分射频联合口服异维 A 酸与单纯分射频治疗痤疮瘢痕的前瞻性随机对照半脸试验：即刻与延迟治疗比较。

Fractional Radiofrequency and Oral Isotretinoin-A Prospective Randomized Controlled Split-Face Trial Comparing Concurrent Versus Delayed Fractional Radiofrequency Treatment for Acne Scars.

机构信息

Division of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.

Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.

出版信息

Lasers Surg Med. 2024 Aug;56(6):574-580. doi: 10.1002/lsm.23811. Epub 2024 Jun 18.

DOI:10.1002/lsm.23811

PMID:38890778

Abstract

BACKGROUND

Therapeutic dogma has been to treat acne scars no less than 6 months after isotretinoin (ITN) cessation.

OBJECTIVE

To evaluate the safety and efficacy of fractional radiofrequency (FRF) in patients treated concurrently with ITN.

METHODS

We conducted a prospective randomized control 3-arm comparative trial to evaluate the treatment of acne scars. Patients received one of three treatment options: (A) ITN and FRF concurrent treatment, (B) ITN monotherapy, and (C) FRF 6 months post-ITN treatment. Patients in the FRF cohorts received three monthly sessions. Patients were followed for adverse effects up to 6-9 months post-FRF treatment. Final cosmesis was scored by three independent dermatologists using two scales: the Echelle d'Evaluation Clinique des Cicatrices d'Acne (ECCA) and an internal 5-point investigator's scale, indicating the percentage of improvement. Subjective analyses by patients were also assessed.

RESULTS

Objective and subjective analyses revealed improvement in the ITN-FRF cohort, which was superior to the delayed FRF cohort and the ITN monotherapy cohort. Specifically, the concurrently treated cohort (ITN-FRF) had a significant reduction in acne scar volume from baseline mean (151.1 ± 44.7 to 97.0 ± 31.2, p < 0.005), outperforming both the delayed FRF and monotherapy ITN treatment cohorts, respectively (155.4 ± 37.8 to 122.0 ± 46.2, 144.6 ± 82.8 to 132.4 ± 62.7). Additionally, the concurrently treated cohort demonstrated improved ECCA scores (36.8 ± 15.5), significantly better than the ITN monotherapy cohort (101.5 ± 20.1, p < 0.01).

LIMITATIONS

Limited patient sample size: 38 patients completed the study; mostly Fitzpatrick Type II-III skin; photographic assessments utilized.

CONCLUSION

Per our prospective trial, concurrent treatment of ITN-FRF is superior to delayed FRF treatment 6 months post-ITN cessation.

摘要

背景

一直以来的治疗准则是在异维 A 酸（ITN）停药后至少 6 个月再治疗痤疮瘢痕。

目的

评估分射频（FRF）治疗同时接受 ITN 治疗的患者的安全性和疗效。

方法

我们进行了一项前瞻性随机对照 3 臂比较试验，以评估痤疮瘢痕的治疗效果。患者接受了以下三种治疗方案之一：（A）ITN 和 FRF 联合治疗；（B）ITN 单药治疗；（C）ITN 停药 6 个月后行 FRF 治疗。FRF 组的患者每月接受 3 次治疗。患者接受 FRF 治疗后 6-9 个月随访不良反应。最终美容效果由 3 位独立皮肤科医生使用两种评分标准进行评分：痤疮瘢痕临床评估量表（ECCA）和内部 5 分研究者评分，分别表示改善的百分比。还对患者进行了主观分析。

结果

客观和主观分析显示，ITN-FRF 组有改善，优于延迟 FRF 组和 ITN 单药治疗组。具体来说，同期治疗组（ITN-FRF）的痤疮瘢痕体积从基线平均值（151.1±44.7 至 97.0±31.2，p<0.005）显著减少，优于延迟 FRF 和 ITN 单药治疗组（155.4±37.8 至 122.0±46.2，144.6±82.8 至 132.4±62.7）。此外，同期治疗组的 ECCA 评分（36.8±15.5）改善明显，优于 ITN 单药治疗组（101.5±20.1，p<0.01）。