Plewig G, Nikolowski J, Wolff H H
J Am Acad Dermatol. 1982 Apr;6(4 Pt 2 Suppl):766-85. doi: 10.1016/s0190-9622(82)70067-2.
Good to excellent clinical results have been obtained in the treatment of severe inflammatory acne (acne conglobata, acne fulminans, and acne conglobata with hidradenitis and dissecting cellulitis of the scalp) with orally administered isotretinoin (13-cis-retinoic acid). Similar promising results have been obtained in patients with severe rosacea and gram-negative folliculitis. Isotretinoin probably has multiple modes of action, including (1) inhibition of sebaceous gland activity, (2) inhibition of the growth of Propionibacterium acnes within the follicle, although the retinoid is not antibacterial, (3) inhibition of inflammation, and (4) alteration of the pattern of keratinization within the follicle, as demonstrated by light and ultrastructural studies.
口服异维A酸（13 - 顺式维甲酸）治疗重度炎性痤疮（聚合性痤疮、暴发性痤疮以及伴有头皮汗腺炎和蜂窝织炎的聚合性痤疮）已取得良好至极佳的临床效果。在重度酒渣鼻和革兰氏阴性菌毛囊炎患者中也获得了类似的良好效果。异维A酸可能具有多种作用方式，包括：（1）抑制皮脂腺活性；（2）抑制毛囊内痤疮丙酸杆菌的生长，尽管维甲酸本身并无抗菌作用；（3）抑制炎症；（4）改变毛囊内的角化模式，这已通过光镜和超微结构研究得到证实。
