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Cardinali C., Gimma A.
Unità operativa Dermatologia, USL 4, Prato, Italy
AIM: The aim of this study has been to assess the degree of tolerability of two different topical treatments in women with persistent acne, in terms of appearance and/or change in skin dryness, exfoliation, itching and burning in subjects treated with clindamycin 1% benzoyl peroxide 3% (CLI/BPO) or with tretinoin cream 0.05%. Secondly, we have evaluated the time necessary to obtain a clinical improvement of acne in terms of reduction of inflammatory lesions by IGA (Investigator’s Global Assessment) scale. Finally, we have assessed the degree of satisfaction, expressed by patients, through the use of a specific questionnaire evaluating the degree of dryness, erythema, burning and itching that were perceived by treated patients.
METHODS: We have enrolled 40 women over the age of 25 years. The first group was prescribed topical therapy with evening monoapplication of (CLI/BPO), while the second group had to apply tretinoin cream 0.05%. Patients of both groups have used the same products for cleansing and moisturizing. The safety of the two treatments was assessed at T4 (after 4 weeks), T8 (after 8 weeks) and T12 (after 12 weeks). The degree of severity of acne was evaluated through the scale IGA and by counting the facial inflammatory and not inflammatory lesions. At the same time it was also made a sebometric evaluation. Lastly, the patients completed a questionnaire to assess the presence of dryness, erythema, burning, itching, based on their perception of the scale SGA (Subjective global assessment). This questionnaire was important to assess the degree of compliance to therapy by patients.
RESULTS: In the group of patients treated with tretinoin, we found, after 4 weeks of use, a score double in size indicating total tolerability. Indeed, they showed a worsening in the severity of dryness, exfoliation, itching and skin tension. The treatment was instead well tolerated at T4 in the group using the association CLI/BPO. After 8 and 12 weeks, the degree of tolerability was more or less similar in the 2 groups. With regard to the degree of exfoliation, we observed a significant increase in the score from 0.75 to 1.75 at T4 in patients using tretinoin. The increase in exfoliation was instead higher at T8 for patients treated with the CLI/BPO association. The association CLI/BPO showed a 50% reduction of inflammatory lesions after 4 weeks of treatment, in particular with this association was obtained a reduction of the degree of severity of the acne from IGA4 to IGA3 in 100% of patients.
CONCLUSION: Our experience has shown that the inflammatory component is significant in adult women with persistent acne. The two treatments may be considered valid therapies for the management of acne in adult age. The association CLI/BPO has shown an advantage in terms of tolerability, total dryness and exfoliation after 4 weeks of treatment compared to tretinoin. The association CLI/BPO was also faster in reducing inflammatory lesions at T4 and T8 compared with tretinoin. Patients treated with tretinoin showed a faster reducing in non-inflammatory acne lesions.