消痤合剂联合异维A胶囊治疗结节囊肿型痤疮临床观察

目的观察消痤合剂联合异维A胶囊治疗结节囊肿性痤疮的疗效。方法将患者随机分为对照组、联合组。对照组口服异维A酸胶囊10mg/次,2次/d;联合组口服异维A酸胶囊10mg/次,2次/d和消痤合剂30ml/次,2次/d,连续观察8周。结果对照组有效率为68.2%,联合组有效率86.7%;联合组有效率明显优于对照组(P0.05)。结论消痤合剂联合异维A胶囊治疗结节囊肿性痤疮能疗效满意。     

ALA-PDT治疗囊肿性痤疮22例疗效观察

目的采用随机对照研究评价3%5-氨基酮戊酸光动力疗法(ALA-PDT)治疗囊肿性痤疮的疗效。方法治疗组22例接受1～3次ALA-PDT,对照组17例口服异维A酸胶丸20mg/d。皮损消退>90%或治疗持续6周为研究终点。结果治疗组第2,4,6周囊肿数目较对照组明显减少(P<0.01);治疗组第2,4,6周有效率分别为9.09%,40.91%,100%,而对照组分别为0,11.76%,58.82%,差异有统计学意义(P均<0.05);B超显示ALA-PDT治疗后囊肿较治疗前缩小或消失(P<0.01)。研究结束时,治疗组患者满意度较对照组高(P<0.05);治疗组复发率较对照组明显降低(P<0.05),且首次复发时间较对照组延长(P<0.05)。结论 ALA-PDT能够安全快速治愈囊肿性痤疮,同时延迟复发。     

曲安奈德局部注射联合异维A口服治疗囊肿型痤疮的疗效观察

目的:探讨囊肿型痤疮的临床治疗效果。方法:将135例囊肿型痤疮患者随机分为两组,治疗组60例采用曲安奈德局部注射联合异维A口服,对照组65例单用异维A口服治疗,均治疗8周,治疗结束后比较两组疗效。结果:8周后,治疗组治愈率为71.7%,总有效率为91.7%;对照组治愈率27.7%,总有效率66.2%,两组总有效率比较,差异有统计学意义(x~2=11.99,P0.05)。结论:曲安奈德局部注射联合异维A口服治疗囊肿型痤疮疗效满意,值得临床推广。     

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.     

中药痤疮方治疗寻常痤疮40例疗效观察

目的观察中药痤疮方治疗肺经风热证寻常痤疮的临床疗效和安全性。方法采用随机、阳性药物对照的临床试验。试验组患者口服中药痤疮方,对照组患者口服异维A酸,疗程6周。在2,4,6周时对两组患者的粉刺、丘疹、脓疱、结节、囊肿、皮脂溢出等评分比较。结果治疗结束时,试验组疗效指数是74.69%±17.34%,与对照组73.68%±12.65%比较差异无显著性(P>0.05);试验组有效率为87.5%,与对照组90.0%比较差异无显著性(P>0.05)。试验组有2例患者发生局部不良反应,对照组有35例发生局部不良反应。结论中药痤疮方治疗肺经风热证寻常痤疮疗效显著,与对照药异维A酸疗效相当,而局部不良反应明显少于异维A酸。     

毫火针治疗结节囊肿型痤疮的临床效应评价

目的 通过对毫火针治疗结节囊肿型痤疮的临床疗效评价,分析其不同方法在治疗结节囊肿型痤疮的疗效差异,优化出最佳的治疗方案.方法 选取2014年9月—2017年9月门诊收治的180例结节囊肿型痤疮患者,随机分为毫火针治疗组(毫火针点刺局部阿是穴)、火针对照组(火针点刺局部阿是穴)和西药对照组(阿达帕林凝胶外涂)各60例.观...     

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     

不同浓度氨基酮戊酸光动力治疗囊肿痤疮疗效观察

目的探索5-氨基酮戊酸光动力疗法(ALA-PDT)治疗囊肿痤疮时5-氨基酮戊酸(ALA)的最适浓度。方法采用随机方法将116例囊肿痤疮患者分为3个治疗组,给予ALA的浓度分别为5%、7.5%、10%,均采用波长632.8 nm的红光照射,每周1次,共4次。结果在治疗结束后2周、1个月、3个月,7.5%和10%浓度组间疗效差异均无统计学意义(P均0.05),而这两组与5%浓度组比较,差异均有统计学意义(P均0.05)。不良反应为红斑、肿胀,部分患者出现轻微渗出及暂时性色素沉着,所有患者均未出现溃疡和瘢痕。结论结合临床有效率及安全性,ALA-PDT治疗囊肿痤疮宜采用7.5%的浓度。     

Update in retinoid therapy of acne

The pathogenesis of acne, the most common skin disease, is complex and multifactorial. Clinical experience has demonstrated that parallel targeting of various pathogenetic factors, achieved either by mono- or combination therapy with appropriate drugs, represents the most effective approach to treating acne. Topical retinoids have been shown to expulse mature comedones, reduce microcomedone formation, and exert immunomodulatory effects. They have broad anti-acne activity without the risk of inducing bacterial resistance, which justifies their use as first-line treatment in most types of noninflammatory and inflammatory acne and makes them uniquely suitable as long-term medication to maintain remission after cessation of initial combination therapy. Systemic isotretinoin as a monotherapeutic agent strongly affects all four major pathogenetic factors and has been, in the hand of experienced dermatologists, a potent and safe agent for the treatment of severe and recalcitrant acne forms for more that 20 years. However, patient counseling, careful monitoring, and evaluation and management of adverse events are necessary. The use of isotretinoin has experienced a drawback now that its indication has been lowered from a first-line to a second-line medication.     

Lactic acid peeling in superficial acne scarring in Indian skin

INTRODUCTION: Chemical peeling with both alpha and beta hydroxy acids has been used to improve acne scarring with pigmentation. Lactic acid, a mild alpha hydroxy acid, has been used in the treatment of various dermatological indications but no study is reported in acne scarring with pigmentation. AIMS: To evaluate the efficacy and safety of full strength pure lactic acid 92% (pH 2.0) chemical peel in superficial acne scarring in Indian skin. MATERIAL AND METHODS: Seven patients, Fitzpatrick skin type IV-V, in age group 20-30 years with superficial acne scarring were enrolled in the study. Chemical peeling was done with lactic acid at an interval of 2 weeks to a maximum of four peels. Pre- and post-peel clinical photographs were taken at every session. Patients were followed every month for 3 months after the last peel to evaluate the effects. Results: At the end of 3 months, there was definite improvement in the texture, pigmentation, and appearance of the treated skin, with lightening of scars. Significant improvement (greater than 75% clearance of lesions) occurred in one patient (14.28%), good improvement (51-75% clearance) in three patients (42.84%), moderate improvement (26-50% clearance) in two patients (28.57%), and mild improvement (1-25% clearance) in one patient (14.28%).     

Isotretinoin therapy and the incidence of acne relapse: a nested case-control study

Background Previous studies on predictors of acne relapse in patients treated with isotretinoin had either small sample sizes, short follow‐up periods, or lacked population‐based data. Objectives To identify and quantify predictors of acne relapse, and predictors of receiving a second isotretinoin treatment. Methods Using the Régie de l’Assurance Maladie du Québec (RAMQ) and Quebec’s hospital discharge (Med‐Écho) administrative databases, a population‐based cohort of 17 351 first‐time isotretinoin users was assembled between 1984 and 2003. A nested case–control analysis was performed to determine predictors of acne relapse (as defined by receiving an antiacne medication). A second nested case–control analysis was performed to determine predictors of receiving a second isotretinoin treatment. The index date of cases was the calendar date of dispensing an antiacne medication (isotretinoin or other). Five controls were matched to each case on follow‐up time. Rate ratios were estimated using conditional logistic regression. Results A total of 7100 (41%) subjects experienced an acne relapse. These were matched to 35 500 controls. Being male, under 16 years of age and living in an urban area, and receiving isotretinoin cumulative doses greater than 2450 mg and an isotretinoin treatment longer than 121 days were statistically associated (P < 0·05) with acne relapse. The publishing of the different Canadian acne guidelines had no impact on the incidence of acne relapse (P > 0·05). A total of 4443 (26%) subjects required a second isotretinoin treatment. These were matched to 22 215 controls. There was a greater probability of receiving a second isotretinoin treatment after the publishing of the Canadian acne guidelines (P < 0·05). Conclusion A relatively high rate of subjects experienced an acne relapse after an isotretinoin treatment.     

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...     

The effectiveness of intermittent isotretinoin treatment in mild or moderate acne

BACKGROUND: Isotretinoin is the only drug that affects almost all factors in acne pathogenesis. Recently, its use for the treatment of chronic mild or moderate acne unresponsive to long-term antibiotic therapy, and with a tendency to cause scarring and leading to negative psychological effects, has became popular. The aim of the study was to investigate the effectiveness of intermittent isotretinoin treatment in mild or moderate acne. METHODS: Sixty patients with mild or moderate acne localized to the face were enrolled in the study. The treatment regimen consisted of isotretinoin, 0.5-0.75 mg/kg per day, applied for 1 week every 4 weeks for a total period of 6 months, according to the degree of acne and number of inflammatory lesions. RESULTS: Forty-one (68.3%) of the 60 patients completed the 6-month therapy. At the end of the treatment complete improvement was observed in 34 patients (82.9%) out of 41. All adverse effects were mild and discontinuation of the treatment was not necessary. CONCLUSION: Intermittent isotretinoin treatment was found to be a safe and effective choice for patients with mild or moderate acne.     

Tricks for improving compliance with acne therapy

Adherence to a medical regimen is the most important aspect of therapeutic efficacy. It goes without saying that a drug that is not used will not be effective. Reasons for noncompliance can be related to the specific disease state, to characteristics of the drugs chosen, to patient personality traits, and to effectiveness of the clinician in dealing with the individual patient. Recognizing, confronting, and improving noncompliant behavior are all part of an effective doctor-patient relationship.