背景:囊性痤疮是痤疮的一种严重形式,通常用口服异维A酸治疗,荷尔蒙,或者抗生素.然而,药物治疗通常有一些副作用和依从性差。火针联合5-氨基乙酰丙酸光动力疗法(ALA-PDT)是一种简单,有效,短期治疗,不良反应少,有望成为治疗囊性痤疮的有效理疗方法。此外,与异维甲酸的组合可以减少药物的剂量,从而减少异维甲酸的副作用。
目的:评价火针预处理ALA-PDT联合小剂量异维A酸治疗重度难治性囊性痤疮的安全性和有效性。
方法:本研究报告10例难治性囊性痤疮患者接受联合治疗。在治疗期间,所有患者每日接受低剂量口服异维A酸胶囊.在ALA-PDT治疗前用火针预处理痤疮病变。痤疮病变的数量,包括丘疹,脓疱,结节性囊肿,在第0、2、4、8和12周记录以评估治疗效果。同时,不良反应,如疼痛,瘙痒,在整个治疗过程中记录和评估色素沉着变化。
结果:综合治疗后,所有患者都取得了良好的治疗效果,第12周的总有效率为90%。治疗后,皮肤病变,如结节,囊肿明显消退。联合治疗没有严重的不良反应,并且具有良好的安全性。
结论:火针预处理ALA-PDT联合小剂量异维A酸治疗重度难治性结节性囊性痤疮安全有效,值得临床推广和研究。
BACKGROUND: Nodulocystic
acne is a severe form of
acne, which is commonly treated with oral isotretinoin, hormones, or antibiotics. However, drug therapy often has some side effects and poor compliance. Fire needle combined with 5-aminolevulinic acid photodynamic therapy (ALA-PDT) is a simple, effective, short-term treatment with few adverse reactions, which is expected to be an effective physiotherapy for nodulocystic
acne. Moreover, the combination with isotretinoin can reduce the dosage of the drug, thereby reducing the side effects of isotretinoin.
OBJECTIVE: To evaluate the safety and efficacy of fire-needle pretreated ALA-PDT combined with low-dose isotretinoin in the treatment of severe refractory nodulocystic acne.
METHODS: This study reported 10 patients with refractory nodulocystic
acne who received combined treatment. During the treatment period, all patients received a low dose of oral isotretinoin capsules daily. The
acne lesions were pretreated with fire needle before ALA-PDT treatment. The number of
acne lesions, including papules, pustules, and nodular cysts, was documented at weeks 0, 2, 4, 8, and 12 to assess the therapeutic efficacy. Concurrently, adverse reactions such as pain, pruritus, and pigmentation changes were recorded and evaluated throughout the treatment course.
RESULTS: After combined treatment, all patients achieved good therapeutic effects, with an overall effective rate of 90 % at week 12. After treatment, skin lesions such as nodules, and cysts subsided significantly. The combination therapy has no serious adverse effects and has a favorable safety profile.
CONCLUSIONS: Fire needle pretreatment ALA-PDT combined with low-dose isotretinoin is effective and safe in the treatment of severe refractory nodular cystic acne, which is worthy of clinical promotion and research.