MODERN APPROACH TO DIAGNOSTICS, PREVENTION AND CORRECTION OF ACNE SCARRING ON THE BASIS OF STUDY OF SKIN MORPHOLOGY BY NONINVASIVE METHODS

Abstract

The efficacy of the long-acting drug of hyaluronidase (bovhyaluronidase azoximer, BHA) in acne and postacne patients has been studied. The main criteria for the efficacy of acne and post-acne therapy in the assessment by confocal laser scanning microscopy and laser Doppler flowmetry are proposed.Materials and methods. Randomized, double-blind, placebo-controlled study, comparative in parallel groups. 90 patients aged 18 to 35 years (23.76 ± 4.59 years) with medium and severe acne and postacne were divided into 2 groups of 45 each by randomization (the first group received BHA 3000ME, the second — a placebo). There were two methods of administration of drug or placebo: intramuscular injection or ultraphoonophoresis. Evaluation of the skin was performed by confocal laser scanning microscopy (CLSM) in vivo (VivaScope®, NY, USA), microcirculation — by the laser Doppler flowmetry (LDF) with the laser capillary blood flow analyzer (LAKK-01, Russia). The effectiveness was evaluated by the Qualitative scaring grading system and Goodman’s quantitative global acne scarring system.Results and conclusions: With the use of BHA 80 % of patients had an improvement, 8.89 % — a significant improvement, postoperative index was reduced from 14.27 ± 5.61 to 10.18 ± 4.63 points (p 0.05). In the placebo group the reduction of indices is insignificant. The effectiveness of the use of BHA by the ultraphonophoresis was lower than by intramuscular injection. A significant change in the microcirculation index (flux) was established from 20.09 ± 1.74 PU (Perfusion Units) up to 15.2 ± 2,1 PU (p = 0,01). The normalization of the microcirculation was noted. According to the results of CLSM, among BHA patients were observed a significant decrease of severe fibrosis and inflammatory infiltration, the number of dilated vessels. In the placebo group signs persisted. Clinical and morphological monitoring showed the expediency, high efficiency and safety of BHA in the therapy of patients with medium and severe acne vulgaris and postacne.