Seukeran D C, Cunliffe W J
Department of Dermatology, Leeds General Infirmary, U.K.
Br J Dermatol. 1998 Jul;139(1):99-101. doi: 10.1046/j.1365-2133.1998.02321.x.
There is a very small number of patients who suffer from acne even in the sixth and seventh decades of life. These patients have suffered from acne for most of their lives, 30-60 years, and have often received multiple courses of antibiotics over many years. We saw 10 such patients over 4 years. One received oral isotretinoin 1 mg/kg per day, but was unable to tolerate the adverse effects of cheilitis and developed hyperlipidaemia. We subsequently treated nine others with oral isotretinoin, 0.25 mg/kg per day, for 6 months; in six the acne had virtually cleared by 3-4 months while the other three cleared by 6 months. Up to 36 months after therapy these patients have remained clear of acne except for one who relapsed after 11 months. Therefore, as these patients respond well with few side-effects both in the long- and short-term to low-dose isotretinoin, they should be treated with isotretinoin, although at the lower starting dose of 0.25 mg/kg per day compared with younger patients who are treated with 0.5-1 mg/kg per day, and the treatment maintained for 6 months.
即使在六七十岁，仍有极少数患者患有痤疮。这些患者一生中大部分时间，即30至60年都患有痤疮，并且多年来经常接受多疗程的抗生素治疗。我们在4年里见到了10例这样的患者。其中1例接受每天1毫克/千克的口服异维A酸治疗，但无法耐受唇炎的不良反应并出现了高脂血症。随后我们用每天0.25毫克/千克的口服异维A酸治疗了另外9例患者，持续6个月；其中6例在3至4个月时痤疮几乎消退，另外3例在6个月时消退。治疗后长达36个月，除1例在11个月后复发外，这些患者的痤疮一直未再出现。因此，由于这些患者对低剂量异维A酸无论在短期还是长期都反应良好且副作用较少，所以他们应该接受异维A酸治疗，不过起始剂量要比年轻患者低，年轻患者的治疗剂量为每天0.5至1毫克/千克，且治疗持续6个月。
