寻常痤疮（AV）是一种常见的皮肤病，会引起心理问题。异维A酸是中重度AV的一线治疗，但其起效延迟。尽管基于光的治疗被广泛用于AV的治疗,缺乏关于具有窄治疗光谱(500-600nm)的精细脉冲光(DPL)的报道。低水平光疗法（LLLT）在抗炎作用和皮肤修复中显示出新兴作用。这项研究调查了使用DPL的低剂量口服异维A酸联合LLLT在中度至重度AV患者中的疗效和安全性。纳入了36例中度至重度AV患者，并接受了低剂量口服异维A酸（10-20mg/天）。面部两侧随机分配接受DPL(6-9J/cm2)或不接受DPL,间隔2周,共4次治疗(第0、2、4、6周)。照片,GAGS得分,丘疹数,脓疱,粉刺,TEWL,黑色素和红斑指数，副作用,功效,在每次访视时和最终治疗后4周(第10周)记录令人满意的评分.33名患者完成了研究。DPL和口服异维A酸联合治疗从第2周开始表现出显著改善的GAGS评分以及病变数量,并维持至第10周。在观察结束时,DPL和异维A酸联合治疗侧的GAGS改善为70.88%,而异维A酸单药治疗侧的GAGS改善为62.12%(p=0.0009).DPL联合侧的丘疹数改善为61.58％，对照组为43.33％（p<0.0001），粉刺酮分别为63.15%和43.30%(p=0.0008)。TEWL和黑色素和红斑指数在第10周时DPL联合治疗也有更好的结果。所有副作用都是暂时的和可耐受的；没有观察到不良反应。DPL口服低剂量异维A酸联合LLLT可在有限的治疗持续时间内减少副作用并获得更好的结果。这促进了异维甲酸单一疗法的起效，并改善了病变清除。
Acne vulgaris (AV) is a common dermatosis that causes psychological problems. Isotretinoin is the first-line treatment for moderate-to-severe AV, but its onset of effect is delayed. Although light-based therapy is widely used in the treatment of AV, there is a lack of reports on delicate pulsed light (
DPL) which has a narrow therapeutic spectrum (500-600 nm). Low-level light therapy (LLLT) has shown an emerging role in anti-inflammatory effects and skin repair. This
study investigates the efficacy and safety of low-dose oral isotretinoin combined with LLLT using
DPL in patients with moderate-to-severe AV. Thirty-six patients with moderate-to-severe AV were enrolled and received low-dose oral isotretinoin (10-20 mg/day). The two sides of the face were randomly assigned to receive
DPL (6-9 J/cm2) or not at an interval of 2 weeks for 4 treatment sessions (weeks 0, 2, 4, 6). Photos, GAGS score, counts of papules, pustules, comedones, TEWL, melanin and erythema index, side effects, efficacy, and satisfactory score were recorded at each visit and at 4 weeks after the final treatment (week 10). Thirty-three patients completed the
study. DPL and oral isotretinoin combined therapy exhibited significantly improved GAGS score as well as the number of the lesions from week 2 and maintained until week 10. At the end of the observation, the improvement of GAGS was 70.88% on the DPL and isotretinoin combined side versus 62.12% on the side with isotretinoin monotherapy (p = 0.0009). The improvement for papule number was 61.58% on the DPL combined side versus 43.33% on the control side (p < 0.0001), for comedone was 63.15% versus 43.30% (p = 0.0008). TEWL and indexes of melanin and erythema also had better outcomes with DPL combined therapy at week 10. All the side effects were temporary and tolerable; no adverse effects were observed. Oral low-dose isotretinoin combined with LLLT by DPL offers a combination with reduced side effects and better outcomes within a limited treatment duration, which advances the onset of effect of isotretinoin monotherapy and improves lesion clearance.
