟发型痤疮的最佳方案和疗效。方法：将112例患者按完全随机设计法分成三组：治疗Ⅰ组采用达英-35联合小剂量甲泼尼龙口服,治疗Ⅱ组采用螺内酯联合小剂量甲泼尼龙口服,对照组采用维胺酯口服,4周为1个疗程,连续治疗12周后观察疗效及不良反应,治疗前后检测三组患者血清睾酮（T）、雌二醇（E2）。结果：12周后,治疗Ⅰ组有效率为73.7%,与对照组比较差异无统计学意义（P〉0.05）;治疗Ⅱ组有效率为41.2%,与对照组比较差异有统计学意义（P〈0.05）;治疗Ⅰ、Ⅱ组治疗前后血清T差异有统计学意义（P〈0.05）,E2差异无统计学意义（P〉0.05）;对照组治疗前后T、E2差异均无统计学意义（P〉0.05）。结论：达英-35联合小剂量甲泼尼龙可有效治疗女性迟发型中重度痤疮。     

Fractional carbon dioxide (CO2) laser combined with topical tretinoin for the treatment of different forms of cystic acne

Nodulocystic acne is prone to scarring and difficult to treat with treatments other than oral isotretinoin. The aim of this article is to discuss the role of a single session of a fractional carbon dioxide (CO₂) laser combined with a topical treatment with a tretinoin and antibiotic gel for a month as a successful treatment to improve nodulocystic acne and chronic microcystic acne. Two cases were involved: the first with nodulocystic acne lesions that persisted after oral retinoids and the second with chronic microcystic acne resistant to topical treatments. After only one session of treatment with the CO₂ laser and the topical treatment, a complete healing of the nodulocystic acne lesions was observed with minimal secondary effects. The microcystic acne showed great improvement. No other topical or oral treatment was needed. This treatment could be a safe and effective treatment for nodulocystic acne lesions and microcystic acne when other treatments fail. More studies should be performed to confirm our results.     

The analysis of acne increasing suicide risk

Acne is associated with depression and anxiety; however, the relationship between acne and suicide is still unclear. This study is aimed to evaluate the association between acne and suicide by conducting a meta-analysis. Studies were identified by electronic searches of the PubMed and EMBASE databases from their inception through Jan 10, 2020. Two authors separately assessed the quality and extracted data from the selected studies. When the heterogeneity was significant, we used a random-effects model to calculate overall pooled risk estimates.Five studies involving a total of 2,276,798 participants were finally included in the meta-analysis; 52,075 participants had acne. Suicide was positively associated with acne in the overall analysis (odds ratio (OR) 1.50, 95% confidence interval (95% CI): 1.09–2.06, P = .004, I² = 74.1%). Subgroup analyses were performed for suicidal behavior groups (P = .002, I² = 80.4%), suicidal ideation or thoughts groups (P = .849, I² = 0.0%), International Classification of Diseases version 9 (ICD-9) groups (P = .137, I² = 49.6%), non-ICD-9 groups (P = .950, I² = 0.0%), American groups (P = .311, I² = 2.4%), and non-American groups (P = .943, I² = 0.0%). Sensitivity analyses indicated flawed results. No publication bias was detected.Acne may significantly increase suicide risk. Clinicians should actively treat acne and consider suicide screening. Further international studies with high-quality analyses are needed as more data are published.Ethical approval and patient consent are not required because this study is a literature-based study.     

中药面膜治疗痤疮40例

目的 评价中药面膜方治疗痤疮的临床疗效.方法 选择15 ～ 30岁痤疮患者51例,随机分为治疗组40例和对照组11例,治疗组睡前外敷中药(白芷、刺蒺藜、茯苓等)面膜方,前5d为1次/d,后改为隔日1次,一般护理及禁忌.对照组予一般护理及禁忌.2组疗程均为30 d,比较2组临床疗效,观察2组治疗前后的积分情况及不良反应.结果 治疗组总有效率90％,对照组总有效率27.3％,治疗组疗效优于对照组(P＜0.01).2组总积分从治疗后均有下降,且与治疗前比较,P＜0.05或P＜0.01.治疗组治疗后总积分与对照组比较,P＜ 0.01.治疗组疗效指数优于对照组(P＜0.01).治疗组中不同分级痤疮患者之间疗效指数比较,差异无统计学意义(P＞0.05).结论 中药面膜方治疗15 ～ 30岁痤疮患者,能有效减轻皮损严重程度、减少皮损数量及减轻皮肤自觉症状,对于不同程度分级的痤疮均有一定疗效.