Ping Yang, Jian Bo Zhong, Xing Yun Zhao, Ali Kamran, Jun Chen, Xu Lou Inmaculada, Wu Li Ming
Department of Dermatology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
Department of Oncology, The Fourth Affiliated Hospital, International Institutes of Medicine, Zhejiang University School of Medicine, Yiwu, China.
Front Med (Lausanne). 2023 May 12;10:1187186. doi: 10.3389/fmed.2023.1187186. eCollection 2023.
Acne vulgaris is a common skin condition that affects a large proportion of teenagers and young adults. Despite the availability of various treatment options, many patients experience inadequate relief or intolerable side effects. Photodynamic therapy (PDT) is a growing interest in the treatment of acne vulgaris, with 5-Aminolaevulinic acid (ALA) being one of the most commonly used photosensitizers. Adalimumab is a biologic medication used to treat inflammatory skin conditions such as Psoriasis and Hidradenitis suppurativa (HS), which targets TNF-α. Combining different therapies, such as ALA-PDT and adalimumab, can often provide more effective and longer-lasting results. This report presents the case of a patient with severe and refractory acne vulgaris who was treated with a combination of ALA-PDT and adalimumab, resulting in significant improvement in the condition. The literature review highlights the significant comorbidity associated with acne, emphasizing the need for potential of TNF-α inhibitors for its effective treatments that address physical symptoms and ALA-PDT is known to treat scar hyperplasia, and to prevent or minimize the formation of post-acne hypertrophic scars. The combination of TNF inhibitors and ALA-PDT or adalimumab has shown promising results in treating inflammatory skin conditions, including severe and refractory acne vulgaris, as per recent studies.
寻常痤疮是一种常见的皮肤疾病，影响着很大一部分青少年和年轻人。尽管有各种治疗选择，但许多患者的症状缓解不充分或出现难以忍受的副作用。光动力疗法（PDT）在寻常痤疮治疗中的应用越来越受到关注，5-氨基酮戊酸（ALA）是最常用的光敏剂之一。阿达木单抗是一种用于治疗银屑病和化脓性汗腺炎（HS）等炎症性皮肤病的生物药物，其作用靶点为肿瘤坏死因子-α（TNF-α）。联合使用不同的疗法，如ALA-PDT和阿达木单抗，通常可以提供更有效和持久的治疗效果。本报告介绍了一例重度难治性寻常痤疮患者，采用ALA-PDT和阿达木单抗联合治疗后病情显著改善。文献综述强调了与痤疮相关的显著合并症，强调了TNF-α抑制剂在有效治疗中的潜力，这种治疗既能解决身体症状，又已知ALA-PDT可治疗瘢痕增生，并预防或减少痤疮后肥厚性瘢痕的形成。根据最近的研究，TNF抑制剂与ALA-PDT或阿达木单抗联合使用在治疗包括重度难治性寻常痤疮在内的炎症性皮肤病方面已显示出有希望的结果。
