Subcision in acne scar with and without subdermal implant: a clinical trial

Background Subcision is a procedure that has been reported to be beneficial in treatment of acne scars. Objective This stady aims to assess the efficacy of subcision in the treatment of rolling acne scars and evaluate a novel subdermal filler ‘absorbable plain catgut suture’ with subcision. Methods Twenty‐two patients with rolling acne scars underwent subcision, 20 of whom completed treatment and follow‐up period. One side of the face underwent subcision and another side subcision with subdermal implant. The patients and investigators’ assessment of improvement were both recorded. Results Subcision showed mild improvement in about 60% of patient and moderate improvement in about 40% of them. The rate of response showed no significant difference with the use of subdermal implant. The side‐effects of local oedema, bruising and infection were all transient. Conclusions Subcision seems to be a safe method to correct the rolling acne scars with long‐term improvement. However, the subdermal implant led to no significant superior results.     

Acne therapy with topical benzoyl peroxide,antibiotics and azelaic acid

Benzoyl peroxide (BPO) was introduced in the treatment of acne in 1934. Despite the fact that only few randomized trials have been published, BPO is considered the standard in topical acne treatment. Anaerobic bacteria are reduced by oxidative mechanisms and the induction of resistant strains is reduced. Topical formulations are available at concentrations of 2.5, 5, 10 and 20 %. The effect is dose‐dependent, but the irritation increases with higher concentrations. Usually 5 % BPO is sufficient to control acne grade I‐II. Due to its strong oxidative potential, patients should be advised that BPO may bleach colored and dark clothing, bedding and even hair. BPO is safe for use in pregnant and lactating females because it is degraded to benzoic acid. It is a cost‐effective treatment for acne grade I–II. Patients with papulopustular acne grade I–II, particularly with marked inflammation, show satisfactory improvement with topical antibiotic treatment. The following compounds are available and effective: erythromycin, clindamycin and tetracycline (the latter being less frequently used). A review in 1990 suggested that topical tetracycline was ineffective in the treatment of acne. Along with eliminating Propionibacterium acnes, the main mechanism of topical antibiotics is their antiinflammatory effect. All three penetrate the epidermal barrier well and are similarly efficacious. Randomized trials have shown that in concentrations of 2–4 %, their effects are comparable to oral tetracycline and minocycline. Combination therapy with retinoids or benzoyl peroxide (BPO) increases efficacy. Retinoids increase penetration and reduce comedones, while topical antibiotics primarily address inflammation. One side effect of topical antibacterial treatment is an increase in drug‐resistant resident skin flora with gram‐negative microorganisms prevailing, which can lead to gram‐negative folliculitis. All three antibiotics fluoresce under black light which may produce interesting effects in a discotheque. There are two reports of topical clindamycin causing pseudomembranous colitis after long‐term and widespread usage. Azelaic acid has a predominant antibacterial action, although it is not considered as an antibiotic in the classical sense. Furthermore, it possesses a modest comedolytic effect. Burning upon application is common. Since azelaic acid is naturally present, systemic side effects are not likely to occur, making it safe for acne treatment during pregnancy and lactation.     

痤疮五脏论治举隅

人体某一局部的病理变化，往往与全身脏腑生理功能失调有关。痤疮的局部病变，也是五脏内部失调的表现。“有诸内，必形诸外”其发生必定与五脏六腑的生理功能失常有着必然的联系。从五脏入手，辨证论治，提高了痤疮在临床上的治愈率，也充分体现中医治病的整体观念和辨证论治在实际临床应用中的原则性和灵活性。     

Laser and other light therapies for the treatment of acne vulgaris: systematic review

Background  Acne is common and can lead to scarring of the skin, as well as to psychological distress and reduced self-esteem. Most topical or oral treatments for acne are inconvenient and have side-effects. Laser and other light therapies have been reported to be convenient, safe and effective in treating acne.
Objectives  To carry out a systematic review of randomized controlled trials of light and laser therapies for acne vulgaris.
Methods  We searched the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, CINAHL, PsycInfo, LILACS, ISI Science Citation Index and Dissertation Abstracts International for relevant published trials.
Results  We identified 25 trials (694 patients), 13 of light therapy and 12 of light therapy plus light-activated topical cream (photodynamic therapy, PDT). Overall, the results from trials of light alone were disappointing, but the trials of blue light, blue–red light and infrared radiation were more successful, particularly those using multiple treatments. Red–blue light was more effective than topical 5% benzoyl peroxide cream in the short term. Most trials of PDT showed some benefit, which was greater with multiple treatments, and better for noninflammatory acne lesions. However, the improvements in inflammatory acne lesions were not better than with topical 1% adapalene gel, and the side-effects of therapy were unacceptable to many participants.
Conclusions  Some forms of light therapy were of short-term benefit. Patients may find it easier to comply with these treatments, despite the initial discomfort, because of their short duration. However, very few trials compared light therapy with conventional acne treatments, were conducted in patients with severe acne or examined long-term benefits of treatment.     

育龄女性痤疮的内分泌水平测定及中医辨证治疗分析

目的对育龄女性痤疮患者进行临床及实验室观察,以与青春期痤疮相区别,使其在临床治疗上更有针对性.方法观察61例患者临床症状、性激素水平,按中医辨证施治的原则拟定治法、方药,总结其临床疗效.结果61例中内分泌检测呈紊乱状态,垂体激素明显降低,卵巢激素低龄组睾酮增高,高龄组雌二醇增高.中医辨证结果:低龄组多以肺胃实热为主,高龄组可分为脾胃湿热、脾虚肝郁证和脾虚食滞、肝肾阴虚证.结论育龄女性痤疮与青春期痤疮在内分泌改变方面确有不同,呈紊乱状态.经中医辨证用药治疗,取得了较满意的效果.     

A cross‐sectional study of psychological morbidity in patients with acne,psoriasis and atopic dermatitis in specialist dermatology and general practices

Background There is considerable evidence for an association of skin diseases with psychological morbidity. This relationship is best established for acne, psoriasis and atopic eczema. Previous studies have mostly been performed in specialist dermatological practice, and there is a lack of studies that include patients from general practice and a lack of controlled studies employing multivariate analysis. Aims/objectives This study aims to examine the relationship of acne, psoriasis and atopic eczema with psychological morbidities in patients recruited from general practice as well as specialist dermatology practice. Methods and subjects In this cross‐sectional study, 108 patients from general and specialist dermatology practices with the three diseases had disease severity assessed and completed measures of minor psychological disturbance (General Health Questionnaire‐12), anxiety and depression (Hospital Anxiety and Depression Scale), public self‐consciousness and social anxiety (Fenigstein Self‐Consciousness Scale), and neuroticism and extraversion/introversion (Eysenck Personality Inventory). Demographic data were also collected, along with self‐ratings of disease severity. Control subjects were 96 patients without skin disease recruited from the same general practices as the subjects. Results On univariate analyses, patients with skin disease had higher levels of minor psychological disturbance, public self‐consciousness and neuroticism than did controls. There were no differences in psychological measures between specialist and general practice patients or between patients with different skin diseases. On multivariate analyses, the significant differences did not persist. Conclusions This study demonstrates confounding in the relationship of skin diseases with psychological morbidity. The complex relationship of skin disease and psychological morbidity should be re‐examined.     

A Large Number of Tandem Repeats in the Polymorphic Epithelial Mucin Gene Is Associated with Severe Acne

Polymorphic epithelial mucin (PEM) or MUC1 is a glycoprotein secreted from various epithelial gland tissues. In skin, PEM is detected in sweat glands and sebaceous glands by the DF3 monoclonal antibody. The gene of PEM includes an allele exhibiting length polymorphism due to a variable number of tandem repeats (VNTR); this is expressed co-dominantly, which may influence the microenvironment of the skin. The allelic size variation of the PEM gene was investigated in Japanese acne patients, atopic dermatitis patients, and healthy controls. The frequency of longer length alleles was significantly higher in severe acne patients.     

维胺酯胶囊治疗寻常痤疮临床疗效观察

目的:观察维胺酯胶囊对寻常痤疮的治疗效果。方法:根据Pillsbury分类法分类,采用维胺酯胶囊口服治疗寻常痤疮。结果:维胺酯胶囊治疗寻常痤疮有效率为85.00%。结论:维胺酯胶囊是治疗寻常痤疮的一种有效药物。     

温灸治疗囊肿结节型痤疮的可行性探讨

痤疮是一种与性腺的内分泌功能有关的毛囊、皮脂腺慢性炎症性皮肤病,严重影响着人的美容和身心健康。对于反复发作的囊肿结节型痤疮如何治疗,已成为亟待解决的问题。本文就近年来对囊肿结节型痤疮的认识及治疗进展方面作一简要综述,并对温灸疗法应用于囊肿结节型痤疮的可行性进行探讨,以期更好地研究及拓展灸法在热证方面的应用。     

蓝光治疗痤疮120例临床疗效观察

目的：观察120例痤疮患者经407～420nm蓝光治疗后皮损及皮肤性质改变情况。方法：应用波长为407～420nm的高强度窄谱蓝光照射痤疮患者皮损，每周治疗2次，每次15～18min，8次为一个疗程。治疗前后做皮肤性质测试，观察痤疮皮损消退情况及皮肤皮脂分泌、水分、弹力度及毛孔的变化。结果：痊愈95例（79．2％），显效12例（10％），有效8例（6．6％），无效5例（4．2％），总有效率95．8％。治疗后患者面部皮脂分泌明显减少，弹性增加，毛孔变细，面部水分较治疗前无明显变化。结论：采用波长为407～420nm的蓝光照射治疗痤疮安全、有效，可以改善皮肤性质，减少痤疮的复发。