1
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Veasey JV, Carvalho GDSM, Valinoto GCJ. Oral isotretinoin for the treatment of chronic pityriasis versicolor: case report and literature review. An Bras Dermatol 2024; 99:639-642. [PMID: 38670865 DOI: 10.1016/j.abd.2023.08.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 08/16/2023] [Accepted: 08/25/2023] [Indexed: 04/28/2024] Open
Affiliation(s)
- John Verrinder Veasey
- Dermatology Clinic, Hospital da Santa Casa de São Paulo, São Paulo, SP, Brazil; Discipline of Dermatology, Santa Casa de São Paulo School of Medical Sciences, São Paulo, SP, Brazil.
| | - Gustavo de Sá Menezes Carvalho
- Dermatology Clinic, Hospital da Santa Casa de São Paulo, São Paulo, SP, Brazil; Discipline of Dermatology, Santa Casa de São Paulo School of Medical Sciences, São Paulo, SP, Brazil
| | - Guilherme Camargo Julio Valinoto
- Dermatology Clinic, Hospital da Santa Casa de São Paulo, São Paulo, SP, Brazil; Discipline of Dermatology, Santa Casa de São Paulo School of Medical Sciences, São Paulo, SP, Brazil
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2
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Bagatin E, Costa CS. Antihistamines reduce isotretinoin-induced pruritus. Int J Dermatol 2024. [PMID: 38856051 DOI: 10.1111/ijd.17318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Accepted: 05/29/2024] [Indexed: 06/11/2024]
Affiliation(s)
- Edileia Bagatin
- Department of Dermatology, Escola Paulista de Medicina, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
| | - Caroline S Costa
- Department of Specialized Medicine, Discipline of Dermatology, Universidade Federal Do Piaui, Sao Paulo, Brazil
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3
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Shahpar A, Nezhad NZ, Sahaf AS, Ahramiyanpour N. A review of isotretinoin in the treatment of frontal fibrosing alopecia. J Cosmet Dermatol 2024; 23:1956-1963. [PMID: 38433314 DOI: 10.1111/jocd.16245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 01/27/2024] [Accepted: 02/09/2024] [Indexed: 03/05/2024]
Abstract
INTRODUCTION Frontal fibrosing alopecia (FFA) is characterized by scarring alopecia of the frontotemporal scalp and facial papules. Isotretinoin is a vitamin A-derived retinoid discovered in 1955 and approved for treating nodulocystic acne. This drug can also affect facial papules and frontotemporal hair loss in patients with FFA. In this article, we conducted a review of the available studies investigating the use of oral isotretinoin for FFA treatment. Our study provides insights into the efficacy and safety of isotretinoin as a potential treatment option for FFA and highlights areas for future research. METHOD In this study, we aimed to investigate the potential advantages and disadvantages of isotretinoin as a treatment for FFA. To identify all relevant articles, we developed a comprehensive search strategy and conducted a thorough search of three major databases: PubMed, Embase, and Science Direct. We retrieved a total of 82 articles from the search results. Two independent reviewers then screened each of the 82 articles based on our inclusion and exclusion criteria, resulting in the identification of 15 articles that were deemed relevant to our study. RESULTS Across the 15 articles, 232 patients who suffered from FFA were involved. Nearly 90% of patients experienced a significant reduction of symptoms after receiving oral isotretinoin at 10-40 mg daily. We conclude that isotretinoin can positively affect facial papules and help suppress hair loss.
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Affiliation(s)
- Amirhossein Shahpar
- Gastrointestinal Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Nazanin Zeinali Nezhad
- Physiology Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
| | - Akram-Sadat Sahaf
- Department of Dermatology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Najmeh Ahramiyanpour
- Department of Dermatology, Bushehr University of Medical Sciences, Bushehr, Iran
- Pathology and Stem Cell Research Center, Bushehr University of Medical Sciences, Bushehr, Iran
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4
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Reynolds RV, Yeung H, Cheng CE, Cook-Bolden F, Desai SR, Druby KM, Freeman EE, Keri JE, Stein Gold LF, Tan JKL, Tollefson MM, Weiss JS, Wu PA, Zaenglein AL, Han JM, Barbieri JS. Guidelines of care for the management of acne vulgaris. J Am Acad Dermatol 2024; 90:1006.e1-1006.e30. [PMID: 38300170 DOI: 10.1016/j.jaad.2023.12.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 12/05/2023] [Indexed: 02/02/2024]
Abstract
BACKGROUND Acne vulgaris commonly affects adults, adolescents, and preadolescents aged 9 years or older. OBJECTIVE The objective of this study was to provide evidence-based recommendations for the management of acne. METHODS A work group conducted a systematic review and applied the Grading of Recommendations, Assessment, Development, and Evaluation approach for assessing the certainty of evidence and formulating and grading recommendations. RESULTS This guideline presents 18 evidence-based recommendations and 5 good practice statements. Strong recommendations are made for benzoyl peroxide, topical retinoids, topical antibiotics, and oral doxycycline. Oral isotretinoin is strongly recommended for acne that is severe, causing psychosocial burden or scarring, or failing standard oral or topical therapy. Conditional recommendations are made for topical clascoterone, salicylic acid, and azelaic acid, as well as for oral minocycline, sarecycline, combined oral contraceptive pills, and spironolactone. Combining topical therapies with multiple mechanisms of action, limiting systemic antibiotic use, combining systemic antibiotics with topical therapies, and adding intralesional corticosteroid injections for larger acne lesions are recommended as good practice statements. LIMITATIONS Analysis is based on the best available evidence at the time of the systematic review. CONCLUSIONS These guidelines provide evidence-based recommendations for the management of acne vulgaris.
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Affiliation(s)
- Rachel V Reynolds
- Department of Dermatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Howa Yeung
- Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia
| | - Carol E Cheng
- Division of Dermatology, Department of Medicine, University of California Los Angeles, Los Angeles, California
| | - Fran Cook-Bolden
- Department of Dermatology, Weill Cornell Medicine, New York, New York
| | - Seemal R Desai
- Innovative Dermatology, Plano, Texas; Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Kelly M Druby
- Penn State Health Hampden Medical Center, Enola, Pennsylvania
| | - Esther E Freeman
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts
| | - Jonette E Keri
- University of Miami, Miller School of Medicine, Miami, Florida; Miami VA Medical Center, Miami, Florida
| | | | - Jerry K L Tan
- Western University, London, Ontario, Canada; Windsor Clinical Research Inc., Windsor, Ontario, Canada
| | - Megha M Tollefson
- Departments of Dermatology and Pediatrics, Mayo Clinic, Rochester, Minnesota
| | - Jonathan S Weiss
- Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia; Georgia Dermatology Partners, Snellville, Georgia
| | - Peggy A Wu
- Department of Dermatology, University of California Davis, Sacramento, California
| | - Andrea L Zaenglein
- Departments of Dermatology and Pediatrics, Penn State/Hershey Medical Center, Hershey, Pennsylvania
| | - Jung Min Han
- American Academy of Dermatology, Rosemont, Illinois.
| | - John S Barbieri
- Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts
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5
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Rocha M, Barnes F, Calderón J, Fierro-Arias L, Gomez CEM, Munoz C, Jannell O, Troieli P. Acne treatment challenges - Recommendations of Latin American expert consensus. An Bras Dermatol 2024; 99:414-424. [PMID: 38402012 PMCID: PMC11074621 DOI: 10.1016/j.abd.2023.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 09/05/2023] [Accepted: 09/09/2023] [Indexed: 02/26/2024] Open
Abstract
BACKGROUND Acne is a chronic inflammatory disorder of the pilosebaceous unit that is associated with a negative impact on quality of life, causing anxiety, depression, and poor self-esteem. The treatment of acne is not simple and presents some new challenges. This article addresses important issues faced by dermatologists on their daily, some of them specific for Latin America. OBJECTIVE To discuss daily practice recommendations when managing acne patients. METHODS A literature review was conducted by a group of eight experts with extensive experience in the field of acne. The results of the data review were presented at an initial kick-off meeting to align the consensus topics. Two e-surveys using the Delphi methodology and an interim group webinar meeting were held. RESULTS The expert panel reached a consensus on all proposed key statements, providing scientific support to help dermatologists and healthcare providers make acne management decisions on topics that can be challenging in the everyday practice of dermatology, such as the characteristics of Generation Z or the importance of the maintenance phase of adult acne treatment. CONCLUSION This article provides current recommendations for managing acne patients. The high level of agreement achieved based on the latest evidence supports the best acne therapeutic choices in both established topics and new important issues that have emerged in recent years, such as the impact of social media, Generation Z characteristics, and transgender male patient specifics.
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Affiliation(s)
- Marco Rocha
- Universidade Federal de São Paulo, São Paulo, SP, Brazil; Sociedade Brasileira de Dermatologia, São Paulo, SP, Brazil.
| | - Franz Barnes
- Iberolatin-American College of Dermatology (CILAD), Panamá City, Panama
| | | | - Leonel Fierro-Arias
- Hospital General de Mexico and American British Cowdray (ABC) Medical Center, Mexico City, Mexico; Mexican Society of Dermatologic & Oncologic Surgery, Iberolatin-American College of Dermatology (CILAD), Mexico City, Mexico
| | | | - Carla Munoz
- Clinica Santa Maria, Santiago de Chile, Chile; Sociedad Chilena Dermatología and Iberolatin-American College of Dermatology (CILAD), Santiago de Chile, Chile
| | - Obregón Jannell
- Lima Dermatology Center Clinic and Esthetic, Lima, Peru; Sociedad Peruana de Dermatologia, Lima, Peru
| | - Patricia Troieli
- School of Medicine University of Buenos Aires, Buenos Aires, Argentina; Argentine Dermatology Society, Iberolatin-American College of Dermatology (CILAD), American Academy of Dermatology and European Academy of Dermatology, Buenos Aires, Argentina
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6
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Mazurek-Durlak Z, Mularczyk K, Kwinta P, Lis G, Cichocka-Jarosz E. Omalizumab in the treatment of Morbihan syndrome in an adolescent girl - case report and literature review. Allergol Immunopathol (Madr) 2024; 52:23-31. [PMID: 38459887 DOI: 10.15586/aei.v52i2.978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 12/15/2023] [Indexed: 03/11/2024]
Abstract
Morbihan syndrome (MS) is characterized by solid facial edema, usually related to rosacea or acne vulgaris. The facial edema deforms the patient's features, can impair peripheral vision, and affects quality of life. Its pathophysiology remains unclear. The disease usually has a slow and chronic course. MS most commonly affects middle-aged Caucasian men with rosacea and is rare in people below 20 years of age. MS is a diagnosis of exclusion. There is no standard treatment for MS, though systemic isotretinoin and antihistamines are mainly used. We present the case of an adolescent girl with MS nonresponding to 19 months of isotretinoin treatment with add-on antihistamines. Therapy with monthly administration of omalizumab (anti-IgE) for 6 months was an effective therapeutic option, improving the quality of life. Our case is the second description of omalizumab use in Morbihan syndrome, the first in an adolescent.
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Affiliation(s)
- Zofia Mazurek-Durlak
- Faculty of Medicine, Department of Pediatrics, Jagiellonian University Medical College, 265, Wielicka Str. 30-663 Krakow, Poland;
| | - Katarzyna Mularczyk
- Faculty of Medicine, Department of Pediatrics, Jagiellonian University Medical College, 265, Wielicka Str. 30-663 Krakow, Poland
| | - Przemko Kwinta
- Faculty of Medicine, Department of Pediatrics, Jagiellonian University Medical College, 265, Wielicka Str. 30-663 Krakow, Poland
| | - Grzegorz Lis
- Faculty of Medicine, Department of Pediatrics, Jagiellonian University Medical College, 265, Wielicka Str. 30-663 Krakow, Poland
| | - Ewa Cichocka-Jarosz
- Faculty of Medicine, Department of Pediatrics, Jagiellonian University Medical College, 265, Wielicka Str. 30-663 Krakow, Poland
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7
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Miot HA, Criado PR, Castro CCSD, Ianhez M, Talhari C, Ramos PM. Bibliometric evaluation of Anais Brasileiros de Dermatologia (2013-2022). An Bras Dermatol 2024; 99:90-99. [PMID: 37775437 DOI: 10.1016/j.abd.2023.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 08/15/2023] [Accepted: 08/15/2023] [Indexed: 10/01/2023] Open
Abstract
The Anais Brasileiros de Dermatologia, published since 1925, is the most influential dermatological journal in Latin America, indexed in the main international bibliographic databases, and occupies the 50th position among the 70 dermatological journals indexed in the Journal of Citations Reports, in 2022. In this article, the authors present a critical analysis of its trajectory in the last decade and compare its main bibliometric indices with Brazilian medical and international dermatological journals. The journal showed consistent growth in different bibliometric indices, which indicates a successful editorial policy and greater visibility in the international scientific community, attracting foreign authors. The increases in citations received (4.1×) and in the Article Influence Score (2.9×) were more prominent than those of the main Brazilian medical and international dermatological journals. The success of Anais Brasileiros de Dermatologia in the international scientific scenario depends on an assertive editorial policy, on promptly publication of high-quality articles, and on institutional stimulus to encourage clinical research in dermatology.
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Affiliation(s)
- Hélio Amante Miot
- Department of Infectology, Dermatology, Diagnostic Imaging and Radiotherapy, Universidade Estadual Paulista, Botucatu, SP, Brazil.
| | - Paulo Ricardo Criado
- Centro Universitário Faculdade de Medicina do ABC, Santo André, SP; and Faculdade de Ciências Médicas de Santos (Fundação Lusíada), Santos, SP, Brazil; Hospital de Dermatologia Sanitária do Paraná and Escola de Medicina, Pontifícia Universidade Católica do Paraná, Curitiba, PR, Brazil
| | - Caio César Silva de Castro
- Department of Dermatology, Hospital de Doenças Tropicais de Goiás, Goiânia, GO, Brazil; Department of Dermatology, Universidade do Estado do Amazonas, Manaus, AM, Brazil
| | - Mayra Ianhez
- Department of Dermatology, Hospital de Doenças Tropicais de Goiás, Goiânia, GO, Brazil
| | - Carolina Talhari
- Department of Dermatology, Universidade do Estado do Amazonas, Manaus, AM, Brazil
| | - Paulo Müller Ramos
- Department of Infectology, Dermatology, Diagnostic Imaging and Radiotherapy, Universidade Estadual Paulista, Botucatu, SP, Brazil
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Almeida LMC, Ianhez M, Dal'Forno T, Picosse FR, Ravelli F, Kamamoto C, Sarlos P, Gold LFS. Long-term maintenance treatment of rosacea: experts' opinion. Int J Dermatol 2024; 63:94-101. [PMID: 38013632 DOI: 10.1111/ijd.16920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 11/07/2023] [Accepted: 11/13/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND Rosacea is a chronic inflammatory dermatosis characterized by remissions and flares. Although the rosacea active treatment phase is well established, the long-term maintenance phase is still challenging. OBJECTIVE To discuss and make recommendations on how to treat patients during the long-term maintenance phase for the main rosacea phenotypes. METHODS A panel of six board-certified Brazilian dermatologists and one American dermatologist gathered to compose a consensus based upon an initial statement on how to treat rosacea during the long-term maintenance phase based on the methodology Nominal Group Technique. The experts discussed each factor based upon an initial statement on how to treat rosacea patients in the long-term maintenance phase. A sequence of comprehensive narrative reviews was performed; a questionnaire preparation about the definition of the maintenance phase and its management was presented; an interpersonal discussion and ranking of the ideas were conducted. Recommendations were made if the specialists had 75% agreement. RESULTS The maintenance treatment phase, which starts by achieving IGA 0 or 1 grades at the active phase, should be considered at least during the 9-month period after remission. The recommendations of all treatments target this period. Daily skincare regimen and sunscreen are crucial. Active treatment phase should be recommended if signs or symptoms reappear or worsen. CONCLUSION Maintenance phase success depends on patient's adherence to daily skin care, appropriate treatments, continued follow-up with dermatologist, and self-assessment to identify new signs and symptoms indicating disease relapse.
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Affiliation(s)
- Luiz M C Almeida
- Department of Dermatology, Santa Casa de Belo Horizonte, Belo Horizonte, Brazil
| | - Mayra Ianhez
- Hospital of Tropical Diseases, Universidade Federal de Goiás Faculdade de Medicina, Goiânia, Brazil
| | - Taciana Dal'Forno
- Dermatology Residency Program, Pontificia Universidade Catolica do Rio Grande do Sul Porto Alegre, Private Practice, Porto Alegre, Brazil
| | - Fabíola R Picosse
- Department of Dermatology, Universidade Federal de São Paulo, São Paulo, Brazil
| | | | | | | | - Linda F S Gold
- Department of Dermatology, Henry Ford Medical Centre, Detroit, MI, USA
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9
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Alfouzan YA, Al-Hammad RA, Alkhuzayem FA, Alkhudair RF, Alotaibi MA, Alajaji AN, Al-Muhaylib AA. Isotretinoin-Related Eye Dryness in Acne Patients in Qassim, Saudi Arabia. Cureus 2023; 15:e49904. [PMID: 38174184 PMCID: PMC10763593 DOI: 10.7759/cureus.49904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/04/2023] [Indexed: 01/05/2024] Open
Abstract
Background Isotretinoin is a commonly prescribed agent mainly used to treat acne vulgaris. Since its Food and Drug Administration (FDA) approval, the subject of its associations with various medical conditions has become a growing interest in many investigational studies. Methodology A retrospective study was conducted using the validated Standardized Patient Evaluation of Eye Dryness (SPEED) questionnaire. All statistical calculations were performed using the Statistical Package for the Social Sciences (SPSS) version 27.0.1 (IBM SPSS Statistics, Armonk, NY). Results The research study involved 107 participants, predominantly Saudi nationals (98.1%), with an average age of 22 years. Regarding the total cumulative dose (TCD), 40.2% had less than 50 mg/kg, 33.6% had between 50 and 100 mg/kg, and 15.9% had more than 100 mg/kg. The majority (73.8%) did not stop using isotretinoin. The average Ocular Surface Disease Index (OSDI) score, indicating ocular surface disease symptoms, was 26.78. There was no significant association between gender, dose/duration of isotretinoin, TCD, and age, and OSDI scores. However, participants with severe OSDI scores were more likely to have worsened pre-existing eye symptoms compared to those with non-severe OSDI scores (35.1% versus 11.4%, p = 0.011). Conclusions This study contributes to the understanding of the impact of isotretinoin usage on ocular surface health. While no significant associations were found between gender, dose, duration, TCD, and age, and OSDI scores, participants with pre-existing eye symptoms were more likely to experience worsened symptoms during isotretinoin treatment.
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Affiliation(s)
| | | | | | | | | | - Abdullah N Alajaji
- Department of Dermatology, Qassim University Medical City (QUMC), Buraydah, SAU
| | - Ahmed A Al-Muhaylib
- Department of Ophthalmology, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, SAU
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10
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Paichitrojjana A, Paichitrojjana A. Oral Isotretinoin and Its Uses in Dermatology: A Review. Drug Des Devel Ther 2023; 17:2573-2591. [PMID: 37649956 PMCID: PMC10464604 DOI: 10.2147/dddt.s427530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 08/20/2023] [Indexed: 09/01/2023] Open
Abstract
In 1982, the Food and Drug Administration (FDA) of the United States of America approved isotretinoin (13-cis-retinoic acid), a retinoid derivative of vitamin A, to treat severe recalcitrant acne vulgaris. Apart from its prescribed use for severe acne, evidence suggests that isotretinoin is commonly used off-label to treat mild-to-moderate acne, inflammatory skin conditions, genodermatoses, skin cancer, and other skin disorders. This is due to its anti-inflammatory, immunomodulatory, and antineoplastic properties. Some "off-label" use is successful, while others are ineffective. Therefore, this information is essential to clinicians for deciding on the appropriate use of isotretinoin. In this article, we aim to review the most updated evidence-based data about the use of oral isotretinoin in dermatology.
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Affiliation(s)
- Anon Paichitrojjana
- School of Anti-Aging and Regenerative Medicine, Mae Fah Luang University, Bangkok, Thailand
| | - Anand Paichitrojjana
- Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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11
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Chen C, Wang P, Zhang L, Liu X, Zhang H, Cao Y, Wang X, Zeng Q. Exploring the Pathogenesis and Mechanism-Targeted Treatments of Rosacea: Previous Understanding and Updates. Biomedicines 2023; 11:2153. [PMID: 37626650 PMCID: PMC10452301 DOI: 10.3390/biomedicines11082153] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 07/22/2023] [Accepted: 07/25/2023] [Indexed: 08/27/2023] Open
Abstract
Rosacea is a chronic inflammatory skin disease characterized by recurrent erythema, flushing, telangiectasia, papules, pustules, and phymatous changes in the central area of the face. Patients with this condition often experience a significant negative impact on their quality of life, self-esteem, and overall well-being. Despite its prevalence, the pathogenesis of rosacea is not yet fully understood. Recent research advances are reshaping our understanding of the underlying mechanisms of rosacea, and treatment options based on the pathophysiological perspective hold promise to improve patient outcomes and reduce incidence. In this comprehensive review, we investigate the pathogenesis of rosacea in depth, with a focus on emerging and novel mechanisms, and provide an up-to-date overview of therapeutic strategies that target the diverse pathogenic mechanisms of rosacea. Lastly, we discuss potential future research directions aimed at enhancing our understanding of the condition and developing effective treatments.
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Affiliation(s)
| | | | | | | | | | | | - Xiuli Wang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai 200040, China
| | - Qingyu Zeng
- Institute of Photomedicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai 200040, China
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12
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Ding RL, Zheng Y, Bu J. Physiological and Psychological Effects of Isotretinoin in the Treatment of Patients with Acne: A Narrative Review. Clin Cosmet Investig Dermatol 2023; 16:1843-1854. [PMID: 37483471 PMCID: PMC10362870 DOI: 10.2147/ccid.s416267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 07/08/2023] [Indexed: 07/25/2023]
Abstract
Isotretinoin (ISO) is a powerful vitamin A derivative that offers the potential for treatment of permanent remission of acne; however, its potential side effects on both physiological and psychological aspects limit its application. This article reviews the side effects of ISO from physiological and psychological aspects in detail, to better screen the suitable population of ISO and improve the efficiency of clinical treatment. Our findings indicate that ISO may cause teratogenicity, skin reactions, ocular reactions, changes in blood indicators, and occasional acne fulminans. To optimize clinical treatment, more attention should be paid to identifying the specific conditions under which these reactions occur, how severe they are, and how they subside to alleviate patient concerns. Regarding the controversial issue of psychological side effects caused by ISO, researchers should shift their focus to the psychological problems that acne itself may cause.
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Affiliation(s)
- Rui-Lian Ding
- Hospital for Skin Disease, Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing, Jiangsu, People’s Republic of China
| | - Yu Zheng
- Hospital for Skin Disease, Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing, Jiangsu, People’s Republic of China
| | - Jin Bu
- Hospital for Skin Disease, Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing, Jiangsu, People’s Republic of China
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13
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Hatami P, Balighi K, Asl HN, Goodarzi A, Aryanian Z. Isotretinoin and timing of procedural interventions: Clinical implications and practical points. J Cosmet Dermatol 2023. [PMID: 37326142 DOI: 10.1111/jocd.15874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 05/01/2023] [Accepted: 06/04/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND For decades, the notion that elective surgeries and cutaneous procedures should be postponed for 6-12 months in patients on, or recently administered with isotretinoin, has been widely accepted. However, some recent studies showed the need for a change in this regard. METHOD Here, we reviewed the existing data in this regard through searching on PubMed, Google Scholar, and Scopus. All of the relevant papers published in English, until October, 2022, which we could access to their full-texts, were included. RESULTS We found some recommendations made by plastic surgeons, dermatologists, ENT surgeons, ophthalmologists, orthopedic surgeons, and dentists regarding the correct timing of procedural interventions in patients on, or recently administered with isotretinoin and tried to summarize them to provide a practical guide for clinicians. CONCLUSION Physicians may discuss with patients regarding the known risk of abnormal wound healing in the setting of systemic isotretinoin treatment and suggest that, when possible, surgical procedures be postponed until the activity of the retinoids has time to subside. It is even more important regarding patients with darker skin phototypes to follow an even more strict guideline.
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Affiliation(s)
- Parvaneh Hatami
- Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Kamran Balighi
- Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Department of Dermatology, School of Medicine Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamed Nicknam Asl
- Department of Dentistry, Rafsanjan University of Medical Sciences (RUMS), Rafsanjan, Iran
| | - Azadeh Goodarzi
- Department of Dermatology, Rasool Akram Medical Complex, Iran University of Medical Sciences (IUMS), Tehran, Iran
- Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Zeinab Aryanian
- Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Department of Dermatology, Babol University of Medical Sciences, Babol, Iran
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Scott-Emuakpor R, Vuthaluru K, Nagre A, Jawed I, Patel PA, Sidhu HK. Role of Oral Retinoids in Treatment of Acne Vulgaris With a Bioinformatics-Based Perspective of Personalized Medicine. Cureus 2023; 15:e38019. [PMID: 37228537 PMCID: PMC10207980 DOI: 10.7759/cureus.38019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/23/2023] [Indexed: 05/27/2023] Open
Abstract
Acne vulgaris is a skin condition characterized by the inflammation or hyperactivity of sebaceous glands on the skin, which results in the creation of comedones, lesions, nodules, and perifollicular hyperkeratinization. Increased sebum production, follicular blockage, and bacterial colonization may contribute to the disease etiology. Environmental factors, hormonal imbalance, and genetic predisposition can alter the severity of the disease. Its mental and monetary effects can be problematic for the society. In this study, we examined the role of isotretinoin in the treatment of acne vulgaris based on evidence from prior research. This review literature study compiled publications on the treatment of acne vulgaris from 1985 to 2022 based on PubMed and Google Scholar publications. Additional bioinformatics analyses were accompanied by GeneCards, STRING model, and DrugBank databases. These complementary analyses were designed to obtain a better perspective of personalized medicine which is highly required for dose-precise administrations of acne vulgaris treatment. Isotretinoin has been recognized as an effective treatment for acne vulgaris, particularly in cases that have been resistant to previous medications or have resulted in scarring, according to gathered data. Oral isotretinoin inhibits the proliferation of Propionibacterium acne, a critical factor in the development of acne lesions; also, it has been shown to be effective in reducing the number of Propionibacterium-resistant patients and regulating sebum production and reducing sebaceous gland size more effectively than other treatment options resulting in general improvements in skin clarity and acne severity and reduce inflammatory in 90% of patients. In addition to its efficacy, the majority of patients have shown that oral isotretinoin is well tolerated. This review highlights the use of oral retinoids, particularly isotretinoin, as an effective and well-tolerated treatment option for acne vulgaris. It has been proven that oral isotretinoin is useful for achieving long-lasting remission in patients with severe or resistant instances. Despite the fact that oral isotretinoin is related to a number of potential harmful effects, skin dryness was the most common side effect reported by patients that can be managed with the aid of suitable monitoring and drug administration against specific genes identified by genotyping of the susceptible variants of genes involved in TGFβ signaling pathway.
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Affiliation(s)
| | | | - Abhijit Nagre
- Medicine, Topiwala National Medical College & Bai Yamunabai Laxman (BYL) Nair Charitable Hospital, Mumbai, IND
| | - Inshal Jawed
- Internal Medicine, Dow Medical College, Karachi, PAK
| | - Priyansh A Patel
- Medicine, Byramjee Jeejeebhoy (BJ) Medical College, Ahmedabad, IND
- Medicine, Medical College Baroda, Baroda, IND
| | - Harmandeep K Sidhu
- Dermatology, Dayanand Medical College and Hospital, Ludhiana, IND
- Medicine, Indira Gandhi Government Medical College and Hospital, Nagpur, IND
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15
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Ibrahim S, Osman B, Awaad RM, Abdoon I. Acne Vulgaris Relapse in Sudanese Patients Treated with Oral Isotretinoin: Rate and Predictive Factors. J Multidiscip Healthc 2023; 16:839-849. [PMID: 37020969 PMCID: PMC10069433 DOI: 10.2147/jmdh.s405509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 03/23/2023] [Indexed: 03/31/2023] Open
Abstract
Purpose Acne vulgaris is a skin disorder primarily affecting teenagers and young adults. Acne relapse is the main drawback of oral isotretinoin (OI), which is the golden therapy for severe acne. This study aimed to assess the rate and predictive factors of acne relapse among Sudanese patients using OI. Patients and Methods A cross-sectional study was conducted in a dermatology and venereology clinic-Sudan, using a self-administered questionnaire and data collection sheet. Patients using OI for acne treatment were enrolled in the study. Chi-square test and logistic regression analysis were used to evaluate the association between variables. P-value <0.05 was considered statistically significant. Results 225 acne patients (mean age: 26.0±4.2 years, females: 88.9%) were included in this study. OI daily dose ranged from 0.25 to 1 mg/kg/day, with frequent daily doses of 40-49 mg (57.3%) over 3-6 months (81.8%). Around one-third of patients (36%) received maintenance therapy after completion of OI course. At a 2-year follow-up, approximately 36% of patients experienced acne relapse that commonly occurred within 6-18 months after the last OI therapy. Early discontinuation of OI was a positive predictor of acne relapse which was 3.99 times greater in patients who had early discontinued OI than those completing the planned OI course (OR=3.99; p=0.002). OI cumulative doses of 120-139 mg/kg and 140-159 mg/kg were negative predictors of acne relapse (OR=0.23; p=0.001 and OR=0.15; p=0.02, respectively). Most patients (94.2%) received prescription OI, and 76.4% of women were advised to use contraceptives. About 69% of patients practiced skin care. Conclusion About one-third of patients experienced acne relapse. Early discontinuation and low cumulative doses of OI are the main risk factors for acne relapse. Long-term therapy of OI, with cumulative doses of 120-159 mg/kg, would be beneficial to reduce acne relapse.
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Affiliation(s)
- Shimaa Ibrahim
- Clinical Pharmacy Program, Faculty of Pharmacy, University of Khartoum, Khartoum, Sudan
| | - Bashier Osman
- Department of Pharmacology, Faculty of Pharmacy, University of Khartoum, Khartoum, Sudan
| | - Reela M Awaad
- Dermatology Department, Awaad Center for Dermatology and Venereology, Khartoum, Sudan
| | - Iman Abdoon
- Department of Pharmacology, Faculty of Pharmacy, University of Khartoum, Khartoum, Sudan
- Correspondence: Iman Abdoon, Department of Pharmacology, Faculty of Pharmacy, University of Khartoum, Qassr Street, Khartoum, Sudan, Email
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16
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Alhetheli G, Alhazmi S, Almutairi S, Alharbi S, Alharbi N, Alsweed M, Al-Dhubaibi MS, Alsaud J, Asiri L. The Effects of Isotretinoin on The Menstrual Cycle: A Cross-Sectional Study. Clin Pract 2022; 12:908-917. [PMID: 36412674 PMCID: PMC9680279 DOI: 10.3390/clinpract12060095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 11/03/2022] [Accepted: 11/07/2022] [Indexed: 11/12/2022] Open
Abstract
Menstrual irregularities during isotretinoin therapy, including amenorrhea, can cause a great deal of health-status uncertainty such as the possibility of pregnancy. This study aimed to evaluate the effects of isotretinoin treatment on the menstrual cycle. This cross-sectional study was conducted among females aged between 15−45 years taking isotretinoin for acne. Descriptive statistics were used in the form of frequencies and percentages to represent categorical variables. Pearson’s chi-squared test was performed to assess the relationship between some of the variables with menstrual irregularities. A logistic regression model was performed to assess the risk factors for developing menstrual irregularities during isotretinoin therapy. Of participants with a known regular menstrual cycle, 10.4% were found to have irregularity in their cycle after starting the drug (p < 0.001). Amenorrhea was the most commonly reported menstrual irregularity in isotretinoin-treated females. Our results showed that single females, those who took isotretinoin for 10−12 months and who were concurrently taking hormonal contraceptives all have a statistically significant higher risk of developing menstrual irregularities than others. In conclusion, we found that a statistically significant number of participants with a regular menstrual cycle pre-isotretinoin intake developed irregularity in their cycle after starting the drug. The mechanism of how isotretinoin influences female hormonal imbalances, thereby affecting menstrual irregularities is still poorly understood and needs to be clarified in further clinical studies.
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Affiliation(s)
- Ghadah Alhetheli
- Division of Dermatology and Cutaneous Surgery, College of Medicine, Qassim University, Buraydah 52571, Saudi Arabia
- Correspondence:
| | - Sadin Alhazmi
- College of Medicine, Qassim University, Buraydah 52571, Saudi Arabia
| | - Shumukh Almutairi
- College of Medicine, Qassim University, Buraydah 52571, Saudi Arabia
| | - Samar Alharbi
- College of Medicine, Qassim University, Buraydah 52571, Saudi Arabia
| | - Norah Alharbi
- College of Medicine, Qassim University, Buraydah 52571, Saudi Arabia
| | - Maha Alsweed
- College of Medicine, Qassim University, Buraydah 52571, Saudi Arabia
| | | | - Jolan Alsaud
- College of Medicine, Qassim University, Buraydah 52571, Saudi Arabia
| | - Lina Asiri
- College of Medicine, Qassim University, Buraydah 52571, Saudi Arabia
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17
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Muacevic A, Adler JR. Isotretinoin-Induced Inflammatory Bowel Disease: Is There a Real Association? Cureus 2022; 14:e29825. [PMID: 36337815 PMCID: PMC9626370 DOI: 10.7759/cureus.29825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/02/2022] [Indexed: 11/26/2022] Open
Abstract
Inflammatory bowel disease (IBD) is an autoimmune inflammatory disorder that affects the gastrointestinal system with an annual increase in incidence and prevalence worldwide. While the precise cause behind IBD remains obscured, certain genetic susceptibilities, in addition to environmental factors, may trigger the stimulation of the immunoinflammatory system against the gastrointestinal system, eventually resulting in IBD. Furthermore, certain medications have been proposed to increase the risk of developing IBD, such as isotretinoin. IBD has been reported during the post-marketing phase of isotretinoin. Subsequently, IBD development was added as a potential gastrointestinal adverse effect of isotretinoin. This review article aims to evaluate the possible association between isotretinoin exposure and the development of inflammatory bowel disease. We enrolled 32 relevant studies, including case reports, case-control, and cohort studies. The results were critically analyzed and reviewed by independent authors to answer the research question and achieve the primary endpoint.
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18
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Efficacy and safety of low-level light therapy by delicate pulsed light combined with low-dose oral isotretinoin for the treatment of acne vulgaris: a randomized split-face study. Lasers Med Sci 2022; 37:3221-3229. [PMID: 35829974 DOI: 10.1007/s10103-022-03606-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 06/28/2022] [Indexed: 10/17/2022]
Abstract
Acne vulgaris (AV) is a common dermatosis that causes psychological problems. Isotretinoin is the first-line treatment for moderate-to-severe AV, but its onset of effect is delayed. Although light-based therapy is widely used in the treatment of AV, there is a lack of reports on delicate pulsed light (DPL) which has a narrow therapeutic spectrum (500-600 nm). Low-level light therapy (LLLT) has shown an emerging role in anti-inflammatory effects and skin repair. This study investigates the efficacy and safety of low-dose oral isotretinoin combined with LLLT using DPL in patients with moderate-to-severe AV. Thirty-six patients with moderate-to-severe AV were enrolled and received low-dose oral isotretinoin (10-20 mg/day). The two sides of the face were randomly assigned to receive DPL (6-9 J/cm2) or not at an interval of 2 weeks for 4 treatment sessions (weeks 0, 2, 4, 6). Photos, GAGS score, counts of papules, pustules, comedones, TEWL, melanin and erythema index, side effects, efficacy, and satisfactory score were recorded at each visit and at 4 weeks after the final treatment (week 10). Thirty-three patients completed the study. DPL and oral isotretinoin combined therapy exhibited significantly improved GAGS score as well as the number of the lesions from week 2 and maintained until week 10. At the end of the observation, the improvement of GAGS was 70.88% on the DPL and isotretinoin combined side versus 62.12% on the side with isotretinoin monotherapy (p = 0.0009). The improvement for papule number was 61.58% on the DPL combined side versus 43.33% on the control side (p < 0.0001), for comedone was 63.15% versus 43.30% (p = 0.0008). TEWL and indexes of melanin and erythema also had better outcomes with DPL combined therapy at week 10. All the side effects were temporary and tolerable; no adverse effects were observed. Oral low-dose isotretinoin combined with LLLT by DPL offers a combination with reduced side effects and better outcomes within a limited treatment duration, which advances the onset of effect of isotretinoin monotherapy and improves lesion clearance.
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19
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Kapała J, Lewandowska J, Placek W, Owczarczyk-Saczonek A. Adverse Events in Isotretinoin Therapy: A Single-Arm Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116463. [PMID: 35682048 PMCID: PMC9180136 DOI: 10.3390/ijerph19116463] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 05/19/2022] [Accepted: 05/24/2022] [Indexed: 11/16/2022]
Abstract
Isotretinoin (ISO) is an oral prescription-only retinoid, well known for its acne-treating effect. However, it affects a substantial number of human cell types, causing a broad spectrum of adverse effects. The purpose of this study is to establish the isotretinoin therapy adverse events among human clinical trials and their prevalence. Two authors (J.K., J.L.) systematically performed the literature review and assessment from December 2021-February 2022. Three databases (PubMed, ClinicalTrials, and Cochrane Library) were searched using the following terms: "isotretinoin acne vulgaris" for published studies in English from 1980-2021. Finally, 25 randomized controlled clinical trials (RCTs) and five open-label clinical trials provided 3274 acne vulgaris suffering patients. Isotretinoin therapy affects almost all of the systems in the human body, causing numerous adverse events. However, they mainly concern mild mucocutaneous conditions (severe cases are rare) and represent individual responses to a drug. In addition, all adverse events are reversible and can be avoided by specific preparations.
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Affiliation(s)
- Jan Kapała
- Medical Faculty, University of Warmia and Mazury in Olsztyn, 10-719 Olsztyn, Poland;
- Correspondence:
| | - Julia Lewandowska
- Medical Faculty, University of Warmia and Mazury in Olsztyn, 10-719 Olsztyn, Poland;
| | - Waldemar Placek
- Department of Dermatology Sexually Transmitted Diseases and Clinical Immunology, University of Warmia and Mazury in Olsztyn, 10-719 Olsztyn, Poland; (W.P.); (A.O.-S.)
| | - Agnieszka Owczarczyk-Saczonek
- Department of Dermatology Sexually Transmitted Diseases and Clinical Immunology, University of Warmia and Mazury in Olsztyn, 10-719 Olsztyn, Poland; (W.P.); (A.O.-S.)
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20
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Costa CS, Bagatin E, Yang Z, Pacheco RL, Magin P, de Sá Urtiga Santos L, Pereira T, Riera R. Systemic pharmacological treatments for acne: an overview of systematic reviews. Hippokratia 2021. [DOI: 10.1002/14651858.cd014917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Caroline S Costa
- Department of Specialised Medicine, Discipline of Dermatology; Universidade Federal do Piaui; Teresina Brazil
| | - Ediléia Bagatin
- Department of Dermatology; Universidade Federal de São Paulo; São Paulo Brazil
| | - Zhirong Yang
- Primary Care Unit, Department of Public Health and Primary Care; School of Clinical Medicine, University of Cambridge; Cambridge UK
| | - Rafael L Pacheco
- Núcleo de Ensino e Pesquisa em Saúde Baseada em Evidências e Avaliação Tecnológica em Saúde (NEP-SBEATS); Universidade Federal de São Paulo; São Paulo Brazil
| | - Parker Magin
- Discipline of General Practice, School of Medicine and Public Health; The University of Newcastle; Newcastle Australia
| | | | - Tiago Pereira
- International Research Center HAOC. Health Technology Assessment Unit; São Paulo Brazil
| | - Rachel Riera
- Cochrane Brazil Rio de Janeiro; Cochrane; Petrópolis Brazil
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21
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Piccione M, Belloni Fortina A, Ferri G, Andolina G, Beretta L, Cividini A, De Marni E, Caroppo F, Citernesi U, Di Liddo R. Xeroderma Pigmentosum: General Aspects and Management. J Pers Med 2021; 11:1146. [PMID: 34834498 PMCID: PMC8624855 DOI: 10.3390/jpm11111146] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 10/27/2021] [Accepted: 10/28/2021] [Indexed: 01/25/2023] Open
Abstract
Xeroderma Pigmentosum (XP) is a rare genetic syndrome with a defective DNA nucleotide excision repair. It is characterized by (i) an extreme sensitivity to ultraviolet (UV)-induced damages in the skin and eyes; (ii) high risk to develop multiple skin tumours; and (iii) neurologic alterations in the most severe form. To date, the management of XP patients consists of (i) early diagnosis; (ii) a long-life protection from ultraviolet radiation, including avoidance of unnecessary UV exposure, wearing UV blocking clothing, and use of topical sunscreens; and (iii) surgical resections of skin cancers. No curative treatment is available at present. Thus, in the last decade, in order to prevent or delay the progression of the clinical signs of XP, numerous strategies have been proposed and tested, in some cases, with adverse effects. The present review provides an overview of the molecular mechanisms featuring the development of XP and highlights both advantages and disadvantages of the clinical approaches developed throughout the years. The intention of the authors is to sensitize scientists to the crucial aspects of the pathology that could be differently targeted. In this context, the exploration of the process underlining the conception of liposomal nanocarriers is reported to focus the attention on the potentialities of liposomal technology to optimize the administration of chemoprotective agents in XP patients.
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Affiliation(s)
- Monica Piccione
- Department of Pharmaceutical and Pharmacological Sciences, University of Padova, 35131 Padova, Italy
| | - Anna Belloni Fortina
- Pediatric Dermatology Unit, Department of Medicine DIMED, University of Padova, 35128 Padova, Italy; (A.B.F.); (F.C.)
| | - Giulia Ferri
- I.R.A. Istituto Ricerche Applicate S.p.A., 20865 Usmate Velate, Italy; (G.F.); (G.A.); (L.B.); (A.C.); (E.D.M.); (U.C.)
| | - Gloria Andolina
- I.R.A. Istituto Ricerche Applicate S.p.A., 20865 Usmate Velate, Italy; (G.F.); (G.A.); (L.B.); (A.C.); (E.D.M.); (U.C.)
| | - Lorenzo Beretta
- I.R.A. Istituto Ricerche Applicate S.p.A., 20865 Usmate Velate, Italy; (G.F.); (G.A.); (L.B.); (A.C.); (E.D.M.); (U.C.)
| | - Andrea Cividini
- I.R.A. Istituto Ricerche Applicate S.p.A., 20865 Usmate Velate, Italy; (G.F.); (G.A.); (L.B.); (A.C.); (E.D.M.); (U.C.)
| | - Emanuele De Marni
- I.R.A. Istituto Ricerche Applicate S.p.A., 20865 Usmate Velate, Italy; (G.F.); (G.A.); (L.B.); (A.C.); (E.D.M.); (U.C.)
| | - Francesca Caroppo
- Pediatric Dermatology Unit, Department of Medicine DIMED, University of Padova, 35128 Padova, Italy; (A.B.F.); (F.C.)
| | - Ugo Citernesi
- I.R.A. Istituto Ricerche Applicate S.p.A., 20865 Usmate Velate, Italy; (G.F.); (G.A.); (L.B.); (A.C.); (E.D.M.); (U.C.)
| | - Rosa Di Liddo
- Department of Pharmaceutical and Pharmacological Sciences, University of Padova, 35131 Padova, Italy
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22
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Bagatin E, Rocha MADD, Freitas THP, Costa CS. Treatment challenges in adult female acne and future directions. Expert Rev Clin Pharmacol 2021; 14:687-701. [PMID: 33957838 DOI: 10.1080/17512433.2021.1917376] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Introduction: Acne is a chronic, inflammatory, and immune-mediated disease of the pilosebaceous unit, highly prevalent in adolescents. However, an increasing number of adults over 25 years old with facial acne, particularly women, have been observed. It is considered a different disease when compared to acne vulgaris. Face is the mainly involved area with inflammatory lesions and more sensitive skin, pointing out the need of a holistic approach.Areas covered: We performed a comprehensive literature search on PubMed database, up to January 2021, regarding adult female acne. We synthesized data about pathogenesis; differences compared to acne vulgaris; and treatment, with focus in the management challenges and perspectives.Expert opinion: It is essential to value the negative impact on quality of life of adult female acne, independently of severity. The disease has prolonged evolution, and patient might be resilient once the improvement, regardless of the treatment option, will just be noticeable after 3 months. Aggravating factors should be clearly discussed, such as the need of changing many habits, especially lesions manipulation. The therapeutic regimen includes make-up and tailored skin care (considering proneness to sensitivity), while anti-acne drugs should be chosen in accordance with desire to be pregnant, presence of pregnancy or breastfeeding.
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Affiliation(s)
| | | | | | - Caroline Sousa Costa
- Department of Specialized Medicine, Discipline of Dermatology - Universidade Federal Do Piauí, Teresina, Brazil
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