2种方法治疗痤疮的疗效比较

目的观察强脉冲光联合抗生素治疗痤疮的疗效。方法125例中重度痤疮患者根据患者自愿选择治疗方式分为治疗组83例、对照组42例，治疗组强脉冲光联合局部使用抗生素治疗；对照组单纯维A酸药物治疗。治疗时间分别为各组1个疗程，治疗后观察2组的临床疗效情况。结果治疗组有效率高于对照组，差异有统计学意义（P〈0．05）。结论强脉冲光联合局部使用抗生素治疗痤疮有较好的临床疗效。     

复方颠倒散药膜对实验性兔耳痤疮的影响研究

目的观察中药制剂复方颠倒散药膜对实验性兔耳痤疮的疗效。方法将16只新西兰白兔随机分为实验组和对照组2组,采用涂抹油酸的方式建立兔耳实验性痤疮动物模型。实验组涂抹复方颠倒散药膜,2ml/次,1次/d,30min后洗去,连续2周;对照组涂抹维A酸乳膏,1ml/次,1次/d。对两组白兔的兔耳分别进行肉眼及组织学检查。结果实验组肉眼见:兔耳皮肤变薄变软,局部毛囊角栓减少,部分角栓脱落后遗留点状凹陷的毛囊,有轻微脱屑,丘疹变平减少;组织学检查见:表皮增厚明显减轻,毛囊口轻度扩张,少量角化物质充填。对照组肉眼可见兔耳皮肤变薄变软,兔耳毛囊角栓较少,丘疹减轻或变平;组织学检查见:表皮轻微角化过度,真皮内可见少量的炎症细胞浸润,毛囊口及漏斗部少量角化物质充填。实验组用药前、后间差异有统计学意义(P=0.01);对照组用药前、后间差异有统计学意义(P=0.01)。实验组和对照组治疗前后差值间差异无统计学意义(P=1)。结论复方颠倒散药膜对实验性兔耳痤疮具有改善毛囊角化异常的作用。     

自拟疏肝清肺饮治疗成年女性轻中度痤疮的临床观察

目的 探讨自拟方疏肝清肺饮治疗成年女性轻、中度痤疮的临床效果.方法 选取首都医科大学良乡教学医院皮肤科门诊年龄25～ 45岁的女性轻、中度痤疮患者86例,按患者单双日就诊次序随机分为2组单日就诊为对照组,双日就诊为观察组.对照组40例口服红霉素肠溶胶囊0.5g/次,2次/d;同时外用0.025％的维A酸乳膏,1次/晚.观察组46例口服自拟疏肝清肺饮,每日1剂,分2次服用;同时也外用0.025％的维A酸乳膏,1次/晚.疗程6周,每周随访1次.疗程结束后分别比较2组患者的治疗效果.结果 对照组患者有效率为75.0％ （30/40）;观察组患者有效率为87.0％ （40/46）,2组的有效率比较差异无统计学意义（P＞0.05）.结论 自拟方疏肝清肺饮配合外用维A酸乳膏治疗成年女性轻、中度痤疮与红霉素肠溶胶囊加维A酸乳膏具有相近的疗效,为临床治疗这类痤疮患者提供了新的选择.     

Adverse events related to topical drug treatments for acne vulgaris

ABSTRACT

Introduction: Acne vulgaris is a widespread skin disease. Topical therapy is a standard treatment for mild to moderate acne. Given the complex pathophysiology of acne, various agents with complementary action are nowadays frequently combined to increase the efficacy of therapy.

Area covered: This review focus on safety profile of topical agents used for the treatment of acne vulgaris, including topical retinoids, benzyl peroxide, azelaic acid, topical antibiotic, and combined agents. Data from clinical trials but also metanalyses, systematic reviews, and other secondary analyses are presented.

Expert opinion: In general, topical agents used for acne vulgaris have a favorable safety profile. The most commonly reported AEs were associated with local skin irritation, usually mild to moderate in intensity, intermittent, and rarely led to the cessation of therapy. Irritative potential seems to be highest for BPO and topical retinoids. Due to the possibility of development of Cutibacterium acnes resistance, topical antibiotics should not be used in monotherapy but as a part of combination therapy. In female adolescent and adults of childbearing potential, topical retinoids should be used with caution, because they are contraindicated in pregnant females (FDA Pregnancy category) C (adapalene, tretinoin) and X (tazarotene).     

痤疮型SAPHO综合征一例诊治分析及文献复习

SAPHO综合征是一组罕见的以皮肤和/或骨与关节炎性病变为主要临床表现的异质性疾病,其典型皮肤表现包括无菌性脓疱病及重度痤疮,此外还涉及化脓性汗腺炎、寻常型银屑病等,部分患者皮肤表现也可缺失。现代医学对本病的亚型分类尚未得到公认,各种亚型在治疗上是否应区别对待也未达成共识。既往中医药诊治SAPHO综合征的病例报道极少,尤其缺乏对痤疮型病例的治疗探讨。本文报道1例患者以“面部炎性丘疹、结节、囊肿3年,右臀区、右髋疼痛2周”为主诉于2017-04-27入住中国中医科学院西苑医院风湿病科,诊断为痤疮型SAPHO综合征,采用中医药治疗有效,揭示本型以湿热毒瘀为本,筋脉拘挛为标,临证应注意清热解毒药物、解痉止痛药物、入心经药物及藤类药物的使用,并结合文献研究探讨本病亚型分类的必要性与可行性。     

CO2点阵激光联合胶原贴敷料治疗面部痤疮凹陷性瘢痕疗效观察

目的：探讨CO2点阵激光联合胶原贴敷料治疗面部痤疮凹陷性瘢痕的疗效。方法选取我院2014年1月至2015年5月收治的面部痤疮凹陷性瘢痕患者84例,采用随机数字表法分为观察组和对照组,每组42例。所有患者均接受CO2点阵激光治疗,观察组外用胶原贴敷料,对照组不作处理。CO2点阵激光治疗结束冰袋冷敷20 min后,进行急性炎症反应的半定量评分;治疗结束后进行疗效评价;治疗结束后6个月记录不良反应等。结果观察组急性炎症反应的半定量评分[(1.52±0.38)分]、误工期[(7.60±2.80) d]、痂皮脱落时间[(6.35±1.50) d]明显低于对照组的[急性炎症反应的半定量评分(2.10±0.52)分、误工期(10.50±3.45) d、痂皮脱落时间(8.25±2.15) d, P<0.05];观察组和对照组的总有效率分别为92.86%和76.19%,两组比较差异有统计学意义(P<0.05);观察组色素沉着发生率为19.05%、持久性潮红发生率为0,感染性脓疱发生率为2.38%,显著低于对照组的30.95%、4.76%、7.14%(P<0.05);两组均未发生瘢痕增生。结论 CO2点阵激光联合胶原贴敷料治疗面部痤疮凹陷性瘢痕疗效显著,其具有不良反应低、结痂时间和误工期短的优点,值得临床推荐使用。     

消痤洁肤乳膏治疗寻常痤疮临床研究

目的探讨消痤洁肤乳膏治疗寻常痤疮的临床疗效。方法对278例寻常痤疮患者随机分为治疗组168例和对照组110例,分别给予消痤洁肤乳膏及复方克林霉素搽剂局部外搽,每日2次。对患者进行细菌学检查、皮脂溢出率测定以及临床疗效评价。结果皮脂溢出率在用消痤洁肤乳膏治疗前为(1.84×10-2±0.63×10-2)g/(m2.m in),治疗4周后为(1.09×10-2±0.43×10-2)g/(m2.m in),治疗前后比较有显著降低(P<0.05)。治疗组与对照组治疗后的细菌清除率分别为85.3%和84.0%,总有效率分别为94.6%和82.7%。结论消痤洁肤乳膏为一种治疗寻常痤疮的安全、有效的外用制剂。     

Pathogenic characteristics of Th17 cells based on IL-17 signaling pathway in regulation of sebaceous gland lipoprotein metabolism in acne rat model

Background: Acne is a common and chronic inflammatory dermatosis of sebaceous gland units of the human hair follicle. Acne is closely related to immune cytokines and cells including T helper 17cells (Th17 cells). Mis-regulated glycolipid metabolism also plays a vital role in the process. Objective: This investigation aimed to explore the role of IL-17 in signaling pathways controlling sebaceous gland lipoprotein metabolism in a rat model of acne. Methods: We generated the rat ear acne model, and investigated the pathological changes of acne skin tissue by histological analysis and the changes in the critical factors including DEFB1, GPR65, FADS1, and FADS2 by Western Blot in this model. Results: There were more Th17 cells in the rat ear acne model than in the control mice. The expression levels of DEFB1, GPR65, FADS1, FADS2 and MOGAT1 were significantly upregulated in serum and tissue from rat acne model, which could be concluded that the Th17 cells play a major role in the pathogenesis of acne based. Conclusion: Although acne is associated with immune effects and glycolipid metabolism, inhibition of IL-17 signaling pathway might be a novel way for acne therapy. Our findings also suggest a new strategy for targeted therapy of acne.     

中西医结合治疗口腔扁平苔藓的临床疗效观察

目的观察盐酸米诺环素和维A酸乳膏联合用药在治疗寻常痤疮中的疗效,探讨其应用价值。方法将60例寻常痤疮患者随机分为实验组和对照组,观察治疗前后皮损改善情况,按4级评分法进行评估。结果实验组有效率为71．4％,对照组有效率为38．9％。结论盐酸米诺环素联合维A酸乳膏治疗寻常痤疮疗效显著,安全可靠,值得临床推广应用。     

治疗痤疮新药sarecycline概述

摘 要Sarecycline是过去40年来首个专门针对皮肤病设计的口服抗菌药,这种首创、窄谱四环素类药在临床研究中已被证明用药后3周可使皮肤炎性皮损显著改善,且有良好的安全性和耐受性,适用于治疗罹患中度至重度痤疮的患者。