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1.2%磷酸克林霉素和0.025%维甲酸凝胶治疗有色人种患者痤疮及痤疮后炎症性色素沉着的疗效和安全性

Efficacy and Safety of Clindamycin Phosphate 1.2% and Tretinoin 0.025% Gel for the Treatment of Acne and Acne-induced Post-inflammatory Hyperpigmentation in Patients with Skin of Color.

作者信息

Callender Valerie D, Young Cherie M, Kindred Chesahna, Taylor Susan C

机构信息

Callender Center for Clinical Research, Glenn Dale, Maryland; Society Hill Dermatology, Philadelphia, Pennsylvania.

出版信息

J Clin Aesthet Dermatol. 2012 Jul;5(7):25-32.

Abstract

OBJECTIVE

To assess the efficacy and safety of a topical gel containing clindamycin 1.2% and tretinoin 0.025% for the treatment of acne and acne-induced postinflammatory hyperpigmentation (PIH) in darker skinned patients.

DESIGN

Randomized, double-blind, placebo-controlled study.

SETTING

Two United States clinical sites.

PARTICIPANTS

Thirty-three patients 12 years of age or older with skin types IV to VI, mild-to-moderate facial acne, and PIH were enrolled.

MEASUREMENTS

Patients applied clindamycin phosphate/tretinoin gel or a nonmedicated vehicle each evening and a sun protection factor 30 sunscreen daily. Changes in skin erythema and hyperpigmentation were measured using a chromameter and photographic images. Efficacy was assessed using the Evaluators Global Acne Severity Scale, lesion counts, Post-inflammatory Hyperpigmentation Severity Scales and Patient's Global Assessment Scale. Safety and tolerability were assessed by adverse event reports and a Safety Assessment Scale.

RESULTS

The mean (SD) baseline inflammatory lesion count was 11.9 (11.1) in clindamycin/tretinoin-treated patients, decreasing by 5.5 (6.56) after 12 weeks while the mean baseline inflammatory lesion count was 13.6 (11.15) in placebo-treated patients, decreasing by 4.1 (11.36) (p=0.05 for change from baseline, clindamycin/tretinoin vs. placebo). Clindamycin/tretinoin-treated patients generally demonstrated superior efficacy versus placebo treatment. The clindamycin/tretinoin topical gel was well tolerated, causing little or no irritation, although one patient withdrew due to periorbital edema of moderate severity possibly related to clindamycin/tretinoin gel.

CONCLUSION

Although limited by small sample size, the results of this pilot study suggest clindamycin phosphate 1.2% and tretinoin 0.025% topical gel is a safe and effective option for treating mild-to-moderate acne in patients with skin of color.

摘要

目的

评估一种含有1.2%克林霉素和0.025%维甲酸的外用凝胶治疗深色皮肤患者痤疮及痤疮所致炎症后色素沉着(PIH)的疗效和安全性。

设计

随机、双盲、安慰剂对照研究。

地点

美国两个临床地点。

参与者

33例12岁及以上、皮肤类型为IV至VI型、轻至中度面部痤疮且有PIH的患者入组。

测量指标

患者每晚涂抹克林霉素磷酸酯/维甲酸凝胶或不含药物的赋形剂,每天使用防晒系数为30的防晒霜。使用色度计和照片图像测量皮肤红斑和色素沉着的变化。使用评估者全球痤疮严重程度量表、皮损计数、炎症后色素沉着严重程度量表和患者整体评估量表评估疗效。通过不良事件报告和安全性评估量表评估安全性和耐受性。

结果

克林霉素/维甲酸治疗组患者的平均(标准差)基线炎症性皮损计数为11.9(11.1),12周后减少5.5(6.56);而安慰剂治疗组患者的平均基线炎症性皮损计数为13.6(11.15),减少4.1(11.36)(克林霉素/维甲酸组与安慰剂组相比,从基线变化的p值为0.05)。克林霉素/维甲酸治疗组患者总体上显示出优于安慰剂治疗的疗效。克林霉素/维甲酸外用凝胶耐受性良好,几乎没有引起刺激,尽管有1例患者因可能与克林霉素/维甲酸凝胶有关的中度严重眶周水肿而退出研究。

结论

尽管受样本量小的限制,这项初步研究的结果表明,1.2%克林霉素磷酸酯和0.025%维甲酸外用凝胶是治疗有色人种患者轻至中度痤疮的一种安全有效的选择。

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