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The management of postacne scarring.

机译：痤疮后疤痕的处理。

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BACKGROUND: Therapeutic intervention for postacne scarring has historically been limited by the considerable morbidity of most treatments for only marginal disease improvement. Within the past decade, however, a greater understanding of the pathogenesis of acne scarring has led to the development of techniques that offer more favorable risk-benefit profiles. OBJECTIVE: The aims of this article are to highlight a number of newer techniques and to assign their appropriateness to particular grades of acne scarring. MATERIALS AND METHODS: Current modalities are discussed as they relate to disease process and specific acne scar types. Techniques are presented in order of most effectual therapeutic interventions for defined grades of acne scarring. Acne scarring grades have been described previously in terms of disease load, severity, and lesion morphologies. RESULTS: A comprehensive discussion of updated therapeutic techniques and their biologic rationales in the treatment of acne scarring is presented. These include targeted interventions of inflammatory and postinflammatory processes, angiogenesis, immunologic processes, dermal and subcutaneous fibrosis, hypertrophy, and keloid scarring. DISCUSSION: A requirement for developing successful treatments for postacne scarring is a greater understanding of its pathogenesis, variability among afflicted individuals, and the inflammatory mediators and immunology of the scarring process. Many innovative techniques introduced in the past decade attempt to counteract these pathologic processes while keeping the procedural and postoperative risks to a minimum.
机译：背景：痤疮后疤痕的治疗干预在历史上一直受到大多数仅能改善边缘疾病的治疗的相当高的发病率所限制。然而，在过去的十年中，对痤疮疤痕发病机理的更深入了解导致了技术的发展，这些技术提供了更有利的风险收益特征。目的：本文的目的是强调一些较新的技术，并将其适用于特定等级的痤疮疤痕。材料和方法：讨论了当前的方式，因为它们与疾病过程和特定的痤疮疤痕类型有关。为确定等级的痤疮疤痕，按最有效的治疗干预顺序提供了技术。痤疮疤痕等级先前已根据疾病负荷，严重程度和病变形态进行了描述。结果：全面讨论更新的治疗技术及其痤疮疤痕治疗的生物学原理。这些措施包括炎症和炎症后过程，血管生成，免疫过程，皮肤和皮下纤维化，肥大和瘢痕scar瘢痕形成的靶向干预。讨论：开发成功的治疗痤疮后疤痕的方法的要求是对其发病机理，患病个体之间的变异性以及疤痕形成过程的炎症介质和免疫学有更深入的了解。在过去的十年中，许多创新技术试图抵消这些病理过程，同时将手术和术后风险降至最低。

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