光动力联合口服异维A酸治疗中重度痤疮疗效分析OA

Objective To evaluate the efficacy and safety of photodynamic therapy(PDT)combined with oral isotretinoin in the treatment of moderate to severe acne.Methods This study was a single center prospective cohort clinical study.Patients with moderate to severe acne who were admitted to the clinic of Guangzhou Institute of Dermatology from January 2019 to July 2022 were enrolled in the study.All patients received ALA-PDT treatment once every other two weeks for 3 times.Patients in the observation group were also given oral isotretinoin at a dose of 10 mg twice-daily.The GAGS score,total number of acne lesions,number of inflammatory lesions,as well as the main adverse reactions were compared between the two groups.Results A total of 49 cases each were enrolled in the ALA-PDT alone and the observation groups.After 4 weeks of treat-ment,the total skin lesion clearance rate and inflammatory acne clearance rate in the observation group were higher than that in the control group(Z=2.45,P=0.014 for lesion clearance rate;Z=3.33,P=0.001 for inflammatory acne clearance rate).In comparison to ALA-PDT treatment alone,other significant improvements in observation group included GAGS scores(t=3.15,P=0.002),total lesion clearance rate(Z=4.01,P＜0.001)and inflammatory acne clearance rate(Z=3.60,P＜0.001)after 6 weeks of treatment.The main adverse reactions,including pain(VAS score),incidence of pigmentation and erythema,did not differ significantly between the two groups(P＞0.05).No patient in either group dropped out of the trial due to adverse reactions.Conclusions The efficacy of PDT combined with isotretinoin is superior to that of the ALA-PDT treatment alone in the treatment of moderate to severe acne,and there are no significant differ-ences in safety between these two treatments.