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антиандрогены в лечении угревой сыпи у женщин |
lucinka
Ранг: Гость
Ф.И.О.: 1
Профессия: менеджер
Адрес: Украина,Киев
Всего сообщений: 3
|  Опубликовано: 11-08-2009 08:40
Страдаю тяжёлой формой акне с 15 лет.Сейчас мне 23.Лицо в рубцах,а сыпет по-прежнему.Никакие косметологи,дерматовенерологи и т.д. не помогли.Здоровье нормальное.Прочитала на вашем сайте сообщение "Антиандрогены – эффективный метод лечения угревой сыпи у женщин".Кроме "Диане", о каких ещё препаратах идёт речь? Спасибо.
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Radislav
Консультант
Ранг: Старожил
Ф.И.О.: 1
Профессия: Clinical pharmacist
Специальность: Consulting
Адрес: Israel
Всего сообщений: 546
| ! Сообщение официального консультанта форума
Опубликовано: 12-08-2009 09:30
"Беллуне 35", Диане 35", "Климен", "Хлое"
 
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interna09spb
Ранг: Постоянный посетитель
Ф.И.О.: 1
Профессия: врач
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Адрес: Санкт-Петербург
Всего сообщений: 172
| Опубликовано: 13-09-2009 18:02
На современном уровне развития медицинской науки, угревая сыпь девушек, излечима. После начала применения оральных
противозачаточных средств, являющихся половыми гормонами, akne vulgaris проходят. Об этом известно всем кожным врачам и гинекологам.
Схема лечения проста. Вы условно представляете себе, что вы уже замужем и живёте взрослой жизнью. При этом, усовно начинаете предохраняться от беременности, оставаясь девочкой (по назначению и под наблюдением гинеколога). Так, давным-давно должны были лечить вас.
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Radislav
Консультант
Ранг: Старожил
Ф.И.О.: 1
Профессия: Clinical pharmacist
Специальность: Consulting
Адрес: Israel
Всего сообщений: 546
| ! Сообщение официального консультанта форума
 Опубликовано: 13-09-2009 20:07
При условии, что причина акне в нарушении гормонального фона. Но есть ещё много всяких причин 
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interna09spb
Ранг: Постоянный посетитель
Ф.И.О.: 1
Профессия: врач
Специальность: хирург
Адрес: Санкт-Петербург
Всего сообщений: 172
| Опубликовано: 14-09-2009 13:39
Пожалуйста, расскажите, какие.
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Radislav
Консультант
Ранг: Старожил
Ф.И.О.: 1
Профессия: Clinical pharmacist
Специальность: Consulting
Адрес: Israel
Всего сообщений: 546
| ! Сообщение официального консультанта форума
Опубликовано: 14-09-2009 21:32
Nevus comedonicus (NC) is an infrequent developmental anomaly manifesting as aggregated open comedones. It consists of dilated follicular or eccrine orifices plugged with keratin. Also known as comedone nevus and nevus acneiformis unilateralis, it may be solitary, congenital, or occur later in life as a result of occupational exposure. The differential diagnosis of NC includes familial dyskeratotic comedones and linear comedone formations usually linked with acne vulgaris or chronically sun-damaged skin (Favre-Racouchot disease). Infrequently, multiple comedones in other unusual contexts may raise NC as a possible consideration. Treatment of NC is generally surgical, through excision or carbon dioxide laser ablation of the involved skin. Medical therapy with topical retinoids may be of some benefit. For more information, see Nevus Comedonicus.
The eruptive vellus hair cysts6 manifest as flesh-colored papules found usually on the face, chest, neck, thighs, groin, buttocks, and axillae. They represent an anomaly of the vellus hair follicles and may be hereditary. Histopathology reveals a mid dermal epithelial cyst containing vellus hairs and keratinous material. These cysts may undergo spontaneous regression, form a connection to the epidermis, or undergo degradation with a resultant foreign body granulomatous formation. Treatment is often difficult. Incision and drainage of individual lesions carries the risk of subsequent scarring, and modalities such as carbon dioxide laser ablation are difficult to use over large surface areas. Topical retinoids and 12% lactic acid preparations have proven useful in some instances. For more information, see Eruptive Vellus Hair Cysts.
Steroid acne7,8 is observed as monomorphous papulopustules located predominantly on the trunk and extremities, with less involvement of the face. Characteristically, it appears after the administration of topical or systemic corticosteroids, including intravenous and inhaled therapy. The eruption usually resolves after discontinuation of the steroid and, in addition, may respond to the usual treatments of acne vulgaris. For more information, see Acne Vulgaris.
Exposure to halogenated aromatic hydrocarbon compounds, such as chlorinated dioxins and dibenzofuranes, by inhalation, ingestion, or direct contact of contaminated compounds or foods induces a cutaneous eruption of polymorphous comedones and cysts referred to as chloracne. Other associated skin findings may include xerosis and pigmentary changes. Internal changes involving the ophthalmic, nervous, and hepatic systems may also occur, and some chloracnegens can be oncogenic. Treatment is difficult because chloracne may persist for years, even without further exposure. Chemicals that contain iodides, bromides, and other halogens can also induce an acneiform eruption similar to that of steroid acne; however, the iodide-induced eruption may be more extreme.
Antibiotics may induce an acute generalized pustular eruption. Penicillins and macrolides are the greatest offenders. Patients usually are febrile with leukocytosis, and the eruption does not usually involve comedones. Other implicated antibiotics include co-trimoxazole, doxycycline, ofloxacin, and chloramphenicol. Other types of medications can also produce an acnelike eruption, including corticotropin, nystatin, isoniazid, itraconazole, hydroxychloroquine, naproxen, mercury, amineptine,9,10,11 the antipsychotics olanzapine and lithium, chemotherapy drugs, and epidermal growth factor receptor inhibitors.12,13,14,15,16,17 For more information, see Drug Eruptions. The Medscape CME course EGFR Inhibitors: Toxicities and Strategies for Effective Management may be of interest.
Various infections may also display an acneiform pattern. Gram-negative folliculitis, a persistent papulopustular eruption, may be a complication in patients on prolonged antibiotic treatment for acne vulgaris or rosacea. It is more common in male patients. Culture of the papulopustules grows gram-negative bacilli and gram-negative rods, including Escherichia coli and Klebsiella, Enterobacter, and Proteus species. Treatment consists of the appropriate antibiotic coverage for the causative organism. Isotretinoin may sometimes be an effective alternative or adjunctive treatment. For more information, see Gram-Negative Folliculitis, Acne Vulgaris, and/or Rosacea.
Pityrosporum folliculitis is another infectious folliculitis that is presumably caused by a host reaction to the yeast Malassezia furfur, previously named Pityrosporum ovale, a normal human skin commensal. It appears primarily on the trunk and upper extremities of late adolescents and young adults. Unlike acne vulgaris, it is pruritic, does not contain comedones, and responds to appropriate antifungal therapy rather than antibiotics. The yeast and hyphae can be observed in biopsy specimens in the widened follicular ostia along with keratinous material, and occasionally, rupture of the follicular wall may occur. Treatment typically involves topical or systemic antifungal therapy. For more information, see Pityrosporum Folliculitis.
Eosinophilic pustular folliculitis (EPF) is another disease of unknown etiology that usually manifests as a recurrent pruritic papulopustular eruption on the face, trunk, and extremities. Histopathology reveals a predominantly perifollicular infiltration of eosinophils with some mononuclear cells and subcorneal pustules composed of eosinophils. EPF has been described in infants and in immunocompromised patients with HIV, and the classic immunocompetent type is known as Ofuji disease (first described by Ofuji in the adult Japanese population). Patients may also demonstrate blood eosinophilia and leukocytosis. Treatment modalities and results vary greatly. Options include topical and systemic corticosteroids, oral antibiotics, indomethacin, dapsone, isotretinoin, and pulsed ultraviolet phototherapy (PUVA). For more information, see Eosinophilic Pustular Folliculitis.
Other infectious diseases may also induce an acnelike pattern.
In secondary syphilis, papulopustules and nodules, some crusted, may occur on the face, trunk, and extremities. The causative agent, the spirochete Treponema pallidum, may be easily observed in biopsy specimens with the Warthin-Starry stain. In addition, serologic tests and the presence of spirochetes on darkfield microscopy may reveal the diagnosis. For more information, see Syphilis.
Mycotic infections may also manifest cutaneously with papules and nodules that may ulcerate and crust.
Sporothrix schenckii, the responsible agent of sporotrichosis, commonly induces a lymphocutaneous reaction, but it can also produce a persistent fixed localized cutaneous papulonodular eruption that may involve the face. The organism can be demonstrated histologically, by peripheral blood smear, and by fungal culture. For more information, see Sporotrichosis.
Cutaneous coccidioidomycosis usually caused by inhalation and dissemination of Coccidioides immitis, may rarely occur by primary inoculation and appear as papulopustules, nodules, or plaques that can eventually ulcerate and crust. For more information, see Coccidioidomycosis.
Rosacea appears similarly to acne vulgaris with papulopustules on the face, but in addition, patients may also have facial flushing and telangiectases. For more information, see Rosacea.
Rosacea is more common in the white population and in women in the third and fourth decades of life. Men, however, are more commonly affected by sebaceous and connective tissue hyperplasia of the nose (rhinophyma), a complication of chronic rosacea. Associated eye findings are variable but include blepharitis, conjunctivitis, iritis, iridocyclitis, hypopyon iritis, and even keratitis.
Although the definitive etiology is unknown, weather extremes, hot or spicy foods, alcohol, and Demodex folliculorum mites can trigger and exacerbate this condition. Acne rosacea has also been associated with the ingestion of a high-dose vitamin B supplement.18
Although biopsies are not usually performed, histopathology may reveal lymphohistiocytic perivascular and perifollicular inflammation, ectatic vascular channels, elastosis, and hypertrophy of the connective tissue and sebaceous follicles. Treatment primarily includes sunscreens and topical antibiotics such as metronidazole, retinoids, and oral tetracyclines.
Perioral dermatitis, also a disorder of unknown etiology, is mainly observed in the young, white, female population as papulopustules with erythematous bases. The eruption is predominantly perioral in location, characteristically sparing the vermilion border of the lip, but it may also include the perinasal and periorbital areas. Biopsies are rarely performed but would show some changes similar to rosacea. The etiology is unknown, as in rosacea, and suggested causative agents include Demodex, topical or inhaled corticosteroids,19 moisturizers, fluorinated compounds, and contact irritants or allergens. Therapy typical includes cessation of halogenated topical steroids and initiation of topical antibiotic therapies such as metronidazole. Proper use of a spacer or inhalation device may help when the dermatitis occurs with inhaled steroids. For more information, see Perioral Dermatitis.
www.medscape.com
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interna09spb
Ранг: Постоянный посетитель
Ф.И.О.: 1
Профессия: врач
Специальность: хирург
Адрес: Санкт-Петербург
Всего сообщений: 172
| Опубликовано: 17-09-2009 11:39
Sapienti sat
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 Уважаемые пациенты! Мы можем ответить на Ваши вопросы, мы можем подсказать Вам, что лучше сделать в конкретной ситуации, но помните, что ни одна виртуальная консультация не заменяет очный визит к врачу. |
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