Intense pulsed light vs. pulsed‐dye laser in the treatment of facial acne: a randomized split‐face trial

Background Various laser and light therapy have been increasingly used for the treatment of acne vulgaris. Patients and methods Twenty patients with facial acne were treated using intense pulsed light (IPL) on one side of the face and pulsed dye laser (PDL) on the other to compare the efficacy and safety of IPL and PDL. Treatment was performed 4 times at 2‐week intervals. Treatment effectiveness was determined using lesion counts, acne severity, patient subjective self‐assessments of improvement, and histopathological examinations, which included immunohistochemical staining for transforming growth factor‐β (TGF‐β). Results Numbers of total acne lesions decreased following both treatments. For inflammatory lesions such as papules, pustules and nodules, IPL‐treated sides showed an earlier and more profound improvement than PDL‐treated sides. However, at 8 weeks after the 4th treatment, a rebound aggravation of acne was observed on IPL‐treated sides. On the contrary, PDL produced gradual improvements during the treatment sessions and these improvements lasted 8 weeks after the 4th treatment. Non‐inflammatory lesions as open and closed comedones also showed improvement following both treatments and PDL‐treated sides showed better improvement as the study proceeded. Histopathological examinations showed amelioration in inflammatory reactions and an increase in TGF‐β expression after both treatments, which were more prominent for PDL‐treated sides. Conclusion Both PDL and IPL were found to treat acne effectively, but PDL showed a more sustained effect. TGF‐β might play a key role in the resolution of inflammatory acne lesions.     

Non‐ablative 1550‐nm erbium‐glass and ablative 10 600‐nm carbon dioxide fractional lasers for acne scars: a randomized split‐face study with blinded response evaluation

Background Non‐ablative 1550‐nm erbium‐doped fractional photothermolysis systems (FPS) and 10 600‐nm carbon dioxide fractional laser systems (CO₂ FS) have been effectively used to treat scars. Objective We compared the efficacy and safety of single‐session treatments of FPS and CO₂ FS for acne scars through a randomized, split‐face, evaluator‐blinded study. Methods Eight patients with acne scars were enrolled in this study. Half of each subject’s face was treated with FPS and the other half was treated with CO₂ FS. We used a quartile grading scale for evaluations. Results At 3 months after the treatment, the mean grade of improvement based on clinical assessment was 2.0 ± 0.5 for FPS and 2.5 ± 0.8 for CO₂ FS. On each side treated by FPS and CO₂ FS, the mean duration of post‐therapy crusting and scaling was 2.3 and 7.4 days respectively and that of post‐therapy erythema was 7.5 and 11.5 days respectively. The mean VAS pain score was 3.9 ± 2.0 with the FPS and 7.0 ± 2.0 with the CO₂ FS. Conclusion We demonstrated the efficacy and safety of single‐session acne scar treatment using FPS and CO₂ FS in East Asian patients. We believe that our study could be used as an essential reference when choosing laser modalities for scar treatment.     

中西医结合治疗痤疮392例

痤疮，好发于青年男女，不仅影响美观，严重者可导致毁容，寻找好的治疗方法是医务工作者义不容辞的责任。近代中医对痤疮病因病机研究的进一步深入，为临床辨证治疗痤疮提供了重要的科学依据。平痤汤加减，三棱针穴位点刺加拔火罐放血，结合紫外线负离子喷雾机治疗痤疮，体现了中医辨证论治、内外兼治的整体治疗特点，疗效显著。     

Isotretinoin: Which dosage?

Long-term clinical experience with isotretinoin has confirmed both therapeutic effectiveness and the ability to induce prolonged remission. Numerous authors have demonstrated the importance of cumulative dose in achieving stable remission.     

难治性寻常型痤疮合并糠秕孢子菌及螨虫感染的临床观察

目的：观察难治性寻常型痤疮合并糠秕孢子菌，螨虫感染情况及加用针对特殊病原体治疗疗效。方法：取104例难治性寻常型痤疮炎性皮损内容物涂片。复方刚果红当色，检查糠秕孢子菌，螨虫，在常规痤疮治疗基础上结合针对所合并的特殊病原体进行综合治疗。结果：104例患者中糠秕孢子菌阳性者38例，螨虫阳性者30例，两者均阳性者6例，总阳性率71．1％。治愈34例，显效25例，有效40例，无效5例，总有效率95．2％，结论：提示合并糠秕孢子菌，螨虫感染是难治性寻常型痤疮的重要病因之一。     

维胺脂和四环素联合治疗痤疮

研究目的探讨座疮有效治疗方法.研究背景目前对症疮的治疗方法很多,但效果均不理想，我们应用了维胺脂和四环素联合治疗寻常痤疮。方法80例寻常痊疮，随机分为2组.观察组40例,用维胺脂加四环素治疗。对照组40例，单用四环素治疗。治疗结果用t检验进行统计学处理.结果观察组总有效率100％，对照组总有效率75％.统计学处理两组有显著性差异（P＜0.01）。尤其对严重痤疮，观察组优于对照组.结论维胺脂加四环素治疗寻常痤疮效果优于单用四环素。     

Outcome measures in acne vulgaris: systematic review

Summary Background Clinical trials require valid and reliable outcome measures to facilitate the interpretation and communication of results, and the secondary use of data for systematic reviews. There are numerous tools available to assess the severity of acne vulgaris in clinical trials, and extensive debate about the merits of these. Objectives To review the literature about investigator‐assessed outcome measures used in clinical trials for acne vulgaris; and to evaluate the measurement properties of these tools. Methods A systematic literature review was conducted of articles outlining and evaluating investigator‐assessed outcome measures for acne. Results Thirty‐one papers met the criteria for inclusion in the literature review, including nine papers proposing a novel means of assessing acne, and five evaluating existing outcome measures. Variable attempts had been made to evaluate these tools. Conclusions The array of evaluation tools used in acne trials prohibits good secondary analysis of trial data, and complicates the interpretation of study results, potentially compromising clinical care. Existing outcome measures need to be assessed further and agreement reached about which should be used more widely. Other innovative methods of assessing acne should also be explored.     

Current understanding and management of hidradenitis suppurativa

PURPOSE: To review the diagnosis and treatment of hidradenitis suppurativa (HS) in primary care. DATA SOURCES: Review of current literature from journals and textbooks as well as clinical experience. CONCLUSIONS: HS, a chronic disease causing scarring and pus formation to the skin bearing apocrine glands, requires continual management by the primary care manager and often deems referral to a dermatologist or surgeon. IMPLICATIONS FOR PRACTICE: If misdiagnosed or poorly managed, HS has detrimental effects on patients' quality of life and self-esteem.     

倒膜疗法结合皮肤护理治疗面部痤疮的临床研究

目的 研究石膏倒膜疗法结合皮肤护理治疗寻常型痤疮的疗效，探讨皮肤护理在治疗中的作用。方法 将279名寻常型痤疮患者随机分为倒膜 外用药物 皮肤护理组、倒膜 外用药物组及单纯外用药物组，8周后观察疗效。结果 3组的有效率分别为87．1％，71．0％，54．8％。结论 倒膜 皮肤护理 外用药物组的疗效明显优于倒膜 外用药物组及单纯外用药物组。护士的积极参与及恰当的皮肤护理对寻常型痤疮的治愈具有重要的促进作用。     

自血疗法对寻常型痤疮患者外周血中CD14^+单核细胞TLR2的表达及血清IL-8、TNF-α浓度的影响

目的观察自血疗法对寻常型痤疮患者外周血中CD14^+单核细胞TLR2的表达及血清IL-8、TNF-α浓度的影响,初步探讨自血疗法治疗寻常型痤疮的部分抗炎机制。方法选取30例寻常型痤疮患者为治疗组,另在本院招募健康志愿者20例作为对照组。分析治疗组采用自血疗法前、后外周血CD14^+单核细胞TLR2的表达及血清IL-8、TNF-α浓度,并与对照组比较。结果治疗组患者TLR2表达与血清IL-8、TNF-α浓度呈正相关(P<0.05)。治疗组干预前的外周血中CD14^+单核细胞TLR2表达及血清IL-8、TNF-α浓度均高于对照组及干预后(P=0.000)。结论TLR2的表达及血清IL-8、TNF-α浓度与寻常型痤疮的发病相关。自血疗法可通过下调寻常型痤疮患者外周血CD14^+单核细胞TLR2的表达,减少血清IL-8、TNF-α的分泌,从而抑制炎症反应的发生。