美国AAD痤疮指南VIP免费

美国美国AADAAD痤疮指南痤疮指南GuidelinesofCareforAcneVulgaris注意本指南的时效性注意本指南的时效性Thisreportreflectsthebestdataavailableatthetimethereportwasprepared,butcautionshouldbeexercisedininterpretingthedata.Theresultsoffuturestudiesmayrequirealterationoftheconclusionsorrecommendationssetforthinthisreport.发表于1990年定义定义DefinitionDefinitionAcnevulgarisisafolliculardisorderthataffectssusceptiblepilosebaceousfollicles,primarilyoftheface,neck,anduppertrunk,andischaracterizedbybothnoninflammatoryandinflammatorylesions.1累及敏感的皮脂腺——面、颈、躯干上部——疾病2有炎性和非炎性皮损流行病学（流行病学（11））Acneisadiseaseofhighprevalenceandaffectsmanypersonsintheirteenageyears.Althoughpeakprevalencemaybeatage17,acnemaybeginasearlyasage8andisnotuncommoninthe10-to12-year-oldagegroupinwhichitisoftenoverlooked.Bothsexesareaffectedequally,butmaleshave,onaverage,greaterdegreesofseverity.流行病学（流行病学（22））Asubstantialpercentageofadultsareaffectedeitherasacontinuationoftheirteenageacneoritsfirstappearanceinthethirdorfourthdecade.流行病学（流行病学（33））Mostcasesofacnesubsideandinvolutespontaneouslyandcompletelywithinafewyearsoftheironset,butasmallpercentageremainactive.Thediseasemaycauseconsiderableemotionaldistressbecauseofitsappearance,evenwhenthediseasehasinvolutedifscarringhastakenplace.Thepsychosocialimpactonteenagersmaybedevastating.诊断诊断Diagnosticcriteria诊断标准–A.Clinical（一）临床Patienthistory病史——为了进行有效的治疗–Duration,toincludeprogressiontopointofmaximalseverity–Location–Seasonalvariation–Aggravationbystress对女性病人对女性病人ForwomenPremenstrualflare-upMenstrualhistoryandpregnancystatusIncreaseofandrogen-dependenthairThinningofscalphairOralcontraceptivesandeffectonacneHormonetestsCosmeticsandmoisturizers:typeandfrequency治疗史治疗史Currenttreatment(s):topicalandsystemic–Ofacne–OfotherdiseasesPasttreatment(s):topicalandsystemic–Ofacne–Ofotherdiseases家族史和其它病史家族史和其它病史FamilyhistoryofacneOtherskindisorders:–Atopy,personalorfamilial(becauseofoccasionalirritationtotopicalacnepreparations)–Hidradenitissuppurativa–DrugallergiesGeneralhealth,especiallybutnotlimitedto:–Hepaticdisease–Renaldisease–EndocrinePhysicalExaminationPhysicalExaminationLesiontype–Noninflammatory：open/closedcomedones–Inflammatory：papules/pustules/nodules/cystsLocation–Face/neck/back/anteriorchest/extremitiesGradation–Mild,moderate,severeComplications–ScarringtypeAtrophicHypertrophicKeloids–Localization–Severity–DiscolorationLocalizationSeverity其它皮损和并发病其它皮损和并发病Otherassociatedfindingsincludebutarenotlimitedto:–PostinflammatorymacularlesionsPostinflammatoryhyperpigmentationandhypopigmentation–Hirsutismforwomen–Alopeciaforwomen–Asymmetryofdistributionofacne–ExcoriationsDiagnostictestsDiagnostictests辅助检查辅助检查Therearenodiagnostictestsforacnevulgaris.However,insomeinstancesdiagnostictestsareusedtodifferentiateandidentifyacne-likeeruptionsortodetectthepresenceofsystemicconditionsthataggravateacne.Suchtestsincludebutarenotlimitedto:用于鉴别、发现加重痤疮的系统原因DiagnostictestsDiagnostictests辅助检查辅助检查Bacteriaculture(e.g.,gram-negativefolliculitis)Hormonalassay(e.g.,presenceofandrogenimbalance)Biopsywhennecessarytodifferentiateacnef...