Rasi Abbas, Behrangi Elham, Rohaninasab Masoumeh, Nahad Zahra Mehr
Skin and Stem Cell Research Center, Department of Dermatology, Tehran University of Medical Sciences, Tehran, Iran, Department of Dermatology, Rasoul-e Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.
Department of Dermatology, Rasoul-e Akram Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Adv Biomed Res. 2014 Mar 31;3:103. doi: 10.4103/2277-9175.129693. eCollection 2014.
Despite advances in acne therapy in recent years, treatment failure is common. Isotretinoin is the only drug that affects almost all factors in acne pathogenesis, but side-effects are common at the doses reported in published studies in the literature. The aim of this study was to investigate the efficacy of low daily dose isotretinoin in moderate to severe acne patients. The secondary objective was to measure the rate of relapse 5 years after the completion of therapy.
In this retrospective, noncomparative study, 146 patients with moderate to severe scare prone acne. Treatment regimen consisted of isotretinoin, fixed 20 mg daily, and duration of treatment-based on the weight of patient, until total cumulative dose of 120 mg/kg of body weight is achieved. No topical or other systemic therapy was allowed during the trial. Liver function tests (serum glutamic-oxalocetic transaminase, serum glutamate pyruvate transaminase, direct and total bilirubin), and lipid profiles (total cholesterol, low-density lipoprotein, high-density lipoprotein, triglyceride) were evaluated for all patients, before the initiation of treatment and again after the 2(nd) month of treatment. All data analyzed by Microsoft Office Excel 2007; in descriptive statics frequency and SPSS.18 software.
At the end of treatment course, (96.4%) demonstrated complete clearing of their acne, defined as no acne or occasional isolated lesions. In 5-year follow-up, relapse accrued in 11 (7.9%) of patients. All adverse effects were mild, and discontinuation of treatment was not necessary.
Low dose isotretinoin was found to be a safe and effective choice for patients with moderate to severe scar prone acne vulgaris.
尽管近年来痤疮治疗取得了进展，但治疗失败仍很常见。异维甲酸是唯一一种几乎影响痤疮发病机制中所有因素的药物，但在文献中发表的研究报告的剂量下，副作用很常见。本研究的目的是调查低日剂量异维甲酸在中度至重度痤疮患者中的疗效。次要目标是测量治疗完成后5年的复发率。
在这项回顾性、非对照研究中，纳入了146例中度至重度易形成瘢痕的痤疮患者。治疗方案为每日固定剂量20mg异维甲酸，治疗持续时间根据患者体重确定，直至达到120mg/kg体重的总累积剂量。试验期间不允许使用局部或其他全身治疗。在治疗开始前和治疗第2个月后，对所有患者进行肝功能检查（血清谷草转氨酶、血清谷丙转氨酶、直接胆红素和总胆红素）和血脂谱（总胆固醇、低密度脂蛋白、高密度脂蛋白、甘油三酯）评估。所有数据通过Microsoft Office Excel 2007进行分析；采用描述性统计学中的频率分析以及SPSS.18软件。
在治疗疗程结束时，96.4%的患者痤疮完全清除，定义为无痤疮或偶尔有孤立性皮损。在5年随访中，11例（7.9%）患者复发。所有不良反应均较轻，无需停药。
低剂量异维甲酸被发现是中度至重度易形成瘢痕的寻常痤疮患者的一种安全有效的选择。
