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东南亚研究联盟关于东南亚患者寻常痤疮管理的指南。

South-East Asia study alliance guidelines on the management of acne vulgaris in South-East Asian patients.

作者信息

Goh Chee Leok, Abad-Casintahan Flordeliz, Aw Derrick Chen Wee, Baba Roshidah, Chan Lee Chin, Hung Nguyen Thanh, Kulthanan Kanokvalai, Leong Hoe Nam, Medina-Oblepias Marie Socouer, Noppakun Nopadon, Sitohang Irma Bernadette, Sugito Titi Lestari, Wong Su-Ni

机构信息

National Skin Centre, Singapore.

Department of Dermatology, Jose R. Reyes Memorial Medical Center, Manila, Philippines.

出版信息

J Dermatol. 2015 Oct;42(10):945-53. doi: 10.1111/1346-8138.12993. Epub 2015 Jul 25.

Abstract

The management of acne in South-East Asia is unique, as Asian skin and local variables require a clinical approach unlike that utilized in other parts of the world. There are different treatment guidelines per country in the region, and a group of leading dermatologists from these countries convened to review these guidelines, discuss current practices and recent advances, and formulate consensus guidelines to harmonize the management of acne vulgaris in the region. Emphasis has been placed on formulating recommendations to impede the development of antibiotic resistance in Propionibacterium acnes. The group adopted the Acne Consensus Conference system for grading acne severity. The group recommends that patients may be treated with topical medications including retinoids, benzoyl peroxide (BPO), salicylic acid, a combination of retinoid and BPO, or a combination of retinoids and BPO with or without antibiotics for mild acne; topical retinoid with topical BPO and a oral antibiotic for moderate acne; and oral isotretinoin if the patient fails first-line treatment (a 6- or 8-week trial of combined oral antibiotics and topical retinoids with BPO) for severe acne. Maintenance acne treatment using topical retinoids with or without BPO is recommended. To prevent the development of antibiotic resistance, topical antibiotics should not be used as monotherapy or used simultaneously with oral antibiotics. Skin care, comprised of cleansing, moisturizing and sun protection, is likewise recommended. Patient education and good communication is recommended to improve adherence, and advice should be given about the characteristics of the skin care products patients should use.

摘要

东南亚痤疮的管理独具特色,因为亚洲人的皮肤和当地的各种因素需要一种与世界其他地区不同的临床方法。该地区每个国家都有不同的治疗指南,来自这些国家的一群顶尖皮肤科医生齐聚一堂,对这些指南进行审查,讨论当前的治疗方法和最新进展,并制定共识指南,以统一该地区寻常痤疮的管理。重点在于制定建议,以阻止痤疮丙酸杆菌产生抗生素耐药性。该小组采用了痤疮共识会议系统来对痤疮严重程度进行分级。该小组建议,对于轻度痤疮患者,可以使用外用药物治疗,包括维甲酸、过氧化苯甲酰(BPO)、水杨酸、维甲酸与BPO的组合,或维甲酸与BPO联合使用(有无抗生素);对于中度痤疮患者,使用外用维甲酸与外用BPO以及口服抗生素治疗;对于重度痤疮患者,如果一线治疗(联合口服抗生素和外用维甲酸与BPO进行6周或8周的试验)失败,则使用口服异维甲酸治疗。建议使用含或不含BPO的外用维甲酸进行痤疮维持治疗。为防止产生抗生素耐药性,外用抗生素不应作为单一疗法使用,也不应与口服抗生素同时使用。同样建议进行皮肤护理,包括清洁、保湿和防晒。建议进行患者教育并保持良好沟通以提高依从性,并且应该就患者应使用的护肤品的特点提供建议。

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