Combined use of energy-based interventions with low-dose isotretinoin for inflammatory acne: An institutional retrospective cohort analysis

Abstract

Background: The combined use of oral isotretinoin with energy-based interventions including fractional microneedle radiofrequency, pulsed dye laser, and ablative fractional laser is an effective way to treat moderate-to-severe inflammatory acne lesions. However, studies regarding its efficacy and safety are limited. Objective: This study aimed to assess the efficacy and safety of a treatment using low-dose isotretinoin with energy-based interventions for inflammatory acne. Methods: This retrospective cohort study included 126 patients who were diagnosed with inflammatory acne and were treated with systemic isotretinoin for at least 3 months. Patients were divided into EBD (energy-based intervention) (n=82) and non-EBD groups (n=44). Clinical outcomes of both groups were assessed using medical records and digital photographs. Results: After treatment, the modified Global Acne Grading Score of the EBD 2 and non-EBD groups decreased by 35.1±17.2 and 25.6±10.1, respectively. The improvement in acne severity was significantly greater in the EBD group than in the non-EBD group. Cumulated isotretinoin dose and frequency of drug related side effects were significantly higher in the non-EBD group than in the EBD group. Limitation: This was a single-center retrospective study. Conclusion: Combined treatment with low-dose isotretinoin and energy-based intervention is well tolerated and associated with positive responses in patients with inflammatory acne.

연구배경: 염증성 여드름 환자에서 저용량의 경구 isotretinoin 제제를 투여하면서 fractional microneedle radiofrequency, pulsed dye laser, ablative fractional laser 등의 레이저 치료를 병용하는 것이 질환의 호전에 도움이 될 수 있으나, 현재 이에 대한 효과 및 안전성에 대해서 연구된 바는 없다. 목적: 염증성 여드름 환자를 대상으로 저용량 경구 isotretinoin 제제와 레이저 병용 요법의 효과와 안전성을 살펴보고자 하였다. 방법: 세브란스병원 피부과에 내원한 염증성 여드름 환자의 의무기록을 통해서 후향적 연구를 진행하였으며, 총 126명 중에서 레이저 시행군 82명, 미시행군 44명이 등록되었다. 결과: 1년의 치료 후 레이저 시행군과 미시행군의 Modified global acne grading score는 각각 35.1±17.2, 25.6±10.1점이 호전되었으며, 레이저 시행군에서 통계적으로 유의하게 호전 정도가 더 높았다. 또한 레이저 시행군은 미시행군에 비해 누적23 약제 투약량과 약제 관련 부작용 빈도가 통계적으로 유의하게 낮았다. 결론: 염증성 여드름 환자에서 경구 isotretinoin 제제와 레이저 병용 요법은 효과적이면서 안전성이 높은 치료 방법이다.