Modern approaches to the prevention and correction of complications caused by systemic treatment of severe acne forms
- Authors: Tlish M.M.1, Shavilova M.E.1
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Affiliations:
- Kuban State Medical University, Ministry of Health of the Russian Federation
- Issue: Vol 95, No 2 (2019)
- Pages: 87-93
- Section: DRUG TREATMENT IN DERMATOVENEROLOGY
- URL: https://ogarev-online.ru/0042-4609/article/view/117022
- DOI: https://doi.org/10.25208/0042-4609-2019-95-2-87-93
- ID: 117022
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Abstract
Background. According to European and RF clinical guidelines, only the systemic use of isotretinoin in severe acne has a high level of evidence. However, this therapy is frequently associated with the development of retinoid dermatitis, the prevention and correction of which requires the application of emollients. Aim. To evaluate the efficacy and tolerability of the Perfectoin cream during treatment and prevention of retinoid dermatitis in patients with severe acne receiving systemic treatment with isotretinoin.
Materials and methods. Two groups of patients each comprising 38 people with moderate, severe and resistant to standard therapy forms of acne were observed. Each group included 22 patients with retinoic dermatitis manifestations and 16 without such symptoms. The patients in the main and comparison groups were prescribed the Perfectoin cream and the dexpanthenol cream, respectively. Control of the skin condition was performed prior to the study and following 1, 3 and 6 months of therapy. Assessment parameters were the main symptoms of retinoid dermatitis (erythema, lichenification, excoriation, itching, feeling of dryness/tightness of the skin), indicators of the hydration of the horny layer of the epidermis and the transepidermal loss of moisture, as well as the dermatology life quality index.
Results. The study has shown that the Perfectoin cream in patients with acne receiving isotretinoin therapy helps to restore skin hydration and leads to a rapid regression of the main dermatological symptoms of retinoid dermatitis, thus improving the overall quality of patients’ life.
Keywords
About the authors
M. M. Tlish
Kuban State Medical University, Ministry of Health of the Russian Federation
Author for correspondence.
Email: tlish_mm@mail.ru
Marina M. Tlish — Dr. Sci. (Med.), Assoc. Prof., Prof. of the Department, Head of the Department of Dermatology and Venereology
tel.: +7 (861) 255-04-44
Russian FederationM. E. Shavilova
Kuban State Medical University, Ministry of Health of the Russian Federation
Email: marina@netzkom.ru
Marina E. Shavilova — Research Assistant, Department of Dermatology and Venereology
tel.: +7 (861) 255-04-44
Russian FederationReferences
- Nast A., Dreno B., Bettoli V. et al. European Evidence-based (S3) Guidelines for the Treatment of Acne. J Eur Acad. Dermatol Venenreol. 2016;30(8):1261–1268.
- Аравийская Е. Р. Тяжелое течение акне: анализ ряда современных методов лечения. Фарматека. 2017;(s1-17):38–43. [Araviyskaya E. R. Severe acne: analysis of some modern methods of treatment. Farmateka. 2017;(s1-17):38–43. (In Russ.)]
- Dréno B. Recent data on epidemiology of acne. Ann Dermatol Venereol. 2010;137(2):49–51.
- Poli F., Dreno B., Verschoore M. An epidemiological study of acne in female adults: results of a survey conducted in France. J Eur Acad Dermatol Venereol. 2001;15(6):541–545.
- Smithard A., Glazebrook C., Williams H. C. Acne prevalence, knowledge about acne and psychological morbidity in mid-adolescence: a community-based study. Br J Dermatol. 2001;145(2):274–279.
- Кубанова А. А., Кубанов А. А., Самцов А. В., Аравийская Е. Р. Акне. Федеральные клинические рекомендации. Дерматовенерология: Болезни кожи. Инфекции, передаваемые половым путем. М.: Деловой экспресс, 2016. C. 9–27. [Kubanova A. A., Kubanov A. A., Samtsov A. V., Araviyskaya E. R. Acne. Federal clinical guidelines. Dermatovenereology: Diseases of the skin. Sexually transmitted infections. Moscow: Delovoy Express, 2016. P. 9–27. (In Russ.)]
- Peck G. L., Olsen T. G., Butkus D. et al. Isotretinoin versus placebo in the treatment of cystic acne. A randomized double-blind study. J Am Acad Dermatol 1982;6:735–745.
- Oprica C., Emtestam L., Hagströmer L., Nord C. E. Clinical and microbiological comparisons of isotretinoin vs. tetracycline in acne vulgaris. Acta Derm Venereol. 2007;87(3):246–254.
- Dhir R., Gehi N. P., Agarwal R., More Y. E. Oral isotretinoin is as effective as a combination of oral isotretinoin and topical anti-acne agents in nodulocystic acne. Indian J Dermatol Venereol Leprol. 2008;74(2):187.
- Levin A. A., Sturzenbecker L. J., Kazmer S. et al. 9-cis retinoic acid stereoisomer binds and activates the nuclear receptor RXR alpha. Nature. 1992;355(6358):359–361.
- Karlsson T., Vahlquist A., Kedishvili N., Törmä H. 13-cis-retinoic acid competitively inhibits 3 alpha-hydroxysteroid oxidation by retinol dehydrogenase RoDH-4: a mechanism for its anti-androgenic effects in sebaceous glands? Biochem Biophys Res Comm. 2003;303(1):273–278.
- Dispenza M., Wolpert E. B., Gilliland K. L. et al. Systemic isotretinoin therapy normalizes exaggerated TLR-2-mediated innate immune responses in acne patients. J Invest Dermatol. 2012;132(9):2198–2205.
- Papaconstantinou E., Aletras A.J., Glass E. et al. Matrix metalloproteinases of epithelial origin in facial sebum of patients with acne and their regulation by isotretinoin. J Invest Dermatol. 2005;125(4):673–684.
- Тлиш М. М., Шавилова М. Е. Изотретиноин в терапии акне. Вестник дерматологии и венерологии. 2017;(4):90–96. [Tlish M. M., Shavilova M. E. Isotrethinoine in acne therapy. Vestnik dermatologii i venerologii. 2017;(4):90–96. (In Russ.)]
- Тлиш М. М., Елистратова А. С., Глузмин М. И. Практические аспекты применения изотретиноина в лечении акне у подростков. Вестник дерматологии и венерологии. 2013;4:85–90. [Tlish M. M., Yelistratova A. S., Gluzmin M. I. Practical aspects of administering Acnecutan for the treatment of acne in teenagers. Vestnik Dermatologii i Venerologii. 2013;4:85–90. (In Russ.)]
- Петрова К. С., Колбина М. С. Акне и эпидермальный барьер. Клиническая дерматология и венерология. 2015;1:90–93. [Petrova K. S., Kolbina M. S. Acne and the epidermal barrier. Klinicheskaya dermatologiya i venerologiya. 2015;1:90–93. (In Russ.)]
- Аравийская Е. Р., Соколовский Е. В. Эффективность средств ухода за кожей у больных акне. Вестник дерматологии и венерологии. 2013;(2):67–71. [Araviyskaya Ye. R., Sokolovsky Ye. V. Daily skin care in acne patients as a real basis for treatnment tolerability. Vestnik Dermatologii i Venerologii. 2013;2:67–71. (In Russ.)]
- Swinyer L. J., Swinyer T. A., Britt M. R. Topical agents all one in acne. JAMA. 1980;243:16–40.
- Sydlik U., Gallitz I., Albrecht C., Abel J., Krutmann J., Unfried K. The compatible solute ectoine protects against nanoparticleinduced neutrophilic lung inflammation. Am J Respir Crit Care Med. 2009;180(1):29–35.
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