Department of Dermato-venereology, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250033, China.
Department of Ultrasound, the People's Hospital of Zhangqiu Area, Jinan, Shandong, 250200, China.
Photodiagnosis Photodyn Ther. 2021 Jun;34:102215. doi: 10.1016/j.pdpdt.2021.102215. Epub 2021 Feb 12.
In China, photodynamic therapy(PDT) has been widely accepted in the treatment of acne. However, there are few studies on PDT combined with isotretinoin of moderate to severe acne.
To evaluate the efficacy and safety of PDT combined with isotretinoin in the treatment of moderate to severe acne.
70 cases of moderate and severe acne patients were randomly divided into PDT group and combination group. In combination group, patients were treated with PDT, once/2weeks, for 3 times; and oral isotretinoin, 10 mg twice a day for 3 months. The PDT group was treated with PDT alone. The skin lesions were counted before treatment and in the 4th, 6th, 8th, and 12th weeks to evaluate the clinical efficacy. Adverse reactions during the treatment were recorded. We monitored the liver function of the combination group once a month. The recurrence rate was recorded 6 months after treatment.
A total of 67 patients completed the study. The effective rates of combination group in the 4th, 6th, 8th, and 12th weeks of treatment were 28.6 %, 71.4 %, 91.4 %, and 94.1 %, respectively; the effective rates of PDT group in the 4th, 6th, 8th, and 12th weeks of treatment were 22.9 %, 54.3 %, 74.3 %, and 78.8 %, respectively; the effective rates of two groups were statistically significant in the 6th, 8th, and 12th weeks of treatment (P < 0.05). There was no significant difference in pain score between two groups during the photodynamic therapy(P＞0.05). Adverse reactions, such as erythema and pustule during photodynamic therapy in both groups were tolerable. The pigmentation subsided in about 3 months. The recurrence rate of combination group was significantly lower than that of PDT group(7% VS 24 %,P＜0.05).
PDT combined with isotretinoin has higher effective rate and lower recurrence rate than single PDT, and is a choice for the treatment of moderate to severe acne.
在中国，光动力疗法（PDT）已被广泛用于治疗痤疮。然而，关于 PDT 联合中重度痤疮异维 A 酸的研究较少。
评价 PDT 联合异维 A 酸治疗中重度痤疮的疗效和安全性。
将 70 例中重度痤疮患者随机分为 PDT 组和联合组。联合组患者采用 PDT 治疗，每 2 周 1 次，共 3 次；同时口服异维 A 酸，每日 2 次，每次 10mg，共 3 个月。PDT 组单独采用 PDT 治疗。于治疗前及治疗后第 4、6、8、12 周计数皮损，评价临床疗效。记录治疗期间不良反应。联合组每月监测 1 次肝功能。治疗结束后 6 个月记录复发率。
共 67 例患者完成研究。治疗后第 4、6、8、12 周，联合组有效率分别为 28.6%、71.4%、91.4%、94.1%，PDT 组分别为 22.9%、54.3%、74.3%、78.8%，两组治疗后第 6、8、12 周有效率比较，差异均有统计学意义（P<0.05）。两组 PDT 治疗过程中的疼痛评分比较，差异无统计学意义（P＞0.05）。两组患者 PDT 治疗过程中均出现红斑、脓疱等不良反应，但均可耐受。皮损处色素沉着约 3 个月消退。联合组复发率明显低于 PDT 组（7%比 24%，P<0.05）。
PDT 联合异维 A 酸治疗中重度痤疮的有效率高于单独 PDT，复发率低于单独 PDT，是治疗中重度痤疮的选择之一。
