〓瘡の薬物療法とメンタルケアおよびケミカルピーリングの併用効果の検討  [in Japanese] Additive Effect of Mental Care and Chemical Peeling in Treating Acne  [in Japanese]

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Abstract

ざ瘡の病因は,脂腺の分泌亢進,毛孔開口部の角化異常に伴う閉塞,ざ瘡桿菌の増殖とそれに伴う炎症の3つがある。一方で,掻破行動(ざ瘡を触ることや潰すこと)は,ざ瘡の増悪因子のひとつである。本研究では,マクロライド系抗生物質のロキシスロマイシンを用いた薬物療法の臨床的有効性を検討し,さらに増悪因子である掻破行動に対するメンタルケア(MC)や毛孔開口部の閉塞の改善に有効とされるケミカルピーリング(CP)を併用することで治療効果の変化を調べた。その結果,炎症性皮疹および非炎症性皮疹の個数の変化,患者の満足度のいずれでもメンタルケア併用群やケミカルピーリング併用群では,ロキシスロマイシン単独投与群に比較して,有意な付加的効果を示していた。従来の抗生物質を用いた基本治療に加えて,さらに高い効果と満足度を得ることのできる付加的治療も今後重要になってくると思われる。

Acne is almost a universal medical problem in adolescence. The causes of acne are excessive sebum production in the sebaceous glands, blockade of the pilosebaceous ducts by follicular plugging and inflammation induced by the infection of <I>Propionibacterium acne</I>. Rubbing and picking also tend to exacerbate acne. In this study, we used systemic therapy of oral antibiotics (Roxithromycin 300 mg/day) for 139 patients as a base treatment. In 42 cases, we also instructed patients to stop picking and performed chemical peeling, which removes abnormal desquamation of the sebaceous follicle epithelium, in 45 patients. The efficacy evaluation was based on the number of inflammatory papules and pustules. The results revealed the additive effect of acne care instructions and chemical peeling in treating acne. The results of a questionnaire on patient satisfaction showed the same additive effects. The basic treatment of oral antibiotics showed an effectiveness of 65.4% in these patients, which thus confirmed the importance of this treatment. To further improve the effectiveness and satisfaction of patients, additional instruction and chemical peeling are both recommended for the treatment of acne.

Journal

  • The Nishinihon Jourrnal of Dermatology  

    The Nishinihon Jourrnal of Dermatology 64(2), 227-231, 2002-04-01 

    Western Division of Japanese Dermatological Association

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