Forbat Emily, Ali Faisal R, Al-Niaimi Firas
a Chelsea and Westminster Hospital , London , UK.
b Dermatological Surgery & Laser Unit , St John's Institute of Dermatology, Guy's Cancer Centre, Guy's and St Thomas' NHS Foundation Trust , London , UK.
J Dermatolog Treat. 2018 Nov;29(7):698-705. doi: 10.1080/09546634.2018.1445194. Epub 2018 Mar 14.
While the use of isotretinoin has revolutionized the treatment of acne vulgaris, isotretinoin is increasingly recognized as a useful therapeutic option for many other cutaneous conditions. We review the evidence underlying the use of isotretinoin for a variety of dermatological indications including hidradenitis suppurativa, sebaceous gland pathology, rosacea, scarring alopecia, cosmetic dermatology, and non-melanoma skin cancer prophylaxis amongst other uses, and thus consider alternative uses within dermatology practice. The studies found benefit of isotretinoin, however most trials lacked statistical power and in many cases the use was limited to case series. Isotretinoin, if used within the correct cohort with appropriate pretreatment counseling regarding side-effects, is a well-tolerated medication with potential as either an adjunctive treatment or a second-line agent in those recalcitrant cases unresponsive to first-line therapy.
虽然异维A酸的使用彻底改变了寻常痤疮的治疗方法，但它越来越被认为是治疗许多其他皮肤病的有效治疗选择。我们回顾了异维A酸用于多种皮肤科适应症的证据，包括化脓性汗腺炎、皮脂腺疾病、玫瑰痤疮、瘢痕性脱发、美容皮肤科以及非黑色素瘤皮肤癌的预防等其他用途，从而探讨其在皮肤科实践中的替代用途。研究发现异维A酸有一定益处，但大多数试验缺乏统计学效力，且在许多情况下其应用仅限于病例系列。如果在正确的人群中使用异维A酸，并就副作用进行适当的预处理咨询，那么它是一种耐受性良好的药物，在那些对一线治疗无反应的顽固性病例中，有作为辅助治疗或二线药物的潜力。
