光动力联合米诺环素治疗中重度痤疮疗效探讨

目的:探讨光动力联合米诺环素治疗中重度痤疮的临床疗效。方法:选择某院2013年1月~2015年1月期间门诊诊治的90例中重度痤疮患者,随机分为对照组和观察组,各45例。对照组口服米诺环素治疗,观察组采用光动力+米诺环素治疗,比较两组临床疗效、生活质量变化,并监测不良反应情况。结果:观察组总有效率、生活质量评分均显著高于对照组,组间差异P0.05。观察组不良反应发生率与对照组比较无显著差异,P0.05。结论:中重度痤疮采用光动力联合米诺环素治疗临床疗效可靠。     

小剂量激素联合米诺环素治疗重度痤疮临床疗效观察

目的 探讨小剂量激素联合米诺环素治疗重度痤疮的临床价值.方法 选取2017年1月至2018年12月就诊我科门诊的重度痤疮患者148例,分为治疗组(盐酸米诺环素胶囊联合小剂量激素)和对照组(盐酸米诺环素胶囊),观察两组患者治疗后2周及12周的疗效、痤疮综合分级系统(global acne grading system,G...     

米诺环素治疗中重度痤疮临床观察

目的 观察米诺环素治疗中重度痤疮的临床治疗效果.方法 72例患者随机分为试验组34例和对照组38例,试验组口服米诺环素治疗,对照组口服罗红霉素治疗,比较2组疗效.结果 试验组不同时间的治愈率和总有效率均高于对照组,差异有统计学意义(P<0.05).结论米诺环素治疗中重度痤疮效果满意,值得临床推广.     

米诺环素治疗中重度痤疮临床观察

目的观察米诺环素治疗中重度痤疮的临床治疗效果。方法 72例患者随机分为试验组34例和对照组38例,试验组口服米诺环素治疗,对照组口服罗红霉素治疗,比较2组疗效。结果试验组不同时间的治愈率和总有效率均高于对照组,差异有统计学意义（P〈0.05）。结论米诺环素治疗中重度痤疮效果满意,值得临床推广。     

阿奇霉素联合二丁颗粒治疗痤疮

目的临床研究阿奇霉素联合二丁颗粒治疗痤疮的疗效。方法选取自2010年6月至2011年12月在本院接受治疗的痤疮患者200例,随机将患者分为两组:①治疗组100例,采用的是阿奇霉素联合二丁颗粒治疗。②对照组100例,采用的是口服盐酸米诺环素胶囊治疗。结果治疗组的总有效率明显高于对照组,P<0.05表示差异有统计学意义。结论阿奇霉素联合二丁颗粒治疗痤疮效果明显。     

痤疮发病机制及其药物治疗的研究进展

目的:了解痤疮的发病机制及其药物治疗的研究进展,为其临床治疗提供参考。方法:查阅近年来国内外相关文献,就痤疮的发病机制及其药物治疗的研究进展进行归纳和总结。结果:痤疮的发病机制主要为雄激素分泌异常、痤疮丙酸杆菌的大量繁殖、炎症损害和免疫失常及毛囊皮脂腺导管角化异常等。痤疮的局部治疗药物中维A酸类药物与抗菌药物可联用于治疗轻、中度痤疮,其中全反式维A酸、阿达帕林与他扎罗汀是治疗轻度痤疮的首选药物,全反式维A酸常联合外用抗菌药物治疗中度痤疮,阿达帕林和克林霉素分别与过氧化苯甲酰联用、果酸参与的联合给药方案也用于治疗痤疮。口服治疗药物中维A酸类药物主要用于重度痤疮,第一代的异维A酸较第二代疗效更好,但均有致畸作用;口服抗菌药物适用于中、重度痤疮患者,多西环素与米诺环素是首选药物,米诺环素联用过氧化苯甲酰疗效好;大环内酯类抗菌药物口服后不良反应较多,故常作为外用药;口服激素类药物中的抗雄激素类药物用于女性患者,但长期使用会引发高胰岛素血症;螺内酯有潜在的安全问题,西咪替丁抗雄激素效果较弱,不作为治疗痤疮的常用药物;糖皮质激素类药物常用于暴发性痤疮或聚合性痤疮的治疗,使用剂量须严格控制。结论:痤疮的治疗应根据痤疮的发生原因和严重程度选择合理的用药方案,增加疗效并减少不良反应的发生,并注意药物相互作用,提高用药安全性。     

柴胡桂枝干姜汤加味联合米诺环素治疗寻常性痤疮疗效观察

目的 探讨中药柴胡桂枝干姜汤加味联合米诺环素治疗寻常性痤疮的效果.方法 将98例寻常性痤疮患者完全随机分为对照组（52例）和观察组（46例）.对照组口服米诺环素胶囊,1次/d,100 mg/次.观察组应用中药汤剂柴胡桂枝干姜汤加味口服,2次/d,200 ml/次;2组疗程均为4周.2组患者均每周复诊1次,观察各项指标进行评估并记录,治疗结束后计算疗效指数.结果 观察组总有效率为73.9％ （34/46）,对照组总有效率为59.6％（31/52）,2组比较差异有统计学意义（x2=9.92,p＜0.05）.不良反应：观察组3例患者服中药后有轻度胃部不适,未影响治疗;对照组患者无明显不适.结论 中药柴胡桂枝干姜汤加味联合米诺环素治疗寻常性痤疮疗效满意.     

加味逍遥散联合盐酸米诺环素治疗玫瑰痤疮的临床观察

目的 探讨加味逍遥散联合盐酸米诺环素用于治疗玫瑰痤疮的临床疗效.方法 选取2011年3月～ 2012年12月北京同仁堂中医医院收治的86例玫瑰痤疮患者,随机将其分为对照组(n=43)和治疗组(n=43).对照组患者给予盐酸米诺环素治疗,治疗组患者在对照组的基础上给予加味逍遥散治疗.观察并比较2组患者的治疗效果.结果 治疗组患者中,痊愈22例,显效15例,临床总有效率为86.04％.对照组患者中,痊愈17例,显效13例,临床总有效率为69.76％.治疗组患者的临床总有效率明显高于对照组患者,2组之间比较差异有统计学意义(P＜0.05).不良反应治疗组为4.65％,对照组为2.32％,差异无统计学意义.结论 加味逍遥散联合盐酸米诺环素用于治疗玫瑰痤疮临床效果好,不良反应少.     

外涂20％超分子水杨酸及口服盐酸米诺环素联合红蓝光治疗中重度痤疮51例

目的 探讨外涂20％超分子水杨酸及口服盐酸米诺环素联合红蓝光治疗仪治疗中重度痤疮的临床效果及不良反应,为中重度痤疮治疗提供更加安全有效的方法.方法 选取2016年5月至2019年2月广西壮族自治区桂东人民医院收治的中重度痤疮病人102例,采用随机数字表法分成观察组与对照组,每组51例,对照组采取口服盐酸米诺环素+红蓝光...     

盐酸米诺环素联合紫外线负离子喷雾、氦-氖激光照射治疗寻常性痤疮150例临床观察

目的:观察盐酸米诺环素联合紫外线负离子喷雾、氦-氖激光照射治疗寻常性痤疮的疗效和安全性。方法:采用盐酸米诺环素、紫外线负离子喷雾、氦-氖激光照射治疗150例,疗程为6周。结果:治愈113例,好转25例,无效12例,总有效率92%。结论:盐酸米诺环素联合紫外线负离子喷雾、氦-氖激光照射治疗寻常性痤疮疗显著,安全性高。     

A multicenter efficacy and tolerability evaluation of benzoyl peroxide in a 10% urea vehicle for the treatment of acne vulgaris

BACKGROUND: Acne vulgaris is a common skin disease that affects 70 to 96% of individuals. Topical benzoyl peroxide has been used successfully for acne treatment; however, it may be accompanied by drying and or flaking skin. The addition of a 10% urea to the product excipient is theorized to moisturize the skin due to its humectant properties, aid in the efficacy of benzoyl peroxide due to its keratolytic properties, and effectively combat Propionibacterium acnes due to its antibacterial properties. OBJECTIVE: To assess the efficacy and tolerability of the treatment of acne vulgaris with multiple strengths of benzoyl peroxide in a 10% urea vehicle gel or cream and cleanser. Methods: A multicenter, non-randomized, open-label study in which 1,089 patients with acne vulgaris were enrolled at 133 participating physician office sites. Qualifying and consenting patients were prescribed either 4.5% or 8.5% benzoyl peroxide in a 10% urea vehicle cream or gel and cleanser. Additional medications were permitted during the study with the exception of those containing benzoyl peroxide. The physician assessed lesion counts, both inflammatory and non-inflammatory, at baseline and Week 4. Dryness and erythema were rated by the physician on a scale from 0 (none) to 8 (severe or deep) at baseline and Week 4. RESULTS: Nine hundred sixty-three patients completed the study. The following significant treatment arms were analyzed: patients treated with 4.5%/8.5% benzoyl peroxide in a 10% urea vehicle product only, patients treated with 4.5%/8.5% benzoyl peroxide in a 10% urea vehicle products along with oral doxycycline, and patients treated with 4.5%/8.5% benzoyl peroxide in a 10% urea vehicle products along with oral minocycline. A 44% (n=567) mean reduction in total lesion count was observed after 4 weeks of treatment with 4.5%/8.5% benzoyl peroxide in a 10% urea vehicle products only. Dual therapy using oral doxycycline (n=17) proved to be even more effective with a significant mean reduction in lesion count of 52% after only 4 weeks of treatment. Dual therapy using oral minocycline (n=21) yielded a significant mean reduction in lesion count of 34% after 14 weeks of treatment. The overall tolerability of the treatment illustrated the utility of urea as a moisturizing agent. CONCLUSION: Benzoyl peroxide in a 10% urea vehicle gel or cream and cleanser, used once daily for 4 weeks was found to be both effective and well tolerated for the treatment of symptoms related to acne vulgaris.     

异维A酸红霉素凝胶联合过氧苯甲酰凝胶治疗中、重度痤疮

目的观察异维A酸红霉素凝胶联合过氧苯甲酰凝胶治疗中、重度痤疮的疗效。方法将201例Ⅱ～Ⅳ度寻常痤疮患者随机分为2组,治疗组106例,对照组95例。治疗组予异维A酸红霉素凝胶联合过氧苯甲酰凝胶,对照组给予异维A酸红霉素凝胶治疗。每2周随访1次,观察疗效及不良反应,8周后进行治疗评定。结果治疗组痊愈率和有效率(58.49%、96.23%)高于对照组(36.84%、88.42%)。结论异维A酸红霉素凝胶联合过氧苯甲酰凝胶治疗中、重度痤疮较单纯外用异维A酸红霉素凝胶疗效好。     

Topical antibacterial therapy for acne vulgaris

Topical antibiotics and benzoyl peroxide, are the two main topical antibacterial treatments indicated for mild-to-moderate acne vulgaris. Topical antibiotics act both as antibacterial agents suppressing Propionibacterium acnes in the sebaceous follicle and as anti-inflammatory agents. Benzoyl peroxide is a powerful antimicrobial agent that rapidly destroys both bacterial organisms and yeasts. Topical clindamycin and erythromycin have been proven to be effective against inflammatory acne vulgaris in concentrations of 1-4% with or without the addition of zinc. However, none of the antibacterials tested was more effective than benzoyl peroxide, which also has the advantage of not being associated with antimicrobial resistance.Topical antibacterial therapy should be discontinued once improvement is observed. If no improvement is observed within 6-8 weeks, the agent should be discontinued and a therapeutic switch considered. The primary limitation of benzoyl peroxide for some acne vulgaris patients is cutaneous irritation or dryness.Antibacterial therapy can be used in combination with other agents. Combining topical antibiotics and topical retinoids may enhance the efficacy, since the retinoid will improve the penetration of the antibiotic. Combining a topical antibiotic with benzoyl peroxide may increase the bactericidal effect of the antibiotic and reduce the potential for bacterial resistance. Topical and oral antibacterials should not be used in combination for the treatment of acne vulgaris, since this association may increase the risk of bacterial resistance.     

Emerging drugs for acne

Acne vulgaris is a common skin disorder that affects most individuals at some point in their lives. It may result in significant morbidity, including cutaneous scarring and psychological impairment. Current treatments include topical retinoids, benzoyl peroxide, topical and systemic antibiotics, and systemic isotretinoin. There are growing concerns of rising antibiotic resistance, significant side effects of isotretinoin therapy, and lack of safe and effective treatment for pregnant females. Recent advances in the pathogenesis of acne have led to a greater understanding of the underlying inflammatory mechanisms and the role the Propionibacterium acnes and biofilms. This has led to the development of new therapeutic targets. This article reviews emerging treatments of acne, including topical picolinic acid, topical antibiotic dapsone, systemic zinc salts, oral antibiotic lymecycline, new formulations of and synergistic combinations of benzoyl peroxide, photodynamic therapy with topical photosensitizers and potential acne vaccines.     

The utility of benzoyl peroxide in hydrophase base (Brevoxyl) in the treatment of acne vulgaris

Available for more than 5 decades, benzoyl peroxide has been a "workhorse" of acne therapy. The benefits of this agent include reduction in Propionibacterium acnes (P. acnes) with decrease in inflammatory lesions, efficacy as both "leave on" and cleanser formulations and reduced emergence of antibiotic-resistant P. acnes strains. As the effect of benzoyl peroxide on P. acnes is a direct toxic effect rather than as a "true" antibiotic, resistance to benzoyl peroxide does not occur and has never been reported. Benzoyl peroxide in hydrophase base (Brevoxyl Creamy Washes and Gels) has shown significant efficacy in the treatment of acne, with lower irritancy than other benzoyl peroxide preparations. It is felt that the low irritancy of this product is related to a unique delivery vehicle containing dimethyl isosorbide, which dissolves benzoyl peroxide crystals on the skin. Clinical studies demonstrating the efficacy and safety of benzoyl peroxide in hydrophase base will be reviewed.     

Treatment considerations for inflammatory acne: clinical evidence for adapalene 0.1% in combination therapies

Acne vulgaris is an exceptionally common, chronic, and recurring disease. It involves multiple etiological factors including follicular hyperkeratinization, increased sebum production, Propionibacterium acnes proliferation, and inflammation. Presently, oral isotretinoin is the only single agent that is effective against all 4 major pathophysiologic features. However, this drug is also responsible for several serious side effects, including teratogenicity. Therefore, it should be used in only the most severe cases and alternative treatment approaches for inflammatory acne, such as initial combination therapy, should be considered first. Combination therapy in inflammatory acne simultaneously targets multiple pathogenic factors. Current guidelines recommend early initiation of combination therapy with a topical retinoid and antimicrobials for mild to moderate inflammatory acne and topical retinoids with oral antibiotics (with or without the use of benzoyl peroxide) for moderate to severe cases of acne, followed by maintenance therapy with topical retinoids. This review evaluates the rationale and clinical evidence for the use of adapalene in combination therapy for inflammatory acne.     

Truncal acne vulgaris: the relative roles of topical and systemic antibiotic therapy

Information is limited on the management of truncal acne vulgaris. Survey results suggest that most dermatologists commonly prescribe oral antibiotic therapy when treating acne involving the chest and back. This article reports therapeutic outcomes based on an investigator-blinded, randomized, 10-week observational trial completed in patients presenting with moderate or severe truncal acne vulgaris. One group received treatment with benzoyl peroxide (BP) 9% cleanser daily, clindamycin 1% foam daily, and doxycycline 100 mg twice daily. The other group received BP cleanser 9% daily and doxycycline 100 mg twice daily without clindamycin 1% foam. Baseline, week 6, and week 10 evaluations were completed. Efficacy parameters included inflammatory and total lesion count reduction, and investigator global assessment. Global evaluations of treatment response were recorded and skin tolerability was also evaluated. This trial was designed to capture observational experience reflective of treatment of patients with truncal acne in a private practice dermatology setting.     

Guidelines for the management of acne vulgaris in adolescents

This article reviews the treatment of acne in adolescents. The choice of therapy should be principally based on the type of lesion and the severity of the acne, but psychosocial disability relating to the disease and the presence of scarring may also influence the approach to treatment.Mild acne generally requires topical treatment only. Benzoyl peroxide, azelaic acid, and antibacterials are generally used for inflammatory lesions. Topical retinoids are particularly effective for noninflamed lesions, and combination therapies are useful for mixed lesions. Moderately severe acne generally requires oral antibacterials. Tetracyclines/oxytetracycline and erythromycin are usually the first-line antibacterials. Second-generation tetracyclines, such as lymecycline, doxycycline, and minocycline, show improved absorption. Minocycline has the advantage of being rarely associated with Propionibacterium acnes antibacterial resistance, but can occasionally lead to potentially serious adverse effects. Trimethoprim is a useful third-line antibacterial therapy for patients resistant to other antibacterial therapies. Benzoyl peroxide should generally be used in combination with oral antibacterials as this has been shown to reduce the development of antibacterial resistance. For severe nodular acne, isotretinoin is the treatment of choice. In addition, over recent years dermatologists have increasingly used this drug to treat patients with moderate acne which has not responded to other systemic therapies, particularly when associated with scarring or significant psychological disability. However, this use is outside the current license of the drug. Isotretinoin is associated with a number of serious adverse effects and careful monitoring of patients during therapy is required.Physical therapies for the treatment of acne nodules and macrocomedones are also important adjuncts to drug therapies.