A Retrospective Study Of Oral Low-dose Isotretinoin Combined With Fruit Acid Peeling In The Treatment Of Moderate To Severe Acne

BackgroundAcne is a common chronic inflammatory dermatosis occurring in pilosebaceous.Acne can be divided into 3 grades and 4 grades according to the lesions.Lesions of moderate to severe acne are relatively heavy and easy to leave acne sequelae,which has a great negative impact on the physical and psychological health of patients.How to relieve the pain of patients quickly and effectively has become the hotspot of present research.In 2011,the European guidelines for the treatment of acne recommended isotretinoin as a first-line drug for moderate to severe acne.Its side effects are related to dose size.In 2016,the American guidelines for the treatment of acne states that low-dose of isotretinoin were equally effective in the treatment of acne,and could also reduce adverse reactions.Guideline for diagnosis and treatment of acne(the 2019 revised edition)recommend the combination of drugs and physical chemotherapy for moderate to severe acne,which can increase drug efficacy and reduce adverse reactions.Fruit acid peeling is a method that apply different concentrations of fruit acid to the surface of the skin to produce controllable damage and promote regeneration.It is also an effective treatment for acne.But there are few reports about oral low-dose isotretinoin combined with fruit acid peeling in the treatment of moderate to severe acne at present,and its efficacy and safety remain to be discussed.ObjectiveInvestigate the safety and effectiveness of oral low-dose isotretinoin combined with fruit acid peeling by comparing the efficacy and adverse reactions of it and isotretinoin alone in the treatment of moderate to severe acne.MethodsA retrospective study was conducted to collect the case data of moderate to severe acne patients treated with low-dose isotretinoin 20mg/d in the dermatology department of our hospital from 2020.6 to 2021.6.Patients were divided into the treatment group and the control group according to whether combined with "fruit acid peeling".Compare the general conditions,the rate of lesions regression and efficacy before treatment and after 2 weeks,4 weeks,6 weeks,8 weeks,10 weeks and 16 weeks of treatment,skin and mucosal dryness and other adverse reactions,levels of aspartate aminotransferase(AST),alanine aminotransferase(ALT)and triglycerides(TG)between the two groups.And collect the adverse reactions after fruit acid peeling in the treatment group.Results82 patients were eventually enrolled in this study,including 48 patients in the treatment group and 34 patients in the control group.1.There were no statistical differences in gender,age,weight and other general conditions between the two groups(P>0.05).2.After 2 weeks,4 weeks,6 weeks,8 weeks and 10 weeks of treatment,there were statistical differences in the rate of lesions regression and efficacy between the two groups(P<0.05)and the rate of lesions regression in treatment group was significantly higher than that in control group.After 16 weeks of treatment,there was no statistically difference in the rate of lesions regression and efficacy between the two groups(P>0.05).3.There were no statistical differences in skin and mucosal dryness,levels of AST,ALT and TG between two groups(P>0.05).4.In the treatment group,different degrees of adverse reactions on the face such as erythema,burning and itching occurring after the fruit acid peeling,among which 13(27.08%)patients showed no influence,25(52.08%)patients showed mild influence,9(18.75%)patients showed moderate influence.These effects were relieved on the same day or the next day.ConclusionCompared with low-dose isotretinoin alone,oral low-dose isotretinoin combined with fruit acid peeling take effect rapidly.And it is safe to use,which is an optimizing treatment for moderate to severe acne.