Supplementary Material for: Clinical and Histological Effects of Topical Epidermal Growth Factor on Acne and Acne Scars

Background: The inflammatory lesions of acne leave scars which greatly affect patients’ quality of life. Treatment options targeting both acne and acne scars are still lacking. Objectives: To evaluate the clinical efficacy of epidermal growth factor ointment (EGFO) on acne and acne scars. Methods: The study design was 12-week, prospective, split-face, single-blinded. The 36 patients with mild to moderate acne vulgaris applied EGFO on one side of the face and the vehicle ointment on the other side twice daily. The patients were assessed every 4 weeks by acne lesion and scar counts, investigator’s global assessment for acne (IGA) and scar (SGA), and the ECCA scar grading scale. Biopsies were performed before and after treatment. Results: Acne and acne scars were significantly improved on EGFO-treated sides, while control sides were not. Acne lesion and scar counts were significantly reduced after 4 weeks, while IGA, SGA, and ECCA grade significantly decreased after 8 weeks. Immunohistochemistry showed decreased expression of keratin 16, NF-κB p65, IL-1α, and IL-8, and increased expression of TGF-β1, elastin, and collagen type 1, 3 after treatment. Conclusions: EGFO can be a treatment option targeting acne and acne scars.背景：痤疮炎性皮损愈合后遗留瘢痕，会严重影响患者的生活质量，目前同时针对痤疮及痤疮瘢痕的治疗方案仍较为匮乏。目的：评估表皮生长因子软膏（epidermal growth factor ointment，EGFO）对痤疮及痤疮瘢痕的临床疗效。方法：本研究采用12周前瞻性分脸对照单盲设计。纳入36例轻中度寻常痤疮患者，每日两次于面部一侧涂抹EGFO，另一侧涂抹赋形剂软膏。每4周对患者进行评估，评估指标包括痤疮皮损及瘢痕计数、研究者整体痤疮评估（investigator’s global assessment for acne, IGA）与瘢痕评估（investigator’s global assessment for scar, SGA），以及ECCA瘢痕分级量表。分别于治疗前后进行皮肤活检。结果：接受EGFO治疗的面部侧别痤疮及痤疮瘢痕均得到显著改善，而对照组侧别无明显改善。治疗4周后，痤疮皮损与瘢痕计数显著降低；治疗8周后，IGA、SGA及ECCA分级均显著下降。免疫组化结果显示，治疗后角蛋白16、NF-κB p65、IL-1α及IL-8的表达水平下调，而TGF-β1、弹性蛋白及Ⅰ、Ⅲ型胶原的表达水平上调。结论：EGFO可作为同时针对痤疮及痤疮瘢痕的治疗选择。