a Department of Dermatology , ABC Hospital , Mexico City , Mexico.
Expert Opin Pharmacother. 2019 Jun;20(8):1009-1024. doi: 10.1080/14656566.2019.1584182. Epub 2019 Mar 8.
Acne vulgaris is the most common skin disease worldwide, yet current treatment options, although effective, are associated with unwanted side effects, chronicity, relapses and recurrences. The adequate control of the four pathogenic mechanisms involved in the appearance of acne lesions is key to treatment success. This paper aims to discuss the novel treatment modalities that have surfaced in consequence of new knowledge obtained in acne pathogenesis.
Pathogenic pathways are evaluated and discussed throughout the paper in relation to the mechanisms of action of novel molecules being investigated for the treatment of acne vulgaris. A comprehensive search was made in PubMed and Clinicaltrial.gov using a different combination of keywords, which included acne vulgaris, treatment, therapy, and therapeutic.
In the near future, more effective treatments with less side effects are expected. The use of topical anti-androgens, coenzyme-A carboxylase inhibitors, and insulin growth factor-1inhibitors to control sebum production seem promising. Selective RAR-agonists have the potential of becoming an alternative to the currently available retinoid therapy in the management of infundibular dyskeratosis with a better safety profile. Antibiotic use will probably decline as more effective options for controlling Cutinebacterium acnes colonization and the inflammation cascade emerge.
寻常痤疮是全球最常见的皮肤病,但目前的治疗方法虽然有效,但存在不良反应、慢性、复发和再发等问题。充分控制痤疮皮损出现的四个发病机制是治疗成功的关键。本文旨在讨论由于痤疮发病机制新认识而出现的新治疗方法。
本文通过评估和讨论与新型分子作用机制相关的发病途径,对寻常痤疮的治疗进行了探讨。在 PubMed 和 Clinicaltrial.gov 上,使用不同的关键词组合进行了全面搜索,包括寻常痤疮、治疗、疗法和治疗。
在不久的将来,预计会有更有效、副作用更小的治疗方法。局部抗雄激素、辅酶 A 羧化酶抑制剂和胰岛素样生长因子-1 抑制剂等用于控制皮脂产生的方法似乎很有前途。选择性 RAR 激动剂有可能成为目前可用的维甲酸治疗方法的替代方案,在治疗毛囊角化不良方面具有更好的安全性。随着控制痤疮丙酸杆菌定植和炎症级联反应的更有效方法的出现,抗生素的使用可能会减少。