Faghihi Gita, Jamshidi Kioumars, Tajmirriahi Nabet, Abtahi-Naeini Bahareh, Nilforoshzadeh Mohamadali, Radan Mohamadreza, Hosseini Sayed Mohsen
Department of Dermatology, Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
Department of Dermatology, School of Medicine, Ilam University of Medical Sciences, Ilam, Iran.
Adv Biomed Res. 2014 Dec 31;3:262. doi: 10.4103/2277-9175.148236. eCollection 2014.
SAHA (Seborrhea, Acne, Hirsutism and Androgenetic Alopecia) syndrome is a dermatologic disorder, with variant response to treatment. Triad of cutaneous hyperandrogenism included nodulocystic or severe acne, female pattern hair loss and hirsutism.
The aim of this study is to compare the effectiveness of isotretinoin and cyproterone compound in the treatment of nodulocystic acne, in patients with SAHA syndrome or triad of cutaneous hyperandrogenism.
30 female patients with SAHA syndrome were divided randomly into two groups. Group A was treated with cyproterone compound from day 5 of menstrual cycle onwards for 3 weeks and a week without it and group B received isotretinoin, with a dose of 0.75 mg/kg per day from the beginning of menses onwards for 4 months. The results were evaluated by a blind dermatologist using Acne Severity Index (ASI) score at baseline and monthly for 4 months.
Despite a continuous reduction in ASI score in both the groups, according to both physician (P = 0.63) and patient (P = 0.25) assessment, cyproterone compound was not statistically more effective than conventional treatment of nodulocystic acne at the end of the study. Side-effects were reported in patients in both groups, generally being mild and tolerable except in two subjects.
This study indicates that cyproterone compound is not superior to isotretinoin in the treatment of nodulocystic acne in patient with SAHA syndrome or triad of cutaneous hyperandrogenism. Indeed, other studies are needed to evaluate the effect of cyproterone compound (regardless of androgen level) and isotretinoin in subjects with only nodulocystic acne.
SAHA（脂溢性皮炎、痤疮、多毛症和雄激素性脱发）综合征是一种皮肤病，对治疗的反应存在差异。皮肤高雄激素血症三联征包括结节囊肿性或重度痤疮、女性型脱发和多毛症。
本研究的目的是比较异维A酸和环丙孕酮复方制剂在治疗SAHA综合征或皮肤高雄激素血症三联征患者的结节囊肿性痤疮方面的有效性。
30例SAHA综合征女性患者随机分为两组。A组从月经周期第5天开始使用环丙孕酮复方制剂治疗3周，停药1周；B组服用异维A酸，从月经开始时起每天剂量为0.75mg/kg，持续4个月。由一名盲法皮肤科医生在基线时以及之后4个月每月使用痤疮严重程度指数（ASI）评分评估结果。
尽管两组的ASI评分均持续降低，但根据医生（P = 0.63）和患者（P = 0.25）的评估，在研究结束时，环丙孕酮复方制剂在统计学上并不比结节囊肿性痤疮的传统治疗更有效。两组患者均报告有副作用，除两名受试者外，一般较轻且可耐受。
本研究表明，在治疗SAHA综合征或皮肤高雄激素血症三联征患者的结节囊肿性痤疮方面，环丙孕酮复方制剂并不优于异维A酸。实际上，需要其他研究来评估环丙孕酮复方制剂（无论雄激素水平如何）和异维A酸在仅患有结节囊肿性痤疮的受试者中的效果。
