Agrawal Dipty A, Khunger Niti
Department of Dermatology, Bharatratna Dr. Babasaheb Ambedkar Municipal General Hospital, Mumbai, Maharashtra, India.
Department of Dermatology and STD, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
J Cutan Aesthet Surg. 2020 Jul-Sep;13(3):210-216. doi: 10.4103/JCAS.JCAS_177_19.
Scarring is one of the most dreadful complications of acne for which patients seek surgical treatment.
The aim of this research was to study the morphological features of acne scarring and the relationship between severity of acne and its treatment with type and severity of acne scars.
This was a hospital-based, noninterventional, cross-sectional study carried out over a period of 1 month on 100 patients with post-acne scarring. A morphological evaluation of the types, sites, and severity of acne scars was done, and details of the severity and treatment of acne were recorded.
Of 100 patients included in the study, 61 were male and 39 were females. Females had an earlier onset of acne (15.8 years) as compared to males (16.5 years). The mean duration of active acne was longer in males (99.3 months) than that in females (74.4 months). Male patients had more severe acne vulgaris as compared to females ( = 0.0001). Of 100 patients, 52 started treatment 1 year after the onset of acne, and 18 patients had never taken any anti-acne medication. Morphologically, majority of post-acne scars were ice pick scars in 94% patients, followed by rolling scars in 86%, boxcar scars in 54%, and keloidal scars in 10% patients. Male patients had more severe acne scarring than females ( < 0.05). Of 54 patients with severe acne, 22 progressed to moderate grade and 32 patients progressed to severe grade of acne scarring. Significant reduction in the severity of acne scarring was observed in patients who received isotretinoin as compared to that in patients who received oral antibiotics.
Majority of patients with active acne delay treatment, which leads to increased acne scarring. Ice pick scars are the most common type of acne scars, and keloidal scars are more common in males. Males have a longer duration of acne, they delay treatment, and have more severe acne scarring. Early introduction of oral isotretinoin may help to reduce the severity of acne scarring. Public education is essential to urge patients to seek early and appropriate treatment of acne that can reduce the incidence and severity of acne scarring and its psychosocial consequences.
瘢痕形成是痤疮最可怕的并发症之一，患者为此寻求手术治疗。
本研究旨在探讨痤疮瘢痕的形态学特征，以及痤疮严重程度与其治疗方法与痤疮瘢痕类型和严重程度之间的关系。
这是一项基于医院的非干预性横断面研究，在1个月内对100例痤疮后瘢痕患者进行。对痤疮瘢痕的类型、部位和严重程度进行形态学评估，并记录痤疮的严重程度和治疗细节。
研究纳入的100例患者中，男性61例，女性39例。女性痤疮发病年龄（15.8岁）早于男性（16.5岁）。男性活动性痤疮的平均病程（99.3个月）长于女性（74.4个月）。与女性相比，男性寻常痤疮更严重（P = 0.0001）。100例患者中，52例在痤疮发病1年后开始治疗，18例患者从未服用过任何抗痤疮药物。形态学上，94%的痤疮后瘢痕患者主要为冰锥样瘢痕，其次为86%的滚轮样瘢痕、54%的箱车样瘢痕和10%的瘢痕疙瘩样瘢痕。男性患者的痤疮瘢痕比女性更严重（P < 0.05）。54例重度痤疮患者中，22例进展为中度痤疮瘢痕，32例进展为重度痤疮瘢痕。与接受口服抗生素治疗的患者相比，接受异维A酸治疗的患者痤疮瘢痕严重程度显著降低。
大多数活动性痤疮患者延迟治疗，导致痤疮瘢痕增加。冰锥样瘢痕是最常见的痤疮瘢痕类型，瘢痕疙瘩样瘢痕在男性中更常见。男性痤疮病程较长，延迟治疗，痤疮瘢痕更严重。早期引入口服异维A酸可能有助于降低痤疮瘢痕的严重程度。开展公众教育对于促使患者尽早寻求适当的痤疮治疗至关重要，这可以降低痤疮瘢痕的发生率和严重程度及其心理社会后果。
