5-氨基酮戊酸光动力疗法治疗中度和重度寻常痤疮的疗效

Clinical effects of 5-aminolaevulinic acid photodynamic therapy in moderate to severe acne vulgaris

目的 观察5-氨基酮戊酸光动力疗法（ALA-PDT）治疗中度和重度寻常型痤疮的临床效果.方法 采用局部外敷5-氨基酮戊酸（ALA）联合红光照射（ALA-PDT）治疗43例中度和重度寻常痤疮患者.每2周照射1次,共3次.在治疗开始后2,4,6,8周对患者进行疗效和不良反应评估.结果 炎性皮损及非炎性皮损在治疗后均明显下降：在治疗后第8周,炎性皮损降低88.9％,而非炎性皮损降低73.4％.在治疗开始后第8周,痊愈24例（55.8％）,显效18例（41.9％）,好转1例（2.3％）.在治疗结束后第4个月出现复发仅2例（4.7％）,重新接受1次ALA-PDT治疗后,皮疹明显好转.不良反应有疼痛、水肿及暂时性色素沉着,无需特殊处理均可逐渐缓解.结论 ALA-PDT是一种安全、有效的治疗中度和重度寻常痤疮的方法.

Objective To evaluate the clinical effectiveness of 5-aminolaevulinic acid （ALA）-based photodynamic therapy （PDT） for the treatment of moderate to severe acne vulgaris.Methods From January to June 2013,a total of 43 patients with moderate to severe acne vulgaris were treated by 5 aminolaevulinic acid based PDT with red light.All patients were received three times of treatment at 2-week intervals.Clinical assessment was conducted before and at 2,4,6 and 8 weeks after treatment.Results The lesion counts of both inflammatory and non-inflammatory lesions were reduced significantly after treatment.The mean percentage reduction in inflammatory lesions was 88.9 % at 8 weeks after the treatment,meanwhile that in non-inflammatory lesions was 73.4%.After 8 weeks of treatment,55.8% patients （24/43）showed clinical cure,and 41.9% patients （18/43）showed excellent response and 2.3% patient （1/43） showed good response.Only 4.7% patients （2/43）showed signs of recurrence after 4 months after ALA-PDT.After one course of ALA-PDT,the symptoms in this recurrent case were significant improvement.The common adverse effects included pain,edema and transient hyperpigmentation.They could gradually disappear without a need of special intervention.Conclusions ALA-PDT is a safe and effective therapeutic option for the treatment of moderate to severe acne vulgaris.