{"id":1148,"date":"2016-09-12T11:23:37","date_gmt":"2016-09-12T02:23:37","guid":{"rendered":"http:\/\/www.hcfm.jp\/journal\/?p=1148"},"modified":"2016-09-12T11:23:37","modified_gmt":"2016-09-12T02:23:37","slug":"%e3%83%8b%e3%82%ad%e3%83%93%e3%81%ae%e6%9c%80%e6%96%b0%e3%82%ac%e3%82%a4%e3%83%89%e3%83%a9%e3%82%a4%e3%83%b3%ef%bc%88%e3%82%ab%e3%83%8a%e3%83%80%ef%bc%89","status":"publish","type":"post","link":"https:\/\/www.hcfm.jp\/journal\/?p=1148","title":{"rendered":"\u30cb\u30ad\u30d3\u306e\u6700\u65b0\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\uff08\u30ab\u30ca\u30c0\uff09"},"content":{"rendered":"

\uff0d\u6587\u732e\u540d\uff0d
\nY Asai MD MSc, A Baibergenova MD PhD, et al. Management of acne: Canadian clinical practice guideline. Canadian Medical Association Journal. 2016, 188(2) : 118-126<\/p>\n

\uff0d\u8981\u7d04\uff0d
\nIntroduction<\/strong>
\n\u30fb\u30cb\u30ad\u30d3\u306f12-24\u6b73\u306e85%\u304c\u7d4c\u9a13\u3059\u308b
\n\u30fb\u7cbe\u795e\u7684\u30b9\u30c8\u30ec\u30b9\u3084\u7622\u75d5\u3092\u3082\u305f\u3089\u3057QOL\u3092\u4f4e\u4e0b\u3055\u305b\u308b\u6050\u308c\u304c\u3042\u308b
\n\u30fb\u30cb\u30ad\u30d3\u306e\u6027\u72b6\u306f\u8907\u6570\u306e\u6bb5\u968e\u306b\u5206\u3051\u3089\u308c\u308b\uff08Figure 1\uff09
\n\u30fb\u524d\u56de\u306e\u30ab\u30ca\u30c0\u306e\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u306f2000\u5e74\u306e\u3082\u306e
\n\u3000\u2192\u30a8\u30d3\u30c7\u30f3\u30b9\u306b\u5f93\u3063\u305f\u65b0\u3057\u3044\u6307\u91dd\u304c\u5fc5\u8981
\n\u30fb3\u3064\u306e\u30ab\u30c6\u30b4\u30ea\u30fc\u306b\u95a2\u3057\u3066\u8a18\u8f09\u3057\u3066\u3044\u304f
\n\u3000A\uff1acomedonal acne\uff08\u9762\u76b0\uff09
\n\u3000\u3000- closed comedones\uff08\u9589\u9396\u9762\u76b0\uff09\uff1a\u767d\u8272
\n\u3000\u3000- open comedones\uff08\u958b\u653e\u9762\u76b0\uff09\uff1agrey\u2013white
\n\u3000\u3000\u3000\u6bdb\u5b54\u306e\u5b8c\u5168\/\u90e8\u5206\u9589\u585e\u3068\u76ae\u8102\u306e\u8caf\u7559\u306b\u3088\u308b
\n\u3000B\u30fbC\uff1amild\u00adto\u00admoderate papulopustular acne\uff08\u708e\u75c7\u6027\u5ea7\u7621\uff09
\n\u3000\u3000\u3000\u3000\u8868\u5c64\u306e\u708e\u75c7\u304c\u898b\u3089\u308c\u308b
\n\u3000D\u30fbE\uff1asevere acne
\n\u3000\u3000\u3000\u81bf\u75b1\u3084\u7d50\u7bc0\u3092\u4f34\u3044\u3001\u6df1\u304f\u7d44\u7e54\u969c\u5bb3\u3092\u8d77\u3053\u3059
\n\u3000\u3000\u3000\u30ec\u30a2\u306a\u30bf\u30a4\u30d7\uff1aconglobate acne\uff08\u96c6\u7c07\u6027\u5ea7\u7621\uff09
\n\"\u677e\u5cf6\u5148\u751f\u56f3\u2460\"<\/a><\/p>\n

\uff1cGL\u306e\u5bfe\u8c61\u3067\u306a\u3044\u3082\u306e\uff1e
\nneonatal, infantile and late\u00adonset acne; acne fulminans; acne inversa (hidradenitis suppurativa); and acne variants such as gram\u00adnegative folliculitis, rosacea, demodicidosis, pustular vasculitis, mechanical acne, oil or tar acne, and chloracne.<\/p>\n

\u30fbEuropean evidence-based guideline for the treatment of acne (2012)\uff08ES3\uff09\u306b\u5185\u5bb9\u3092\u5408\u308f\u305b\u308b\u3088\u3046\u306b\u3057\u3066\u3044\u308b
\n\u3000\u203b2016\u3082\u51fa\u3066\u3044\u308b\u3088\u3046\u3067\u3059\u304c\u6709\u6599<\/p>\n

Method<\/strong>
\n\u30fbGuideline panel composition
\n\u3000\u904b\u55b6\u59d4\u54e1\u4f1a\uff08C.L. and J. Tan\uff09\u304c\u9078\u629c\u3000\u4ed6\u306b\u306f\u5730\u57df\u306e\u4ee3\u8868\u3084\u75ab\u5b66\u3068\u76ae\u819a\u79d1\u306e\u30a8\u30ad\u30b9\u30d1\u30fc\u30c8\uff08Y.A. and A.B.\uff09\u3082
\n\u30fbGuideline development
\n\u3000AGREE II\u306b\u6e96\u62e0\u3000\u9069\u5fdc\u306b\u3064\u3044\u3066\u306fADAPTE framework\u306b\u5f93\u3046
\n\u30002007\u301c2013\u5e74\u306e\u30b7\u30b9\u30c6\u30de\u30c6\u30a3\u30c3\u30af\u30ec\u30d3\u30e5\u30fc\u306e\u4e2d\u304b\u30895\u3064\u9078\u629c\uff08ES3\u3068\u30de\u30ec\u30fc\u30b7\u30a2\u306e\u306f\u8cea\u304c\u9ad8\u3044\uff09
\n\u30002010.3\u301c2013.3\u306e\u6587\u732e\u3092\u691c\u7d22\u3057\u305f\u3000\u51fa\u7248\u524d\u306b\u8ffd\u52a0\u30672015.7\u307e\u3067\u306e\u6587\u732e\u3092\u8abf\u3079\u305f
\n\u3000\u30af\u30e9\u30a4\u30c6\u30ea\u30a2\u306b\u5408\u81f4\u3057\u305f\u3082\u306e\u30922\u4eba\u306e\u30ec\u30d3\u30e5\u30fc\u30a2\u30fc\uff08Y.A. and A.B.\uff09\u304c\u8a55\u4fa1
\n\u3000Grade A, B, C\u306b\u8a55\u4fa1\u3057\u30a8\u30d3\u30c7\u30f3\u30b9\u30ec\u30d9\u30eb1-4\u3092\u6c7a\u3081\u305f
\n\u3000\u51fa\u3066\u304d\u305f\u63a8\u5968\u3092\u30d1\u30cd\u30eb\u30c7\u30a3\u30b9\u30ab\u30c3\u30b7\u30e7\u30f3\u3057\u305f
\n\u3000blinded online Delphi process\u3067\u6c7a\u5b9a
\n\u30fbStakeholder review
\n\u30fbMitigation of competing interests
\n\u3000Valeant, Galderma, Cipher, Bayer and Mylan\u306e\u63f4\u52a9\u3042\u308a
\n\u3000\u30d0\u30a4\u30a2\u30b9\u3092\u53d7\u3051\u306a\u3044\u3088\u3046\u5de5\u592b\u3057\u305f<\/p>\n

Recommendations<\/strong>
\n\u30fb\u30a2\u30eb\u30b4\u30ea\u30ba\u30e0\uff08Figure 2\uff09\u3092\u63b2\u8f09
\n\u30fbfull guideline\u306fAppendix 4\u53c2\u7167
\n\u30fb\u9762\u76b0\u306e\u307f\u306b\u95a2\u3059\u308b\u30a8\u30d3\u30c7\u30f3\u30b9\u306f\u306a\u304b\u3063\u305f\u305f\u3081\u3001\u8efd\u75c7\u306e\u708e\u75c7\u6027\u5ea7\u7621\u306e\u7d50\u679c\u3092\u5143\u306b\u3057\u3066\u3044\u308b<\/p>\n

\u25cecomedonal acne
\n\u5916\u7528\u85ac\u304c\u57fa\u672c
\n\u30fb\u30ec\u30c1\u30ce\u30a4\u30c9\uff08\u4e00\u822c\u540d \u30a2\u30c0\u30d1\u30ec\u30f3\uff0c\u5546\u54c1\u540d\u30c7\u30a3\u30d5\u30a7\u30ea\u30f3\u30b2\u30eb\uff09
\n\u3000\u3000\u30fbbenzoyl peroxide\uff08BPO\uff09\uff1a\u904e\u9178\u5316\u30d9\u30f3\u30be\u30a4\u30eb\uff08\u5546\u54c1\u540d\uff1a \u30d9\u30d4\u30aa\u30b2\u30eb\uff09
\n\u3000\u203b\u30ab\u30ca\u30c0\u3067\u306fOCT\u3068\u3057\u3066\u8ca9\u58f2
\n\u30fb\u30ec\u30c1\u30ce\u30a4\u30c9\uff0bBPO\u307e\u305f\u306f\u30af\u30ea\u30f3\u30c0\u30de\u30a4\u30b7\u30f3<\/p>\n

\u4e7e\u71e5\u808c\u3084\u523a\u6fc0\u306b\u5f31\u3044\u808c\u306b\u306f\u30af\u30ea\u30fc\u30e0\u3084\u30ed\u30fc\u30b7\u30e7\u30f3\u3092
\n\u8102\u3063\u307d\u3044\u808c\u306b\u306f\u30b2\u30eb\u3092<\/p>\n

\u52b9\u679c\u4e0d\u826f\u306e\u5834\u5408\u3001\u5973\u6027\u3067\u306f\u7d4c\u53e3\u907f\u598a\u85ac\u306e\u4f75\u7528\u3082\u691c\u8a0e\u3059\u308b
\n\"\u677e\u5cf6\u5148\u751f\u56f3\u2461\"<\/a><\/p>\n

\"\u677e\u5cf6\u5148\u751f\u56f3\u2462\"<\/a><\/p>\n

\u25cemild\u00adto\u00admoderate papulopustular acne\uff08\u9650\u5c40\u6027\uff09
\n\u30fbBPO\u5358\u72ec
\n\u30fb\u30ec\u30c1\u30ce\u30a4\u30c9
\n\u30fb\u4f75\u7528<\/p>\n

\u25cesevere acne
\n\u30fb\u7d4c\u53e3\u6297\u83cc\u85ac\u306e\u4f75\u7528
\n\u3000\u30c6\u30c8\u30e9\u30b5\u30a4\u30af\u30ea\u30f3or\u30c9\u30ad\u30b7\u30b5\u30a4\u30af\u30ea\u30f3\u3092\u63a8\u5968
\n\u3000\u30df\u30ce\u30b5\u30a4\u30af\u30ea\u30f3\u306fdrug-induced lupus\u3084hepatitis\u306e\u30ea\u30b9\u30af\u304c\u4e0a\u304c\u308b
\n\u3000\u305f\u3060\u3057\u8010\u6027\u83cc\u306e\u8a98\u5c0e\u306b\u306f\u6c17\u3092\u3064\u3051\u306a\u3051\u308c\u3070\u306a\u3089\u306a\u3044
\n\u30fb\u5973\u6027\u306e\u5834\u5408\u306f\u7d4c\u53e3\u907f\u598a\u85ac\u306e\u4f75\u7528\u3082\u691c\u8a0e
\n\u30fb\u7d4c\u53e3\u30a4\u30bd\u30c8\u30ec\u30c1\u30ce\u30a4\u30f3\uff08\u65e5\u672c\u3067\u306f\u672a\u627f\u8a8d\uff09
\n\u3000\u50ac\u5947\u5f62\u6027\u304c\u3042\u308b\u306e\u3067\u907f\u598a\u3092\uff01<\/p>\n

Implementation<\/strong>
\n5\u5e74\u4ee5\u5185\u306b\u6539\u5b9a\u3059\u308b\u4e88\u5b9a<\/p>\n

Gaps in knowledge<\/strong>
\n\u30fb\u4f53\u5e79\u306e\u5ea7\u7621\u3078\u306e\u6709\u52b9\u6027\u306e\u30a8\u30d3\u30c7\u30f3\u30b9\u304c\u306a\u3044
\n\u30fbminimal effect size\u304c\u306f\u3063\u304d\u308a\u3057\u306a\u3044
\n\u30fb\u5ea7\u7621\u306e\u91cd\u75c7\u5ea6\u306e\u56fd\u969b\u7684\u6a19\u6e96\u304c\u6c7a\u307e\u3063\u3066\u3044\u306a\u3044
\n\u30fbQOL\u4f4e\u4e0b\u306b\u5bfe\u3059\u308b\u88dc\u52a9\u7642\u6cd5\uff08\u5fc3\u7406\u7642\u6cd5\u306a\u3069\uff09\u306e\u77e5\u898b\u304c\u306a\u3044
\n\u30fb\u8010\u6027\u83cc\u3092\u9632\u3050\u305f\u3081\u306b\u6297\u83cc\u85ac\u5185\u670d\u671f\u9593\u3092\u3069\u308c\u304f\u3089\u3044\u306b\u3059\u308c\u3070\u3044\u3044\u306e\u304b\u6c7a\u307e\u3063\u3066\u3044\u306a\u3044
\n\u30fb\u3088\u304f\u4f7f\u308f\u308c\u3066\u3044\u308b\u6cbb\u7642\uff08erythromycin\u2013tretinoin\u3001spironolactone\u3001isotretinoin\uff09\u306e\u52b9\u679c<\/p>\n

Conclusion<\/strong>
\n\u65e9\u671f\u767a\u898b\u3001\u65e9\u671f\u6cbb\u7642\u306b\u3088\u308a\u3001\u7622\u75d5\u306a\u3069\u306e\u5f8c\u907a\u75c7\u3092\u9632\u3052\u308b\u3002<\/p>\n

\u3010\u958b\u50ac\u65e5\u3011
\n\u30002016\u5e749\u67087\u65e5\uff08\u6c34\uff09<\/p>\n","protected":false},"excerpt":{"rendered":"

\uff0d\u6587\u732e\u540d\uff0d Y Asai MD MSc, A Baibergenova MD PhD, et al. Management of acne: Canadian clinical practice guideline. C … \u7d9a\u304d\u3092\u8aad\u3080 \u30cb\u30ad\u30d3\u306e\u6700\u65b0\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\uff08\u30ab\u30ca\u30c0\uff09<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[17],"tags":[],"class_list":["post-1148","post","type-post","status-publish","format-standard","hentry","category-17"],"_links":{"self":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/1148","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=1148"}],"version-history":[{"count":2,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/1148\/revisions"}],"predecessor-version":[{"id":1153,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/1148\/revisions\/1153"}],"wp:attachment":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=1148"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=1148"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=1148"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}