寻常痤疮可能与色素沉着过度有关,特别是肤色的人。这种痤疮引起的黄斑色素沉着(AMH),也称为炎症后色素沉着或PIH,通常是持久的,并对生活质量产生负面影响。缺乏治疗痤疮和AMH的大规模随机对照临床试验。出于这个原因,无法提出循证治疗建议。然而AMH是一个常见的情况,对于临床医生来说,有关于管理策略的指导是很重要的。作者,由10名经过董事会认证的皮肤科医生组成的小组,进行了改良的Delphi共识程序,以就AMH的一线治疗达成共识,以及不同患者亚组的治疗选择是否会发生变化.我们达成共识,大多数痤疮和AMH患者应接受局部类维生素A和过氧化苯甲酰的早期有效治疗。旨在解决AMH的疗法-包括氢醌,壬二酸,化学剥离,或抗氧化剂-也可以考虑增强治疗方案对痤疮和色素沉着的影响。化学剥离可用作辅助或二线治疗。本出版物详细介绍了Delphi过程的结果,回顾相关文献,为AMH提供建议,并讨论适当的治疗方案。
Acne vulgaris can be associated with hyperpigmentation, particularly in individuals with skin of color. This acne-induced macular hyperpigmentation (AMH), also called postinflammatory hyperpigmentation, is often long lasting and negatively impacts quality of life. Large-scale, randomized, controlled clinical trials with regard to the treatment of acne and AMH are lacking. For this reason, evidence-based treatment recommendations cannot be made. However, AMH is a common condition, and it is important for clinicians to have guidance on management strategies. The authors, a group of 10 board-certified dermatologists, conducted a modified Delphi
consensus process to reach a
consensus on first-line therapy for AMH and determine whether therapeutic choices change in different patient subgroups. We reached a
consensus that most patients with acne and AMH should receive early and efficacious acne treatment with a topical retinoid and benzoyl peroxide. Therapies aimed at addressing AMH-including hydroquinone, azelaic acid, chemical peel, or antioxidants-may also be considered for enhancing the effect of the treatment regimen on acne and pigmentation. Chemical peels may be used as adjunctive or second-line therapy. This article details the results of the Delphi process, reviews relevant literature for providing recommendations for AMH, and discusses appropriate treatment options.