Leyden James, Stein-Gold Linda, Weiss Jonathan
Department of Dermatology, University of Pennsylvania School of Medicine, Philadelphia, PA, USA.
Department of Dermatology, Henry Ford Hospital, Detroit, MI, USA.
Dermatol Ther (Heidelb). 2017 Sep;7(3):293-304. doi: 10.1007/s13555-017-0185-2. Epub 2017 Jun 5.
Acne-focused dermatology expert groups have consistently recommended that most patients with acne be treated with a combination of topical retinoid and antimicrobial therapy. This is based on clinical data as well as evidence that these drug classes have different and complementary mechanisms of action that target multiple aspects of acne's complex pathophysiology. Recent evidence-based guidelines for acne, including those from the American Academy of Dermatology (AAD) and the European Dermatology Forum (EDF), have agreed that retinoids have an essential role in this widespread disease. The AAD states "retinoids are the core of topical therapy for acne because they are comedolytic, resolve the precursor microcomedone lesion, and are anti-inflammatory;" further, they "allow for maintenance of clearance." Despite uniform recommendation for use of topical retinoids, a recent study of prescribing practices from 2012 to 2014 indicated that dermatologists prescribed retinoids just 58.8% of the time while non-dermatologists prescribed them for only 32.4% of cases. In this article, we review the reasons supporting retinoids as the mainstay of acne therapy and discuss some of the perceived barriers that may be limiting use of this important drug class. Further, we discuss how and when titrating retinoid concentrations may be utilized in clinical practice.
Galderma International.
专注于痤疮治疗的皮肤科专家组一直建议，大多数痤疮患者应采用外用维甲酸和抗菌疗法联合治疗。这是基于临床数据以及证据表明，这些药物类别具有不同且互补的作用机制，可针对痤疮复杂病理生理学的多个方面。近期基于证据的痤疮治疗指南，包括美国皮肤科协会（AAD）和欧洲皮肤科论坛（EDF）的指南，都一致认为维甲酸在这种广泛存在的疾病中起着至关重要的作用。美国皮肤科协会指出“维甲酸是痤疮外用治疗的核心，因为它们具有溶解粉刺的作用，可消除微粉刺前驱病变，并且具有抗炎作用”；此外，它们“能够维持清除效果”。尽管一致推荐使用外用维甲酸，但最近一项关于2012年至2014年处方习惯的研究表明，皮肤科医生使用维甲酸的时间仅占58.8%，而非皮肤科医生仅在32.4%的病例中使用。在本文中，我们回顾了支持维甲酸作为痤疮治疗主要药物的原因，并讨论了一些可能限制这类重要药物使用的认知障碍。此外，我们还讨论了在临床实践中如何以及何时调整维甲酸浓度。
高德美国际公司。
