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Perera MPN, Peiris WMDM, Pathmanathan D, Mallawaarachchi S, Karunathilake IM. Relationship between acne vulgaris and cosmetic usage in Sri Lankan urban adolescent females. J Cosmet Dermatol 2017; 17:431-436. [DOI: 10.1111/jocd.12431] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/28/2017] [Indexed: 01/09/2023]
Affiliation(s)
| | | | | | - Sudaraka Mallawaarachchi
- Advanced Computing and Simulation Laboratory (AχL); Department of Electrical and Computer Systems Engineering; Monash University; Clayton VIC Australia
| | - Indika Mahesh Karunathilake
- Faculty of Medicine; Medical Education Development and Research Centre; University of Colombo; Colombo Sri Lanka
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102
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Fractional carbon dioxide laser for the treatment of facial atrophic acne scars: prospective clinical trial with short and long-term evaluation. Lasers Med Sci 2017; 32:2047-2054. [PMID: 28894992 DOI: 10.1007/s10103-017-2322-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Accepted: 09/05/2017] [Indexed: 10/18/2022]
Abstract
The aim of this study was to evaluate the efficacy and safety of fractional carbon dioxide laser for the treatment of acne scars. Thirty-one participants, 15 female and 16 male, whose mean age was 34.84 ± 10.94 years, were included in this prospective study. The study took place between 2012 and 2016. Participants were evaluated with the "ECCA Grading Scale" before the first session, 3 months (short-term evaluation) and 3 years after the last session (long-term evaluation). Participants received two or three treatment sessions at 4-week intervals, with a 10,600 nm fractional carbon dioxide laser with pulse energies ranging between 100 and 160 mJ, 120 spot type, 75-100 spot/cm2 density, and 30 W power. Self-assessments by the participants were done 3 months and 3 years after the last session. The mean ECCA score was 107.90 ± 39.38 before the first session, and 82.17 ± 36.23 at the time of short-term evaluation (p = 0.000). The grade of improvement at the short-term evaluation was as follows: no improvement, mild, moderate, and significant improvement for 7 (22.6%), 11 (35.5%), 9 (29%), and 4 (12.9%) of the participants, respectively. Regarding self-assessments, 80.6 and 61.3% of the participants rated themselves as having at least mild improvement at the short-term and the long-term follow-up periods, respectively. The results of this study suggest that fractional carbon dioxide laser is an efficient treatment option for acne scars. Furthermore, self-assessment results show that more than half of the participants still experience at least mild improvement at the end of 3 years.
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Wolkenstein P, Machovcová A, Szepietowski J, Tennstedt D, Veraldi S, Delarue A. Acne prevalence and associations with lifestyle: a cross-sectional online survey of adolescents/young adults in 7 European countries. J Eur Acad Dermatol Venereol 2017; 32:298-306. [DOI: 10.1111/jdv.14475] [Citation(s) in RCA: 80] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Accepted: 06/28/2017] [Indexed: 11/26/2022]
Affiliation(s)
- P. Wolkenstein
- Department of Dermatology; Hôpital Henri Mondor; APHP; UPEC; Créteil France
| | - A. Machovcová
- Department of Dermatology and Venerology; Motol Hospital; Prague Czech Republic
| | - J.C. Szepietowski
- Department of Dermatology, Venerology and Allergology; Medical University; Wroclaw Poland
| | - D. Tennstedt
- Department of Dermatology; UCL; Cliniques Universitaires Saint-Luc; Brussels Belgium
| | - S. Veraldi
- Department of Pathophysiology and Transplantation; University of Milan; Milan Italy
| | - A. Delarue
- Pierre Fabre Dermatologie; Les Cauquillous; Lavaur France
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104
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El-Taweel AA, Salem RM, El-Shimi OS. Predictive value of serum markers for postacne scarring. J Cosmet Dermatol 2017; 17:491-494. [DOI: 10.1111/jocd.12402] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2017] [Indexed: 01/09/2023]
Affiliation(s)
| | | | - Ola S El-Shimi
- Clinical and Chemical Pathology; Faculty of Medicine; Benha University; Benha Egypt
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105
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Mastrofrancesco A, Ottaviani M, Cardinali G, Flori E, Briganti S, Ludovici M, Zouboulis C, Lora V, Camera E, Picardo M. Pharmacological PPARγ modulation regulates sebogenesis and inflammation in SZ95 human sebocytes. Biochem Pharmacol 2017; 138:96-106. [DOI: 10.1016/j.bcp.2017.04.030] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 04/26/2017] [Indexed: 01/10/2023]
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106
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Epidemiology of acne vulgaris in adolescent male students in Arar, Kingdom of Saudi Arabia. J Egypt Public Health Assoc 2017; 91:144-149. [PMID: 27749646 DOI: 10.1097/01.epx.0000492401.39250.62] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Acne vulgaris is the most common cutaneous disorder affecting adolescents and young adults. Small, noninflamed acne lesions may not be more than a slight nuisance, but, in individuals with more severe inflammatory disease, pain, social embarrassment, and both physical and psychological scarring can be life altering. Despite its high prevalence, no previous community-based studies have been conducted in Arar, northern border of Kingdom of Saudi Arabia, addressing this issue. OBJECTIVES The aim of this study was to estimate the prevalence of acne vulgaris, to describe the sociodemographic characteristics of cases, and to determine the aggravating factors and the psychological impact of acne vulgaris in a representative sample of secondary school male students in Arar city, Kingdom of Saudi Arabia. PATIENTS AND METHODS This was a cross-sectional study. A multistage systematic random sampling technique was followed. A total of 400 male students during the academic year 2015-2016 were included in the study. Data were collected by means of personal interview and filling-in a questionnaire. RESULTS The overall prevalence of acne vulgaris was 53.5%. The mean age of onset was 15.0±1.2 years. Positive family history of acne vulgaris was found in 46.7% of cases. The skin was greasy in 61.7% of cases. Acne site was the face in 67.3%, the back in 4.7%, and both in 28% of the cases. More than half (54.2%) of the cases had first-degree acne. Students mentioned several factors affecting the appearance of acne; 59.8% of cases reported a relation of increased acne appearance with the cleanliness of the skin, 35.5% reported relation with consumption of fatty meals, 24.2% with eating chocolate, 23.3% with consumption of spicy food, 12.1% with excess intake of cola drinks, 31.8% with heavy smoking, and 60.7% reported increased acne appearance in summer months. CONCLUSION AND RECOMMENDATIONS Acne was highly prevalent among secondary school male students in Arar city, Kingdom of Saudi Arabia. Several risk factors increased the appearance of acne, including, skin cleanliness, certain diets, and smoking. There was clear seasonal variation, with a higher prevalence mainly in summer. Therefore, community-based multiple strategies are required to combat with increasing rate of acne vulgaris and its subsequent complications among adolescents in Arar city and to educate them about its causes and the risk factors for its development.
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107
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Le Moigne M, Bulteau S, Grall-Bronnec M, Gerardin M, Fournier JP, Jonville-Bera AP, Jolliet P, Dreno B, Victorri-Vigneau C. Psychiatric disorders, acne and systemic retinoids: comparison of risks. Expert Opin Drug Saf 2017; 16:989-995. [PMID: 28657366 DOI: 10.1080/14740338.2017.1344641] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND The link between isotretinoin, treatment of a severe form of acne, and psychiatric disorders remains controversial, as acne itself could explain the occurrence of psychiatric disorders. This study aims at assessing the disproportionality of psychiatric adverse events reported with isotretinoin in the French National PharmacoVigilance Database, compared with other systemic acne treatments and systemic retinoids. MATERIALS AND METHODS Data were extracted from the French National PharmacoVigilance Database for systemic acne treatments, systemic retinoids and drugs used as comparators. Each report was subjected to double-blind analysis by two psychiatric experts. A disproportionality analysis was performed, calculating the number of psychiatric ADRs divided by the total number of notifications for each drug of interest. RESULTS Concerning acne systemic treatments: all 71 reports of severe psychiatric disorders involved isotretinoin, the highest proportion of mild/moderate psychiatric adverse events was reported with isotretinoin (14.1%). Among systemic retinoids, the highest proportion of severe and mild/moderate psychiatric events occurred with isotretinoin and alitretinoin. CONCLUSION Our study raises the hypothesis that psychiatric disorders associated with isotretinoin are related to a class effect of retinoids, as a signal emerges for alitretinoin. Complementary studies are necessary to estimate the risk and further determine at-risk populations.
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Affiliation(s)
- M Le Moigne
- a Dermato-Oncology Unit , University Hospital Hôtel-Dieu , Nantes , France
| | - S Bulteau
- b Addictology and Psychiatry Department , 'Behavioral Addictions/Complex Affective Disorders' Clinical Investigation Unit , Nantes , France
| | - Marie Grall-Bronnec
- b Addictology and Psychiatry Department , 'Behavioral Addictions/Complex Affective Disorders' Clinical Investigation Unit , Nantes , France.,c INSERM UMR 1246 , University of Nantes and Tours , Nantes et Tours , France
| | - M Gerardin
- d Clinical Pharmacology Department , CEIP, University Hospital Hôtel-Dieu , Nantes , France
| | | | - A P Jonville-Bera
- c INSERM UMR 1246 , University of Nantes and Tours , Nantes et Tours , France.,f Regional Pharmacovigilance Center, Department of Clinical Pharmacology , University Hospital of Tours , Tours , France
| | - Pascale Jolliet
- c INSERM UMR 1246 , University of Nantes and Tours , Nantes et Tours , France.,d Clinical Pharmacology Department , CEIP, University Hospital Hôtel-Dieu , Nantes , France
| | - Brigitte Dreno
- a Dermato-Oncology Unit , University Hospital Hôtel-Dieu , Nantes , France
| | - C Victorri-Vigneau
- c INSERM UMR 1246 , University of Nantes and Tours , Nantes et Tours , France.,d Clinical Pharmacology Department , CEIP, University Hospital Hôtel-Dieu , Nantes , France
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108
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The use of complementary medicine among acne valguris patients: Cross sectional study. JOURNAL OF DERMATOLOGY & DERMATOLOGIC SURGERY 2017. [DOI: 10.1016/j.jdds.2017.06.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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109
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Burris J, Rietkerk W, Shikany JM, Woolf K. Differences in Dietary Glycemic Load and Hormones in New York City Adults with No and Moderate/Severe Acne. J Acad Nutr Diet 2017; 117:1375-1383. [PMID: 28606553 DOI: 10.1016/j.jand.2017.03.024] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Accepted: 03/27/2017] [Indexed: 11/26/2022]
Abstract
BACKGROUND Glycemic index (GI) and glycemic load (GL) may be implicated in acne pathogenesis. OBJECTIVE This cross-sectional study examined differences between GI/GL and biological factors associated with acne among adults with and without moderate/severe acne. Secondary objectives included examining differences between food-aggravated acne beliefs and acne-specific quality of life among adults with and without moderate/severe acne. DESIGN As part of a cross-sectional study, participants completed a 5-day food record; blood draw to measure biological factors associated with acne (ie, glucose, insulin, insulin-like growth factor-1, insulin-like growth factor binding protein-3, and sex hormone-binding globulin concentrations); body composition assessment; and questionnaire to evaluate food-aggravated acne beliefs and acne-specific quality of life. Food records were analyzed using Nutrition Data Services for Research. PARTICIPANTS Sixty-four participants (no acne, n=32; moderate/severe acne, n=32) from New York City, NY, were included in this study. STATISTICAL ANALYSIS Independent sample t tests and Mann-Whitney tests examined differences in anthropometric measurements, dietary intakes, biological factors associated with acne, insulin resistance, and acne-specific quality of life between acne groups. A χ2 test for independence assessed differences in food-aggravated acne beliefs between acne groups. RESULTS Participants with moderate/severe acne consumed greater total carbohydrate (P=0.003), available carbohydrate (P<0.001), percent energy from carbohydrate (P<0.001), and GL (P<0.001) compared to participants without acne. Participants with moderate/severe acne had greater insulin (P=0.002) and insulin-like growth factor-1 (P=0.009) concentrations, greater insulin resistance (P=0.001), and lower sex hormone-binding globulin (P=0.015) concentrations compared to participants without acne. Although there were no differences between groups, 61% of participants reported food-influenced acne. Participants with moderate/severe acne reported a lower quality of life compared to participants without acne (P<0.001). CONCLUSIONS The results from this cross-sectional study suggest a relationship between dietary carbohydrate, including GL, and acne. Future research is necessary to determine the effect of medical nutrition therapy on biological factors associated with acne and acne severity.
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Abstract
BACKGROUND Acne vulgaris is a chronic dermatologic complaint with a multifactorial cause. Traditionally, antibiotics and retinoids have been used to manage the condition; patient compliance has been an ongoing issue. A variety of energy-based devices have been reported to be effective in the treatment of acne vulgaris. OBJECTIVE To review and summarize the current literature specific to treatment of acne vulgaris with energy-based devices. METHODS A review of the current literature of energy-based devices used for the treatment of acne vulgaris. RESULTS AND CONCLUSIONS Although limited randomized controlled trials for the treatment of acne have been performed, significant clinical improvement of acne vulgaris, especially of inflammatory lesions, has been demonstrated with a variety of energy-based devices. Newer approaches may lead to even better results.
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112
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McGoldrick RB, Theodorakopoulou E, Azzopardi EA, Murison M. Lasers and ancillary treatments for scar management Part 2: Keloid, hypertrophic, pigmented and acne scars. Scars Burn Heal 2017; 3:2059513116689805. [PMID: 29799579 PMCID: PMC5965340 DOI: 10.1177/2059513116689805] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
The formation of a wide range of excessive scars following various skin injuries is a natural consequence of healing. Scars resulting from surgery or trauma affect approximately 100 million people per annum in the developed world and can have profound physical, aesthetic, psychological and social consequences. Thus, scar treatment is a priority for patient and physician alike. Laser treatment plays an important role in scar management with additional support from ancillary modalities. Subsequent to part 1: Burns scars, part 2 focuses on our strategies and literature review of treatment of keloid, hypertrophic, pigmented and acne scars where lasers are used in conjunction with other measures, and illustrated with case studies.
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Affiliation(s)
- Rory Boyd McGoldrick
- Welsh Regional Burns, Plastic, Reconstructive Surgery and Laser Unit, Morriston Hospital, Swansea, Wales, UK
| | - Evgenia Theodorakopoulou
- Welsh Regional Burns, Plastic, Reconstructive Surgery and Laser Unit, Morriston Hospital, Swansea, Wales, UK
| | | | - Maxwell Murison
- Welsh Regional Burns, Plastic, Reconstructive Surgery and Laser Unit, Morriston Hospital, Swansea, Wales, UK
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113
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Pashinjan AG, Shahnovich AA. Topical antibacterial medications for therapy of patient with acne. VESTNIK DERMATOLOGII I VENEROLOGII 2017. [DOI: 10.25208/0042-4609-2017-93-1-64-67] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Problems of acne pathogenesis are reviewed. Efficacy evaluation and safety use of 1% clindamycin solution at patient with acne are demonstrated.
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114
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Szabó K, Erdei L, Bolla BS, Tax G, Bíró T, Kemény L. Factors shaping the composition of the cutaneous microbiota. Br J Dermatol 2017; 176:344-351. [PMID: 27518483 DOI: 10.1111/bjd.14967] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/03/2016] [Indexed: 12/12/2022]
Abstract
From birth, we are constantly exposed to bacteria, fungi and viruses, some of which are capable of transiently or permanently inhabiting our different body parts as our microbiota. The majority of our microbial interactions occur during and after birth, and several different factors, including age, sex, genetic constitution, environmental conditions and lifestyle, have been suggested to shape the composition of this microbial community. Propionibacterium acnes is one of the most dominant lipophilic microbes of the postadolescent, sebum-rich human skin regions. Currently, the role of this bacterium in the pathogenesis of the most common inflammatory skin disease, acne vulgaris, is a topic of intense scientific debate. Recent results suggest that Westernization strongly increases the dominance of the Propionibacterium genus in human skin compared with natural populations living more traditional lifestyles. According to the disappearing microbiota hypothesis proposed by Martin Blaser, such alterations in the composition of our microbiota are the possible consequences of socioeconomic and lifestyle changes occurring after the industrial revolution. Evanescence of species that are important elements of the human ecosystem might lead to the overgrowth and subsequent dominance of others because of the lack of ecological competition. Such changes can disturb the fine-tuned balance of the human body and, accordingly, our microbes developed through a long co-evolutionary process. These processes might lead to the transformation of a seemingly harmless species into an opportunistic pathogen through bacterial dysbiosis. This might have happened in the case of P. acnes in acne pathogenesis.
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Affiliation(s)
- K Szabó
- MTA-SZTE Dermatological Research Group, Szeged, Hungary
| | - L Erdei
- Department of Dermatology and Allergology, University of Szeged, Szeged, Hungary
| | - B Sz Bolla
- Department of Dermatology and Allergology, University of Szeged, Szeged, Hungary
| | - G Tax
- Department of Dermatology and Allergology, University of Szeged, Szeged, Hungary
| | - T Bíró
- DE-MTA 'Lendület' Cellular Physiology Research Group, Departments of Physiology and Immunology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - L Kemény
- MTA-SZTE Dermatological Research Group, Szeged, Hungary.,Department of Dermatology and Allergology, University of Szeged, Szeged, Hungary
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Survivin as a Novel Biomarker in the Pathogenesis of Acne Vulgaris and Its Correlation to Insulin-Like Growth Factor-I. DISEASE MARKERS 2016; 2016:7040312. [PMID: 27803511 PMCID: PMC5075610 DOI: 10.1155/2016/7040312] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Revised: 09/01/2016] [Accepted: 09/07/2016] [Indexed: 01/10/2023]
Abstract
Survivin, a member of the inhibitor of apoptosis protein family, has an important role in cell cycle regulation. Insulin-like growth factor-I (IGF-I) is a polypeptide hormone with wide range of biologic effects including stimulation of lipogenesis in sebaceous glands. Their overexpression in some fibrotic disorders suggests a possible implication of both IGF-I and survivin in the pathogenesis of acne and/or acne scars. The current study aimed to assess and correlate serum levels of IGF-I and survivin in patients with active acne vulgaris and postinflammatory acne scars and to evaluate their lesional expressions in comparison to healthy controls. Serum IGF-I and survivin were estimated using commercially available ELISA kits and their tissues expressions were investigated using Western blotting. Our findings suggest that IGF-I and survivin could play potential roles in the pathogenesis of active acne vulgaris and more importantly in postinflammatory acne scars with significant positive correlation coefficient between serum levels of IGF-I and survivin which support IGF-I-/PI3K-/AKT-mediated downregulation of nuclear expression of FoxO transcription factors resulting in enhanced survivin expression.
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116
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Campbell CE, Strassmann BI. The blemishes of modern society? Acne prevalence in the Dogon of Mali. Evol Med Public Health 2016; 2016:325-337. [PMID: 27651516 PMCID: PMC5046992 DOI: 10.1093/emph/eow027] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Non-communicable diseases may reflect an evolutionary mismatch between our human ancestry and modern environments. To explore the mismatch hypothesis for Acne vulgaris, we studied the prevalence and severity of acne in Dogon adolescents in Mali, West Africa. METHODOLOGY We graded the prevalence and severity of acne in 1182 Dogon adolescents aged 11-18 years from nine villages using facial photos taken as part of a prospective cohort study. Eighty-nine (89%) of the individuals in the cohort migrated to the city during adolescence, enabling us to assess the effect of urban migration. Using multivariable logistic regression, we estimated the effect of predictor variables on the presence of acne. RESULTS The prevalence of acne in the cohort was 28%, with 90% of cases being mild or very mild. Thus, the prevalence and severity of acne was much lower than for adolescents in high-income countries. Controlling for age, puberty, and body mass index (BMI), the odds of boys developing acne was 85% lower in the city than in the villages (P = 0.002). CONCLUSION AND IMPLICATIONS Acne is similar to the 'diseases of civilization' in being promoted by the pro-inflammatory properties of modern diets. The low prevalence and severity of acne in the Dogon supports the mismatch hypothesis and suggests that acne should join the list of diseases of modern lifestyles. However, we also observed an unexpected decrease in acne in urban boys. Future research is needed for a deeper mechanistic understanding of the interplay between diet, inflammation, immune function and other environmental exposures that differ between urban and rural environments.
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Affiliation(s)
- Christine E Campbell
- Department of Anthropology & Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Beverly I Strassmann
- Department of Anthropology & Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
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Ramrakha S, Fergusson DM, Horwood LJ, Dalgard F, Ambler A, Kokaua J, Milne BJ, Poulton R. Cumulative mental health consequences of acne: 23-year follow-up in a general population birth cohort study. Br J Dermatol 2016; 175:1079-1081. [PMID: 25819106 DOI: 10.1111/bjd.13786] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- S Ramrakha
- Dunedin Multidisciplinary Health and Development Unit, Department of Psychology, University of Otago, Otago, New Zealand.
| | - D M Fergusson
- Christchurch Health and Development Study, Department of Psychological Medicine, University of Otago, Otago, New Zealand
| | - L J Horwood
- Christchurch Health and Development Study, Department of Psychological Medicine, University of Otago, Otago, New Zealand
| | - F Dalgard
- Hospital Trust and Department of Dermatology, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Dunedin, New Zealand
| | - A Ambler
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Kings College London, London, U.K
| | - J Kokaua
- Pacific Division, Health Sciences, University of Otago, Otago, New Zealand
| | - B J Milne
- Centre of Methods and Policy Application in the Social Sciences, University of Auckland, Auckland, New Zealand
| | - R Poulton
- Dunedin Multidisciplinary Health and Development Unit, Department of Psychology, University of Otago, Otago, New Zealand
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118
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Prior JC. Adolescents’ Use of Combined Hormonal Contraceptives for Menstrual Cycle–Related Problem Treatment and Contraception: Evidence of Potential Lifelong Negative Reproductive and Bone Effects. ACTA ACUST UNITED AC 2016. [DOI: 10.1080/23293691.2016.1196080] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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119
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Lauermann FT, Almeida HLD, Duquia RP, Souza PRMD, Breunig JDA. Acne scars in 18-year-old male adolescents: a population-based study of prevalence and associated factors. An Bras Dermatol 2016; 91:291-5. [PMID: 27438194 PMCID: PMC4938271 DOI: 10.1590/abd1806-4841.20164405] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Accepted: 07/19/2015] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Acne vulgaris is a pilosebaceous follicle disorder affecting over 85% of adolescents to some degree. It frequently causes psychological distress that may persist into adulthood due to scarring. Little information about post-acne scarring epidemiology is available. OBJECTIVES To describe prevalence, distribution patterns and associated factors of acne scarring in young males, drawing on a representative population sample from a southern Brazilian city. METHODS A cross-sectional study was undertaken during presentation for military service, which is compulsory for all 18-year-old males. A questionnaire was applied, covering topics like diet, smoking habits, ethnicity, family structure, socio-economic level, as well as specific questions about active acne and resulting scars. Dermatologists conducted the clinical examination. RESULTS A total of 2,201 male adolescents were interviewed and examined. The overall prevalence of acne scarring was 22%. The malar region was the most frequently involved, present in 80% of affected individuals, followed by the frontal region (31.5%), back (17%), anterior chest (8.2%) and mentonian region (6.4%). Correlation between the intensity of clinical acne and the presence of scars was found, but no association was observed with educational level, smoking, ethnicity, obesity or socio-economic status. CONCLUSIONS There is a high prevalence of acne scars among this population. This is the first study to ascertain a correlation between acne scarring and factors such as socio-economic status and educational level. The direct relation between acne severity and scarring indicates that prompt and effective treatment is the best way to reduce scarring.
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Affiliation(s)
| | | | - Rodrigo Pereira Duquia
- Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) - Porto Alegre (RS), Brazil
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Yang Q, Huang W, Qian H, Chen S, Ma L, Lu Z. Efficacy and safety of 1550-nm fractional laser in the treatment of acne scars in Chinese patients: A split-face comparative study. J COSMET LASER THER 2016; 18:312-6. [DOI: 10.1080/14764172.2016.1188211] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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121
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Ozuguz P, Kacar SD, Asik G, Ozuguz U, Karatas S. Evaluation of leptin, adiponectin, and ghrelin levels in patients with acne vulgaris. Hum Exp Toxicol 2016; 36:3-7. [PMID: 26860691 DOI: 10.1177/0960327116630355] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
BACKGROUND The research evaluating adipokines are very few in patients with acne vulgaris. The hypothesis that hyperinsulinemic and high glycemic index diet plays a role in the pathogenesis of acne is still controversial. In this study, we aimed to evaluate adipokines such as leptin (L), adiponectin (A), ghrelin and A levels, and A/L rates that indicate insulin resistance in nonobese patients with severe acne vulgaris. MATERIAL AND METHOD Thirty patients who are nonobese with moderate acne vulgaris, aged 18 to 25 years, and 15 age-sex compatible controls were included in our study. The acne lesions were assessed using the Global Acne Grading Scale (GAGS). All participants were evaluated for the parameters that may affect the metabolism of serum L, A, and ghrelin levels in blood, and their body mass index were calculated. The significance level was determined as p ≤ 0.05. RESULTS Of the 30 patients, 17 were women and 13 were men. The mean age was 20.60 years and the mean duration of the disease were 2.8 years. All of patients had moderate acne vulgaris (GAGS 19-30). Of the 15 controls, 11 were women and 4 were men. The mean age was 21.20 years. There were not a statistically significant difference in L, ghrelin, A levels, and A/L ratio between the two groups. CONCLUSIONS Adipokines may have a role in the pathogenesis of acne vulgaris. L, A, ghrelin, and insulin resistance may not participate in the responsible mechanisms in nonobese patients with moderate acne vulgaris.
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Affiliation(s)
- P Ozuguz
- 1 Department of Dermatology, Faculty of Medicine, Afyon Kocatepe University, Afyon, Turkey
| | - S D Kacar
- 1 Department of Dermatology, Faculty of Medicine, Afyon Kocatepe University, Afyon, Turkey
| | - G Asik
- 2 Department of Microbiology, Faculty of Medicine, Afyon Kocatepe University, Afyon, Turkey
| | - U Ozuguz
- 3 Department of Endocrinology and Metabolism, Faculty of Medicine, Afyon Kocatepe University, Afyon, Turkey
| | - S Karatas
- 1 Department of Dermatology, Faculty of Medicine, Afyon Kocatepe University, Afyon, Turkey
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Lazic Mosler E, Leitner C, Gouda MA, Carter B, Layton AM, KhalafAllah MT. Topical antibiotics for acne. Hippokratia 2016. [DOI: 10.1002/14651858.cd012263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Elvira Lazic Mosler
- General Hospital "Dr. Ivo Pedišić"; Department for Dermatology and Venereology; J.J. Strossmayera 59 Sisak Croatia 44000
- University of Zagreb School of Medicine; Department of Anatomy; Zagreb Croatia
- Catholic University of Croatia; Zagreb Croatia
| | - Christina Leitner
- University Hospitals Coventry and Warwickshire NHS Trust; Department of Dermatology; Clifford Bridge Road Coventry UK
| | - Mohamed A Gouda
- Menoufia University; Faculty of Medicine; Shebin Al-Kom Menoufia Egypt
| | - Ben Carter
- Cardiff University School of Medicine; Institute of Primary Care & Public Health; 3rd Floor, Neuadd Meirionnydd, Heath Park Cardiff UK CF14 4YS
| | - Alison M Layton
- Harrogate and District NHS Foundation Trust; Department of Dermatology; Harrogate UK
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Al-Hammadi A, Al-Ismaily A, Al-Ali S, Ramadurai R, Jain R, McKinley-Grant L, Mughal TI. Topical, Biological and Clinical Challenges in the Management of Patients with Acne Vulgaris. Sultan Qaboos Univ Med J 2016; 16:e152-60. [PMID: 27226905 DOI: 10.18295/squmj.2016.16.02.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2014] [Revised: 07/02/2015] [Accepted: 01/18/2016] [Indexed: 11/16/2022] Open
Abstract
Acne vulgaris is one of the most common chronic inflammatory skin disorders among adolescents and young adults. It is associated with substantial morbidity and, rarely, with mortality. The exact worldwide incidence and prevalence are currently unknown. Current challenges involve improving understanding of the underlying pathophysiology of acne vulgaris and developing a practical treatment consensus. Expert panel discussions were held in 2013 and 2014 among a group of scientists and clinicians from the Omani and United Arab Emirate Dermatology Societies to ascertain the current optimal management of acne vulgaris, identify clinically relevant end-points and construct suitable methodology for future clinical trial designs. This article reviews the discussions of these sessions and recent literature on this topic.
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Affiliation(s)
- Anwar Al-Hammadi
- Department of Dermatology, Rashid Hospital, Dubai, United Arab Emirates
| | | | - Sameer Al-Ali
- Department of Dermatology, Abu Dhabi Dermatology Clinic, Abu Dhabi, United Arab Emirates
| | - Rajesh Ramadurai
- Department of Clinical & Medical Affairs, Glenmark Pharmaceuticals Private Ltd., Mumbai, India
| | - Rishi Jain
- Department of Clinical & Medical Affairs, Glenmark Pharmaceuticals Private Ltd., Mumbai, India
| | - Lynn McKinley-Grant
- Department of Dermatology, George Washington University Hospital, Washington D.C., USA
| | - Tariq I Mughal
- Department of Hematology & Oncology, Tufts University Medical Center, Boston, Massachusetts, USA
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Vilar GN, Santos LAD, Sobral Filho JF. Quality of life, self-esteem and psychosocial factors in adolescents with acne vulgaris. An Bras Dermatol 2016; 90:622-9. [PMID: 26560206 PMCID: PMC4631226 DOI: 10.1590/abd1806-4841.201533726] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2014] [Accepted: 09/19/2014] [Indexed: 11/22/2022] Open
Abstract
Background Dermatological diseases, among which acne vulgaris, have psychological impact on
the affected generating feelings of guilt, shame and social isolation. Objectives To compare quality of life, self-esteem and other psychosocial variables amongst
adolescents with and without acne vulgaris, and between levels of severity. Methods Cross-sectional observational study in a sample of 355 high school students from
the city of João Pessoa. Data collection was performed with questionnaires and
clinical-dermatological evaluation. The primary variables were the incidence of
AV; quality of life, set by the Children's Dermatology Quality of Life Index and
Dermatology Quality of Life Index; and self-esteem, measured by the Rosenberg
Self-Esteem Scale. For calculation of statistical tests, we used the SPSS 20.0
software, considering p=0.05. Results The sample, with an average age of 16, showed 89.3% prevalence of acne vulgaris.
The most prevalent psychosocial issue was "afraid that acne will never cease",
present in 58% of affected youth. The median score of Quality of Life in
Children's Dermatology Index was different amongst students with and without acne
vulgaris (p=0.003), as well as the Quality of Life in Dermatology (p=0.038)
scores, so that students with acne vulgaris have worse QoL. There was a
correlation between the severity of acne vulgaris and worse quality of life.
Self-esteem was not significantly associated with the occurrence or severity of
acne vulgaris. Conclusions acne vulgaris assumes significance in view of its high prevalence and the effect
on quality of life of adolescents, more severe at the more pronounced stages of
disease (p<0.001). The psychosocial impact of acne vulgaris should be valued in
the management of patients with this condition.
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Kang D, Shi B, Erfe MC, Craft N, Li H. Vitamin B12 modulates the transcriptome of the skin microbiota in acne pathogenesis. Sci Transl Med 2016; 7:293ra103. [PMID: 26109103 DOI: 10.1126/scitranslmed.aab2009] [Citation(s) in RCA: 92] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Various diseases have been linked to the human microbiota, but the underlying molecular mechanisms of the microbiota in disease pathogenesis are often poorly understood. Using acne as a disease model, we aimed to understand the molecular response of the skin microbiota to host metabolite signaling in disease pathogenesis. Metatranscriptomic analysis revealed that the transcriptional profiles of the skin microbiota separated acne patients from healthy individuals. The vitamin B12 biosynthesis pathway in the skin bacterium Propionibacterium acnes was significantly down-regulated in acne patients. We hypothesized that host vitamin B12 modulates the activities of the skin microbiota and contributes to acne pathogenesis. To test this hypothesis, we analyzed the skin microbiota in healthy subjects supplemented with vitamin B12. We found that the supplementation repressed the expression of vitamin B12 biosynthesis genes in P. acnes and altered the transcriptome of the skin microbiota. One of the 10 subjects studied developed acne 1 week after vitamin B12 supplementation. To further understand the molecular mechanism, we revealed that vitamin B12 supplementation in P. acnes cultures promoted the production of porphyrins, which have been shown to induce inflammation in acne. Our findings suggest a new bacterial pathogenesis pathway in acne and provide one molecular explanation for the long-standing clinical observation that vitamin B12 supplementation leads to acne development in a subset of individuals. Our study discovered that vitamin B12, an essential nutrient in humans, modulates the transcriptional activities of skin bacteria, and provided evidence that metabolite-mediated interactions between the host and the skin microbiota play essential roles in disease development.
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Affiliation(s)
- Dezhi Kang
- Department of Molecular and Medical Pharmacology, Crump Institute for Molecular Imaging, David Geffen School of Medicine, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, USA
| | - Baochen Shi
- Department of Molecular and Medical Pharmacology, Crump Institute for Molecular Imaging, David Geffen School of Medicine, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, USA
| | - Marie C Erfe
- Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA 90502, USA
| | - Noah Craft
- Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA 90502, USA
| | - Huiying Li
- Department of Molecular and Medical Pharmacology, Crump Institute for Molecular Imaging, David Geffen School of Medicine, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, USA. UCLA-Department of Energy (DOE) Institute for Genomics and Proteomics, Los Angeles, CA 90095, USA.
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Zouboulis CC, Bettoli V. Management of severe acne. Br J Dermatol 2016; 172 Suppl 1:27-36. [PMID: 25597508 DOI: 10.1111/bjd.13639] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/13/2014] [Indexed: 12/28/2022]
Abstract
Acne is the most common skin disease, affecting up to 95% of adolescents. Severe episodes of acne can cause considerable physical and psychological scarring, and overexpression of transforming growth factor-β can lead to formation of hypertrophic scars and keloids. The severity of acne in adolescence is associated with a positive history of severe acne in first-degree relatives, especially the mother. In most cases acne is a chronic disease, and it is often a component of systemic diseases or syndromes. All forms of severe acne require systemic treatment. The available options include oral antibiotics, hormonal antiandrogens for female patients and oral isotretinoin, as well as other combination treatments. Oral isotretinoin is the only drug available that affects all four pathogenic factors of acne. However, due to possible serious side-effects, a European directive states that oral isotretinoin should be used only as a second-line therapy in cases of severe, nodular and conglobate acne. The pharmaceutical quality of generic isotretinoin products and the obtainability of isotretinoin through e-pharmacies without prescription raise new therapeutic problems. New anti-inflammatory compounds, such as the 5-lipoxygenase inhibitor zileuton, may replace systemic antibiotics in the future, especially under the scope of antibiotic resistance prevention. This review looks into the various options and latest approaches, and factors to consider, when combating severe acne.
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Affiliation(s)
- C C Zouboulis
- Departments of Dermatology, Venereology, Allergology and Immunology, Dessau Medical Center, Auenweg 38, 06847, Dessau, Germany
| | - V Bettoli
- Department of Clinical and Experimental Medicine, Section of Dermatology, Azienda Ospedaliero-Universitaria di Ferrara, University of Ferrara, via Aldo Moro 8, Località Cona-44100, Ferrara, Italy
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Schaller M, Sebastian M, Ress C, Seidel D, Hennig M. A multicentre, randomized, single-blind, parallel-group study comparing the efficacy and tolerability of benzoyl peroxide 3%/clindamycin 1% with azelaic acid 20% in the topical treatment of mild-to-moderate acne vulgaris. J Eur Acad Dermatol Venereol 2016; 30:966-73. [PMID: 26915831 DOI: 10.1111/jdv.13541] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Accepted: 10/19/2015] [Indexed: 12/01/2022]
Abstract
BACKGROUND Mild-to-moderate acne vulgaris is treated with a range of mono- and combination therapies; however, clinical evidence is still required to optimize treatment recommendations. OBJECTIVE To compare the efficacy, tolerability and safety of a combination of benzoyl peroxide 3% and clindamycin 1% (BPO + CLN) with azelaic acid 20% (AzA) for the topical treatment of mild-to-moderate acne vulgaris. METHOD This was a randomized, assessor-blinded, parallel-group, multicentre study conducted in Germany. Patients with a confirmed diagnosis of acne vulgaris, aged 12-45 years, were randomized 1 : 1 to once-daily BPO + CLN gel or twice-daily AzA cream for up to 12 weeks. The primary endpoint was the percentage change in inflammatory lesions from baseline at Week 4. Secondary endpoints included total and inflammatory lesion counts and tolerability assessments. For selected secondary endpoints, inductive statistical analysis was performed post hoc. Patient safety was assessed by adverse event (AE) monitoring. RESULTS Efficacy was assessed in the modified intent-to-treat (mITT) population [patients using ≥1 dose of study medication (ITT), plus baseline and ≥1 post-baseline lesion count (n = 215)]. There was a statistically significant difference in the primary endpoint, with a median decrease of -52.6% for BPO + CLN (n = 107) vs.-38.8% for AzA (n = 108; P = 0.0004). There was also a greater difference in secondary lesion endpoints at Week 12, with a median decrease in inflammatory lesions of -78.8% and -65.3% and total lesions of -69.0% and -53.9% with BPO + CLN and AzA, respectively (both P < 0.0001). Tolerability was acceptable for both treatments. Overall, 55.6% (BPO + CLN) and 69.7% (AzA) of patients reported treatment-emergent AEs, and 15.7% and 35.8% of patients experienced application site reactions with BPO + CLN (24 events; 17 patients) and AzA (60 events; 39 patients) treatment, respectively (ITT population). CONCLUSION BPO + CLN demonstrated greater efficacy than AzA in the treatment of mild-to-moderate acne vulgaris and has a positive tolerability and safety profile.
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Affiliation(s)
- M Schaller
- Department of Dermatology, University of Tübingen, Tübingen, Germany
| | | | - C Ress
- GlaxoSmithKline Germany, Munich, Germany
| | - D Seidel
- GlaxoSmithKline Germany, Munich, Germany
| | - M Hennig
- GlaxoSmithKline Germany, Munich, Germany
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129
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Resistin gene polymorphisms are associated with acne and serum lipid levels, providing a potential nexus between lipid metabolism and inflammation. Arch Dermatol Res 2016; 308:229-37. [PMID: 26858108 DOI: 10.1007/s00403-016-1626-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Revised: 01/12/2016] [Accepted: 01/20/2016] [Indexed: 12/19/2022]
Abstract
Acne vu lgaris is a multifactorial inflammatory skin disease causing social stigma and psychological effect on patients. We hypothesized that the genes that can affect both lipid metabolism and inflammation may be central for acne formation and present targets for treatment. Pro-inflammatory adipokine resistin, one such likely target, activates NFkB and JNK pathways inducing TLR-2, IL-1, IL-6, and TNFα genes. The polymorphisms in promoter and intron region of the resistin gene affect its expression levels. Therefore, we explored the association of resistin polymorphisms (RETN +299G > A and -420C > G) with pathogenesis of acne vulgaris. We used PCR-RFLP method to genotype at the two single nucleotide polymorphisms at RETN promoter in 530 acne patients vs. 550 age- and sex-matched control subjects. We also measured serum lipid levels in acne patients and associated these with RETN genotypes. We found that the RETN gene polymorphisms are strongly associated with acne vulgaris and the severity of acne symptoms. In females the variant allele frequencies of both SNPs are statistically higher in patients than in controls; in males frequency distribution does not reach significance. The haplotype containing both variant alleles is significantly more common in patients than in controls. We find no association of RETN SNPs with the acne types. Importantly, we found that the levels of HDL-C were significantly decreased in variant genotype of RETN. Our results show that the RETN polymorphisms expected to boost resistin expression increase the risk of developing acne. We suggest that resistin may provide an attractive target for treatment.
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130
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Okoro EO, Bulus NG, Zouboulis CC. Study of Facial Sebum Levels and Follicular Red Fluorescence in Patients with Acne Vulgaris in Nigeria. Dermatology 2015; 232:156-61. [DOI: 10.1159/000439378] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Accepted: 08/13/2015] [Indexed: 11/19/2022] Open
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131
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Abstract
Acne vulgaris is a chronic inflammatory disease - rather than a natural part of the life cycle as colloquially viewed - of the pilosebaceous unit (comprising the hair follicle, hair shaft and sebaceous gland) and is among the most common dermatological conditions worldwide. Some of the key mechanisms involved in the development of acne include disturbed sebaceous gland activity associated with hyperseborrhoea (that is, increased sebum production) and alterations in sebum fatty acid composition, dysregulation of the hormone microenvironment, interaction with neuropeptides, follicular hyperkeratinization, induction of inflammation and dysfunction of the innate and adaptive immunity. Grading of acne involves lesion counting and photographic methods. However, there is a lack of consensus on the exact grading criteria, which hampers the conduction and comparison of randomized controlled clinical trials evaluating treatments. Prevention of acne relies on the successful management of modifiable risk factors, such as underlying systemic diseases and lifestyle factors. Several treatments are available, but guidelines suffer from a lack of data to make evidence-based recommendations. In addition, the complex combination treatment regimens required to target different aspects of acne pathophysiology lead to poor adherence, which undermines treatment success. Acne commonly causes scarring and reduces the quality of life of patients. New treatment options with a shift towards targeting the early processes involved in acne development instead of suppressing the effects of end products will enhance our ability to improve the outcomes for patients with acne.
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132
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Park SY, Park MY, Suh DH, Kwon HH, Min S, Lee SJ, Lee WJ, Lee MW, Ahn HH, Kang H, Lee JB, Ro YS, Ahn KJ, Kim MN, Kim KJ, Kim NI. Cross-sectional survey of awareness and behavioral pattern regarding acne and acne scar based on smartphone application. Int J Dermatol 2015; 55:645-52. [PMID: 26340516 DOI: 10.1111/ijd.12853] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2014] [Revised: 08/06/2014] [Accepted: 09/08/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND Although acne scar is a permanent sequela that may be induced by improper management of active acne lesion, patient behavior patterns and awareness regarding acne are unclear. The aim of this study was to identify awareness and behavioral patterns concerning acne and acne scar of people having acne and differences between those with and without acne scars. METHODS The survey was performed via smartphone application for 900 participants in their second to fourth decade having current or previous acne lesions. They were further categorized into two groups based on the presence of acne scar (scar and scarless groups) with no statistical difference in demographic composition. RESULTS The mean age of all participants was 24.6 ± 5.3. The scar group had a longer disease duration (4.9 years) than those of the scarless group (2.2 years). Participants in the scar group thought that acne scarring affected psychosocial aspects more negatively compared with those in the scarless group. Participants in the scarless group visited dermatology clinics earlier than those in the scar group. In the scar group, 62.1% of participants have never had their acne scars treated medically. Most (88.6%) participants from both groups believed that non-dermatologic treatment caused side effects or aggravated their acne. CONCLUSIONS Participants with acne scars tended to treat their acne and acne scars improperly, which could negatively affect their daily lives. Acne scars are sequelae of acne and should be regarded as a distinct disease entity, requiring a patient's early visit to dermatologic clinics.
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Affiliation(s)
- Seon Yong Park
- Department of Dermatology, Seoul National University College of Medicine, Seoul, South Korea.,Acne and Rosacea Research Laboratory, Seoul National University Hospital, Seoul, South Korea
| | - Mi Youn Park
- Department of Dermatology, National Medical Center, Seoul, South Korea
| | - Dae Hun Suh
- Department of Dermatology, Seoul National University College of Medicine, Seoul, South Korea.,Acne and Rosacea Research Laboratory, Seoul National University Hospital, Seoul, South Korea
| | - Hyuck Hoon Kwon
- Department of Dermatology, Seoul National University College of Medicine, Seoul, South Korea.,Acne and Rosacea Research Laboratory, Seoul National University Hospital, Seoul, South Korea
| | - Seonguk Min
- Department of Dermatology, Seoul National University College of Medicine, Seoul, South Korea.,Acne and Rosacea Research Laboratory, Seoul National University Hospital, Seoul, South Korea
| | - Sang Joo Lee
- Yeonsei Star Skin and Laser Clinic, Seoul, South Korea
| | - Weon Ju Lee
- Department of Dermatology, Kyungpook National University School of Medicine, Daegu, South Korea
| | - Mi Woo Lee
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Hyo Hyun Ahn
- Department of Dermatology, College of Medicine, Korea University, Seoul, South Korea
| | - Hoon Kang
- Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Jee Bum Lee
- Department of Dermatology, Chonnam National University Medical School, Gwangju, South Korea
| | - Young Suck Ro
- Department of Dermatology, Hanyang University College of Medicine, Seoul, South Korea
| | - Kyu Joong Ahn
- Department of Dermatology, School of Medicine, Konkuk University, Seoul, South Korea
| | - Myeung Nam Kim
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, South Korea
| | - Kwang Joong Kim
- Department of Dermatology, College of Medicine, Hallym University, Anyang, South Korea
| | - Nack In Kim
- Department of Dermatology, Kyung Hee University School of Medicine, Seoul, South Korea
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Abstract
The review covers current concepts of the pathogenesis of acne. It presents the data of international and Russian clinical studies conducted to assess the efficacy and safety of drugs comprising 15% azelaic acid and used for the treatment of acne. The authors describe mechanisms of the effect of azelaic acid on major stages of the pathogenesis of acne. They substantiate the need in basic care in the treatment of acne by the example of products of the JOYSKIN line. The authors discuss the effect of different components of skin care products on the acne-prone skin.
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134
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A Canadian study of the use of poly-L-lactic acid dermal implant for the treatment of hill and valley acne scarring. Dermatol Surg 2015; 41:587-94. [PMID: 25915626 DOI: 10.1097/dss.0000000000000366] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Hill and valley scarring is 1 of 3 atrophic scar types that occur as a result of acne, becoming more apparent with facial skin aging. Treatment includes resurfacing techniques and the use of injectable fillers. Poly-L-lactic acid is an injectable collagen builder that has been used for the treatment of HIV-associated lipodystrophy and cosmetic enhancement. OBJECTIVE To determine the degree of correction attainable with poly-L-lactic acid and safety findings for the treatment of hill and valley acne scarring. MATERIALS AND METHODS Poly-L-lactic acid was injected over 3 to 4 serial treatments at 4-week intervals in 22 subjects in this single-arm, unblinded, open-label Phase II study. Efficacy was determined by physician, blinded evaluator, and subject assessment of scar improvement using Likert scales, comparing photographs taken by 3 camera systems at treatment visits 2 to 4 and follow-up to baseline. Subjects also assessed treatment satisfaction. RESULTS Percentage of patients with much to excellent improvement using the most sensitive camera system (VISIA-CR) ranged from 45.5% to 68.2%. Subject treatment satisfaction scores increased by 44%. One patient experienced a palpable nonvisible nodule. No subjects discontinued treatment. CONCLUSION Injectable poly-L-lactic acid facilitated improvement in hill and valley acne scarring and was well tolerated.
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135
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Abstract
Acne vulgaris, an epidemic inflammatory skin disease of adolescence, is closely related to Western diet. Three major food classes that promote acne are: 1) hyperglycemic carbohydrates, 2) milk and dairy products, 3) saturated fats including trans-fats and deficient ω-3 polyunsaturated fatty acids (PUFAs). Diet-induced insulin/insulin-like growth factor (IGF-1)-signaling is superimposed on elevated IGF-1 levels during puberty, thereby unmasking the impact of aberrant nutrigenomics on sebaceous gland homeostasis. Western diet provides abundant branched-chain amino acids (BCAAs), glutamine, and palmitic acid. Insulin and IGF-1 suppress the activity of the metabolic transcription factor forkhead box O1 (FoxO1). Insulin, IGF-1, BCAAs, glutamine, and palmitate activate the nutrient-sensitive kinase mechanistic target of rapamycin complex 1 (mTORC1), the key regulator of anabolism and lipogenesis. FoxO1 is a negative coregulator of androgen receptor, peroxisome proliferator-activated receptor-γ (PPARγ), liver X receptor-α, and sterol response element binding protein-1c (SREBP-1c), crucial transcription factors of sebaceous lipogenesis. mTORC1 stimulates the expression of PPARγ and SREBP-1c, promoting sebum production. SREBP-1c upregulates stearoyl-CoA- and Δ6-desaturase, enhancing the proportion of monounsaturated fatty acids in sebum triglycerides. Diet-mediated aberrations in sebum quantity (hyperseborrhea) and composition (dysseborrhea) promote Propionibacterium acnes overgrowth and biofilm formation with overexpression of the virulence factor triglyceride lipase increasing follicular levels of free palmitate and oleate. Free palmitate functions as a "danger signal," stimulating toll-like receptor-2-mediated inflammasome activation with interleukin-1β release, Th17 differentiation, and interleukin-17-mediated keratinocyte proliferation. Oleate stimulates P. acnes adhesion, keratinocyte proliferation, and comedogenesis via interleukin-1α release. Thus, diet-induced metabolomic alterations promote the visible sebofollicular inflammasomopathy acne vulgaris. Nutrition therapy of acne has to increase FoxO1 and to attenuate mTORC1/SREBP-1c signaling. Patients should balance total calorie uptake and restrict refined carbohydrates, milk, dairy protein supplements, saturated fats, and trans-fats. A paleolithic-like diet enriched in vegetables and fish is recommended. Plant-derived mTORC1 inhibitors and ω-3-PUFAs are promising dietary supplements supporting nutrition therapy of acne vulgaris.
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Affiliation(s)
- Bodo C Melnik
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Germany
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136
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Ultrasonic delivery of silica–gold nanoshells for photothermolysis of sebaceous glands in humans: Nanotechnology from the bench to clinic. J Control Release 2015; 206:30-6. [DOI: 10.1016/j.jconrel.2015.03.004] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Revised: 02/05/2015] [Accepted: 03/01/2015] [Indexed: 11/21/2022]
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137
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L-Ascorbyl-2-phosphate attenuates NF-κB signaling in SZ95 sebocytes without affecting IL-6 and IL-8 secretion. Arch Dermatol Res 2015; 307:595-605. [PMID: 25894228 PMCID: PMC4540786 DOI: 10.1007/s00403-015-1565-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2014] [Revised: 03/31/2015] [Accepted: 04/11/2015] [Indexed: 12/03/2022]
Abstract
Acne is the most common inflammatory skin disease. Interleukin-1 (IL-1) is at the beginning of the cytokine signaling cascade and may be involved in the pathogenesis of this disorder. It activates redox-sensitive transcription factors, which induce IL-6 and IL-8 expression. Interestingly, l-ascorbyl-2-phosphate (APS) was shown to have beneficial effects in patients with acne vulgaris. The mechanism of action of this agent remains unknown. Here, we investigated if APS attenuates IL-1β- or TNF-α-mediated IL-6 and IL-8 expression in SZ95 sebocytes, whereas TNF-α was used as control. We also explored NF-κB activation which is known to orchestrate IL-1β- and TNF-α-mediated cytokine expression in many cell types. Both IL-1β and TNF-α increased IL-6 and IL-8 mRNA expression in SZ95 sebocytes. However, only IL-1β induced IL-6 and IL-8 secretion. IL-1β but not TNF-α activated NF-κB canonical signaling as demonstrated by Iκ-Bα phosphorylation and degradation as well as by nuclear accumulation of NF-κB/p65. Concomitant treatment of SZ95 sebocytes with APS attenuated the effect of IL-1β and TNF-α on IL-6 and IL-8 gene expression as well as on IL-1β-mediated NF-κB signaling. In contrast, APS failed to reduce IL-1β-mediated IL-6 and IL-8 secretion, presumably by maintained IL-1β-mediated p38 activation, which is known to control IL-8 secretion. Our findings shed light into the impact of IL-1β on the inflammatory cytokine response and its molecular mechanisms in human sebocytes. Our data further suggest that the beneficial effect of APS in acne patients involves attenuation of NF-κB signaling but not reduction of IL-6 or IL-8 secretion.
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138
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Chen YC, Tsai PJ, Huang YB, Wu PC. Optimization and validation of high-performance chromatographic condition for simultaneous determination of adapalene and benzoyl peroxide by response surface methodology. PLoS One 2015; 10:e0120171. [PMID: 25793581 PMCID: PMC4368549 DOI: 10.1371/journal.pone.0120171] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Accepted: 01/26/2015] [Indexed: 11/23/2022] Open
Abstract
The aim of this study was to develop a simple and reliable high-performance chromatographic (HPLC) method for simultaneous analysis of adapalene and benzoyl peroxide in pharmaceutical formulation by response surface methodology (RSM). An optimized mobile phase composed of acetonitrile, tetrahydrofuran and water containing 0.1% acetic acid at a ratio of 25:50:25 by volume was successfully predicted by using RSM. An isocratic separation was achieved by using the condition. Furthermore, the analytical method was validated in terms of specificity, linearity, accuracy and precision in a range of 80% to 120% of the expected concentration. Finally, the method was successfully applied to the analysis of a commercial product.
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Affiliation(s)
- Yi-Cheng Chen
- School of Pharmacy, College of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan, Republic of China
| | - Pi-Ju Tsai
- Department of Business Administration, I-Shou University, Kaohsiung, Taiwan, Republic of China
| | - Yaw-Bin Huang
- School of Pharmacy, College of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan, Republic of China
| | - Pao-Chu Wu
- School of Pharmacy, College of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan, Republic of China
- * E-mail:
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139
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Tan J, Frey MP, Knezevic S, Poulin Y, Lynde CW, Gulliver WP, Gupta AK, Sebaldt RJ, Thomas DR, Sapra S. The Relationship Between Dermatologist- and Patient-Reported Acne Severity Measures and Treatment Recommendations. J Cutan Med Surg 2015; 19:464-9. [DOI: 10.1177/1203475415576464] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: Acne treatment recommendations for individual patients may be derived from multiple factors including dermatologist- and patient-reported constructs. Objectives: To evaluate the effects of dermatologist- and patient-reported measures on acne treatment recommendations by dermatologists. Methods: An observational cross-sectional survey of acne patients was conducted with patient-reported quality of life and dermatologist-reported measures of primary and secondary (scar) acne severity using 3 assessment approaches: maximal regional grade, total grade, and facial grade. Results: The most highly associated factors with acne treatment recommendations were patient emotions, maximal regional acne severity, and total acne scar grade. Better acne-specific quality of life was negatively related to acne treatment recommendation intensity, while all 3 grading approaches were positively related to acne treatment recommendations. Conclusions: For dermatologists, overall acne severity is most highly associated with maximal regional acne grade, total scar grade, and patient’s emotional response to acne.
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Affiliation(s)
- Jerry Tan
- Department of Medicine, University of Western Ontario, London, ON, Canada
| | - Marc P. Frey
- Department of Psychology, University of Windsor, Windsor, ON, Canada
| | - Sanja Knezevic
- Department of Medicine, University of Western Ontario, London, ON, Canada
| | - Yves Poulin
- Hôpital Hôtel-Dieu de Québec and Centre de Recherche Dermatologique du Québec métropolitain, Quebec City, QC, Canada
| | | | - Wayne P. Gulliver
- Faculty of Medicine, Memorial University of Newfoundland, St. John’s, NF, Canada
| | - Aditya K. Gupta
- Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Rolf J. Sebaldt
- Department of Medicine and Department of Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, ON, Canada
| | - David R. Thomas
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, BC, Canada
| | - Sheetal Sapra
- Institute of Cosmetic and Laser Surgery, Oakville, ON, Canada
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140
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Karciauskiene J, Valiukeviciene S, Stang A, Gollnick H. Beliefs, perceptions, and treatment modalities of acne among schoolchildren in Lithuania: A cross-sectional study. Int J Dermatol 2015; 54:e70-8. [DOI: 10.1111/ijd.12753] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
- Jurgita Karciauskiene
- Department of Skin and Venereal Diseases; Lithuanian University of Health Sciences; Kaunas Lithuania
| | - Skaidra Valiukeviciene
- Department of Skin and Venereal Diseases; Lithuanian University of Health Sciences; Kaunas Lithuania
| | - Andreas Stang
- Institute of Clinical Epidemiology; Martin-Luther-University; Halle Germany
| | - Harald Gollnick
- Department of Dermatology and Venereology; Otto-von-Guericke-University; Magdeburg Germany
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141
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Wang H, Guo M, Shen S, He L, Zhang X, Zuo X, Yang S. Variants inSELL,MRPS36P2,TP63,DDB2,CACNA1H,ADAM19,GNAI1,CDH13andGABRG2interact to confer risk of acne in Chinese population. J Dermatol 2015; 42:378-81. [PMID: 25573302 DOI: 10.1111/1346-8138.12754] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2014] [Accepted: 11/18/2014] [Indexed: 12/18/2022]
Affiliation(s)
- HongYan Wang
- Institute of Dermatology and Department of Dermatology at No. 1 Hospital; Anhui Medical University; Hefei Anhui China
| | - MeiHua Guo
- Kunming Medical University; Kunming Yunnan China
| | - SongKe Shen
- Institute of Dermatology and Department of Dermatology at No. 1 Hospital; Anhui Medical University; Hefei Anhui China
| | - Li He
- Kunming Medical University; Kunming Yunnan China
| | - XueJun Zhang
- Institute of Dermatology and Department of Dermatology at No. 1 Hospital; Anhui Medical University; Hefei Anhui China
| | - XianBo Zuo
- Institute of Dermatology and Department of Dermatology at No. 1 Hospital; Anhui Medical University; Hefei Anhui China
| | - Sen Yang
- Institute of Dermatology and Department of Dermatology at No. 1 Hospital; Anhui Medical University; Hefei Anhui China
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142
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Comparative Effectiveness of Topical Drugs in Dermatologic Priority Diseases: Geometry of Randomized Trial Networks. J Invest Dermatol 2015; 135:76-83. [DOI: 10.1038/jid.2014.296] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Revised: 06/04/2014] [Accepted: 06/11/2014] [Indexed: 02/07/2023]
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143
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Bíró T. Human sebocytes: the new leptin connection? Br J Dermatol 2014; 171:1288. [PMID: 25523251 DOI: 10.1111/bjd.13397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- T Bíró
- DE-MTA 'Lendület' Cellular Physiology Research Group, Department of Physiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.
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144
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Wolkenstein P, Misery L, Amici JM, Maghia R, Branchoux S, Cazeau C, Voisard JJ, Taïeb C. Smoking and dietary factors associated with moderate-to-severe acne in French adolescents and young adults: results of a survey using a representative sample. Dermatology 2014; 230:34-9. [PMID: 25413494 DOI: 10.1159/000366195] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Accepted: 07/22/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Dietary factors and smoking play a role in acne. METHODS CSA Santé conducted a survey in France in 2012. Each individual answered a questionnaire to report acne, with associated epidemiological variables. Data on subjects between 15 and 24 years of age were extracted. The characteristics of subjects reporting acne were compared to subjects reporting no acne, using univariate and multivariate analysis. RESULTS The daily consumption of chocolate and sweets was independently and highly associated with acne, with an odds ratio of 2.38 (95% CI: 1.31-4.31). Smoking more than 10 cigarettes a day was highly associated with no acne, with an odds ratio of 0.44 (95% CI: 0.30-0.66). The regular use of cannabis was associated with acne, with an odds ratio of 2.88 (95% CI: 1.55-5.37). CONCLUSION Chocolate, sweets and cannabis smoking are associated with acne. We found tobacco to be protective. We failed to investigate the respective roles of sugar, lipids and milk.
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Affiliation(s)
- Pierre Wolkenstein
- Department of Dermatology, AP-HP, Henri Mondor Hospital, Université Paris-Est Créteil Val de Marne (UPEC), Créteil, France
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145
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Bowe W, Patel NB, Logan AC. Acne vulgaris, probiotics and the gut-brain-skin axis: from anecdote to translational medicine. Benef Microbes 2014; 5:185-99. [PMID: 23886975 DOI: 10.3920/bm2012.0060] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Acne vulgaris has long been postulated to feature a gastrointestinal mechanism, dating back 80 years to dermatologists John H. Stokes and Donald M. Pillsbury. They hypothesised that emotional states (e.g. depression and anxiety) could alter normal intestinal microbiota, increase intestinal permeability, and contribute to systemic inflammation. They were also among the first to propose the use of probiotic Lactobacillus acidophilus cultures. In recent years, aspects of this gut-brain-skin theory have been further validated via modern scientific investigations. It is evident that gut microbes and oral probiotics could be linked to the skin, and particularly acne severity, by their ability to influence systemic inflammation, oxidative stress, glycaemic control, tissue lipid content, and even mood. This intricate relationship between gut microbiota and the skin may also be influenced by diet, a current area of intense scrutiny by those who study acne. Here we provide a historical background to the gut-brain-skin theory in acne, followed by a summary of contemporary investigations and clinical implications.
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Affiliation(s)
- W Bowe
- Department of Dermatology, State University of New York Downstate Medical Center, 450 Clarkson Ave, Brooklyn, NY 11203, USA
| | - N B Patel
- New Jersey Medical School, University of Medicine and Dentistry of New Jersey, 150 Bergen Street, Newark, NJ 07103, USA
| | - A C Logan
- Genuine Health, 775 East Blithedale Avenue, Suite 364, Mill Valley, CA 94941, USA
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146
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Bagatin E, Timpano DL, Guadanhim LRDS, Nogueira VMA, Terzian LR, Steiner D, Florez M. Acne vulgaris: prevalence and clinical forms in adolescents from São Paulo, Brazil. An Bras Dermatol 2014; 89:428-35. [PMID: 24937816 PMCID: PMC4056700 DOI: 10.1590/abd1806-4841.20142100] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2012] [Accepted: 03/02/2013] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Acne is a common disease in adolescents, but there are no epidemiological
data for acne in Brazil. OBJECTIVES To estimate the prevalence and degree of acne in adolescents from Sao Paulo
and study socio-demographic factors, family history and lifestyle,
associated with the disease. METHODS Cross-sectional study with 452 adolescents aged between 10 and 17 (mean=13.3
years), students from elementary and high school, examined by 3 independent
evaluators. RESULTS 62.4% were female, 85.8% white and 6.4% were aged 14. The prevalence was
96.0% and increased with age - all students over 14 had acne. The most
prevalent form of acne was comedonal (61.1%), followed by mild (30.6%) and
moderate (7.6%) papular-pustular, which affected mostly the face (97.5%).
About half of the adolescents reported family history for acne in mother or
father, and 20.6% reported previous treatment for acne. There was a higher
chance of presenting non-comedonal acne with increased age (p<0.001). DISCUSSION The prevalence of acne in adolescents varies widely due to the clinical
features and diagnostic methods used. Adolescents whose brothers/sisters had
acne (OR=1.7-p=0.027) and those over 13 (OR=8.3-p<0.001), were more
likely to have non-comedonal acne. CONCLUSION This study showed high prevalence of acne in adolescents from Sao Paulo,
predominantly the comedonal form on the face, with a higher chance of
presenting non-comedonal acne with increased age.
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Affiliation(s)
| | | | | | | | | | - Denise Steiner
- Universidade de Mogi das Cruzes, Mogi das Cruzes, SP, Brazil
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147
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Lu PH, Hsu CH. Body mass index is negatively associated with acne lesion counts in Taiwanese women with post-adolescent acne. J Eur Acad Dermatol Venereol 2014; 29:2046-50. [PMID: 25266447 DOI: 10.1111/jdv.12754] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2014] [Accepted: 08/18/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND Acne in adult women tends to be chronic, refractory to treatment and associated with psychosocial problems. Body mass index (BMI) has been reported to be a risk factor for acne in school children and adolescents, but not in adult women. OBJECTIVES The aim of this study was to demonstrate the relationship between BMI and acne lesion counts in women with post-adolescent acne. METHODS Hundred and four women between 25 and 45 years of age, with moderate or severe acne vulgaris were enrolled in this study. The main outcome evaluated was the number of acne lesions, which were then assessed using multiple linear regression analysis. RESULTS The coefficients of multiple regression analysis with stepwise model showed that BMI (β = -0.36; p = 0.001) and family history (β = 0.21; p = 0.04) were the main predictors of the number of acne lesions. CONCLUSION Initial findings indicate that BMI is negatively associated with the number of acne lesions in Taiwanese women with moderate to severe post-adolescent acne.
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Affiliation(s)
- P H Lu
- Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Dermatology, Far Eastern Memorial Hospital, Taipei, Taiwan
| | - C H Hsu
- Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Branch of Linsen and Chinese Medicine, Taipei City Hospital, Taipei, Taiwan
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148
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Dogra S, Yadav S, Sarangal R. Microneedling for acne scars in Asian skin type: an effective low cost treatment modality. J Cosmet Dermatol 2014; 13:180-7. [DOI: 10.1111/jocd.12095] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Sunil Dogra
- Department of Dermatology; PGIMER; Chandigarh India
| | - Savita Yadav
- Department of Dermatology; PGIMER; Chandigarh India
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149
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Inoue T, Miki Y, Kakuo S, Hachiya A, Kitahara T, Aiba S, Zouboulis CC, Sasano H. Expression of steroidogenic enzymes in human sebaceous glands. J Endocrinol 2014; 222:301-12. [PMID: 24938708 DOI: 10.1530/joe-14-0323] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Androgens are well known to influence sebum synthesis and secretion. Various factors related to androgen biosynthesis are expressed in human sebaceous glands. In this study, immunohistochemical analysis of human skin specimens from 43 subjects indicated that various androgen-producing and -metabolizing enzymes were functionally localized to sebocytes accumulating lipid droplets and that the exclusive expression of 17β-hydroxysteroid dehydrogenase type 2 (17β-HSD2 (HSD17B2)) in sebaceous glands was negatively correlated with that of peroxisome proliferator-activated receptor gamma (PPARγ (PPARG)), which also significantly changed in an age-dependent manner. We also demonstrated that the changes of 17β-HSD2 expression in human immortalized sebocytes (SZ95) influenced the expressions of sebogenesis-related factors. In addition, the overexpression of 17β-HSD2 in SZ95 significantly increased the androstenedione production and markedly decreased the amounts of testosterone and dihydrotestosterone when DHEA was added externally. On the other hand, the phosphorylation of mammalian target of rapamycin, which is well known to induce sebum secretion and the onset and/or aggravation of acne, was increased by the addition of testosterone in the presence of IGF1 in hamster sebocytes. These results all indicated that local androgen biosynthesis and metabolism in human sebaceous glands could play a pivotal role in sebum synthesis and secretion.
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Affiliation(s)
- Takayoshi Inoue
- Departments of PathologyDermatologyTohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, JapanBiological Science LaboratoriesKao Corporation, Haga, Tochigi, JapanDepartments of DermatologyVenereology, Allergology and Immunology, Dessau Medical Center, Dessau, GermanyDepartments of PathologyDermatologyTohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, JapanBiological Science LaboratoriesKao Corporation, Haga, Tochigi, JapanDepartments of DermatologyVenereology, Allergology and Immunology, Dessau Medical Center, Dessau, Germany
| | - Yasuhiro Miki
- Departments of PathologyDermatologyTohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, JapanBiological Science LaboratoriesKao Corporation, Haga, Tochigi, JapanDepartments of DermatologyVenereology, Allergology and Immunology, Dessau Medical Center, Dessau, Germany
| | - Shingo Kakuo
- Departments of PathologyDermatologyTohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, JapanBiological Science LaboratoriesKao Corporation, Haga, Tochigi, JapanDepartments of DermatologyVenereology, Allergology and Immunology, Dessau Medical Center, Dessau, Germany
| | - Akira Hachiya
- Departments of PathologyDermatologyTohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, JapanBiological Science LaboratoriesKao Corporation, Haga, Tochigi, JapanDepartments of DermatologyVenereology, Allergology and Immunology, Dessau Medical Center, Dessau, Germany
| | - Takashi Kitahara
- Departments of PathologyDermatologyTohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, JapanBiological Science LaboratoriesKao Corporation, Haga, Tochigi, JapanDepartments of DermatologyVenereology, Allergology and Immunology, Dessau Medical Center, Dessau, Germany
| | - Setsuya Aiba
- Departments of PathologyDermatologyTohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, JapanBiological Science LaboratoriesKao Corporation, Haga, Tochigi, JapanDepartments of DermatologyVenereology, Allergology and Immunology, Dessau Medical Center, Dessau, Germany
| | - Christos C Zouboulis
- Departments of PathologyDermatologyTohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, JapanBiological Science LaboratoriesKao Corporation, Haga, Tochigi, JapanDepartments of DermatologyVenereology, Allergology and Immunology, Dessau Medical Center, Dessau, Germany
| | - Hironobu Sasano
- Departments of PathologyDermatologyTohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, JapanBiological Science LaboratoriesKao Corporation, Haga, Tochigi, JapanDepartments of DermatologyVenereology, Allergology and Immunology, Dessau Medical Center, Dessau, Germany
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150
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Gollnick HP, Zouboulis CC. Not all acne is acne vulgaris. DEUTSCHES ARZTEBLATT INTERNATIONAL 2014; 111:301-12. [PMID: 24828100 PMCID: PMC4098044 DOI: 10.3238/arztebl.2014.0301] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2013] [Revised: 03/19/2014] [Accepted: 03/19/2014] [Indexed: 01/15/2023]
Abstract
BACKGROUND Acne is the most common skin disease in adolescence, with a prevalence of nearly 100%. About 60% of affected adolescents have mild acne for which they use non-prescription preparations without consulting a physician. The remaining 40% constitute the population of acne patients seen in medical practice. The course of acne can be either acute or chronic; its manifestations can appear in waves, sometimes with dramatically severe inflammation leading rapidly to scarring. Acne often has adverse emotional consequences. Its treatment is markedly better than in the past because of new pharmacological and physicochemical approaches and because evidence-based guidelines are now available. METHOD This article is based on a selective review of the literature and also incorporates the authors' own clinical and scientific experience. RESULTS Acne vulgaris of grade I or II in an adolescent is generally not hard to treat. In contrast, the more severe grades III and IV and conglobate acne often present a therapeutic challenge, as they are associated with varying constellations of acute lesions, scarring, inflammation, and emotional disturbances. These conditions often require systemic treatment with tetracyclines, which are especially useful because of their para-antibiotic antiinflammatory effect. Severe cases must be treated with isotretinoin. Women can benefit from anti-androgenic contraceptive drugs. Retinoids or azelaic acid are used in maintenance therapy to suppress the formation of microcomedones, the precursor stage of acne lesions. CONCLUSION A variety of effective treatments for acne are available, depending on the severity of the condition.
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Affiliation(s)
- Harald P Gollnick
- Department of Venerology and Dermatology, Otto von Guericke University Magdeburg
| | - Christos C Zouboulis
- Departments of Dermatology, Venereology, Allergology and Immunology, Dessau Medical Center
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