Division of Pediatric and Adolescent Dermatology, Rady Children's Hospital, San Diego and Department of Pediatrics, University of California, San Diego, San Diego, California, USA.
Pediatrics. 2013 May;131 Suppl 3:S163-86. doi: 10.1542/peds.2013-0490B.
Acne vulgaris is one of the most common skin conditions in children and adolescents. The presentation, differential diagnosis, and association of acne with systemic pathology differs by age of presentation. Current acknowledged guidelines for the diagnosis and management of pediatric acne are lacking, and there are variations in management across the spectrum of primary and specialty care. The American Acne and Rosacea Society convened a panel of pediatric dermatologists, pediatricians, and dermatologists with expertise in acne to develop recommendations for the management of pediatric acne and evidence-based treatment algorithms.
Ten major topic areas in the diagnosis and treatment of pediatric acne were identified. A thorough literature search was performed and articles identified, reviewed, and assessed for evidence grading. Each topic area was assigned to 2 expert reviewers who developed and presented summaries and recommendations for critique and editing. Furthermore, the Strength of Recommendation Taxonomy, including ratings for the strength of recommendation for a body of evidence, was used throughout for the consensus recommendations for the evaluation and management of pediatric acne. Practical evidence-based treatment algorithms also were developed.
Recommendations were put forth regarding the classification, diagnosis, evaluation, and management of pediatric acne, based on age and pubertal status. Treatment considerations include the use of over-the-counter products, topical benzoyl peroxide, topical retinoids, topical antibiotics, oral antibiotics, hormonal therapy, and isotretinoin. Simplified treatment algorithms and recommendations are presented in detail for adolescent, preadolescent, infantile, and neonatal acne. Other considerations, including psychosocial effects of acne, adherence to treatment regimens, and the role of diet and acne, also are discussed.
These expert recommendations by the American Acne and Rosacea Society as reviewed and endorsed by the American Academy of Pediatrics constitute the first detailed, evidence-based clinical guidelines for the management of pediatric acne including issues of special concern when treating pediatric patients.
寻常痤疮是儿童和青少年中最常见的皮肤疾病之一。临床表现、鉴别诊断以及痤疮与全身病理的关联因发病年龄而异。目前，缺乏公认的儿童痤疮诊断和管理指南，而且在初级保健和专科保健的范围内，管理方法存在差异。美国痤疮和酒渣鼻学会召集了一组儿童皮肤科医生、儿科医生和痤疮专家，制定了儿童寻常痤疮的管理建议和基于证据的治疗方案。
确定了儿童寻常痤疮诊断和治疗的 10 个主要专题领域。进行了全面的文献检索，并对文章进行了筛选、审查和证据分级评估。将每个专题领域分配给 2 名专家评审员，他们制定和提出了总结和建议，以供批评和编辑。此外，还在整个共识建议中使用了推荐等级分类，包括对证据体的推荐强度的评级，以评估和管理儿童寻常痤疮。还制定了实用的基于证据的治疗方案。
根据年龄和青春期状态，提出了儿童寻常痤疮的分类、诊断、评估和管理建议。治疗考虑因素包括使用非处方产品、局部过氧化苯甲酰、局部维 A 酸、局部抗生素、口服抗生素、激素治疗和异维 A 酸。详细介绍了青少年、青春期前、婴儿期和新生儿痤疮的简化治疗方案和建议。还讨论了其他考虑因素，包括痤疮对心理社会的影响、治疗方案的依从性以及饮食与痤疮的关系。
这些由美国痤疮和酒渣鼻学会提出的专家建议，经美国儿科学会审查和认可，构成了儿童寻常痤疮管理的第一个详细的基于证据的临床指南，包括在治疗儿科患者时特别关注的问题。
