背景:寻常痤疮通常影响成年人,青少年,和9岁或以上的青春期前。
目的:本研究的目的是为痤疮的治疗提供循证建议。
方法:一个工作组进行了系统审查,并应用了建议分级,评估,发展,和评估方法,用于评估证据的确定性并制定和分级建议。
结果:本指南提出了18项循证建议和5项良好实践声明。对过氧化苯甲酰提出了强有力的建议,局部类维生素A,局部抗生素,和口服多西环素。口服异维A酸强烈建议用于严重的痤疮,造成社会心理负担或疤痕,或标准口服或局部治疗失败。有条件的建议是局部使用的克拉维酮,水杨酸,和壬二酸,以及口服米诺环素,sareccine,联合口服避孕药,和螺内酯.将局部疗法与多种作用机制相结合,限制全身抗生素的使用,将全身性抗生素与局部治疗相结合,对于较大的痤疮病灶,增加病灶内注射皮质类固醇激素是推荐的良好实践声明.
结论:分析是基于系统评价时现有的最佳证据。
结论:这些指南为寻常痤疮的治疗提供了循证建议。
BACKGROUND: Acne vulgaris commonly affects adults, adolescents, and preadolescents aged 9 years or older.
OBJECTIVE: The objective of this study was to provide evidence-based recommendations for the management of acne.
METHODS: A work group conducted a systematic review and applied the Grading of Recommendations, Assessment, Development, and Evaluation approach for assessing the certainty of evidence and formulating and grading recommendations.
RESULTS: This
guideline presents 18 evidence-based recommendations and 5 good practice statements. Strong recommendations are made for benzoyl peroxide, topical
retinoids, topical antibiotics, and oral doxycycline. Oral isotretinoin is strongly recommended for acne that is severe, causing psychosocial burden or scarring, or failing standard oral or topical therapy. Conditional recommendations are made for topical clascoterone, salicylic acid, and azelaic acid, as well as for oral minocycline, sarecycline, combined oral contraceptive pills, and spironolactone. Combining topical therapies with multiple mechanisms of action, limiting systemic antibiotic use, combining systemic antibiotics with topical therapies, and adding intralesional corticosteroid injections for larger acne lesions are recommended as good practice statements.
CONCLUSIONS: Analysis is based on the best available evidence at the time of the systematic review.
CONCLUSIONS: These
guidelines provide evidence-based recommendations for the management of acne vulgaris.