Scott-Emuakpor Renee, Vuthaluru Kiranmayi, Nagre Abhijit, Jawed Inshal, Patel Priyansh A, Sidhu Harmandeep K
Dermatology, International European University, Kyiv, UKR.
Pediatrics, Jawaharlal Nehru Medical College, Belgaum, IND.
Cureus. 2023 Apr 23;15(4):e38019. doi: 10.7759/cureus.38019. eCollection 2023 Apr.
Acne vulgaris is a skin condition characterized by the inflammation or hyperactivity of sebaceous glands on the skin, which results in the creation of comedones, lesions, nodules, and perifollicular hyperkeratinization. Increased sebum production, follicular blockage, and bacterial colonization may contribute to the disease etiology. Environmental factors, hormonal imbalance, and genetic predisposition can alter the severity of the disease. Its mental and monetary effects can be problematic for the society. In this study, we examined the role of isotretinoin in the treatment of acne vulgaris based on evidence from prior research. This review literature study compiled publications on the treatment of acne vulgaris from 1985 to 2022 based on PubMed and Google Scholar publications. Additional bioinformatics analyses were accompanied by GeneCards, STRING model, and DrugBank databases. These complementary analyses were designed to obtain a better perspective of personalized medicine which is highly required for dose-precise administrations of acne vulgaris treatment. Isotretinoin has been recognized as an effective treatment for acne vulgaris, particularly in cases that have been resistant to previous medications or have resulted in scarring, according to gathered data. Oral isotretinoin inhibits the proliferation of Propionibacterium acne, a critical factor in the development of acne lesions; also, it has been shown to be effective in reducing the number of Propionibacterium-resistant patients and regulating sebum production and reducing sebaceous gland size more effectively than other treatment options resulting in general improvements in skin clarity and acne severity and reduce inflammatory in 90% of patients. In addition to its efficacy, the majority of patients have shown that oral isotretinoin is well tolerated. This review highlights the use of oral retinoids, particularly isotretinoin, as an effective and well-tolerated treatment option for acne vulgaris. It has been proven that oral isotretinoin is useful for achieving long-lasting remission in patients with severe or resistant instances. Despite the fact that oral isotretinoin is related to a number of potential harmful effects, skin dryness was the most common side effect reported by patients that can be managed with the aid of suitable monitoring and drug administration against specific genes identified by genotyping of the susceptible variants of genes involved in TGFβ signaling pathway.
寻常痤疮是一种皮肤疾病，其特征为皮肤上皮脂腺的炎症或功能亢进，这会导致粉刺、皮损、结节以及毛囊周围角化过度的形成。皮脂分泌增加、毛囊堵塞和细菌定植可能促成该疾病的病因。环境因素、激素失衡和遗传易感性会改变疾病的严重程度。其对心理和经济的影响可能给社会带来问题。在本研究中，我们基于先前研究的证据，考察了异维A酸在寻常痤疮治疗中的作用。本综述文献研究根据PubMed和谷歌学术出版物，汇编了1985年至2022年期间关于寻常痤疮治疗的出版物。另外还借助基因卡数据库、STRING模型和药物银行数据库进行了生物信息学分析。这些补充分析旨在更好地了解个性化医疗，这对于精确剂量给药治疗寻常痤疮至关重要。根据收集到的数据，异维A酸已被公认为是治疗寻常痤疮的有效药物，尤其适用于对先前药物有抗药性或已导致瘢痕形成的病例。口服异维A酸可抑制痤疮丙酸杆菌的增殖，痤疮丙酸杆菌是痤疮皮损形成的关键因素；此外，与其他治疗方案相比，它已被证明在减少对痤疮丙酸杆菌耐药的患者数量、调节皮脂分泌以及更有效地减小皮脂腺大小方面有效，从而总体改善皮肤清晰度和痤疮严重程度，并使90%的患者炎症减轻。除了其疗效外，大多数患者表明口服异维A酸耐受性良好。本综述强调了口服维甲酸类药物，尤其是异维A酸，作为治疗寻常痤疮的有效且耐受性良好的治疗选择。已证明口服异维A酸对于重度或耐药病例的患者实现长期缓解很有用。尽管口服异维A酸与一些潜在有害影响有关，但皮肤干燥是患者报告的最常见副作用，借助对参与转化生长因子β信号通路的易感基因变体进行基因分型鉴定出的特定基因进行适当监测和给药，可对其进行控制。
