New horizons in systemic therapy of acne

Abstract

According to some authors, systemic corticosteroids can be used at the beginning of the course of treatment, which helps to accelerate the achievement of a significant effect and reduces the severity of side effects of retinoids. However, many issues of the combined use of isotretinoin and systemic corticosteroids in terms of the methodological approach remain unclear, which determined the purpose of this research.Material and methods. We observed 84 patients with moderate to severe acne. Among them, 51 (60.7 %) women and 33 (39.3 %) men, the average age of the patients was 17.1 ± 1.8 years. Patients were divided into 2 groups: moderate severe course — 1 group (n = 40), severe acne — 2 group (n = 44). Within the groups, depending on the therapy, the patients were divided into 2 subgroups: A subgroup — received isotretinoin in standard dosages, B subgroup — received isotretinoin also in standard dosages, while the initiation of therapy was carried out while taking systemic corticosteroid (1 month dexamethasone was prescribed at a dose 1 mg / day in 1 dose (in the morning)).The results of the study. The dynamics of the DICI index, the global IGA score, DICI showed comparable efficacy results in long-term follow-ups and early differences, an advantage was noted in the groups treated with dexetozone.Findings. Systemic retinoid is effective in preventing the formation of post-acne scars, which allows us to recommend it as the first choice in patients with risk factors for scar development. Important factors in the effectiveness of isotretinoin and the prevention of relapse are individual dose selection, the total cumulative and single dose and the duration of therapy for at least 6 months. The data obtained showed that the administration of a systemic corticosteroid in low doses (1 mg / day of dexamethasone) for 1 month of taking isotretinoin improves the effectiveness of therapy in the early stages of therapy and reduces the frequency / severity of side effects of retinoids.