PIEL-L Latinoamericana Publicacion periodica en dermatologia | Fundada en 1998
Mymensingh Med J. 2013 Jan;22(1):42-8.
Hasibur MR, Meraj Z.
Abstract
Acne vulgaris is one of the most common skin disorders. It mainly affects adolescent, though may present at any age. The conventionally used dose of isotretinoin in acne causes significant dose-related adverse effects. Low-dose isotretinoin has been used successfully, in mild to moderate papulopustular acne. To observe whether the addition of an antibacterial enables use of isotretinoin in low doses even in moderate to severe acne. An open-label, non-comparative study was carried out for 24 weeks. Eighty two teenagers with moderate to severe papulo-pustular acne vulgaris were enrolled. These patients were treated with a combination of low-dose isotretinoin (0.3mg/kg/day) and pulsed oral azithromycin (500mg/day over three consecutive days in each week for one month. No topical treatment was permitted. Response to treatment was assessed at monthly intervals and was recorded as a percentage decrease in overall severity of disease. Treatment was continued to complete clearance of lesions or to 24 weeks. All patients were also evaluated at six months post-treatment. Eighty (97.56%) patients had complete clearance of disease activity after treatment duration of 24 weeks. Only two (2.43%) patients had a relapse of disease during the post-treatment follow-up period. Four (4.87%) patients were observed with adverse effects. Three (3.65%) patients had initial aggravation of disease that was managed with oral betamethasone and this disappeared with continuation of treatment. A combination of low-dose isotretinoin and oral azithromycin pulse is effective in moderate to severe acne.
Estimados colegas : queria comentar el articulo de isotret y azt,para agregar que yo estoy usando desde el año pasado pulsos de azitromicina en acne moderado y aveces tambien severo como primera linea de medicacion sistemica con buenos resultados,evidenciados por aclaramiento de las lesiones inflamatorias papulo pust no asi no inflamat ,como los comedones,a los cuales indico extraccion y adapalene al 0,1 con menor irritacion de la piel,estos pulsos los distribuyo en 500 mgr 2 veces por semana continuando 3 semanas de tto,lo0s pctes aceptan mejor los pulsos,por menor efectos adversos y facilidad en el cumplimiento del mismo.para mi es una opcion a los ttos convencionales con muy buenos resultados ,que eficacia tendria usar isotretinoina topica mas pulsos de azt(azitromicina)en casos de acne moderado o leve ?es la pregunta que me hago,pero creo que esta demostrado que isotretinoina topica no sirve para nada ,si alguien tiene una opinion diferente la escuchemos
dra m f lui san salvador de jujuy argentina
Uso bastante la azatioprina con mejores resultados que otros antimicrobianos, 500 mh dia por 5 dias, luego pasado 1 dia por 6 semanas, es interesante la opción de combinarla con isotretinoina , aunque si recordamos el modo de acción de la isotretinoina al disminiur el sebo disminuye bastante el P.Acne.
Edith Jiménez
Cochabamba – Bolivia