Abstract
BACKGROUND: Treatment of acne vulgaris remains an actual task of practical medicine. Despite the fact that the participation of severe acne in the structure of the morbidity of acne vulgaris is relatively small, precisely they most often leave behind scars, are accompanied by a pronounced cosmetic defect and significantly reduce the patients quality of life. Systemic treatment with isotretinoin is the gold standard of management of such patients, but this type of treatment is often accompanied by an exacerbation reaction, which negatively affects the general condition of the patient and reduces the compliance of treatment.
AIM: To determine the effectiveness of the combined use of isotretinoin and a systemic corticosteroid in the treatment of severe forms of acne.
MATERIALS AND METHODS: We observed 27 patients (16 men and 11 women) with severe or very severe grade on the IGA scale. All patients received combination therapy with isotretinoin (Sotret) at a dose of 0.5 mg/kg/day (cumulative dose from 120 to 150 mg/kg) for 8 months and prednisolone 30 mg/day 7 days, followed by dose reduction within a month. The assessment of treatment efficacy was based on the IGA scale, indicators DIA, DLQI and counting the number of inflammatory and non-inflammatory elements.
RESULTS: During the 8 months of the study, 81.4% of patients achieved a 2-point reduction in the degree on the IGA scale (clear or almost clear skin). The DLQI index showed 74.9% improvement compared to the start of treatment. The average DIA values decreased by 72%. The reduction in the number of inflammatory and non-inflammatory elements showed a marked clinical improvement (91.4% for nodules and 98.3% for pustules). Exacerbations of acne were recorded in 18.5% of patients.
CONCLUSIONS: Combined systemic treatment with isotretinoin and prednisolone for severe acne decreases the number of exacerbations and reduces the duration of treatment.