皮肤性病学acne痤疮.pptVIP

Treatment of Acne Daily care clean, avoid irritate, diet, rest Local treatment Tretinoin is good at reducing the number of comdeones, but may be irritant Benzoyl peroxide applied twice a day, works by reducing the numbe of P.acne. Local treatment Antibiotics clindamycin, erythromycin along or with zinc or benzoyl peroxide, can be used for mild or moderately severe acne azelaic acid selenium sulfide Treatment of Acne Oral treatment moderate or severe acne Antibiotics Tetracycline(the first-line)、500mg twice daily(taken half an hour before food), Minocycline Doxycycline Erythromycin Retinoid Isotretinoin reduces sebum excretion Inhibits P.acne A course lasts 4 months Monitoring of liver funcion Teratogenic Common side-effects cracked lips, dry skin, nose bleeds, hair loss, muscle aches Antiandrogen Is used in females Moderate to severe acne 达英-35、螺内酯、西咪替丁 Steroid Other therapies Acne scar may require injection with steroid, cyst sometimes excision Comedones can be removed using an extractor Photodynamic Therapy Acne Acne Acne is a chronic inflammatory disease of pilosebaceous follicles Site of predilection are the face, neck, upper trunk, and upper arms. Equel sex incidence Women erlier than men Peak age is 18 years Etiology of Acne Androgen Increased sebum excretion-seborrhoea Pilosebaceous duct hyperkeratosis Propionibacterium acnes Inflammation Etiology of Acne acne 毛囊皮脂腺导管异常角化 痤疮丙酸杆菌增殖 皮脂分泌过多 遗传、免疫、内分泌 雄激素 Pathogenesis of Acne Androgen seborrhoea triglyceride propionibacterium acnes colonization free fatty acid 低分子多肽 Pilosebaceous duct hyperkeratosis Inflammatory cell chemotaxis Comedone (open、chosed) papular、pustular、 nodule、cyst、scar Clinical Manifestation Age 15-30 lesion Comedone Papule Pustule Nodule Cyst Scar Whitehead Blackhead Clinical Manifestation Site of predilection have many sebaceous gland: face, neck, upper trunk, and upper arms Few self-symptom，pain, chronic 痤疮的严重程度分类 Some variants of acne Conglobata