中国痤疮治疗指南课件_1.ppt

严重痤疮患者血清雌二醇的水平明显增高，认为高水平雌二醇刺激胸腺激素的释放，影响痤疮的炎症过程。 An essential role for androgens in stimulating sebum production is supported by the following clinical evidence: 1. The development of early acne in the prepubertal period has been associated with elevated serum levels of DHEAS, a precursor for testosterone. 2. Androgen-insensitive subjects who lack functional androgen receptors do not produce sebum and do not develop acne. 3. Androgen-producing tumors of the ovary or the adrenal gland are often associated with the development of acne. 4. Systemic administration of testosterone and DHEAS increases the size and secretion of sebaceous glands. 5. Severe acne is often associated with elevated serum androgen levels. 雄激素在痤疮的发病中起重要作用， 是通过刺激皮脂腺细胞增生分泌以及皮脂腺导管角化异常堵塞管腔而发生的。Iw a t a等 应用切除睾丸的山羊进行了皮脂腺与睾酮关系的研 究， 发现皮脂腺大小、 分泌程度和皮脂腺导管上皮细胞角化程度与血清睾酮水平变化呈正相关。 * 又称为持久性痤疮或青春期后痤疮， Hyperandrogenicity had failed to respond to multiple courses of antibiotics, and 64 (32%) had relapsed after treatment with one or more courses of isotretinoin. A family history revealed that 100 (50%) of patients had a first-degree relative with post-adolescent acne. External factors, such as cosmetics, drugs and occupation, were not found to be significant aetiological factors. * * The acne was significantly more severe in the female patients with abnormal menses than that of normal menses (p=0.0006). A premenstrual flare was recorded in 58.8％ of women in our study, 30.5% reported no relationship with mense periods, and the result is similar to other studies. Author:Yetunde Olutunmbi, BA1, Kristina Paley, MD2, and Joseph C. English III, MD2 1School of Medicine; 2Department of Dermatology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA Females who present with varying acneiform lesions along the mandible and chin or ‘‘beard area’’ tend to have a type of acne that typically flares during certain portions of the menstrual cycle and responds to hormonal therapy. These patients are not in a hyperandrogenic s