Features of Clinical Picture and Course of Acne Vulgaris Associated with Disbacteriosis
About the author:
Popova І. B.
CLINICAL AND EXPERIMENTAL MEDICINE
Type of article:
The purpose of the research is to study the effect of disbacteriosis on the clinical course of acne vulgaris. Methods and Materials. 114 patients (22 men and 92 women), aged from 15 to 35 years old (average age is 23 years old), with acne have been observed. Group I included 94 patients with papular pustular form of acne. Group II included 20 patients with nodose cystous form of acne, characterizing by the formation of deep infiltrates and cystous cavities, filled with pus, and conjugating with each other. Results and Discussion. All patients have been provided with conventional treatment, including probiotics (Bactisporinum siccum, Bactisubtil, Bifidumbacterin forte, Bificol, Acilact, etc.), prebiotics (Hylak forte), antibacterial drugs (Furazolidone, Metronidazolum), antibiotics (Flemoxin Solutab, Clarithromycin, etc.), antifungal drugs (Diflucan®, Ketoconazolum, Pimafucin), enzymatic drug (Mezym forte, Panzinorm forte, Kreon, etc.), enterosorbents (Polyphepan, Enterodes, absorbent carbon), vitamins (Aevit, Duovit, etc.). It has been observed that dynamics of complaints (unstable stool, abdominal swelling and rumbling, spasmodic and aching abdominal pains) during the therapy depended directly on intake of drugs, correcting the composition of gut organisms. It has been admitted that patients with papular pustular form of acne vulgaris and manifested disbacteriosis experienced reliably late remission (on the average in 68 months from the therapy beginning) in comparison with patients without disbacteriosis (on the average in 23 months from the therapy beginning; р < 0,001). From out point of view, this fact makes it evident that, apart of the major well known etiological factors, various disturbances of digestion system, which lead to alteration of gut organisms, can have serious effect on a clinical course of acne. Treatment of patients with papular pustular form of acne and manifested disbacteriosis has been provided according to two regimes for more detailed study of gut organisms’ effect on the efficiency of acne treatment: the 1st treatment regimen included use of conventional treatment of acne; the 2nd regimen included measures taken on simultaneous application of the 1st regimen with correction of disbacteriosis. Patients with normal composition of gut organisms received only conventional treatment. In 3 months from the moment the therapy began its effectiveness has been estimated depending on the applied therapy regimen and manifestation of disbacteriosis. In case when disbacteriosis was not identified provision of only conventional therapy facilitated effective treatment during 23 months. At the same time no patient with manifested disbacteriosis has experienced improvement in the clinical course of disease during the same period of time. In addition to conventional therapy agents for gut organisms’ correction in patients with disbacteriosis resulted in health improvement during 3 months in 26 % of patients with papular pustular form of acne and significant improvement in 39 % of cases. Thus, the majority of patients with acne vulgaris experience these or that gut organisms’ disturbances, likely intensifying the clinical signs of acne. Identified features show latent pathogenetic correlation of these pathologic processes (comorbidity), which should be taking into consideration while correcting the clinical and prophylactic measures. Therefore, state of gut organisms has significant effect on the clinical course of acne vulgaris. Timely detection of disturbances of microbiocoenosis and its normalization facilitates the increase in effectiveness of acne treatment. Patients with manifested disbacteriosis require complex therapy of acne vulgaris, including not only the use of conventional management, but also disbacteriosis correction to reduce terms and improve the results of acne treatment.
acne vulgaris, gut organisms, disbacteriosis correction
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Publication of the article:
«Bulletin of problems biology and medicine» Issue 3 part 2 (111), 2014 year, 221-224 pages, index UDK 616. 53002:616. 34002