Department of Dermatology, University of Athens, Andreas Sygros Hospital, 5 Ionos Dragoumi St, 16121 Athens, Greece.
Clin Dermatol. 2010 Jan-Feb;28(1):24-30. doi: 10.1016/j.clindermatol.2009.03.005.
Acne is one of the most prevalent diseases in dermatology: Millions of people worldwide experience this distressing condition. To determine the appropriate therapeutic strategy, there is a strong need for a standardized classification system of acne. The exact molecular mechanism of action of isotretinoin is not completely understood; however, oral isotretinoin targets simultaneously at all major mechanisms of acne pathogenesis. Various mass media reports about the risk of teratogenicity and depression from isotretinoin usage as well as the creation of intense prevention programs have created an obstacle to the use of the most active available drug against acne, presenting isotretinoin as a very dangerous regimen. According to recommendations of several international experts, which we share, oral isotretinoin may be prescribed not only to patients with severe disease but indications should be broadened to also include patients with less severe forms of acne, especially in cases with scarring, significant psychologic stress, or failure to respond to conventional therapy.
全世界有数百万人患有这种令人痛苦的疾病。为了确定适当的治疗策略，非常需要一个标准化的痤疮分类系统。异维 A 酸的确切作用机制尚未完全明了；然而，口服异维 A 酸同时针对痤疮发病机制的所有主要机制。关于异维 A 酸使用的致畸性和抑郁风险的各种大众媒体报道，以及高强度预防计划的制定，给最有效的痤疮治疗药物的使用带来了障碍，使异维 A 酸成为一种非常危险的疗法。根据我们共同分享的几位国际专家的建议，口服异维 A 酸不仅可以开给重症患者，而且应该扩大适应证，还包括病情较轻的痤疮患者，特别是有疤痕、明显心理压力或对常规治疗无效的患者。
