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Tratamiento del acné vulgaris
1Division of Dermatology, University of Toronto, Toronto, Ontario.
JAMA
|August 12, 2004
Resumen
El tratamiento individualizado del acné vulgaris, que incluye retinoides tópicos y antibióticos, mejora los resultados. El manejo efectivo requiere la adaptación de las terapias a las presentaciones específicas del acné para maximizar los resultados y minimizar la resistencia.
Área de la Ciencia:
- Dermatología Dermatología dermatología.
- La medicina basada en la evidencia es la medicina basada en la evidencia.
Sus antecedentes:
- El aumento de la gestión del acné vulgaris por no dermatólogos.
- Necesidad de estrategias de tratamiento individualizadas basadas en la presentación del acné para obtener mejores resultados.
Objetivo del estudio:
- Revise la mejor evidencia disponible para el tratamiento individualizado del acné.
- Proporcionar orientación para el manejo de diferentes presentaciones del acné vulgaris.
Principales métodos:
- Revisión sistemática de artículos en inglés sobre el tratamiento del acné (1966-2004).
- Centrado en ensayos controlados aleatorios bien diseñados, metanálisis y revisiones sistemáticas.
- Reconocida falta de estandarización en la literatura sobre el acné con respecto a las medidas de resultado y la clasificación de la gravedad.
Principales resultados:
- Los retinoides tópicos son efectivos para el acné comedonal, reduciendo las lesiones en un 40-70%.
- Se recomienda la terapia de combinación (antibióticos tópicos + retinoides) para el acné inflamatorio de leve a moderado.
- Antibióticos orales para el acné inflamatorio de moderado a severo; isotretinoína para el acné severo, recalcitrante o cicatrizante.
- Evite el uso prolongado de antibióticos para minimizar la resistencia bacteriana; la isotretinoína requiere estrictas precauciones para las mujeres en edad fértil.
Conclusiones:
- Las respuestas al tratamiento del acné varían significativamente.
- El uso simultáneo de múltiples modalidades de tratamiento es común.
- El tratamiento individualizado basado en la presentación clínica da los mejores resultados.
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