medalphabetМедицинский алфавитMedical alphabet2078-56312949-2807ООО «Альфмед»10.33667/2078-5631-2024-9-61-65medalphabet-3777Research ArticleСтатьиСовременные подходы к терапии акне: обзор клинических рекомендаций и разбор клинических случаевModern approaches to acne therapy: review of clinical recommendations and analysis of clinical caseshttps://orcid.org/0000-0002-5044-5265КругловаЛ. С.KruglovaL. S.

Круглова Лариса Сергеевна - д.м.н., проф., проректор по учебной работе,

зав. кафедрой дерматовенерологии и косметологии.

Москва

Larisa S. Kruglova - DM Sci (habil.), professor, vice-rector for academic affairs, head of Dept of Dermatovenereology and Cosmetology.

Moscow

kruglovals@mail.ruhttps://orcid.org/0000-0003-3437-5233ГрязеваН. В.GryazevaN. V.

Грязева Наталья Владимировна - к.м.н., врач-дерматовенеролог, доцент кафедры дерматовенерологии и косметологии.

Москва

Natalya V. Gryazeva - PhD Med, dermatovenereologist, associate professor at Dept of Dermatovenereology and Cosmetology.

Moscow

tynrik@yandex.ruФГБУ ДПО «Центральная государственная медицинская академия» Управления делами Президента Российской ФедерацииРоссияCentral State Medical Academy of the Administrative Department of the President of RussiaRussian Federation20242107202409Дерматология (1)6165Copyright © Круглова Л.С., Грязева Н.В., 20242024Круглова Л.С., Грязева Н.В.Kruglova L.S., Gryazeva N.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-alphabet.com/jour/article/view/3777

В настоящей статье представлен обзор современных гайдлайнов по лечению пациентов с акне. Обсуждаются вопросы назначения как топической, так и системной терапии акне. Особое внимание уделено терапии системным изотретиноином. Обсуждаются клинические примеры назначения препарата Сотрет при акне средней и тяжелой степеней тяжести.

This article provides an overview of modern guidelines for acne treatment. The issues of prescribing both topical and systemic acne therapy are discussed. Particular attention is paid to systemic isotretinoin therapy. Clinical examples of the use of the drug Erase for acne of moderate and severe severity are discussed.

клинические рекомендациитерапия акнеакне средней и тяжелой степени тяжестисистемный изотретиноинguidelinesacne therapymoderate and severe acnesystemic isotretinoinReferencesReynolds RV, Yeung H, Cheng CE, Cook-Bolden F, Desai SR, Druby KM, Freeman EE, Keri JE, Stein Gold LF, Tan JKL, Tollefson MM, Weiss JS, Wu PA, Zaenglein AL, Han JM, Barbieri JS. Guidelines of care for the management of acne vulgaris. J Am Acad Dermatol. 2024 Jan 30: S0190–9622(23)03389–3.Reynolds RV, Yeung H, Cheng CE, Cook-Bolden F, Desai SR, Druby KM, Freeman EE, Keri JE, Stein Gold LF, Tan JKL, Tollefson MM, Weiss JS, Wu PA, Zaenglein AL, Han JM, Barbieri JS. Guidelines of care for the management of acne vulgaris. J Am Acad Dermatol. 2024 Jan 30: S0190–9622(23)03389–3.Tyring SK, Kircik LH, Pariser DM, Guenin E, Bhatt V, Pillai R. Novel tretinoin 0.05 % lotion for the once-daily treatment of moderate-to-severe acne vulgaris: assessment of efficacy and safety in patients aged 9 years and older. J Drugs Dermatol JDD. 2018;17(10):1084–1091.Tyring SK, Kircik LH, Pariser DM, Guenin E, Bhatt V, Pillai R. Novel tretinoin 0.05 % lotion for the once-daily treatment of moderate-to-severe acne vulgaris: assessment of efficacy and safety in patients aged 9 years and older. J Drugs Dermatol JDD. 2018;17(10):1084–1091.Thiboutot D, Pariser DM, Egan N, et al. Adapalene gel 0.3% for the treatment of acne vulgaris: a multicenter, randomized, double-blind, controlled, phase III trial. J Am Acad Dermatol. 2006;54:242–250.Thiboutot D, Pariser DM, Egan N, et al. Adapalene gel 0.3% for the treatment of acne vulgaris: a multicenter, randomized, double-blind, controlled, phase III trial. J Am Acad Dermatol. 2006;54:242–250.Shalita AR, Chalker DK, Griffith RF, et al. Tazarotene gel is safe and effective in the treatment of acne vulgaris: a multicenter, double-blind, vehicle-controlled study. Cutis. 1999;63:349–354.Shalita AR, Chalker DK, Griffith RF, et al. Tazarotene gel is safe and effective in the treatment of acne vulgaris: a multicenter, double-blind, vehicle-controlled study. Cutis. 1999;63:349–354.Tanghetti EA, Werschler WP, Lain T, Guenin E, Martin G, Pillai R. Tazarotene 0.045% lotion for once-daily treatment of moderate-to-severe acne vulgaris: results from two phase 3 trials. J Drugs Dermatol. 2020;19:70–77.Tanghetti EA, Werschler WP, Lain T, Guenin E, Martin G, Pillai R. Tazarotene 0.045% lotion for once-daily treatment of moderate-to-severe acne vulgaris: results from two phase 3 trials. J Drugs Dermatol. 2020;19:70–77.Tan J, Thiboutot D, Popp G, et al. Randomized phase 3 evaluation of trifarotene 50 mug/g cream treatment of moderate facial and truncal acne. J Am Acad Dermatol. 2019;80(6):1691–1699.Tan J, Thiboutot D, Popp G, et al. Randomized phase 3 evaluation of trifarotene 50 mug/g cream treatment of moderate facial and truncal acne. J Am Acad Dermatol. 2019;80(6):1691–1699.Thiboutot D, Pariser DM, Egan N, et al. Adapalene gel 0.3% for the treatment of acne vulgaris: a multicenter, randomized, double-blind, controlled, phase III trial. J Am Acad Dermatol. 2006;54:242–250.Thiboutot D, Pariser DM, Egan N, et al. Adapalene gel 0.3% for the treatment of acne vulgaris: a multicenter, randomized, double-blind, controlled, phase III trial. J Am Acad Dermatol. 2006;54:242–250.Webster GF, Sugarman J, Levy-Hacham O, Toledano O. Microencapsulated benzoyl peroxide and tretinoin for the treatment of acne vulgaris: results from a phase 2 multicenter, double-blind, randomized, vehicle-controlled study. Skinmed. 2020;18(6):343–351.Webster GF, Sugarman J, Levy-Hacham O, Toledano O. Microencapsulated benzoyl peroxide and tretinoin for the treatment of acne vulgaris: results from a phase 2 multicenter, double-blind, randomized, vehicle-controlled study. Skinmed. 2020;18(6):343–351.Gollnick HP, Draelos Z, Glenn MJ, et al. Adapalene-benzoyl peroxide, a unique fixed-dose combination topical gel for the treatment of acne vulgaris: a transatlantic, randomized, double-blind, controlled study in 1670 patients. Br J Dermatol. 2009;161:1180–1189.Gollnick HP, Draelos Z, Glenn MJ, et al. Adapalene-benzoyl peroxide, a unique fixed-dose combination topical gel for the treatment of acne vulgaris: a transatlantic, randomized, double-blind, controlled study in 1670 patients. Br J Dermatol. 2009;161:1180–1189.Jarratt MT, Brundage T. Efficacy and safety of clindamycintretinoin gel versus clindamycin or tretinoin alone in acne vulgaris: a randomized, double-blind, vehicle-controlled study. J Drugs Dermatol. 2012;11:318–326.Jarratt MT, Brundage T. Efficacy and safety of clindamycintretinoin gel versus clindamycin or tretinoin alone in acne vulgaris: a randomized, double-blind, vehicle-controlled study. J Drugs Dermatol. 2012;11:318–326.Shalita A, Weiss JS, Chalker DK, et al. A comparison of the efficacy and safety of adapalene gel 0.1 % and tretinoin gel 0.025 % in the treatment of acne vulgaris: a multicenter trial. J Am Acad Dermatol. 1996;34:482–485.Shalita A, Weiss JS, Chalker DK, et al. A comparison of the efficacy and safety of adapalene gel 0.1 % and tretinoin gel 0.025 % in the treatment of acne vulgaris: a multicenter trial. J Am Acad Dermatol. 1996;34:482–485.Dunlap FE, Mills OH, Tuley MR, Baker MD, Plott RT. Adapalene 0.1% gel for the treatment of acne vulgaris: its superiority compared to tretinoin 0.025 % cream in skin tolerance and patient preference. Br J Dermatol. 1998;139(Suppl 52):17–22.Dunlap FE, Mills OH, Tuley MR, Baker MD, Plott RT. Adapalene 0.1% gel for the treatment of acne vulgaris: its superiority compared to tretinoin 0.025 % cream in skin tolerance and patient preference. Br J Dermatol. 1998;139(Suppl 52):17–22.Kakita L. Tazarotene versus tretinoin or adapalene in the treatment of acne vulgaris. J Am Acad Dermatol. 2000;43: S 51-S 54.Kakita L. Tazarotene versus tretinoin or adapalene in the treatment of acne vulgaris. J Am Acad Dermatol. 2000;43: S 51-S 54.Webster GF, Berson D, Stein LF, Fivenson DP, Tanghetti EA, Ling M. Efficacy and tolerability of once-daily tazarotene 0.1 % gel versus once-daily tretinoin 0.025 % gel in the treatment of facial acne vulgaris: a randomized trial. Cutis. 2001;67:4–9.Webster GF, Berson D, Stein LF, Fivenson DP, Tanghetti EA, Ling M. Efficacy and tolerability of once-daily tazarotene 0.1 % gel versus once-daily tretinoin 0.025 % gel in the treatment of facial acne vulgaris: a randomized trial. Cutis. 2001;67:4–9.SA, Gilbert R, Baker M, Guibal F, Tuley MR. Comparative tolerance of adapalene 0.1 % gel and six different tretinoin formulations. Br J Dermatol. 1998;139(Suppl 52): 34–40.SA, Gilbert R, Baker M, Guibal F, Tuley MR. Comparative tolerance of adapalene 0.1 % gel and six different tretinoin formulations. Br J Dermatol. 1998;139(Suppl 52): 34–40.Pedace FJ, Stoughton R. Topical retinoic acid in acne vulgaris. Br J Dermatol. 1971;84:465–469.Pedace FJ, Stoughton R. Topical retinoic acid in acne vulgaris. Br J Dermatol. 1971;84:465–469.Christiansen JV, Gadborg E, Ludvigsen K, et al. Topical tretinoin, vitamin A acid (Airol) in acne vulgaris. A controlled clinical trial. Dermatol. 1974;148:82–89.Christiansen JV, Gadborg E, Ludvigsen K, et al. Topical tretinoin, vitamin A acid (Airol) in acne vulgaris. A controlled clinical trial. Dermatol. 1974;148:82–89.Cunliffe WJ, Caputo R, Dreno B, et al. Clinical efficacy and safety comparison of adapalene gel and tretinoin gel in the treatment of acne vulgaris: Europe and U.S. multicenter trials. J Am Acad Dermatol. 1997;36: S 126-S 134.Cunliffe WJ, Caputo R, Dreno B, et al. Clinical efficacy and safety comparison of adapalene gel and tretinoin gel in the treatment of acne vulgaris: Europe and U.S. multicenter trials. J Am Acad Dermatol. 1997;36: S 126-S 134.Krishnan G. Comparison of two concentrations of tretinoin solution in the topical treatment of acne vulgaris. Practitioner. 1976;216:106–109.Krishnan G. Comparison of two concentrations of tretinoin solution in the topical treatment of acne vulgaris. Practitioner. 1976;216:106–109.Проект клинических рекомендаций. Акне вульгарные. РОДВК, 2020, стр.31. Информация на сайте https://www.cnikvi.ru/docs/clinic_recs/klinicheskie-rekomendatsii-2019–2020/ дата входа 20.01.2023.Draft clinical guidelines. Acne vulgar. RODVK, 2020, p. 31. Information on the website https://www.cnikvi.ru/docs/clinic_recs/klinicheskie-rekomendatsii-2019–2020/ entry date 01/20/2023.Круглова Л. С., Иконникова Е. В. Результаты открытого сравнительного исследования эффективности и переносимости терапии двумя лекарственными формами адапалена (0,1 % крем и 0,1 % гель) с применением косметических средств и без них при акне легкой и средней степени. Клиническая дерматология и венерология. 2018;17(5):74–82. https://doi.org/10.17116/klinderma20181705174.Kruglova L. S., Ikonnikova E. V. Results of an open comparative study of the effectiveness and tolerability of therapy with two dosage forms of adapalene (0.1 % cream and 0.1 % gel) with and without the use of cosmetics for mild to moderate acne. Clinical dermatology and venereology. 2018;17(5):74–82. https://doi.org/10.17116/klinderma20181705174.Cunliffe WJ, Dodman B, Ead R. Benzoyl peroxide in acne. Practitioner. 1978;220:479–482.Cunliffe WJ, Dodman B, Ead R. Benzoyl peroxide in acne. Practitioner. 1978;220:479–482.Fulton JE Jr, Farzad-Bakshandeh A, Bradley S. Studies on the mechanism of action to topical benzoyl peroxide and vitamin A acid in acne vulgaris. J Cutan Pathol. 1974;1:191–200.Fulton JE Jr, Farzad-Bakshandeh A, Bradley S. Studies on the mechanism of action to topical benzoyl peroxide and vitamin A acid in acne vulgaris. J Cutan Pathol. 1974;1:191–200.Mills O Jr, Thornsberry C, Cardin CW, Smiles KA, Leyden JJ. Bacterial resistance and therapeutic outcome following three months of topical acne therapy with 2% erythromycin gel versus its vehicle. Acta Derm Venereol. 2002;82:260–265.Mills O Jr, Thornsberry C, Cardin CW, Smiles KA, Leyden JJ. Bacterial resistance and therapeutic outcome following three months of topical acne therapy with 2% erythromycin gel versus its vehicle. Acta Derm Venereol. 2002;82:260–265.Stein Gold L, Baldwin H, Kircik LH, et al. Efficacy and safety of a fixed-dose clindamycin phosphate 1.2 %, benzoyl peroxide 3.1 %, and adapalene 0.15 % gel for moderate-to-severe acne: a randomized phase II study of the first triple-combination drug. Am J Clin Dermatol. 2022;23(1):93–104.Stein Gold L, Baldwin H, Kircik LH, et al. Efficacy and safety of a fixed-dose clindamycin phosphate 1.2 %, benzoyl peroxide 3.1 %, and adapalene 0.15 % gel for moderate-to-severe acne: a randomized phase II study of the first triple-combination drug. Am J Clin Dermatol. 2022;23(1):93–104.Harper JC. The efficacy and tolerability of a fixed combination clindamycin (1.2 %) and benzoyl peroxide (3.75 %) aqueous gel in patients with facial acne vulgaris: gender as a clinically relevant outcome variable. J Drugs Dermatol. 2015;14(4):381–384.Harper JC. The efficacy and tolerability of a fixed combination clindamycin (1.2 %) and benzoyl peroxide (3.75 %) aqueous gel in patients with facial acne vulgaris: gender as a clinically relevant outcome variable. J Drugs Dermatol. 2015;14(4):381–384.Pariser DM, Rich P, Cook-Bolden FE, Korotzer A. An aqueous gel fixed combination of clindamycin phosphate 1.2% and benzoyl peroxide 3.75% for the once-daily treatment of moderate to severe acne vulgaris. J Drugs Dermatol. 2014; 13(9):1083–1089.Pariser DM, Rich P, Cook-Bolden FE, Korotzer A. An aqueous gel fixed combination of clindamycin phosphate 1.2% and benzoyl peroxide 3.75% for the once-daily treatment of moderate to severe acne vulgaris. J Drugs Dermatol. 2014; 13(9):1083–1089.Cook-Bolden FE. Efficacy and tolerability of a fixed combination of clindamycin phosphate (1.2%) and benzoyl peroxide (3.75 %) aqueous gel in moderate or severe adolescent acne vulgaris. J Clin Aesthet Dermatol. 2015;8(5):28–32.Cook-Bolden FE. Efficacy and tolerability of a fixed combination of clindamycin phosphate (1.2%) and benzoyl peroxide (3.75 %) aqueous gel in moderate or severe adolescent acne vulgaris. J Clin Aesthet Dermatol. 2015;8(5):28–32.Gold MH, Korotzer A. Sub-group analyses from a trial of a fixed combination of clindamycin phosphate 1.2 % and benzoyl peroxide 3.75 % gel for the treatment of moderate-to-severe acne vulgaris. J Clin Aesthet Dermatol. 2015;8(12):22–26.Gold MH, Korotzer A. Sub-group analyses from a trial of a fixed combination of clindamycin phosphate 1.2 % and benzoyl peroxide 3.75 % gel for the treatment of moderate-to-severe acne vulgaris. J Clin Aesthet Dermatol. 2015;8(12):22–26.Cunliffe WJ, Holland KT. Clinical and laboratory studies on treatment with 20% azelaic acid cream for acne. Acta Derm Venereol Suppl. 1989;143:31–34Cunliffe WJ, Holland KT. Clinical and laboratory studies on treatment with 20% azelaic acid cream for acne. Acta Derm Venereol Suppl. 1989;143:31–34Katsambas A, Graupe K, Stratigos J. Clinical studies of 20% azelaic acid cream in the treatment of acne vulgaris. Comparison with vehicle and topical tretinoin. Acta Derm Venereol Suppl. 1989;143:35–39.Katsambas A, Graupe K, Stratigos J. Clinical studies of 20% azelaic acid cream in the treatment of acne vulgaris. Comparison with vehicle and topical tretinoin. Acta Derm Venereol Suppl. 1989;143:35–39.Iraji F, Sadeghinia A, Shahmoradi Z, Siadat AH, Jooya A. Efficacy of topical azelaic acid gel in the treatment of mildmoderate acne vulgaris. Indian J Dermatol Venereol Leprol. 2007;73:94–96.Iraji F, Sadeghinia A, Shahmoradi Z, Siadat AH, Jooya A. Efficacy of topical azelaic acid gel in the treatment of mildmoderate acne vulgaris. Indian J Dermatol Venereol Leprol. 2007;73:94–96.Katsambas A, Graupe K, Stratigos J. Clinical studies of 20% azelaic acid cream in the treatment of acne vulgaris. Comparison with vehicle and topical tretinoin. Acta Derm Venereol Suppl. 1989;143:35–39.Katsambas A, Graupe K, Stratigos J. Clinical studies of 20% azelaic acid cream in the treatment of acne vulgaris. Comparison with vehicle and topical tretinoin. Acta Derm Venereol Suppl. 1989;143:35–39.Akamatsu H., Komura J., Asada Y., Miyachi Y., Niwa Y. Inhibitory effect of azelaic acid on neutrophil functions: a possible cause for its efficacy in treating pathogenetically unrelated diseases. Arch Dermatol Res 1991; 283: 162–166.Akamatsu H., Komura J., Asada Y., Miyachi Y., Niwa Y. Inhibitory effect of azelaic acid on neutrophil functions: a possible cause for its efficacy in treating pathogenetically unrelated diseases. Arch Dermatol Res 1991; 283: 162–166.Bladon P.T., Burke B.M., Cunliffe W.J., Forster R.A., Holland K.T., King K. Topical azelaic acid and the treatment of acne: a clinical and laboratory comparison with oral tetracycline. Br J Dermatol 1986; 114: 493–499.Bladon P.T., Burke B.M., Cunliffe W.J., Forster R.A., Holland K.T., King K. Topical azelaic acid and the treatment of acne: a clinical and laboratory comparison with oral tetracycline. Br J Dermatol 1986; 114: 493–499.Cunliffe W. J., Holland K. T. Clinical and laboratory studies on treatment with 20 % azelaic acid cream for acne. Acta Derm Venereol Suppl (Stockh) 1989; 143: 31–34.Cunliffe W. J., Holland K. T. Clinical and laboratory studies on treatment with 20 % azelaic acid cream for acne. Acta Derm Venereol Suppl (Stockh) 1989; 143: 31–34.Bojar R. A., Cunliffe W. J., Holland K. T. Disruption of the transmembrane pH gradient – a possible mechanism for the antibacterial action of azelaic acid in Propionibacterium acnes and Staphylococcus epidermidis. J Antimicrob Chemother 1994; 34: 321–330.Bojar R. A., Cunliffe W. J., Holland K. T. Disruption of the transmembrane pH gradient – a possible mechanism for the antibacterial action of azelaic acid in Propionibacterium acnes and Staphylococcus epidermidis. J Antimicrob Chemother 1994; 34: 321–330.Bojar R.A., Cutcliffe A.G., Graupe K., Cunliffe W.J., Holland K.T. Azelaic acid: a review of its antimicrobial properties. Rec Contemp Pharmacother 1993; 4: 403–414.Bojar R.A., Cutcliffe A.G., Graupe K., Cunliffe W.J., Holland K.T. Azelaic acid: a review of its antimicrobial properties. Rec Contemp Pharmacother 1993; 4: 403–414.Ozkan M., Durmaz G., Sabuncu I., Saracoglu N., Akgun Y., Urer S. Clinical efficacy of topical clindamycin phosphate and azelaic acid on acne vulgaris and emergence of resistant coagulasenegative Staphylococci. Turk J Med Sci 2000; 30: 483–487.Ozkan M., Durmaz G., Sabuncu I., Saracoglu N., Akgun Y., Urer S. Clinical efficacy of topical clindamycin phosphate and azelaic acid on acne vulgaris and emergence of resistant coagulasenegative Staphylococci. Turk J Med Sci 2000; 30: 483–487.Nguyen Q. H., Bui T. P. Azelaic acid: pharmacokinetic and pharmacodynamic properties and its therapeutic role in hyperpigmentary disorders and acne. Int J Dermatol 1995; 34 (2): 75–84.Nguyen Q. H., Bui T. P. Azelaic acid: pharmacokinetic and pharmacodynamic properties and its therapeutic role in hyperpigmentary disorders and acne. Int J Dermatol 1995; 34 (2): 75–84.Breathnach A., Nazzaro-Porro M., Passi S., Zina G. Azelaic acid therapy in disorders of pigmentation. Clinics Dermatol 1989; 7:106–119.Breathnach A., Nazzaro-Porro M., Passi S., Zina G. Azelaic acid therapy in disorders of pigmentation. Clinics Dermatol 1989; 7:106–119.Graupe K., Cunliffe W.J., Gollnick H.P., Zaumseil R.P. Efficacy and safety of topical azelaic acid (20 percent cream): an overview of results from European clinical trials and experimental reports. Cutis 1996; 57: 20–35.Graupe K., Cunliffe W.J., Gollnick H.P., Zaumseil R.P. Efficacy and safety of topical azelaic acid (20 percent cream): an overview of results from European clinical trials and experimental reports. Cutis 1996; 57: 20–35.Ortonne J. P., Lacour J. P. Assessment of the phototoxicity of azelaic acid using the modified method of Kaidbey and Kligman. Nouv Dermatol 1992; 11: 490–495.Ortonne J. P., Lacour J. P. Assessment of the phototoxicity of azelaic acid using the modified method of Kaidbey and Kligman. Nouv Dermatol 1992; 11: 490–495.Villani A, Nastro F, Di Vico F, Fabbrocini G, Annunziata MC, Genco L. Oral isotretinoin for acne: a complete overview. Expert Opin Drug Saf. 2022;21:1027–1037.Villani A, Nastro F, Di Vico F, Fabbrocini G, Annunziata MC, Genco L. Oral isotretinoin for acne: a complete overview. Expert Opin Drug Saf. 2022;21:1027–1037.Nast A, Dr eno B, Bettoli V, et al. European evidence-based (S 3) guideline for the treatment of acne – update 2016 -short version. J Eur Acad Dermatol Venereol. 2016;30: 1261–1268.Nast A, Dr eno B, Bettoli V, et al. European evidence-based (S 3) guideline for the treatment of acne – update 2016 -short version. J Eur Acad Dermatol Venereol. 2016;30: 1261–1268.Oon HH, Wong SN, Aw DCW, Cheong WK, Goh CL, Tan HH. Acne management guidelines by the Dermatological Society of Singapore. J Clin Aesthet Dermatol. 2019;12:34–50.Oon HH, Wong SN, Aw DCW, Cheong WK, Goh CL, Tan HH. Acne management guidelines by the Dermatological Society of Singapore. J Clin Aesthet Dermatol. 2019;12:34–50.Kassem B, Ismail M, Hassan F. Evaluation of the efficacy and relapse rates of treatment protocols for moderate acne using isotretinoin based on the global acne grading system: randomized, controlled, comparative study. Dermatol Ther. 2022;35: e15974.Kassem B, Ismail M, Hassan F. Evaluation of the efficacy and relapse rates of treatment protocols for moderate acne using isotretinoin based on the global acne grading system: randomized, controlled, comparative study. Dermatol Ther. 2022;35: e15974.Borghi A, Mantovani L, Minghetti S, Giari S, Virgili A, Bettoli V. Low-cumulative dose isotretinoin treatment in mild-tomoderate acne: efficacy in achieving stable remission. J Eur Acad Dermatol Venereol. 2011;25:1094–1098.Borghi A, Mantovani L, Minghetti S, Giari S, Virgili A, Bettoli V. Low-cumulative dose isotretinoin treatment in mild-tomoderate acne: efficacy in achieving stable remission. J Eur Acad Dermatol Venereol. 2011;25:1094–1098.Kaymak Y, Ilter N. The effectiveness of intermittent isotretinoin treatment in mild or moderate acne. J Eur AcadDermatol Venereol. 2006;20:1256–1260.Kaymak Y, Ilter N. The effectiveness of intermittent isotretinoin treatment in mild or moderate acne. J Eur AcadDermatol Venereol. 2006;20:1256–1260.Barbieri JS, Shin DB, Wang S, Margolis DJ, Takeshita J. The clinical utility of laboratory monitoring during isotretinoin therapy for acne and changes to monitoring practices over time. J Am Acad Dermatol. 2020;82:72–79.Barbieri JS, Shin DB, Wang S, Margolis DJ, Takeshita J. The clinical utility of laboratory monitoring during isotretinoin therapy for acne and changes to monitoring practices over time. J Am Acad Dermatol. 2020;82:72–79.Wright S, Strunk A, Garg A. Risk of new-onset inflammatory bowel disease among patients with acne vulgaris exposed to isotretinoin. J Am Acad Dermatol. 2021;84:41–45.Wright S, Strunk A, Garg A. Risk of new-onset inflammatory bowel disease among patients with acne vulgaris exposed to isotretinoin. J Am Acad Dermatol. 2021;84:41–45.Webster GF, Leyden JJ, Gross JA. Results of a phase III, double-blind, randomized, parallel-group, non-inferiority study evaluating the safety and efficacy of isotretinoinLidose in patients with severe recalcitrant nodular acne. J Drugs Dermatol. 2014;13:665–670.Webster GF, Leyden JJ, Gross JA. Results of a phase III, double-blind, randomized, parallel-group, non-inferiority study evaluating the safety and efficacy of isotretinoinLidose in patients with severe recalcitrant nodular acne. J Drugs Dermatol. 2014;13:665–670.chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://www.absorica.com/pdfs/Absorica_Prescribing_Information.pdf дата входа 26.03.2024.chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://www.absorica.com/pdfs/Absorica_Prescribing_Information.pdf дата входа 26.03.2024.https://www.accessdata.fda.gov/scripts/cder/ob/index.cfm дата входа 26.03.2024.https://www.accessdata.fda.gov/scripts/cder/ob/index.cfm дата входа 26.03.2024.Waldman A, Bolotin D, Arndt KA, et al. ASDS guidelines task force: consensus recommendations regarding the safety of lasers, dermabrasion, chemical peels, Energy devices, and skin surgery during and after isotretinoin use. Dermatol Surg. 2017;43:1249–1262.Waldman A, Bolotin D, Arndt KA, et al. ASDS guidelines task force: consensus recommendations regarding the safety of lasers, dermabrasion, chemical peels, Energy devices, and skin surgery during and after isotretinoin use. Dermatol Surg. 2017;43:1249–1262.Waldman A, Bolotin D, Arndt KA, et al. ASDS guidelines task force: consensus recommendations regarding the safety of lasers, dermabrasion, chemical peels, Energy devices, and skin surgery during and after isotretinoin use. Dermatol Surg. 2017;43:1249–1262.Waldman A, Bolotin D, Arndt KA, et al. ASDS guidelines task force: consensus recommendations regarding the safety of lasers, dermabrasion, chemical peels, Energy devices, and skin surgery during and after isotretinoin use. Dermatol Surg. 2017;43:1249–1262.Del Rosso JQ, et al. Optimizing use of oral antibiotics in acne vulgaris. Dermatol Clin. 2009;27:33–42.Del Rosso JQ, et al. Optimizing use of oral antibiotics in acne vulgaris. Dermatol Clin. 2009;27:33–42.Garner SE, et al. Minocycline for acne vulgaris: efficacy and safety. Cochrane Database Syst Rev. 2012;2012(8): CD 002086. https://doi.org/10.1002/14651858.CD002086.pub2.Garner SE, et al. Minocycline for acne vulgaris: efficacy and safety. Cochrane Database Syst Rev. 2012;2012(8): CD 002086. https://doi.org/10.1002/14651858.CD002086.pub2.Lee YB, Byun EJ, Kim HS. Potential role of the microbiome in acne: a comprehensive review. J Clin Med. 2019;8:987.Lee YB, Byun EJ, Kim HS. Potential role of the microbiome in acne: a comprehensive review. J Clin Med. 2019;8:987.van Wolferen M, Orell A, Albers SV. Archaeal biofilm formation. Nat Rev Microbiol. 2018;16:699–713.van Wolferen M, Orell A, Albers SV. Archaeal biofilm formation. Nat Rev Microbiol. 2018;16:699–713.Duarte-Neto AN. Pathology of infectious diseases: new agents, opportunistic, neglectable, emergent, reemergent diseases and why not super resistant nosocomial bacteria? Autops Case Rep. 2019;9: e2019126.Duarte-Neto AN. Pathology of infectious diseases: new agents, opportunistic, neglectable, emergent, reemergent diseases and why not super resistant nosocomial bacteria? Autops Case Rep. 2019;9: e2019126.Flemming HC, Wingender J, Szewzyj U, Steinberg P, Rice SA, Kjelleberg S. Biofilms: an emergent form of bacterial life. Nat Rev Microbiol. 2016;14:563–75.Flemming HC, Wingender J, Szewzyj U, Steinberg P, Rice SA, Kjelleberg S. Biofilms: an emergent form of bacterial life. Nat Rev Microbiol. 2016;14:563–75.Jahns AC, Lundskog B, Ganceviciene R, Palmer RH, Golovleva I, Zouboulis CC, et al. An increased incidence of Propionibacterium acnes biofilms in acne vulgaris: a case–control study. Br J Dermatol. 2012;167:50–8.Jahns AC, Lundskog B, Ganceviciene R, Palmer RH, Golovleva I, Zouboulis CC, et al. An increased incidence of Propionibacterium acnes biofilms in acne vulgaris: a case–control study. Br J Dermatol. 2012;167:50–8.Ogawara H. Comparison of antibiotic resistance mechanisms in antibiotic-producing and pathogenic bacteria. Molecules. 2019;24:3430.Ogawara H. Comparison of antibiotic resistance mechanisms in antibiotic-producing and pathogenic bacteria. Molecules. 2019;24:3430.Feuillolay C, Pecastaings S, Le Gac C, Fiorini-Puybaret C, Luc J, Joulia P, et al. A Myrtus communis extract enriched in myrtucummulones and ursolic acid reduces resistance of Propionibacterium acnes biofilms to antibiotics used in acne vulgaris. Phytomedicine. 2016;23:307–15.Feuillolay C, Pecastaings S, Le Gac C, Fiorini-Puybaret C, Luc J, Joulia P, et al. A Myrtus communis extract enriched in myrtucummulones and ursolic acid reduces resistance of Propionibacterium acnes biofilms to antibiotics used in acne vulgaris. Phytomedicine. 2016;23:307–15.Zaenglein AL, Pathy AL, Scholosser BJ, Alikhan A, Baldwin H, Berson DS, et al. Guidelines of care for the management of acne vulgaris. J Am Acad Dermatol. 2016;74:945–73.Zaenglein AL, Pathy AL, Scholosser BJ, Alikhan A, Baldwin H, Berson DS, et al. Guidelines of care for the management of acne vulgaris. J Am Acad Dermatol. 2016;74:945–73.Plewig G, Melnik B, Chen W. Plewig and Kligman’s Acne and Rosacea. 4th ed. Cham: Springer Nature Switzerland AG; 2019.Plewig G, Melnik B, Chen W. Plewig and Kligman’s Acne and Rosacea. 4th ed. Cham: Springer Nature Switzerland AG; 2019.

The authors declare that there are no conflicts of interest present.