MODERN APPROACH TO DIAGNOSTICS, PREVENTION AND CORRECTION OF ACNE SCARRING ON THE BASIS OF STUDY OF SKIN MORPHOLOGY BY NONINVASIVE METHODS

Cover Page


Cite item

Full Text

Abstract

The efficacy of the long-acting drug of hyaluronidase (bovhyaluronidase azoximer, BHA) in acne and postacne patients has been studied. The main criteria for the efficacy of acne and post-acne therapy in the assessment by confocal laser scanning microscopy and laser Doppler flowmetry are proposed.

Materials and methods. Randomized, double-blind, placebo-controlled study, comparative in parallel groups. 90 patients aged 18 to 35 years (23.76 ± 4.59 years) with medium and severe acne and postacne were divided into 2 groups of 45 each by randomization (the first group received BHA 3000ME, the second — a placebo). There were two methods of administration of drug or placebo: intramuscular injection or ultraphoonophoresis. Evaluation of the skin was performed by confocal laser scanning microscopy (CLSM) in vivo (VivaScope®, NY, USA), microcirculation — by the laser Doppler flowmetry (LDF) with the laser capillary blood flow analyzer (LAKK-01, Russia). The effectiveness was evaluated by the Qualitative scaring grading system and Goodman’s quantitative global acne scarring system.

Results and conclusions: With the use of BHA 80 % of patients had an improvement, 8.89 % — a significant improvement, postoperative index was reduced from 14.27 ± 5.61 to 10.18 ± 4.63 points (p < 0.05). In the placebo group the reduction of indices is insignificant. The effectiveness of the use of BHA by the ultraphonophoresis was lower than by intramuscular injection. A significant change in the microcirculation index (flux) was established from 20.09 ± 1.74 PU (Perfusion Units) up to 15.2 ± 2,1 PU (p = 0,01). The normalization of the microcirculation was noted. According to the results of CLSM, among BHA patients were observed a significant decrease of severe fibrosis and inflammatory infiltration, the number of dilated vessels. In the placebo group signs persisted. Clinical and morphological monitoring showed the expediency, high efficiency and safety of BHA in the therapy of patients with medium and severe acne vulgaris and postacne. 

About the authors

M. N. Ostretsova

I. M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)

Author for correspondence.
Email: mostretsova@gmail.com

Dermatologist, Postgraduate Student, Department of Skin and Venereal Diseases,

Trubetskaya str., 8, bldg 2, Moscow, 119991

Russian Federation

E. S. Snarskaya

I. M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)

Email: snarskaya-dok@mail.ru

Dr. Sci. (Medicine), Prof., Department of Skin and Venereal Diseases,

Trubetskaya str., 8, bldg 2, Moscow, 119991

Russian Federation

S. B. Tkachenko

Russian Medical Academy of Continuing Professional Education of the Ministry of Health of the Russian Federation

Email: doc4200@yandex.ru

RAS Corresponding Member, Dr. Sci. (Medicine), Prof., Department of Clinical Physiology and Functional Diagnostics,

Barrikadnaya str., 2/1, bldg 1, Moscow, 125993

Russian Federation

A. S. Allenova

I. M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)

Email: Erika-mma@yandex.ru

Dermatologist, Junior Researcher, Research Department of Immune Dependent Dermatoses at the Science and Technology Park of biomedicine,

Trubetskaya str., 8, bldg 2, Moscow, 119991

Russian Federation

References

  1. Thiboutot D., Gollnick H., Bettoli V., et al. Global Alliance to Improve Outcomes in Acne. New insights into the management of acne: an update from the Global Alliance to Improve Outcomes in Acne group. J. Am. Acad. Dermatol. 2009;60:S1–50. doi: 10.1016/j.jaad.2009.01.019
  2. Кунгуров Н. В., Кохан М. М., Зильберберг Н. В., Игликов В. А., Толстая А. И., Костырева И. Е., Волкова Н. В. Методические рекомендации: Терапия больных акне и постакне. Екатеринбург; АграфЕк; 2013. [Kungurov N. V., Kokhan M. M., Zilberberg N. V., Iglikov V. A., Tolstaya A. I., Kostyreva I. E., Volkova N. V. Method. Recommendations: Therapy of acne and post-acne patients. Ekaterinburg, AgrafEk: 20. (In Russ.)]
  3. Fabbrocini G., Annunziata M.C., D’Arco V., De Vita V., Lodi G., Mauriello M.C., et al. Acne scars: pathogenesis, classification and treatment. Dermatology research and practice. 2010; 2010:893080. doi: 10.1155/2010/893080
  4. Снарская Е. С. Комплексная терапия эстетических дефектов кожи в результате патологического фиброгенеза. Consilium medicum. Дерматология. 2013;2–3:15–20. [Snarskaya E. S. Complex therapy of aesthetic skin defects as a result of pathological fibrogenesis. Dermatologija (Suppl.), 2013;2–3:15–20. (In Russ.)]
  5. Buhren B. A., Schrumpf H., Hoff N. P., Bolke E., Hilton S., Gerber P.A. Hyaluronidase: from clinical applications to molecular and cellular mechanisms. Eur. J. Med. Res. 2016;21:5. doi: 10.1186/s40001-016-0201-5
  6. Олисова О. Ю., Теплюк Н. П., Ткаченко С. Б., Алленова А. С., Варшавский В. А., Зайденов В. А. Применение конфокальной лазерной сканирующей микроскопии в диагностике буллезного пемфигоида Левера. Альманах клинической медицины. 2016;44(1):33–38. [Olisova O. Yu., Teplyuk N. P., Tkachenko S. B., Allenova A. S., Varshavskij V. A., Zaidenov V. A. The use of confocal laser scanning microscopy in the diagnosis of Lever bullous pemphigoid. Al’manah klinicheskoj mediciny. 2016;44(1):33–38. (In Russ.)]
  7. Fabbrocini G., ArdigoҒ M., Mordente I., Ayala F., Cacciapuoti S., et al. Confocal Microscopy Images to Monitor Skin Needling in the Treatment of Acne Scars. J. Clin. Exp. Dermatol. Res. 2015;6:301. doi: 10.4172/2155-9554.10000301
  8. Goodman G. J., Baron J. A. Postacne scarring: a qualitative global scarring grading system. Dermatol. Surg. 2006;32(12):1450–58. doi: 10.1111/j.1524-4725.2006.32354.x
  9. Goodman G. J., Baron J. A. Postacne scarring--a quantitative global scarring grading system. J. Cosmet. Dermatol. 2006;5(1):48–52. doi: 10.1111/j.1473-2165.2006.00222.x
  10. Manfredini M., Greco M., Farnetani F., Ciardo S., De Carvalho N., Mandel V. D., et al. Acne: morphologic and vascular study of lesions and surrounding skin by means of optical coherence tomography. J. Eur. Acad. Dermatol. Venereol. 2017. doi: 10.1111/jdv.14369
  11. Wang H. B., Fang Y., Yu W. R. Advancement in the research of fractional carbon dioxide laser in treating burn scars. Zhonghua Shao Shang Za Zhi.2012;28(6):465–7.
  12. Гафаров Т. У., Еникеев Д. А., Идрисова Л. Т., Еникеева С. А., Галимов Д. М. Моделирование атрофического рубцового дефекта кожи у лабораторных животных. Успехи современного естествознания. 2013;6:28– 42. [Gafarov T. U., Enikeev D. A., Idrisova L. T, Enikeeva S. A., Galimov D. M. Atrophic skin scars modeling in rats. Uspehi sovremennogo estestvoznanija. 2013;6:28–42. (In Russ.)]
  13. Некрасов А. В., Пучкова Н. Г., Карапутадзе Н. Т. Физико-химические принципы создания лонгидазы. Иммунология. 2006;2:114–108. [Nekrasov A. V., Puchkova N. G., Karaputadze N. T. The physical-chemical principles of Longidaza creation. Immunology. 2006;2:114–108. (In Russ.)]
  14. Круглова Л. С., Дворников А. С. Опыт применения фотофореза и фонофореза с Лонгидазой у пациентов с ограниченной склеродермией и вульгарными угрями. Российский журнал кожных и венерических болезней. 2010;6:8–10. [Kruglova L. S., Dvornikov A. S. Longidaza administration by photophoresis and phonophoresis to patients with circumscribed scleroderma and acne vulgaris. Rossijskij zhurnal kozhnyh i venericheskih boleznej. 2010;6:8–10. (In Russ.)]
  15. Татевосян А. А., Ткаченко С. Б., Потекаев Н. Н., Лукашева Н. Н. Оценка эффективности лечения акне с помощью неинвазивных методов исследования. Экспериментальная и клиническая дерматокосметология. 2010;5:3–6. [Tatevosjan A. A., Tkachenko S. B., Potekaev N. N., Lukasheva N. N.
  16. Non-invasive evaluation of the efficiency of treatment for acne. Jeksperimental’naja i klinicheskaja dermatokosmetologija. 2010;5:3–6. (In Russ.)]

Supplementary files

Supplementary Files
Action
1. JATS XML

Copyright (c) 2018 Ostretsova M.N., Snarskaya E.S., Tkachenko S.B., Allenova A.S.

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия ПИ № ФС 77 - 60448 от 30.12.2014.


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies