异维A酸与痤疮

痤疮是一种毛囊皮脂腺的慢性炎性皮肤病,治疗方法较多,但存在起效慢、疗效不明确、易复发等问题。异维A酸是目前治疗痤疮最有效的药物,本文综述异维A酸治疗痤疮的机理、适合人群、临床疗效、安全性等。     

不同剂量异维A酸胶囊治疗中度痤疮临床疗效观察

目的:评价不同剂量异维A酸治疗中度痤疮的疗效及安全性。方法:采用随机、平行、对照的临床试验,将受试对象随机分甲、乙、丙三组,分别服用0.25 mg/(kg.d)、0.5 mg/(kg.d)、0.75 mg/(kg.d)、异维A酸,三组患者均治疗6周,在治疗第2、4、6周,对三组患者进行疗效比较。结果:在治疗第2周结束时,三组患者的总有效率丙组(27.3%)>乙组(23.1%)>甲组(10.7%),三组间两两比较其有效率差异均无统计学意义(P>0.05);于治疗第4组结束时,三组患者的总有效率丙组(77.3%)>乙组(65.4%)>甲组(25.6%),丙组与乙组的总有效率均明显高于甲组(2分别为13.487和8.095,均P<0.05);乙组与丙组的总有效率比较差异无统计学意义(χ2=0.367,P>0.05);在治疗第6周结束时,三组患者的总有效率丙组(86.4%)>乙组(73.1%)>甲组(42.9%),丙组与乙组的总有效率均明显高于甲组(χ2分别为5.035和9.898,均P<0.05);乙组与丙组的总有效率比较差异无统计学意义(2=0.595,P>0.05)。结论:综合临床疗效和不良反应等因素,采用0.5 mg/(kg.d)异维A酸顿服是治疗中度痤疮较为安全、有效的治疗方法。     

异维A酸胶丸治疗痤疮的疗效观察

笔者从2002年起采用异维A酸(商品名：泰尔丝)治疗难治性痤疮42例,取得了较好的临床效果,现报告如下。     

异维A酸在痤疮治疗中的应用

痤疮是一种影响大多数青少年的慢性炎症性疾病,主要累及面部和躯干,可能遗留各种类型的瘢痕,严重影响患者的生活质量.早期、有效和安全的治疗是解决疾病的关键.口服异维A酸是治愈或长期缓解中重度痤疮的独特治疗方法,它能抑制皮脂腺的活动,并具有抗炎和免疫调节功能,能及时有效的控制症状,可防止产生更多的瘢痕和心理社会影响.我们对异...     

异维A酸联合克林霉素治疗痤疮疗效观察

目的 :观察异维A酸联合克林霉素治疗痤疮的疗效。方法 :治疗组口服异维A酸胶丸每日2 0mg,分 2次口服 ,同时口服克林霉素胶囊每日 3 0 0mg,分 2次口服。 4周后异维A酸改为每日 1 0mg,1次顿服 ;克林霉素改为每日 1 5 0mg,1次顿服。对照组口服维生素B6片 ,每日 60mg,分 3次口服 ,同时口服四环素片每日 1g,分 2次口服。4周后四环素片改为每日 5 0 0mg,1次顿服。两组患者均外用氯霉素洗剂 ,每日 2次 ,共用 8周。结果 :停药时治疗组总有效率 81 7% ,对照组总有效率 2 8 3 %。两组比较有显著性差异 ( χ2 =3 4 48,P <0 0 0 1 )。结论 :异维A酸联合克林霉素治疗痤疮副作用小 ,疗效满意     

口服异维A酸治疗中重度痤疮临床观察

我科自2003年起,采用异维A酸胶丸口服治疗中、重度痤疮患者,取得明显效果,且不良反应少,现将结果报告如下。1病例和方法1.1病例选择1.1.1入选标准入选患者具有典型的中、重度痤疮[1]的临床表现,病程2个月～3年,入选前多采用过其他药物治疗,效果不理想。年龄18～40岁,性别不限,愿意配合试验者。对育龄期妇女嘱其在服药期间及服药前1个月至停药后3个月严格避孕。1.1.2排除标准妊娠期和哺乳期妇女;患心、肝、肾功能不全者或系统性疾病者;血脂异常者;不能合作者。1.1.3剔除标准不遵医嘱用药者;未完成疗程或资料不全者;对异维A酸过敏或不能耐受…     

异维A酸隔日疗法和每日疗法治疗痤疮疗效比较

目的:观察异维A酸(泰尔丝)隔日疗法和每日疗法治疗痤疮的疗效,以及在保证疗效的前提下唾液腺分泌减少的发生率.方法:将受试者分为两组,即异维A酸隔日疗法B组(试验组)和每日疗法组(对照组).试验组中体重≥50kg者,隔日口服异维A酸10 mg,每日3次;体重＜50 kg者,隔日口服异维A酸10 mg,每日2次.对照组中体重≥50 kg者,每日口服异维A酸3次,每次10mg;体重＜50 kg者,每日口服异维A酸2次,每次10mg,两组患者疗程均为6周.结果:经过6周的治疗,试验组患者有效率为77.17%,对照组患者有效率为85.00%.第2、4、6周末时试验组和对照组患者唾液腺分泌减少的发生率分别为26%、31.25%、32.18%和28.87%、34.12%、48.68%.结论:异维A酸隔日疗法治疗痤疮的疗效与每日疗法相当,唾液腺分泌减少的发生率更低.     

异维A酸治疗寻常痤疮66例

2005年6月至2007月4月，我科采用了异维A酸胶丸（商品名：泰尔丝，上海信谊延安药业有限公司生产）治疗寻常痤疮66例，取得了满意的疗效，现报告如下。1资料与方法1．1临床资料入选患者均为门诊病例，符合临床诊断标准。按Pillsbury分类法选择Ⅲ度、Ⅳ度患者。Ⅲ度患者32例，男18例，女14例，平均年龄22岁（18～30岁），病程3个月～2年；Ⅳ度患者34例，男21例，女13例，     

口服异维A酸治疗痤疮的研究

口服异维A酸是目前临床上最为有效的抗痤疮药物,可同时作用于痤疮发病的4个主要环节。异维A酸在皮脂腺细胞内独特的分子作用机制使其具有强大的抑制皮脂腺分泌活性,近来其对痤疮免疫和炎症反应的拮抗作用也越来越受到重视。口服异维A酸主要用于治疗结节囊肿型重度痤疮以及其他治疗效果不好的中、重度寻常痤疮,使用剂量应根据患者的体重、疗效、依从性及不良反应进行综合判定。小剂量[0.25~0.5 mg/(kg·d)]治疗可以显著降低药物的不良反应及增加患者依从性;累积剂量达60~120 mg/kg可以明显降低痤疮复发率。异维A酸不良反应大多以皮肤黏膜为主要表现,严重不良反应罕见,致畸是其最严重的不良反应。口服异维A酸能快速改善痤疮皮损,有效预防痤疮瘢痕形成,改善患者生活质量。     

异维A酸联合水杨酸治疗中重度痤疮的疗效观察

目的:探讨口服异维A酸胶囊联合30％超分子水杨酸治疗中重度痤疮的临床疗效.方法:将80例中重度痤疮患者随机分为对照组(40例)和观察组(40例),对照组给予异维A酸胶囊10 mg口服,一天2次,连续8周;观察组给予异维A酸胶囊的同时联合30％超分子水杨酸治疗,每隔4周治疗一次,共3次.比较两组患者总积分、临床疗效、不良...     

Severe acne infantum successfully treated with isotretinoin

Treatment of severe nodular infantile acne with oral isotretinoin has been effective and well tolerated in a small number of patients. We present another instance of successful treatment of severe acne with oral isotretinoin in a young infant and suggest that isotretinoin should be the treatment of choice for severe nodular acne in children and infants, especially if topical treatments or oral antibiotics have failed.     

Severe vulval apocrine acne successfully treated with prednisolone and isotretinoin

Apocrine acne, otherwise known as hidradenitis suppurativa, is a chronic inflammatory scarring disease affecting the apocrine gland-bearing skin. We present a case of a 34-year-old woman with severe vulval apocrine acne who was successfully treated initially with prednisolone and then maintained on long-term isotretinoin. This case indicates that long-term treatment with isotretinoin may be more successful than the usual 4-6 months treatment regime.     

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％。     

Treatment of acne with intermittent isotretinoin

Adults with acne represent an increasingly important population of acne sufferers referred for treatment. Acne, in these patients, is generally mild or moderate in severity but tends to be resistant to conventional antibiotic therapy. A study was carried out to assess the efficacy of intermittent moderate dose isotretinoin as a treatment for acne. Eighty consecutive patients, over the age of 25 years, referred with acne unresponsive to, or relapsing rapidly after three or more courses of conventional antibiotic therapy were recruited. Acne severity was assessed on the face, chest and back using the Leeds grading scale and the number of inflamed lesions was counted at the site showing the highest acne grade. The patients were 22 men and 58 women. The treatment regimen consisted of isotretinoin, 0.5mg/kg per day for 1 week in every 4 weeks for a total period of 6 months. Seventy-five patients completed the study. The therapy was very well tolerated with mild cheilitis as the only side-effect. At the end of treatment, both total acne grade and lesion counts were significantly reduced (P<0.0001). The acne had resolved in 68 (88%) patients. Twelve months after treatment, acne grades and inflamed lesion counts remained significantly improved (P<0.0001) in the 68 patients who responded; however, 26 (39%) patients had relapsed. There was a significantly higher incidence of relapse in patients with predominantly truncal acne (P=0.01). Patients who relapsed also had a significantly higher total acne grade, lesion count (P<0.0001) and sebum excretion rate (P<0.001) compared with those whose acne resolved. This study suggests that intermittent moderate dose isotretinoin may be a cost-effective alternative to full dose isotretinoin in a carefully selected group of adult patients with acne. Selection criteria should include predominantly facial acne, total acne grade less than 1, inflamed lesion count less than 20 and sebum excretion rate less than 1.25μg/cm² per min.     

Inflammatory responses in acne patients treated with 13-cis-retinoic acid (isotretinoin)

Twelve patients with acne vulgaris treated with isotretinoin for 4 months showed increased levels of immunoglobulins and helper T cells at 8 weeks and increased levels of B cells at 16 weeks.