Department of Dermatology, The Second Affiliated Hospital, Northwest Hospital, Xi'an Jiaotong University, 157 Xiwu Road, Xi'an, 710004, Shaanxi, China.
Department of Dermatology, The Seventh Affiliated hospital, Sun Yat-sen University, Guangzhou, China.
Lasers Med Sci. 2022 Oct;37(8):3221-3229. doi: 10.1007/s10103-022-03606-z. Epub 2022 Jul 13.
Acne vulgaris (AV) is a common dermatosis that causes psychological problems. Isotretinoin is the first-line treatment for moderate-to-severe AV, but its onset of effect is delayed. Although light-based therapy is widely used in the treatment of AV, there is a lack of reports on delicate pulsed light (DPL) which has a narrow therapeutic spectrum (500-600 nm). Low-level light therapy (LLLT) has shown an emerging role in anti-inflammatory effects and skin repair. This study investigates the efficacy and safety of low-dose oral isotretinoin combined with LLLT using DPL in patients with moderate-to-severe AV. Thirty-six patients with moderate-to-severe AV were enrolled and received low-dose oral isotretinoin (10-20 mg/day). The two sides of the face were randomly assigned to receive DPL (6-9 J/cm) or not at an interval of 2 weeks for 4 treatment sessions (weeks 0, 2, 4, 6). Photos, GAGS score, counts of papules, pustules, comedones, TEWL, melanin and erythema index, side effects, efficacy, and satisfactory score were recorded at each visit and at 4 weeks after the final treatment (week 10). Thirty-three patients completed the study. DPL and oral isotretinoin combined therapy exhibited significantly improved GAGS score as well as the number of the lesions from week 2 and maintained until week 10. At the end of the observation, the improvement of GAGS was 70.88% on the DPL and isotretinoin combined side versus 62.12% on the side with isotretinoin monotherapy (p = 0.0009). The improvement for papule number was 61.58% on the DPL combined side versus 43.33% on the control side (p < 0.0001), for comedone was 63.15% versus 43.30% (p = 0.0008). TEWL and indexes of melanin and erythema also had better outcomes with DPL combined therapy at week 10. All the side effects were temporary and tolerable; no adverse effects were observed. Oral low-dose isotretinoin combined with LLLT by DPL offers a combination with reduced side effects and better outcomes within a limited treatment duration, which advances the onset of effect of isotretinoin monotherapy and improves lesion clearance.
寻常痤疮（AV）是一种常见的皮肤病，会导致心理问题。异维 A 酸是中重度 AV 的一线治疗药物，但起效时间延迟。虽然光疗广泛用于 AV 的治疗，但对窄谱（500-600nm）的精细脉冲光（DPL）治疗的报道较少。低水平光疗（LLLT）在抗炎作用和皮肤修复方面显示出新兴作用。本研究探讨了低剂量口服异维 A 酸联合 DPL 低水平光疗治疗中重度 AV 的疗效和安全性。36 例中重度 AV 患者接受低剂量口服异维 A 酸（10-20mg/d）。将面部两侧随机分为接受 DPL（6-9J/cm）或不接受治疗，间隔 2 周，共 4 个疗程（第 0、2、4、6 周）。每次就诊和最后一次治疗后 4 周（第 10 周）记录照片、GAGS 评分、丘疹、脓疱、粉刺、TEWL、黑素和红斑指数、副作用、疗效和满意度。33 例患者完成了研究。DPL 和口服异维 A 酸联合治疗从第 2 周开始显著改善 GAGS 评分和皮损数量，并持续至第 10 周。观察结束时，DPL 和异维 A 酸联合治疗组 GAGS 改善率为 70.88%，而异维 A 酸单药治疗组为 62.12%（p=0.0009）。DPL 联合治疗组丘疹数改善率为 61.58%，对照组为 43.33%（p<0.0001），粉刺数改善率为 63.15%，对照组为 43.30%（p=0.0008）。第 10 周 DPL 联合治疗组 TEWL 和黑素及红斑指数也有更好的结果。所有副作用均为暂时性且可耐受；未观察到不良反应。口服低剂量异维 A 酸联合 DPL 的 LLLT 提供了一种副作用更小、治疗时间有限、疗效更好的组合，可加快异维 A 酸单药治疗的起效时间，改善皮损清除率。
