الفهرس 
ACNE VULGARIS: OVERVIEWOnly 14 pages are availabe for public view
Abstract
Acne vulgaris is a chronic inflammatory condition of the pilosebaceous unit of the skin. It is one of the most frequent chronic skin diseases and the commonest dermatologic disorder of adolescents.
There are four primary pathogenic factors, which interact in complex manner to produce acne lesions:
Increased sebum production by the sebaceous gland.
Propionibacterium acne (P. acnes) follicular colonization.
Alteration in the keratinization process.
Release of inflammatory mediators into the skin.
Acne lesions are further divided into those that are noninflammatory (comedones) and inflammatory (papules, pustules, nodules and cysts).
There’ re many clinical types of acne like acne vulgaris, acne conglobata, acne fulminans, acne excoriée, neonatal acne, infantile acne, tropical acne, occupational acne, acne cosmetica, acne mechanica, drug induced acne and radiation acne.
Treatment possibilities for acne vulgaris include topical agents, systemic antibiotics, hormonal agents, isotretonoin and recently laser therapy.In this study we compared between low dose isotretonoin (2.0 mg/ kg/ day) for three months and long pulsed Nd:YAG laser 3201 nm, on inflammatory acne in a group of 02 patients, randomly picked and devided into two groups. group (I): receiving low dose isotretonoin (2.0 mg/kg/day) for 1 months and group (II): 02 patients receiving long pulsed 3201 nm Nd:YAG laser (1 sessions), as a treatment with the following parameters:
Fluece: 02 J/ cm², pulse duration: 1 ms, spot size: 2 mm, frequency: 3 Hz and frequency of sessions: 1 sessions with 1
weeks apart from each other.
After applying the protocol of the study and follow up patient for further 3 month, we concluded that long pulsed Nd:YAG laser 3201 nm has a better improvement response with a mean of total improvement percent ~707 compared to ~00% with low dose isotrtinoin.
According to Hayashi (0222) classification of acne, we observed that most of acne cases before treatment were of moderate type in both groups I&II but after treatment, most of cases became of moderate type and mild type in group I and group II respectively. In relation to stages of inflammatory acne, group I treated with low dose isotretonoin had means of change percentages ~ 007, 717 and 707 on papular, nodular and pustular stages respectively while group II treated with long pulsed Nd:YAG laser 3201nm. had means of changes percentages ~ 007, 217 and 207 on papular, nodular and pustular stages respectively. In the duration of our treatment protocol, it was clear according to our study that pustular skin lesion showed the best improvement percentage either with long pulsed Nd: YAG laser 3201nm or low dose isotretinoin while papular skin lesions showed the least improvement percentage either with long pulsed Nd: YAG laser 3201nm or low dose isotretinoin.
Although prevalence of acne changed with age, sex, marital status, type of job and duration of lesions but all of these factors have no significant impact on improvement percentage either with low dose isotretonoin (2.0 mg\kg\day) or long pulsed Nd: YAG laser 3201 nm. A slight better improvement response was observed with males, singles, patients with non stressful jobs and patients with longer duration of acne. Consequently, according to our study they have no rule on choice of treatment line among the two lines of treatment.
Long pulsed Nd:YAG laser 3201 nm is a safe and effective option for treatment of inflammatory acne rather than low dose isotretonoin due to the side effects of isotretonoin (like xerosis, xerophthalmia,headache, menstrual irrigularities and blurring of vision) in comparison to long pulsed Nd:YAG laser with minimal side effects (like transient erythema).
Although both lines of treatment have a rule on decreasing acne scarring, but we concentrated in this study on the effect of these two lines on the active skin lesions of inflammatory acne.