Department of Dermatology, Faculty of Medicine, Kagawa University, Kita-gun, Kagawa, Japan.
J Dermatolog Treat. 2012 Feb;23(1):37-45. doi: 10.3109/09546634.2010.519016. Epub 2011 Jan 22.
The efficacy of combined therapy with a retinoid and antibiotic for Japanese patients with acne vulgaris remains to be established. Further, maintenance strategies limiting the use of topical retinoids must be identified. The objectives of this study are to determine the efficacy of sequential application of topical adapalene and clindamycin phosphate and to assess the impact of this regimen on patients' quality of life. Sixty-six patients were recruited. The regimen comprised two phases. For the 4-week initial treatment, 1% clindamycin phosphate gel was applied twice daily and 0.1% adapalene gel, once. In the 4-week maintenance phase, patients were randomly assigned to the OD group (adapalene applied once daily) or the TW group (adapalene applied once daily on 2 days per week). The acne severity score, lesion counts, microcomedone count, and sebum amount were measured. Quality of life (QOL) was assessed using Skindex-16. All parameters improved significantly by week 4 of initial treatment. No statistically significant differences were found in the improvement of clinical findings between the groups. All QOL scores improved significantly and did not significantly differ between the groups. Our regimen may enable clinical control of acne in Japanese patients and improve their QOL. For limiting retinoid use, weekly application of adapalene during maintenance is suitable.
联合应用维 A 酸类药物和抗生素治疗日本寻常痤疮患者的疗效尚待确定。此外,还需要明确限制局部用维 A 酸类药物使用的维持策略。本研究的目的是确定局部应用阿达帕林和克林霉素磷酸酯序贯疗法的疗效,并评估该方案对患者生活质量的影响。共招募了 66 名患者。该方案包括两个阶段。在 4 周的初始治疗中,每天应用 2 次 1%克林霉素磷酸酯凝胶和 1 次 0.1%阿达帕林凝胶。在 4 周的维持阶段,患者被随机分配至每日 1 次(OD 组)或每周 2 次(TW 组,每周 2 天应用阿达帕林凝胶)。评估痤疮严重程度评分、皮损计数、微粉刺计数和皮脂量。采用 Skindex-16 评估生活质量(QOL)。所有参数在初始治疗的第 4 周均显著改善。组间临床发现改善无统计学差异。所有 QOL 评分均显著改善,组间无显著差异。我们的方案可能使日本患者的痤疮得到临床控制,并改善他们的生活质量。为了限制维 A 酸类药物的使用,在维持治疗期间每周应用阿达帕林是合适的。