Department of Systematic Pathology, Division of Clinical Dermatology, University of Naples Federico II, via S. Pansini 5, Naples, Italy.
Am J Clin Dermatol. 2011 Apr 1;12(2):133-41. doi: 10.2165/11530630-000000000-00000.
Acne vulgaris is a complex, chronic, and common skin disorder of pilosebaceous units. The major pathogenic factors involved are ductal hyperkeratinization, obstruction of sebaceous follicles resulting from abnormal keratinization of the infundibular epithelium, stimulation of sebaceous gland secretion by androgens, and microbial colonization of pilosebaceous units by Propionibacterium acnes, which promotes perifollicular inflammation.
The aim of the study was to investigate the therapeutic effects of resveratrol, a natural phytoalexin produced by some spermatophytes, such as grapes and other plants, on acneic skin.
Resveratrol was incorporated in a carboxymethylcellulose-based gel. The chemical stability of resveratrol after storage at 4°C for 30 days was investigated by high-performance liquid chromatography (HPLC). The resveratrol-containing hydrogel was administered to 20 patients affected by acne vulgaris enrolled in this single-blind study. The resveratrol-containing formulation was applied daily as a solo treatment on the right side of the face for 60 days, while the hydrogel vehicle was applied to the left side of the face as a control. To objectively evaluate the results, a digital photographic database was used to collect images. The number and type of lesions were recorded for each patient, to compare the Global Acne Grading System (GAGS) score before treatment with that obtained at the end of the study. Moreover, with the innovative technique of follicular biopsy, areas of acneic skin were prepared for histopathology. The average area occupied by microcomedones at baseline was compared with that at the end of treatment.
HPLC analysis demonstrated that resveratrol, upon incorporation into the gel, did not convert to its cis-isomer when stored at 4°C for 30 days. All patients were satisfied with the active treatment and none experienced adverse effects. Clinical evaluation showed a 53.75% mean reduction in the GAGS score on the resveratrol-treated sides of the face compared with 6.10% on the vehicle-treated sides of the face. These data were supported by histologic analysis, which showed a 66.7% mean reduction in the average area of microcomedones on the resveratrol-treated sides of the face. The comparison with the vehicle-treated side of the face (9.7% reduction) showed a clinically relevant and statistically significant decrease of lesions in areas treated with resveratrol-containing hydrogel.
This pilot study showed positive results for resveratrol gel in acne, and should be considered a valid starting point for further testing of the effectiveness of this molecule in different concentrations and formulations and in a larger group of patients.
寻常痤疮是一种复杂的、慢性的、常见的毛囊皮脂腺单位疾病。涉及的主要致病因素有导管过度角化、漏斗部内上皮的异常角化导致的皮脂腺滤泡阻塞、雄激素刺激皮脂腺分泌以及痤疮丙酸杆菌定植于毛囊皮脂腺单位，从而促进毛囊周围炎症。
本研究旨在探讨白藜芦醇对痤疮皮肤的治疗作用。白藜芦醇是一种天然植物抗毒素，由一些种子植物如葡萄和其他植物产生。
将白藜芦醇掺入羧甲基纤维素基凝胶中。通过高效液相色谱（HPLC）研究白藜芦醇在 4°C 下储存 30 天后的化学稳定性。将含有白藜芦醇的水凝胶用于 20 名患有寻常痤疮的患者，这些患者参与了这项单盲研究。在 60 天的时间里，每天在右侧面部使用含有白藜芦醇的制剂作为单一治疗，而左侧面部则使用水凝胶载体作为对照。为了客观评估结果，使用数码摄影数据库收集图像。记录每位患者的病变数量和类型，以比较治疗前和研究结束时的全球痤疮分级系统（GAGS）评分。此外，采用毛囊活检的创新技术，制备痤疮皮肤区域进行组织病理学检查。比较基线时微粉刺的平均面积与治疗结束时的面积。
HPLC 分析表明，白藜芦醇在掺入凝胶后，在 4°C 下储存 30 天时不会转化为顺式异构体。所有患者均对活性治疗满意，无不良反应。临床评估显示，与水凝胶载体治疗侧相比，白藜芦醇治疗侧的 GAGS 评分平均降低了 53.75%。组织学分析也支持这一结果，显示白藜芦醇治疗侧的微粉刺平均面积平均减少了 66.7%。与水凝胶载体治疗侧（减少 9.7%）相比，白藜芦醇水凝胶治疗侧的病变减少具有临床相关性和统计学意义。
这项初步研究显示白藜芦醇凝胶对痤疮有积极的效果，应该被认为是进一步测试该分子在不同浓度和配方以及更大患者群体中的有效性的一个有效起点。
