Minocycline in the treatment of patients with acne vulgaris
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Central State Medical Academy of Department for Presidential Affairs of the Russian Federation, Moscow, Russia
Acne can occur in any age group, but it most commonly develops during adolescence. It is a multifactorial dermatosis, in the pathogenesis of which genetically determined hyperandrogenism and a genetically predetermined type of sebaceous gland secretion play an important role. Four main factors are identified in the pathogenesis of acne:
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Increased sebum production
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Excessive follicular hyperkeratosis
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Colonization by Cutibacterium acnes (C. acnes)
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Inflammation
Inflammation in acne is primary, present in all forms, and precedes follicular hyperkeratosis, while C. acnes actively participates in the formation of microcomedones. The pathogenesis of acne involves numerous inflammatory mediators, some of which are activated by the proliferation of C. acnes bacteria (the strains involved in the pathogenesis of acne differ from those found on healthy skin) within the blocked sebaceous gland duct [4–6].
Background. Acne vulgaris is a chronic inflammatory disease, manifested by open or closed comedones and inflammatory skin lesions in the form of papules, pustules, nodes.
Objective. Improvement of the effectiveness and safety of the therapy of severe papulopustular acne by inclusion of systemic antibiotic minocycline at a minimal daily dose of 50 mg in combination with topical fixed combination of adapalene+benzoyl peroxide in the treatment regimen in accordance with clinical guidelines.
Methods. 20 patients (16 women and 4 men) with severe papulopustular acne aged 14 to 39 years were followed-up. Depending on age, patients were divided into 2 groups: group 1 (n=11) – acne vulgaris (14–24 years old patients), group 2 (n=9) – adult acne (patients over 25 years old). All patients received a course of peroral minolexin (minocycline) at a daily dose of 50 mg for 6–8 weeks, a topical preparation (adaptalen+benzoyl peroxide) and specialized dermatocosmetics (cleansing, moisturizing). As control methods, IGA and HRQOL scales were used, as well as laboratory analysis data (complete blood count, biochemical blood test – ASAT, ALAT, GGTP, ANA).
Results. Against the background of the therapy, 7 (64%) patients of the first group achieved complete clearance of the skin – IGA=0,4 (36%) – practically clear skin – IGA<1. In 5 (56%) patients of the second group, complete clearance of the skin was achieved – IGA=0, in 4 (44%) – practically clear skin – IGA<1. According to the HRQOL questionnaire, in patients of first group self-perception indicators improved by 42.7%, emotional sphere indicators – by 37%, social sphere ones – by 38.7%, acne symptoms – by 44%. In patients of the second group, self-perception indicators improved by 53%, emotional sphere indicators – by 41.7%, social sphere indicators – by 47.4%, acne symptoms – by 51.6%. In general, according to the HRQOL scale, there was an improvement in patients of the first group by 40.5%, in patients of the second group by 48.6%. During the whole follow-up period, there were no adverse events requiring cancellation or correction of the prescribed therapy.
Conclusion. Minolexin (minocycline) at a daily dose of 50 mg is a highly effective and safe drug for the treatment of patients with severe papulopustular acne and can be recommended for widespread use in clinical practice, including in combination with topical therapy with a fixed combination of adapalene+benzoyl peroxide.
Key words: minocycline, minolexin, antibacterial therapy, acne vulgaris, fixed combination of adapalene+benzoyl peroxide, severe papulopustular acne
For citations: Kruglova L.S., Gryazeva N.V. The experience of use of the minocycline at a daily dose of 50 mg and topical therapy in patients with acne vulgaris. Farmateka. 2020;27(8): . (in Russian). DOI: https: //dx.doi.org/10.18565/pharmateca.2020.8.00-00Detailed Description
The full text of the article is available in the file: "Experience with the Use of Minocycline at a Daily Dosage of 50 mg and Topical Therapy in Patients with Acne Vulgaris".
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