红蓝光联合倒模治疗痤疮疗效评价

目的：评价红蓝光联合倒模治疗轻中度痤疮的疗效和安全性。方法：96例轻中度痤疮患者随机分为实验组（50例）和对照组（46例）。实验组采用红蓝光照射联合倒模治疗;对照组仅用倒模治疗,每周2次,4周后采用痤疮综合分级系统（GAGS）评价疗效,同时观察不良反应。结果：实验组和对照组有效率分别为88.00%和47.83%,差异有统计学意义（P<0.01）,两组均无明显不良反应。结论：红蓝光联合倒模治疗轻中度痤疮安全有效。     

The skin microbiome: Associations between altered microbial communities and disease

A single square centimetre of the human skin can contain up to one billion microorganisms. These diverse communities of bacteria, fungi, mites and viruses can provide protection against disease, but can also exacerbate skin lesions, promote disease and delay wound healing. This review addresses the current knowledge surrounding the healthy skin microbiome and examines how different alterations to the skin microbial communities can contribute to disease. Current methodologies are considered, changes in microbial diversity and colonisation by specific microorganisms are discussed in the context of atopic dermatitis, psoriasis, acne vulgaris and chronic wounds. The recent impact of modern Westernised lifestyles on the human skin microbiome is also examined, as well as the potential benefits and pitfalls of novel therapeutic strategies. Further analysis of the human skin microbiome, and its interactions with the host immune system and other commensal microorganisms, will undoubtedly elucidate molecular mechanisms for disease and reveal gateways for novel therapeutic treatment strategies.     

CO_2点阵激光Deep与Superficial模式联合治疗萎缩性痤疮瘢痕的临床分析

目的:评价CO2点阵激光Deep与Superficial模式联合治疗萎缩性痤疮瘢痕的临床疗效和安全性。方法:对纳入的20例萎缩性痤疮瘢痕患者进行病例对照研究,每例患者治疗2个疗程,治疗后3个月进行疗效和安全性评价,对治疗前后萎缩性痤疮瘢痕严重程度评分,评估临床疗效和不良反应,同时统计患者主观评价。结果:所有患者瘢痕严重程度评分由治疗前(64.3±19.8)分下降至(39.8±14.3)分,改善百分比达(37.6±9.6)%,其中17例患者认为皮损明显或显著改善,无严重不良反应。结论:CO2点阵激光Deep与Superficial模式联合治疗萎缩性痤疮瘢痕,是一种安全有效的新型治疗方法。     

CYP19a1基因的单核苷酸多态性与中国汉族成人寻常痤疮的关联研究

目的:初步探索CYP19a1基因的单核苷酸多态性(SNP)与中国汉族成人寻常痤疮发病和严重程度的关系。方法:共纳入309例Pillsbury分级Ⅰ~Ⅳ的寻常痤疮患者,分为轻度组(Ⅰ级,99例)和中重度组(Ⅱ~Ⅳ级,210例)。从患者外周静脉血中抽提DNA组,经多重聚合酶链式反应(PCR)获取目的基因片段后,采用SNa Pshot分型技术检测CYP19a1基因上的10个候选SNP位点的基因型。结果:1 rs28892002位点在显性遗传模式下,CC基因型的分布频率在中重度组显著高于轻度组(58.5%vs.46.5%,P=0.046,OR=0.614,95%CI=0.379~0.993);2 rs2255192-rs4646-rs10064-rs700519这组单倍型在显性模式下,其C-C-CC、C-C-T-C基因型在两组间分布差异有统计学意义(P值分别为0.0000、0.0216,OR值分别为5.0198和2.0707)。结论:中国汉族人群中,CYP19a1基因上的rs28892002位点CC野生纯合子基因型可能增加中重度寻常痤疮的患病风险;rs2255192-rs4646-rs10064-rs700519这组单倍型在显性模式下,其C-C-C-C、C-C-T-C基因型可能减少中、重度寻常痤疮的患病风险。     

Inhibition of retinoic acid catabolism by minocycline: evidence for a novel mode of action?

Retinoic acid (RA) represents an essential and highly potent endogenous retinoid with pronounced anti‐inflammatory properties and potent anti‐acne activity, and has recently been suggested to share a common anti‐inflammatory mode of action with tetracycline antibiotics. We hypothesized that tetracyclines may directly interfere with RA homeostasis via inhibition of its local cytochrome P450 (CYP450)‐mediated degradation, an essential component of tightly regulated skin RA homeostasis. To test this hypothesis, we performed controlled in vitro RA metabolism assays using rat skin microsomes and measured RA levels in a RA‐synthesizing human keratinocyte cell line, both in the presence and in the absence of minocycline, a tetracycline popular in acne treatment. Interestingly, minocycline potently blocked RA degradation in rat skin microsomes, and strikingly enhanced RA levels in RA‐synthesizing cell cultures, in a dose‐dependent manner. These findings indicate a potential role for CYP‐450‐mediated RA metabolism in minocycline's pleiotropic mode of action and anti‐acne efficacy and could account for the overlap between minocycline and RA‐induced effects at the level of their molecular mode of action, but also clinically at the level of the rare side effect of pseudotumor cerebri, which is observed for both, RA and minocycline treatment.     

Management of acne vulgaris with hormonal therapies in adult female patients

Acne vulgaris is a very common condition affecting up of 93% of adolescents. Although rare, this disease may persist in adulthood. In adult women with acne (those older than 25 years old), this condition is particularly relevant because of the refractory to conventional therapies, which makes acne a challenge for dermatologists in this group of patients. In order to its potential risk for chronicity and the involvement of visible anatomical sites such as face and upper torso, acne has been associated with a wide spectrum of psychological and social dysfunction such as depression, anxiety, suicidal ideation, somatization, and social inhibition. In particular, adult women with acne have been shown to be adversely impacted by the effect of acne on their quality of life. For the last four decades, dermatologists have used hormonal therapies for the management of acne vulgaris in adult women, which are considered a rational choice given the severity and chronicity of this condition in this group of patients. The aim of this work is to review the hormonal drugs for management of acne.     

Treatment of atrophic facial acne scars with fractional Er:Yag laser

Background: Acne scars are often a permanent disfiguring sequel of acne vulgaris. Although many treatment modalities are available, they are often non satisfactory for all patients. Objective: To determine the effectiveness and safety of fractional 1540 nm erbium_glass laser treatment of facial acne scars in Iraqi patients. Patients and methods: Twenty one patients were enrolled in this prospective clinical study. Three sessions of the 1540 nm erbium glass laser were applied at 2-week intervals. The patients were assessed at 1, 3, and 6 months after the last session. The effect of treatment was assessed by objective (Sharquie scoring system for grading acne scarring and visual analog scale) and subjective (patient satisfaction) methods. Results: Two patients were defaulted. Eleven patients (57.9%) showed improvement from moderate to mild grade, and no grade changes were detected in eight patients (42.1%). The mean score of the visual analog scale prior to treatment was 8.61 ± 0.86 and decreased to 6.15 ± 1.28 (P = 0.037). Ten patients were satisfied to varying degrees. No significant side effects were noted. Conclusion: Non-ablative fractional 1540 nm erbium glass laser is an effective and safe method to treat acne scars and represent good alternative for patients who cannot use the ablative methods because of its longer downtime.