Epidemiology of acne in the general population: the risk of smoking

BACKGROUND: Acne is a common skin disorder, but epidemiological data from the general population obtained by examination are scarce. Clinical experience suggests an association between smoking and acne, although confirmatory evidence from appropriate studies is lacking. OBJECTIVES: To determine the prevalence and demographic factors of acne in a general population sample and to investigate the association of smoking and acne on a qualitative and quantitative level. METHODS: In a cross-sectional study, 896 citizens (aged 1--87 years, median 42) of the City of Hamburg were dermatologically examined. The prevalence and severity of acne were recorded and further information on demographic variables, medical history, and alcohol and cigarette consumption were obtained by a standardized interview. RESULTS: According to the clinical examination, acne was present in 26.8% overall, and was more prevalent in men (29.9%) than women (23.7%) (odds ratio, OR 1.37, 95% confidence interval, CI 1.01--1.87). Prevalence followed a significant linear trend over age with peak prevalence between 14 and 29 years (P < 0.001). The reported age at onset was significantly lower in women than men (P = 0.015). According to multiple logistic regression analyses acne prevalence was significantly higher in active smokers (40.8%, OR 2.04, 95% CI 1.40--2.99) as compared with non-smokers (25.2%). A significant linear relationship between acne prevalence and number of cigarettes smoked daily was obtained (trend test: P < 0.0001). In addition, a significant dose-dependent relationship between acne severity and daily cigarette consumption was shown by linear regression analysis (P = 0.001). CONCLUSIONS: Smoking is a clinically important contributory factor to acne prevalence and severity.     

New photographic techniques for clinical evaluation of acne

Clinical evaluation of acne is usually based on direct visual assessment and ordinary flash photography, both of which are compromised by viewer subjectivity. It is difficult to accurately assess individual acne lesions and to observe early response to therapy. Standard flash photography has inherent limitations owing to the physics of light; it does not permit consistent visualization of subtle cutaneous characteristics like erythema or microcomedones, and it tends to blur distinctions between active inflammatory lesions and older hyperpigmented macules. Over the last decade there has been increasing interest in newer techniques aimed at increasing the accuracy and objectivity of acne evaluation. These include parallel‐polarized light photography, cross (or perpendicular)‐polarized light photography, videomicroscopy, and fluorescence photography. This article will review the advances of the past decade and summarize new techniques to evaluate acne lesions. Moreover, findings of a study that evaluated the course of individual acne lesions and the effects of adapalene gel 0.1% on inflammatory and non‐inflammatory acne lesions will be viewed. In this study, the use of parallel‐polarized and cross‐polarized photography, in combination with videomicroscopy and sebum production measurement, provided objective, detailed information on the evolution of different variable acne lesions and their response to adapalene gel 0.1%. Adapalene treatment produced rapid resolution of inflammatory and non‐inflammatory lesions, and inhibited formation of new lesions. Sebum secretion rates also declined during treatment. Use of the new assessment techniques proved to be a valuable, non‐invasive and reliable method of assessing acne vulgaris and its response to treatment.     

Topical 5-aminolaevulinic acid photodynamic therapy for the treatment of skin conditions other than non-melanoma skin cancer

Topical 5-aminolaevulinic acid (ALA) photodynamic therapy (PDT) is used increasingly for superficial non-melanoma skin cancer (NMSC) and dysplasia. However, the relative accumulation of the photosensitizer protoporphyrin IX (PpIX) in diseased tissue is not specific for neoplastic disease, and has been shown after the application of ALA to benign proliferative skin conditions such as viral warts and psoriasis. This review appraises the quality of evidence available for the use of topical ALA-PDT in the treatment of skin conditions other than NMSC. The diseases that have been studied in most detail are recalcitrant viral warts, acne, psoriasis and cutaneous T-cell lymphoma. Publications relating to the treatment of other diseases by topical PDT are restricted to small case series or case reports. The relevant literature will be discussed and the potential for topical PDT in the treatment of several skin diseases is highlighted, although more detailed studies are required to clarify the role of PDT beyond the treatment of NMSC.     

佛香精油脂质体凝胶剂的制备及其抗痤疮丙酸杆菌作用研究

摘 要: 目的 制备佛香(佛手：丁香1:3)精油脂质体凝胶（Bergamot and clove essential oil liposomes gel, BCEO-Lip-Gel）,研究其抗痤疮丙酸杆菌（Propionibacteriumacnes,P·acnes）作用机制。方法 采用薄膜水化-高压均质法制备佛香精油脂质体,再进一步负载于卡波姆基质,即得;利用傅里叶红外光谱（FTIR）、差示扫描量热仪（DSC）分析精油装载状态;气相色谱-质谱联用（GC-MS）技术分析筛选精油指标成分;改良Franz扩散池研究制剂体外经皮渗透和皮肤滞留性能;通过测定BCEO-Lip-Gel对痤疮丙酸杆菌抑制率、碱性磷酸酶（AKP）、总蛋白及细胞膜含量研究其抑菌机制。结果 佛香精油装载于脂质载体疏水区内;佛香精油中指标成分为D-柠檬烯和丁香酚;BCEO-Lip-Gel可提高精油稳定性及皮肤滞留量;BCEO-Lip-Gel在精油含量为1.068 mg/ml时对痤疮丙酸杆菌的抑制率可达到(65.9±1.7)%,可通过破坏细菌细胞壁、细胞膜结构和降低细菌蛋白质合成而抑制痤疮丙酸杆菌生长。结论 BCEO-Lip-Gel有助于提高精油脂质体稳定性且发挥缓释作用,延长药物抑菌时效,达到长效抑菌效果。     

百癣夏塔热片联合夫西地酸乳膏治疗寻常痤疮的临床研究

目的探讨百癣夏塔热片联合夫西地酸乳膏治疗寻常痤疮的临床疗效。方法选取2017年6月—2018年6月在监利县人民医院治疗的寻常痤疮患者98例,根据用药的不同分为对照组(49例)和治疗组(49例)。对照组患者取适量夫西地酸乳膏涂于患处,3次/d;治疗组在对照组基础上口服百癣夏塔热片,1.55 g/次,3次/d。两组患者均治疗4周。观察两组患者临床疗效,同时比较治疗前后两组患者红斑、色素沉着、Acne-QOL和SF-36评分及血清白细胞介素-8(IL-8)、可溶性白细胞介素-2受体(sIL-2R)、肿瘤坏死因子-α(TNF-α)、IL-10和γ干扰素(IFN-γ)水平。结果治疗后,对照组临床有效率为81.63%,显著低于治疗组的97.96%,两组比较差异具有统计学意义(P0.05)。治疗后,两组患者红斑、色素沉着评分显著降低(P0.05),Acne-QOL和SF-36评分显著升高(P0.05),且治疗组红斑、色素沉着、Acne-QOL和SF-36评分明显优于对照组(P0.05)。治疗后,两组患者血清IL-8、s IL-2R和TNF-α水平均显著降低(P0.05),IL-10和IFN-γ水平显著升高(P0.05),且治疗组上述炎症因子水平明显好于对照组(P0.05)。结论百癣夏塔热片联合夫西地酸乳膏治疗寻常痤疮可有效改善患者临床症状,促进皮损修复,降低机体炎症反应,提高患者生活质量。     

浅析卫气与痤疮

目前主流观点将痤疮分为肺经风热证、肠胃湿热证、痰湿瘀滞证三个证型,在各种证型中分析多从\"热\"\"火\"而论,关于痤疮与卫气的关系少有阐述。作者认为\"阳郁\"是贯穿痤疮发病不同阶段、不同证型的主线,\"郁\"是痤疮之关键,\"卫气闭郁、郁而化热、火毒凝滞、痰瘀互结\"是痤疮的根本病机。     

百部复方消痤膏治疗寻常性痤疮

目的:观察百部复方消痤膏治疗寻常性痤疮的临床疗效及探讨其作用机制。方法:将130例寻常痤疮(Ⅰ级~Ⅱ级)患者随机分为治疗组、对照组。治疗组用百部复方消痤膏,每天早、晚各用温水洗脸后涂于皮损处;对照组用过氧化苯甲酰凝胶,每天早、晚各用温水洗脸后涂于皮损处。两组均治疗8周,比较两组患者临床疗效,观察两组患者治疗前及治疗后2,4,6,8周时粉刺、脓疱、总皮损减少率及不良反应,并观察体外抑菌杀螨效果。结果:治疗组有效率92.30%,对照组有效率67.26%,治疗组明显优于对照组(P<0.01)。两组中的粉刺、脓疱、总皮损治疗后减少率均具有统计学意义(P<0.05)。其中,第4,6,8周粉刺减少率治疗组优于对照组(P<0.01);第2,4,6,8周脓疱减少率治疗组优于对照组(P<0.01)。百部复方消痤膏外用无不良反应。体外抑菌杀螨实验表明,百部复方消痤膏对痤疮致病菌群的抑制作用优于对照组,同时对蠕形螨虫也有较好的杀灭作用。结论:百部复方消痤膏治疗寻常痤疮疗效好,作用快速,无不良反应,其机制与抗炎、抑菌、杀螨有关。     

加味五味消毒饮治疗中重度痤疮患者观察及对Th17细胞影响

目的： 通过研究寻常性痤疮患者Th17细胞的相关指标,观察加味五味消毒饮治疗中重度痤疮疗效以及对Th17细胞的影响。方法：健康对照组30例,轻度痤疮组32例以及中重度痤疮组45例,检测三组外周血IL-17水平和Th17细胞在外周血中占CD4 细胞比例。45例中重度痤疮患者随机分成两组,治疗组采用加味五味消毒饮治疗（n=25）,对照组采用异维A酸治疗(n=20),比较临床疗效和治疗前后Th17细胞相关指标。结果：健康对照组、轻度痤疮组两项指标显著低于中重度痤疮组（P<0.05）,健康对照组和轻度痤疮组之间无显著差别(P>0.05)。治疗组和对照组治疗前后,外周血Th17细胞相关指标显著降低（P<0.05）。结论：加味五味消毒饮和异维A酸都能有效的治疗中重度痤疮,治疗后外周血IL-17水平和Th17细胞在外周血中占CD4 细胞比例显著降低。     

ALA-PDT联合IPL治疗中重度痤疮28例

目的观察强脉冲光(intense pulsed light,IPL)和5-氨基酮戊酸光动力技术(5-aminolevulinic acidphotodynamic therapy,ALA-PDT)相结合治疗中重度痤疮的有效性和安全性。方法 28例中重度痤疮患者于皮损部位涂抹10%ALA霜,避光封包60 min后,采用420～950 nm IPL治疗。每周治疗1次,连续4次。治疗结束后第4、8、12周随访。结果经过4次治疗和12周随访,患者总有效率达78.6%,平均疗效指数为(73.4±4.2)%;炎症性和非炎症性皮损平均减少率分别达到(84.3±3.6)%和(56.1±5.2)%。患者无色沉、水疱、结痂等严重不良反应。有4例患者出现一过性皮损加重和局部红肿。结论 ALA-IPL-PDT治疗能有效治疗中重度痤疮,效果维持达治疗结束后12周,且无严重的色素沉着等不良反应。     

水光注射配合强脉冲光治疗女性迟发型痤疮的效果及对血清炎症因子的影响

目的 探讨水光注射联合强脉冲光治疗女性迟发性痤疮的效果及对血清炎症水平的影响。方法 选择2022年2月-2024年1月我院收治的女性迟发性痤疮患者120例,按随机数字表法原则分成观察组（n =60）、对照组（n =60）。对照组采取单纯强脉冲光治疗,观察组采取水光注射配合强脉冲光治疗,比较两组临床疗效、血清炎症因子[超敏C反应蛋白（hs-CRP）、白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）]及不良反应发生情况。结果 观察组治疗总有效率为95.00%,高于对照组的80.00%（P＜0.05）;两组治疗3个月后血清hs-CRP、IL-6、TNF-α均低于治疗前,且观察组低于对照组（P＜0.05）;观察组不良反应发生率与对照组比较,差异无统计学意义（P＞0.05）。结论 针对女性迟发性痤疮的患者,采取水光注射配合强脉冲光的方法治疗效果良好,可降低血清炎症因子水平,且并未增加不良反应发生几率,应用安全性较高。