Rizova E, Pagnoni P A, Stoudemayer T, Poncet M, Kligman A M
SKIN Incorporated, Conshohocken, Pennsylvania, USA.
Cutis. 2001 Oct;68(4 Suppl):25-33.
Assessment of improvement in acne lesions following treatment is often based on clinical evaluation and photographs. However, limitations are associated with this sublective evaluation, making it difficult to accurately review individual acne lesions and to observe early response to therapy. Conventional photographs do not allow us to visualize small lesions, and it can be difficult to differentiate inflammatory lesions as papules or small nodules. Our objective was to evaluate a new standardized method for tracking individual acne lesions based on photographs. The effect of adapalene gel 0.1% on both inflammatory and noninflammatory acne lesions was evaluated using this technique. Polarized light photography and videomicroscopy were used to record the evolution of acne lesions over a 16-week period in 5 volunteers with moderate acne vulgaris. During the first 4 weeks before treatment, acne lesions were evaluated on a 3-times weekly basis to establish a pattern of progression and determine the length of time to resolution. Sebum secretion rates were monitored using Sebutape adhesive patches applied to the forehead and both cheeks for 1 hour. After 4 weeks, adapalene gel 0.1% was used once daily at bedtime for 8 weeks; polarized light photography, videomicroscopy, and assessment of sebum production followed treatment response. This treatment period was followed by a further 4-week phase, after which acne lesions and sebum secretion rates were evaluated. Our results showed that the new methodology was appropriate to track acne lesions and allowed an accurate and more oblective evaluation of individual lesions. Using this methodology demonstrated that adapalene gel 0.1% causes rapid resolution of inflammatory and noninflammatory lesions. The probability of clearing inflammatory and noninflamma tory lesions during the treatment period increased, and the probability of new lesions appearing decreased. Sebum secretion rates declined in patients while on study drug, returning to near pretreatment levels following therapy cessation. Using sophisticated photography and videomicroscopy every other day proved to be a valuable, noninvasive, and reliable method of following response to adapalene treatment in patients with moderate acne vulgaris.
痤疮病变治疗后的改善评估通常基于临床评估和照片。然而，这种主观评估存在局限性，难以准确复查单个痤疮病变并观察治疗的早期反应。传统照片无法让我们看清小病变，且难以区分炎性病变是丘疹还是小结节。我们的目的是评估一种基于照片追踪单个痤疮病变的新标准化方法。使用该技术评估了0.1%阿达帕林凝胶对炎性和非炎性痤疮病变的效果。在5名中度寻常痤疮志愿者中，使用偏光摄影和视频显微镜记录了16周内痤疮病变的演变情况。在治疗前的前4周，每周对痤疮病变进行3次评估，以建立进展模式并确定消退所需时间。使用粘贴在前额和双颊1小时的皮脂分泌测试条监测皮脂分泌率。4周后，0.1%阿达帕林凝胶在睡前每日使用1次，共8周；治疗反应后进行偏光摄影、视频显微镜检查和皮脂分泌评估。此治疗期之后是另外4周阶段，之后评估痤疮病变和皮脂分泌率。我们的结果表明，新方法适用于追踪痤疮病变，并能对单个病变进行准确且更客观的评估。使用该方法表明，0.1%阿达帕林凝胶可使炎性和非炎性病变迅速消退。治疗期间清除炎性和非炎性病变的概率增加，出现新病变的概率降低。在服用研究药物期间患者的皮脂分泌率下降，停药后恢复到接近治疗前水平。事实证明，每隔一天使用精密的摄影和视频显微镜检查是一种有价值、非侵入性且可靠的方法，可用于追踪中度寻常痤疮患者对阿达帕林治疗的反应。
