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Introduction. Acne is one of the most common dermatological diseases. It may have a chronic course, leaving permanent marks, and in last years has been tending to have more and more severe clinical course with widespread skin lesions. According to recent studies, the development of acne is due to the combined effect of endogenous and exogenous factors, among which endocrine diseases, disorders of metabolic processes, reduced systemic immunity and phagocytic ability of mononuclear phagocytes and granulocytes at various stages of phagocytosis of pyogenic cocci, which contributes to more severe clinical course, and frequent relapse of this diseases. It was also proved that the intestinal microbiota plays an important role in the formation of homeostasis and immune response. The Objective of the study is to determine the evolution of phagocytosis indices in patients with acne under different comprehensive treatments, using oral antibiotics, immunotherapy (PRPtherapy), probiotics, low-dose birth control pills and IPL- therapy.
Materials and methods. We observed 93 women with acne aged from 18 to 25 years old. In 19 (20.43%) patient mild acne was diagnosed, in 41 (44.09%) – moderate acne, in 33 (35.48%) persons – severe acne, 54 (58.06%) persons suffered from acne up to 1 year, 39 (41.93%) – from 1 to 3 years. To assess the state of phagocytosis in patients with acne vulgaris, we determined phagocytic activity (PA) and phagocytic index (PI) of polymorphonuclear leukocytes, nitro blue tetrazolium recovery test (NBT test spontaneous) and NBT-test pyrogenal stimulated by recognized methods.
Results. Analysis of the studied parameters of phagocytosis at the end of treatment showed a significant increase in patients of the core group who were administered a comprehensive treatment which included oral antibiotic, probiotic, and low-dose birth control pills, PRP-therapy and IPLtherapy, as compared with the patients of other groups under study.
Conclusions. Using combined therapy for women with acne occurring against the backdrop of a sluggish process of phagocytosis and concomittant intestinal dysbiosis leads to normalization of the leading indices of phagocytosis (PI, PA, NBT tests both spontaneous and stimulated), and enchances their phagocytic activity both during capture and formation of bactericidal activity and in the final stages of phagocytosis justifying the feasibility of a combined use of antibiotics, probiotic, low-dose birth control pills PRP-therapy and IPL-therapy in the treatment of acne.
Key words: acne, phagocytosis, probiotic, PRP-therapy, IPL-therapy, low-dose birth control pills.