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寻常痤疮是临床上最常见的皮肤病之一,是一种由多因素综合作用引起的,累及毛囊皮脂腺的慢性炎症性皮肤病,其发病率呈逐年上升的趋势,并且影响患者的生活质量.传统的治疗方法为局部或系统治疗,具有潜在的毒副作用,加之细菌对抗生素耐药性的不断增加.近年来,光动力疗法已广泛应用于痤疮的治疗中,并成为治疗痤疮的有效方法,尤其是针对炎症性痤疮,其疗效优于单独光照治疗.光动力疗法的光源主要有二极管激光、强脉冲光、蓝光、红光.研究结果显示,该疗法安全、有效,不良反应较小. 相似文献
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Oral antibiotics are commonly used to treat acne vulgaris, primarily in patients presenting with moderate to severe facial or truncal disease severity. These agents are most appropriately used in combination with a topical regimen containing benzoyl peroxide and a topical retinoid. The most common oral antibiotics for treating acne vulgaris are the tetracycline derivatives, although macrolide agents such as erythromycin have also been used extensively. Over the past 4 decades, as the sensitivity of Propionibacterium acnes to several oral and topical antibiotics has decreased, the efficacy of oral tetracycline and erythromycin has markedly diminished, leading to increased use of doxycycline, minocycline, and other agents, such as trimethoprim/sulfamethoxazole. 相似文献
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A staple clinical skill in a dermatologist’s repertoire is the ability to treat acne vulgaris effectively. Light‐based therapies such as photodynamic therapy (PDT) widen the therapeutic options available for acne. Numerous review articles have agreed on the answer to core questions such as: ‘Does PDT work?’ and ‘Which acne lesions respond best to PDT?’ They conclude that PDT is especially useful in inflammatory acne and may be superior to light therapy alone. This literature review seeks to offer guidance regarding treatment‐specific queries about the photosensitizer, route of administration, treatment intervals, light sources and patient selection. Ovid Medline, PubMed and EMBASE database searches were executed between January 2007 and March 2008. Due to the scarcity of data, all five randomized trials, four of which were at least investigator blinded and controlled, 12 open clinical studies, two case reports and two abstracts published in English were considered. Four hundred and nineteen patients were recruited. As the quality of the data was suboptimal in a significant number of articles, the conclusions are drawn in very broad strokes: topical short‐contact (90 min or less) 5‐aminolaevulinic acid or methyl aminolaevulinate using a noncoherent light source at 2–4‐week intervals for a total of two to four treatments produces the greatest clinical effect. Papulopustular acne is more responsive and all Fitzpatrick skin types are eligible. However, patients with skin types I–III have a reduced risk of postinflammatory hyperpigmentation seen in darker skin types. These treatment parameters demonstrate a good side‐effect profile resulting in acne remission for at least 3 months to a year in a relatively cost‐effective manner. Well‐designed nonsplit‐face randomized controlled trials would offer further guidance, especially for queries surrounding the light source and illumination schemes. 相似文献
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Acne vulgaris is a common disease with prevalence up to 80 % during adolescence. Twin studies provide solid evidence of a genetic background for this disease. Similarly there is no doubt about the influences of hormones, especially androgens, on the disorder. Less clear, however, is the data on other risk factors as smoking and certain diets. 相似文献
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Rachita Dhurat Deepti Shukla Rachel K. Lim Carlos G. Wambier Andy Goren 《Dermatologic therapy》2021,34(1):e14680
Acne vulgaris (AV) is the most common skin condition affecting adolescents, most likely due to elevated androgen levels during puberty. Androgens stimulate and enlarge the sebaceous glands and keratinocytes, resulting in increased production of sebum and abnormal hyperproliferation of keratinocytes which lead to the formation of acne lesions. Current standard of care for AV includes topical therapies for mild cases and antibiotics or oral retinoids for severe cases. In recent years, spironolactone, an aldosterone antagonist and diuretic, has been applied to the treatment of AV due to its anti‐androgen effects. Spironolactone is currently recommended in women who use oral contraceptives, are refractory to or contraindicated for standard treatment, show clinical signs of hyperandrogenism, or present with late‐onset or persistent‐recurrent AV past the teenage years. It is not prescribed to adolescents due to potential side effects; however, current data studying adults indicate that most side effects are mild, and that potential associations with hyperkalemia and increased risk of cancer are not sufficiently supported. Hence, we believe that spironolactone may be a safe and effective therapy for adolescent AV. 相似文献
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本文通过103例寻常痤疮病人随机地分成三组,分别用四环素,每天1.0克;安体舒通,每天60毫克;和安体舒通与四环素并用进行观察,结果示:安体舒通疗效明显优于四环素,安体舒通与四环素并用效果极佳。治疗期间未出现任何明显的副作用。因此,安体舒通作为一种雄激素拮抗剂,短期治疗寻常痤疮是完全可靠的。 相似文献
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痤疮是一种有着极其复杂发病机制且十分常见的皮肤疾病。人群发病率非常高,特别是青少年。痤疮主要发生于面部,可形成粉刺、丘疹、脓疱、囊肿、结节、瘢痕等损害。活动性痤疮及其后遗症,特别是持久性瘢痕,对患者的生理和心理都会造成很大的影响。因此,痤疮和痤疮瘢痕的治疗显得非常重要。目前越来越多的物理疗法应用于临床,并取得很好的疗效。本文主要对寻常痤疮及痤疮瘢痕的物理治疗方面的有关进展做一综述。 相似文献
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Light/laser therapy in the treatment of acne vulgaris 总被引:2,自引:0,他引:2
Acne vulgaris is one of the most prevalent skin diseases known. As common as this condition is, the social and psychological consequences are limitless. Although current treatments are available and include topical or oral antibiotics, it is crucial to develop a less risky and more effective therapy such as light/laser therapy. This article focuses specifically on the benefits of the light/laser treatment on acne vulgaris. Porphyrins accumulated in the bacteria, Propionibacterium acnes, one of the etiologic factors involved in the pathogenesis, allows phototherapy to be a successful modality. They have specific absorption peaks at which lasers have optimal effects. The longer the wavelength of the light is, the deeper its penetration and thus the greater its damage to the sebaceous glands. Although blue light is best for the activation of porphyrins, red light is best for deeper penetration and an anti-inflammatory effect. Ultraviolet (UV) light, although it may have initial an anti-inflammatory effects, has been proven to be potentially carcinogenic and have adverse effects such as aging (by UV-A) and burning (by UV-B). Previous studies indicate successful long-term intervention and selective damage of the sebaceous glands by using a diode laser with indocyanine green (ICG) dye. Mid-infrared lasers have been found to decrease lesion counts while also reducing the oiliness of skin and the scarring process. Nonablative laser treatment of acne scars using the Er:YAG laser with a short-pulsed mode has been successful in reducing the appearance of scars by stimulating neocollagenesis. The light/laser therapy has started to be explored with promising results in highly selected patients that require further investigation in greater populations and well-designed protocols. 相似文献
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Acne vulgaris, a common and chronic disorder of the pilosebaceous unit, affects up to 85% of adolescent and young adults. Although the current treatment options are effective, they are associated with unwanted side effects, chronicity, relapses, and recurrences. Recently, the Food and Drug Administration approved topical application of gold microparticles for selective photothermolysis to treat acne vulgaris. Here, we report two cases showing the efficacy of gold nanoshell‐mediated photothermal therapy for recurrent acne that were refractory to previous treatments. In both cases, three sessions of photothermal therapy prevented the development of new lesions during a follow‐up period of 3–4 months without causing any adverse effects. The two cases reported here demonstrate the possibility of gold nanoshell‐mediated photothermal therapy as a safe and effective treatment for recurrent acne vulgaris in Asian patients. 相似文献
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Neşe Göçer Gürok MD 《Journal of Cosmetic Dermatology》2023,22(8):2318-2323
Background
Acne vulgaris is a chronic inflammatory disease with multifactorial etiology. Studies on the pathogenesis of acne are still important. Recently, various studies have been conducted on the significance of genetics in the pathogenesis of acne. Blood group is transferred genetically and could affect the development, progress, and severity of certain diseases.Aim
In the current study, the correlation between the severity of acne vulgaris and ABO blood groups was investigated.Materials and Methods
A total of 380 patients (263 mild and 117 severe acne vulgaris patients) and 1000 healthy individuals were included in the study. Severity of acne vulgaris patients and healthy controls was determined based on the blood group and Rh factor data obtained retrospectively from the patient files in the hospital automation system.Results
In the study, the rate of females was significantly higher in the acne vulgaris group (X2:154.908; p:0.000). The mean age of the patient was significantly lower when compared to the controls (t:37.127; p:0.0001). The mean age of the patients with severe acne was significantly lower when compared to those with mild acne. When compared to the control group, the incidence of severe acne was higher in those A blood type when compared to the patients with mild acne, while the incidence of mild acne was higher in other blood groups when compared to the control (X2:17.756; p:0.007). No significant difference was determined between the Rh blood groups of the patients with mild, severe acne and the control group (X2:0.812; p:0.666).Conclusion
The results revealed a significant correlation between acne severity and ABO blood groups. Future studies that would be conducted with larger samples in different centers could confirm the current study findings. 相似文献13.
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Propionibacterium acnes plays an important role in the development of acne, and inflammatory lesions are improved by antibiotics. Long-term use of antibiotics may result in development of resistant strains and treatment failure. The aim of the present study was to investigate the isolation rate of P. acnes and to evaluate its antibiotic susceptibility to widely used antibiotics in acne in Korea. Among 46 patients, 31 P. acnes strains were cultured. Isolated P. acnes was measured for minimum inhibitory concentration (MIC) of tetracycline, doxycycline, minocycline, erythromycin and clindamycin using an Epsilometer test. Age, disease duration and previous history of antibiotic therapy for acne were compared in relation to the MIC. The mean MIC of tetracycline, minocyclines, doxycycline, clindamycin and erythromycin were all below the breakpoint of antibiotic resistance. The patients with acne vulgaris with disease duration of more than 2 years documented higher MIC values in doxycycline, erythromycin, and clindamycin than those of less than 2 years. The patients who were previously treated with topical or systemic antibiotics showed higher MIC in doxycycline. Antibiotic resistance of P. acnes is still low in Korea, but at this point, there is an increasing trend of MIC. Caution and acknowledgement of increased risk of antibiotic resistant P. acnes should be advised in acne antibiotic treatment to minimize and avoid the emergence of the resistant strain. 相似文献
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Background Some past studies reported that oxidative stress components such as reactive oxygen species (ROS) or lipid peroxide (LPO) are involved in the pathogenesis and progression of acne vulgaris. In this study, we hypothesized that the pathogenesis of acne vulgaris may depend on the differences in antioxidative activity among antioxidants in our body. We collected samples of stratum corneum from acne patients and healthy subjects and compared the quantity of gluthathione (GSH), one of many antioxidative components in our body, for comparison. Methods Samples of stratum corneum were collected from facial acne‐involved lesion, facial uninvolved area, and the medial side of the upper arm in acne vulgaris patients. Similarly, samples were collected from a facial uninvolved area and the medial side of the upper arm in healthy subjects. The quantity of GSH was measured in each area. In vitro effects of alpha‐melanocyte stimulating hormone (α‐MSH) on GSH synthesis‐related gene were also examined. Results The quantity of GSH in stratum corneum from each area was significantly lower in acne vulgaris patients than that of healthy subjects. There was no significant difference in quantity of GSH between the acne‐involved lesion and uninvolved area in acne patients. In vitro studies showed that the expression level of Glutamate‐cysteine ligase catalytic subunit (GCLC), one of the GSH synthesis‐related genes, was significantly decreased by the additional use of α‐MSH. Conclusions We conclude that a decline in antioxidative activity led by a decrease in GSH quantity may play an important role in pathogenesis of acne vulgaris. The use of α‐MSH may further decrease the GSH level. 相似文献
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雄激素在痤疮发生过程中起着重要的作用,对于抗生素和维A酸类药物反应不佳的女性患者而言,无论其血雄激素水平是否正常,联合使用抗雄激素疗法可能是一种理想的选择,但具体机制尚不明确.抗雄激素疗法的药物可分为以下4类:雄激素受体拮抗剂、肾上腺源性雄激素阻断剂、卵巢源性雄激素阻断剂、酶抑制剂.外用抗雄激素制剂可能成为新的研究方向.概述抗雄激素治疗痤疮的机制、治疗方法以及新的研究进展. 相似文献
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异维A酸治疗中度寻常痤疮临床疗效观察 总被引:7,自引:1,他引:7
目的:评价异维A酸治疗中度痤疮的疗效和安全性。方法:采用随机、阳性药物平行对照的临床试验。试验组患者每日服用异维A酸(泰尔丝);对照组患者每日服用维胺酯,两组患者均治疗6周。治疗2、4、6周,对两组痤疮患者的粉刺、丘疹、脓疱、结节囊肿、皮脂溢出等评分比较。结果:试验组皮损的总评分差值从(0.2166±0.1291)分增至(6.2469±1.1826)分,对照组则从(0.1290±0.3191)分增至(5.6297±1.4489)分,两组间痤疮评分差值比较,差异有显著性。治疗结束时,试验组痊愈率和有效率分别为58.18%和100.00%,对照组分别为22.41%和82.75%,二组间疗效比较差异有显著性。试验组有23例患者出现局部不良反应,对照组有31例患者出现局部不良反应。结论:异维A酸治疗中度寻常痤疮疗效好于维胺酯。 相似文献
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寻常痤疮细菌感染病因学探讨 总被引:19,自引:0,他引:19
对132例寻常痤疮患者的皮损内容取材,同时进行需氧菌和厌氧菌培养。其中有112例分离到细菌,细菌培养阳性率84.8%。112例共分离出137株细菌,其中需氧菌75株,厌氧菌62株,痤疮丙酸杆菌的分离率为42.3%。112例中58例分离到痤疮丙酸杆菌,阳性率为51.8%;24例为混合感染。16例用特丽仙溶液治疗6周后,细菌培养阴转率为75.0%;脓疱、丘疹、粉刺数的平均值分别由2.06、17.69和23.63个减至0.75、3.63和15.56个。结果证明细菌感染在寻常痤疮病因学中的作用。 相似文献
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G Sarici S Cinar F Armutcu C Altınyazar R Koca NS Tekin 《Journal of the European Academy of Dermatology and Venereology》2010,24(7):763-767
Background Acne vulgaris is one of the common dermatological diseases and its pathogenesis is multifactorial. In this study, we aimed to determine the effects of oxidative stress in acne vulgaris. Materials and methods The study involved 32 patients with acne vulgaris in the patient group and 34 healthy adults in the control group. The parameters of oxidative stress such as catalase (CAT), superoxide dismutase (SOD), xanthine oxidase (XO), nitric oxide (NO) and malondialdehyde (MDA) in the venous blood of patients were measured spectrophotometrically. The values were compared with those of the control group. Results The serum levels of MDA and XO activity in the patients with acne vulgaris were significantly higher than those of the controls. A significantly lower SOD and CAT activity was found in the patient group than in the control group. Although the patient group had higher serum levels of NO than the control group, the difference was not statistically significant. Conclusion These results suggest that oxidative damage may play a role in the pathogenesis of acne; therefore, significant alterations may occur in the antioxidant defence system. 相似文献