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并非所有的痤疮都是寻常痤疮。

Not all acne is acne vulgaris.

作者信息

Gollnick Harald P, Zouboulis Christos C

机构信息

Department of Venerology and Dermatology, Otto von Guericke University Magdeburg, Departments of Dermatology, Venereology, Allergology and Immunology, Dessau Medical Center.

出版信息

Dtsch Arztebl Int. 2014 Apr 25;111(17):301-12. doi: 10.3238/arztebl.2014.0301.

Abstract

BACKGROUND

Acne is the most common skin disease in adolescence, with a prevalence of nearly 100%. About 60% of affected adolescents have mild acne for which they use non-prescription preparations without consulting a physician. The remaining 40% constitute the population of acne patients seen in medical practice. The course of acne can be either acute or chronic; its manifestations can appear in waves, sometimes with dramatically severe inflammation leading rapidly to scarring. Acne often has adverse emotional consequences. Its treatment is markedly better than in the past because of new pharmacological and physicochemical approaches and because evidence-based guidelines are now available.

METHOD

This article is based on a selective review of the literature and also incorporates the authors' own clinical and scientific experience.

RESULTS

Acne vulgaris of grade I or II in an adolescent is generally not hard to treat. In contrast, the more severe grades III and IV and conglobate acne often present a therapeutic challenge, as they are associated with varying constellations of acute lesions, scarring, inflammation, and emotional disturbances. These conditions often require systemic treatment with tetracyclines, which are especially useful because of their para-antibiotic antiinflammatory effect. Severe cases must be treated with isotretinoin. Women can benefit from anti-androgenic contraceptive drugs. Retinoids or azelaic acid are used in maintenance therapy to suppress the formation of microcomedones, the precursor stage of acne lesions.

CONCLUSION

A variety of effective treatments for acne are available, depending on the severity of the condition.

摘要

背景

痤疮是青少年时期最常见的皮肤病,患病率近100%。约60%的患病青少年患有轻度痤疮,他们在未咨询医生的情况下自行使用非处方制剂。其余40%则是医疗实践中所见的痤疮患者群体。痤疮病程可为急性或慢性;其表现可呈波浪式出现,有时炎症极为严重,迅速导致瘢痕形成。痤疮常产生不良情绪后果。由于新的药理和物理化学方法以及循证指南的出现,其治疗效果比过去明显更好。

方法

本文基于对文献的选择性综述,并融入了作者自身的临床和科学经验。

结果

青少年I级或II级寻常痤疮通常不难治疗。相比之下,更严重的III级和IV级痤疮以及聚合性痤疮往往带来治疗挑战,因为它们伴有不同组合的急性皮损、瘢痕形成、炎症和情绪障碍。这些情况通常需要用四环素进行全身治疗,四环素因其抗抗生素抗炎作用而特别有用。重症病例必须用异维A酸治疗。女性可受益于抗雄激素避孕药。维甲酸或壬二酸用于维持治疗,以抑制微粉刺(痤疮皮损的前期阶段)的形成。

结论

根据病情严重程度,有多种有效的痤疮治疗方法可供选择。

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