Turk Cemre Busra, Baykara Ulusan Melis, Döş Yusuf Mert, Manav Baş Vildan, Sarikaya Tellal Ebru, Koku Aksu Ayse Esra
Dr. Turk is with the Wellman Center for Photomedicine at Massachusetts General Hospital in Boston, Massachusetts.
Additionally, Dr. Turk is with the Department of Dermatology at Harvard Medical School in Boston, Massachusetts.
J Clin Aesthet Dermatol. 2023 Sep;16(9):46-51.
Although the effects of oral isotretinoin (OI) on acne vulgaris and preventing further acne scars have been well-documented, the specific impact of OI alone on pre-existing atrophic acne scars (AAS) remains unclear. No clinical study has objectively evaluated the effect of OI on AAS yet.
We sought to investigate the OI effect on AAS quantitatively and reliably by shear-wave elastography (SWE).
This work is a single-center, prospective and observational study. Thirty patients with moderate and severe acne vulgaris accompanied by AAS were included. We started the OI with a standard dose regime. On Days 0 and 90 of treatment, patients' global acne grading system (GAGS) and the Goodman and Baron's Qualitative Global Scar Rating System (GSRS) were evaluated. The dermal thickness, subcutaneous tissue thickness, scar size, and scar and subcutaneous tissue's elastic modules were measured on both cheeks of each patient by SWE.
The improvement in GSRS stages and GAGS scores in 90 days were statistically significant (respectively; =0.029, <0.001). Scar size and dermal thickness decreased, while the subcutaneous tissue thickness and the elastic modulus of scar and subcutaneous tissue increased in bilateral cheeks. The thickness changes in the right side dermis, and subcutaneous tissue on both sides were noteworthy (<0.05).
Besides its well-known effect on acne vulgaris, OI also could be an effective treatment option for reducing scar size and severity while improving skin elasticity. SWE may help follow skin and scar properties.
尽管口服异维甲酸（OI）对寻常痤疮及预防进一步的痤疮瘢痕形成的作用已有充分记录，但OI单独对已存在的萎缩性痤疮瘢痕（AAS）的具体影响仍不清楚。尚无临床研究客观评估OI对AAS的影响。
我们试图通过剪切波弹性成像（SWE）定量且可靠地研究OI对AAS的影响。
本研究为单中心、前瞻性观察性研究。纳入30例伴有AAS的中重度寻常痤疮患者。我们采用标准剂量方案开始使用OI。在治疗的第0天和第90天，评估患者的整体痤疮分级系统（GAGS）和古德曼和巴伦定性整体瘢痕评级系统（GSRS）。通过SWE测量每位患者双颊的真皮厚度、皮下组织厚度、瘢痕大小以及瘢痕和皮下组织的弹性模量。
90天时GSRS分期和GAGS评分的改善具有统计学意义（分别为；=0.029，<0.001）。双侧脸颊的瘢痕大小和真皮厚度减小，而皮下组织厚度以及瘢痕和皮下组织的弹性模量增加。右侧真皮和双侧皮下组织的厚度变化值得注意（<0.05）。
除了其对寻常痤疮的众所周知的作用外，OI还可能是减少瘢痕大小和严重程度并改善皮肤弹性的有效治疗选择。SWE可能有助于跟踪皮肤和瘢痕特性。
