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Zolotarev O, Khakimova A, Rahim F, Senel E, Zatsman I, Gu D. Scientometric analysis of trends in global research on acne treatment. Int J Womens Dermatol 2023; 9:e082. [PMID: 37521754 PMCID: PMC10378739 DOI: 10.1097/jw9.0000000000000082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 03/12/2023] [Indexed: 08/01/2023] Open
Abstract
Acne or acne vulgaris is the most common chronic inflammatory disease of the sebaceous follicles. Objectives The present study aims to identify the main lines of research in the field of acne treatment using reproducible scientometric methods. In this article, we reviewed the following research trends: facial acne, different antibiotics, retinoids, anti-inflammatory drugs, epidermal growth factor receptor inhibitors therapy, and associated diseases. Methods The analysis of publications from the PubMed collection was carried out from 1871 to 2022. All data were analyzed using Microsoft Excel. The evolution of the terminological portrait of the disease is shown. Results Trends in the use of various groups of antibiotics, retinoids, anti-inflammatory drugs, and photodynamic therapy for acne treatment have been found. There is a growing interest in clindamycin and doxycycline (polynomial and exponential growth, respectively). The effects of isotretinoin are also being studied more frequently (active linear growth). The publication of studies on spironolactone is increasing (linear growth). There is also a steady interest in the use of epidermal growth factor receptor inhibitors in the recent years. There is active research on acne and polycystic ovary syndrome (exponential growth). Limitations Only articles in English were selected. The most frequent terms were considered. Conclusions The dynamics of publication activity in the field of acne was considered. The aim of the current scientometric study was to analyze the global trends in acne treatments. The trend analysis made it possible to identify the most explored areas of research, as well as indicate those areas in dermatology in which interest is declining.
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Affiliation(s)
- Oleg Zolotarev
- Institute of Information Systems and Engineering Computer Technologies, Russian New University, Moscow, Russia
| | - Aida Khakimova
- Institute of Information Systems and Engineering Computer Technologies, Russian New University, Moscow, Russia
| | - Fakher Rahim
- Department of Anesthesia, Cihan University - Sulaimaniya, Kurdistan Region, Iraq
| | - Engin Senel
- Department of Dermatology and Venereology, Hitit University Faculty of Medicine, Corum, Turkey
| | - Igor Zatsman
- Research Department, Institute of Informatics Problems FRC CSC RAS, Moscow, Russia
| | - Dongxiao Gu
- MIS School of Management, Hefei University of Technology, Hefei, Anhui, China
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Lennon C, Voss K, Vitek WS. Preconception health optimization in women with polycystic ovary syndrome - how to find the time? Curr Opin Endocrinol Diabetes Obes 2022; 29:541-546. [PMID: 36218230 DOI: 10.1097/med.0000000000000781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
PURPOSE OF REVIEW Polycystic ovary syndrome (PCOS) is the most common endocrine disorder among reproductive-age women, the most common cause of infertility among women and a major contributor to pregnancy complications. RECENT FINDINGS Diagnostic and associated features of PCOS, including hyperandrogenism, insulin resistance, and obesity, contribute to the 2-4-fold increased risk of pregnancy-induced hypertension and preeclampsia, gestational diabetes and preterm birth observed among pregnant women with PCOS. PCOS should be diagnosed according to the 2018 International Guideline. Screening for and optimizing management of hypertension, impaired glucose tolerance and obesity in the preconception window in women with PCOS provides an opportunity to increase the odds of a spontaneous pregnancy, live birth with fertility treatment and possibly reduce the risk of pregnancy complications. SUMMARY Providers should prioritize individualizing recommendations for preconception health optimization in women with PCOS in order to maximize the chance of conception, a healthy pregnancy and the health of future generations.
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Affiliation(s)
- Clare Lennon
- University of Rochester School of Medicine & Dentistry
| | - Kathryn Voss
- University of Rochester Medical Center, Department of Obstetrics and Gynecology, Rochester, New York, USA
| | - Wendy S Vitek
- University of Rochester Medical Center, Department of Obstetrics and Gynecology, Rochester, New York, USA
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Schrager S, Larson M, Carlson J, Ledford K, Ehrenthal DB. Beyond Birth Control: Noncontraceptive Benefits of Hormonal Methods and Their Key Role in the General Medical Care of Women. J Womens Health (Larchmt) 2020; 29:937-943. [PMID: 32155101 DOI: 10.1089/jwh.2019.7731] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Contraceptives that contain estrogen and/or progestins are used by millions of women around the world to prevent pregnancy. Owing to their unique physiological mechanism of action, many of these medications can also be used to prevent cancer and treat multiple general medical conditions that are common in women. We performed a comprehensive literature search. This article will describe the specific mechanisms of action and summarize the available data documenting how hormonal contraceptives can prevent ovarian and uterine cancer and be used to treat women with a variety of gynecological and nongynecological conditions such as endometriosis, uterine fibroids, heavy menstrual bleeding, polycystic ovary syndrome, acne, and migraines. Contraceptive methods containing estrogen and progestin can be used for a wide variety of medical issues in women.
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Affiliation(s)
- Sarina Schrager
- Department of Family Medicine and Community Health, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
| | - Magnolia Larson
- Department of Family Medicine and Community Health, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
| | - Jensena Carlson
- Department of Family Medicine and Community Health, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
| | - Kathryn Ledford
- Department of Family Medicine and Community Health, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
| | - Deborah B Ehrenthal
- Department of Obstetrics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin.,Department of Gynecology and Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
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Girling JE, Hawthorne SCJ, Marino JL, Nur Azurah AG, Grover SR, Jayasinghe YL. Paternal Understanding of Menstrual Concerns in Young Women. J Pediatr Adolesc Gynecol 2018; 31:459-467. [PMID: 29655581 DOI: 10.1016/j.jpag.2018.04.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 03/20/2018] [Accepted: 04/05/2018] [Indexed: 11/30/2022]
Abstract
STUDY OBJECTIVE No studies have specifically considered paternal understanding of menstruation. This study aimed to establish the degree of understanding of fathers of adolescent girls with menstrual symptoms relative to mothers. DESIGN AND SETTING This was a cross-sectional survey-based study. Adolescent patients attending an outpatient gynecology clinic for dysmenorrhea and/or heavy menstrual bleeding and their parents were invited to complete surveys. PARTICIPANTS Sixty surveys were completed (24 of 40 daughters, 20 of 40 mothers, 16 of 40 fathers). INTERVENTIONS AND MAIN OUTCOME MEASURES Surveys aimed to test parents' understanding of menstrual symptoms and potential medications, as well as fathers' concerns with their daughters' health. RESULTS The fathers' knowledge of menstrual symptoms was poorer than mothers, although most knew heavy menstrual bleeding (15/16, 94%) and mood swings (14/16, 87%). Many parents answered "don't know" or did not answer questions about potential consequences of medications, although parents were clearly concerned about side effects. Most fathers (13/16, 81%) were open to discussing menstrual concerns with daughters; however, only 54% (13/24) of daughters were open to such discussions. Of fathers, 81% (13/16) were sympathetic/concerned, 56% (9/16) felt helpless, and 13% (2/16) were frustrated when daughters were in pain. When asked about effects, 88% (14/16) of fathers (79% [15/20] of mothers) were worried about their daughter's welfare and 63% (10/16) (55% [11/20] of mothers) about schooling. CONCLUSION We present, to our knowledge, the first insight into fathers' knowledge of their daughters' menstrual health. Overall, parents have an incomplete picture of menstrual symptoms. Even in this cohort, which could be expected to be well informed because of their daughters' attendance at a tertiary hospital, it is clear that further knowledge would assist them caring for their daughters.
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Affiliation(s)
- Jane E Girling
- Gynaecology Research Centre, The University of Melbourne Department of Obstetrics and Gynaecology and Royal Women's Hospital, Melbourne, Victoria, Australia.
| | - Samuel C J Hawthorne
- Gynaecology Research Centre, The University of Melbourne Department of Obstetrics and Gynaecology and Royal Women's Hospital, Melbourne, Victoria, Australia; Department of Gynaecology, Royal Children's Hospital, Parkville, Victoria, Australia
| | - Jennifer L Marino
- Gynaecology Research Centre, The University of Melbourne Department of Obstetrics and Gynaecology and Royal Women's Hospital, Melbourne, Victoria, Australia; Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia
| | - Abdul G Nur Azurah
- Department of Obstetrics and Gynaecology, UKM Medical Centre, Kuala Lumpur, Malaysia
| | - Sonia R Grover
- Department of Gynaecology, Royal Children's Hospital, Parkville, Victoria, Australia; Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia; Department of Obstetrics and Gynaecology, UKM Medical Centre, Kuala Lumpur, Malaysia; Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Yasmin L Jayasinghe
- Gynaecology Research Centre, The University of Melbourne Department of Obstetrics and Gynaecology and Royal Women's Hospital, Melbourne, Victoria, Australia; Department of Gynaecology, Royal Children's Hospital, Parkville, Victoria, Australia; Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia
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Szöllősi AG, Oláh A, Bíró T, Tóth BI. Recent advances in the endocrinology of the sebaceous gland. DERMATO-ENDOCRINOLOGY 2018; 9:e1361576. [PMID: 29484098 PMCID: PMC5821152 DOI: 10.1080/19381980.2017.1361576] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Accepted: 07/26/2017] [Indexed: 12/13/2022]
Abstract
The sebaceous gland, long considered an evolutionary relic with little-to-no physiological relevance in humans, has emerged in recent decades as a key orchestrator and contributor to many cutaneous functions. In addition to the classical physico-chemical barrier function of the skin against constant environmental challenges, a more novel, neuro-immune modulatory role has also emerged. As part of the complex intercellular communication network of the integumentary system, the sebaceous gland acts as a “relay station” in the skin for many endocrine factors. This review aims to offer a comprehensive overview of endocrine effects and subsequent interactions on this much maligned mini-organ.
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Affiliation(s)
- Attila G Szöllősi
- Department of Physiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Attila Oláh
- Department of Physiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Tamás Bíró
- Department of Immunology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Balázs István Tóth
- Department of Physiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
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Layton AM, Eady EA, Whitehouse H, Del Rosso JQ, Fedorowicz Z, van Zuuren EJ. Oral Spironolactone for Acne Vulgaris in Adult Females: A Hybrid Systematic Review. Am J Clin Dermatol 2017; 18:169-191. [PMID: 28155090 PMCID: PMC5360829 DOI: 10.1007/s40257-016-0245-x] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND The management of acne in adult females is problematic, with many having a history of treatment failure and some having a predisposition to androgen excess. Alternatives to oral antibiotics and combined oral contraceptives (COCs) are required. OBJECTIVE Our aim was to conduct a hybrid systematic review of the evidence for benefits and potential harms of oral spironolactone in the management of acne in adult females. METHODS The review was conducted according to a previously published protocol. Three reviewers independently selected relevant studies from the search results, extracted data, assessed the risk of bias, and rated the quality of the evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. RESULTS Ten randomized controlled trials (RCTs) and 21 case series were retrieved. All trials were assessed as being at a 'high risk' of bias, and the quality of evidence was rated as low or very low for all outcomes. Apart from one crossover trial that demonstrated statistical superiority of a 200 mg daily dose versus inflamed lesions compared with placebo, data from the remaining trials were unhelpful in establishing the degree of efficacy of lower doses versus active comparators or placebo. Menstrual side effects were significantly more common with the 200 mg dose; frequency could be significantly reduced by concomitant use of a COC. Pooling of results for serum potassium supported the recent recommendation that routine monitoring is not required in this patient population. CONCLUSION This systematic review of RCTs and case series identified evidence of limited quality to underpin the expert endorsement of spironolactone at the doses typically used (≤100 mg/day) in everyday clinical practice.
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Affiliation(s)
- Alison M Layton
- Department of Dermatology, Harrogate and District NHS Foundation Trust, Harrogate, HG2 7SX, UK
| | - E Anne Eady
- Department of Dermatology, Harrogate and District NHS Foundation Trust, Harrogate, HG2 7SX, UK.
| | - Heather Whitehouse
- Department of Dermatology, Harrogate and District NHS Foundation Trust, Harrogate, HG2 7SX, UK
| | - James Q Del Rosso
- Lakes Dermatology and Del Rosso Dermatology Research Center, Las Vegas, NV, USA
| | | | - Esther J van Zuuren
- Department of Dermatology, Leiden University Medical Center, Leiden, The Netherlands
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Ruiz de Luzuriaga AM, Mhlaba J, Roman C. Primary Care of Adult Women. Obstet Gynecol Clin North Am 2016; 43:181-200. [DOI: 10.1016/j.ogc.2016.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Gollnick HP, Bettoli V, Lambert J, Araviiskaia E, Binic I, Dessinioti C, Galadari I, Ganceviciene R, Ilter N, Kaegi M, Kemeny L, López-Estebaranz JL, Massa A, Oprica C, Sinclair W, Szepietowski JC, Dréno B. A consensus-based practical and daily guide for the treatment of acne patients. J Eur Acad Dermatol Venereol 2016; 30:1480-90. [PMID: 27177989 DOI: 10.1111/jdv.13675] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Accepted: 02/11/2016] [Indexed: 01/01/2023]
Abstract
BACKGROUND Many current guidelines provide detailed evidence-based recommendations for acne treatment. OBJECTIVE To create consensus-based, simple, easy-to-use algorithms for clinical acne treatment in daily office-based practice and to provide checklists to assist in determining why a patient may not have responded to treatment and what action to take. METHODS Existing treatment guidelines and consensus papers were reviewed. The information in them was extracted and simplified according to daily clinical practice needs using a consensus-based approach and based on the authors' clinical expertise. RESULTS As outcomes, separate simple algorithms are presented for the treatment of predominant comedonal, predominant papulopustular and nodular/conglobate acne. Patients with predominant comedonal acne should initially be treated with a topical retinoid, azelaic acid or salicylic acid. Fixed combination topicals are recommended for patients with predominant papulopustular acne with treatment tailored according to the severity of disease. Treatment recommendations for nodular/conglobate acne include oral isotretinoin or fixed combinations plus oral antibiotics in men, and these options may be supplemented with oral anti-androgenic hormonal therapy in women. Further decisions regarding treatment responses should be evaluated 8 weeks after treatment initiation in patients with predominant comedonal or papulopustular acne and 12 weeks after in those with nodular/conglobate acne. Maintenance therapy with a topical retinoid or azelaic acid should be commenced once a patient is clear or almost clear of their acne to prevent the disease from recurring. The principal explanations for lack of treatment response fall into 5 main categories: disease progression, non-drug-related reasons, drug-related reasons, poor adherence, and adverse events. CONCLUSION This practical guide provides dermatologists with treatment algorithms adapted to different clinical features of acne which are simple and easy to use in daily clinical practice. The checklists to establish the causes for a lack of treatment response and subsequent action to take will facilitate successful acne management.
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Affiliation(s)
- H P Gollnick
- Department of Dermatology & Venereology, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - V Bettoli
- Department of Clinical and Experimental Medicine, O.U. of Dermatology, Azienda Ospedaliero-Universitaria, University of Ferrara, Ferrara, Italy
| | - J Lambert
- Department of Dermatology, University Hospital of Antwerp, University of Antwerp, Edegem, Belgium
| | - E Araviiskaia
- Department of Dermatology and Venereal Diseases, First I. P. Pavlov State Medical University of St. Petersburg, St. Petersburg, Russia
| | - I Binic
- Department of Dermatovenerology, Faculty of Medicine, University of Nis, Nis, Serbia
| | - C Dessinioti
- Department of Dermatology, A. Syggros Hospital, University of Athens, Athens, Greece
| | - I Galadari
- School of Medicine, United Arab Emirates University, Al-Ain, United Arab Emirates
| | - R Ganceviciene
- Clinic of Infectious, Chest Diseases, Dermatovenereology and Allergology, Vilnius University, Vilnius, Lithuania
| | - N Ilter
- Department of Dermatology, Gazi University Medical School, Ankara, Turkey
| | - M Kaegi
- Hautzentrum Zürich, Zürich, Switzerland
| | - L Kemeny
- Department of Dermatology and Allergology University of Szeged, Szeged, Hungary
| | | | - A Massa
- Clínica Dermatológica Dr António Massa, Porto, Portugal
| | - C Oprica
- Department of Laboratory Medicine, Karolinska Institutet Karolinska University Hospital Huddinge, Stockholm, Sweden.,Diagnostiskt Centrum Hud, Stockholm, Sweden
| | - W Sinclair
- Department of Dermatology, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa
| | - J C Szepietowski
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland
| | - B Dréno
- Department of Dermato-Cancerology, University of Nantes, Nantes, France
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Çinar L, Kartal D, Ergin C, Aksoy H, Karadag MA, Aydin T, Cinar E, Borlu M. The effect of systemic isotretinoin on male fertility. Cutan Ocul Toxicol 2015; 35:296-9. [PMID: 26653640 DOI: 10.3109/15569527.2015.1119839] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND/OBJECTIVE Acne vulgaris is one of the most common diseases of the youth. Systemic isotretinoin is the only drug which acts on all of the etiopathogenic mechanisms of acne. Isotretinoin has some well-known side effects. Besides these, there is a suspicion whether it causes infertility or not. In this study, we aimed to evaluate the effects of systemic isotretinoin on male fertility. METHODS Eighty one male patients, who were older than 18 years of age, and had severe or refractory acne vulgaris were included in the study. They were given a total dose of 120 mg/kg of systemic isotretinoin over a period of six months. Before and after the study, the spermiogram parameters of the patients were evaluated to show any possible effect on male fertility. The patients' total testosterone, follicle stimulating hormone and luteinizing hormone levels were also evaluated. RESULTS All of the spermiogram parameters changed positively (p < 0.05). There was no significant change in the hormone levels. CONCLUSION Systemic isotretinoin has a positive effect on male fertility. Since the hormone levels did not change significantly, this positive effect of isotretinoin is not via the hypothalamic-pituitary-gonadal axis but can be due to its regenerative and proliferative effects on the testes.
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Affiliation(s)
- Levent Çinar
- a Faculty of Medicine , Dermatology and Venereology Department, Erciyes University , Kayseri , Turkey
| | - Demet Kartal
- a Faculty of Medicine , Dermatology and Venereology Department, Erciyes University , Kayseri , Turkey
| | - Can Ergin
- b Dermatology and Venereology Department, Diskapi Yildirim Beyazit Education and Research Hospital , Ankara , Turkey
| | - Huseyin Aksoy
- c Obstetrics and Gynecology Department, Kayseri Military Hospital , Kayseri , Turkey
| | - Mert Ali Karadag
- d Urology Department, Faculty of Medicine, Kafkas University , Kayseri , Turkey , and
| | - Turgut Aydin
- e Obstetrics and Gynecology Department, Kayseri Acibadem Hospital , Kayseri , Turkey
| | - Elif Cinar
- e Obstetrics and Gynecology Department, Kayseri Acibadem Hospital , Kayseri , Turkey
| | - Murat Borlu
- a Faculty of Medicine , Dermatology and Venereology Department, Erciyes University , Kayseri , Turkey
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Schmidt TH, Shinkai K. Evidence-based approach to cutaneous hyperandrogenism in women. J Am Acad Dermatol 2015; 73:672-90. [PMID: 26138647 DOI: 10.1016/j.jaad.2015.05.026] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Revised: 05/15/2015] [Accepted: 05/16/2015] [Indexed: 10/23/2022]
Abstract
Hirsutism, acne, and androgenetic alopecia are classically considered signs of cutaneous hyperandrogenism (CHA). These common skin findings have significant impacts on the quality of patients' lives and pose the diagnostic challenge of excluding underlying disorders. Many with CHA have normal serum androgen levels. Hirsutism is more strongly associated with hyperandrogenism than are acne or androgenetic alopecia. Variable association of CHA with hyperandrogenemia results from the complexity of the underlying pathophysiology, including factors local to the pilosebaceous unit. CHA often occurs in the setting of polycystic ovary syndrome, the most common disorder of hyperandrogenism, but can also present in uncommon conditions, including nonclassic adrenal hyperplasia and androgen-producing tumors. A thorough history and full skin examination are important to guide appropriate diagnostic evaluation. Oral contraceptive pills with or without antiandrogens can provide therapeutic benefit for hirsutism and acne. Medical options for androgenetic alopecia remain limited. Multidisciplinary approaches may be needed given endocrine, metabolic, reproductive, and psychiatric disorders associated with CHA. More high-quality studies into the mechanisms of CHA and the benefits of antiandrogenic therapies are needed. We provide an evidence-based review of key diagnostic and therapeutic considerations in the treatment of women with CHA.
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Affiliation(s)
- Timothy H Schmidt
- Department of Dermatology, University of California San Francisco, San Francisco, California
| | - Kanade Shinkai
- Department of Dermatology, University of California San Francisco, San Francisco, California.
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Abstract
BACKGROUND Acne occurs because the sebaceous glands are overstimulated by high levels of androgens or are hypersensitive to normal levels of testosterone. In women with mild or moderate acne, the association of norgestimate (NG), and ethinyl estradiol (EE) is an effective treatment. This is related to the effect of oral contraceptives on androgen production and transport and the antiandrogenic properties of NG itself. DESIGN The present work was undertaken to find out whether NG and its derivative, 17-deacetylnorgestimate(dNG), present steroid activities other than antiandrogen activities, using human progesterone receptor(PR), estrogen receptor α(ERα) and β(ERβ), glucocorticoid receptor(GR) and mineralocorticoid receptor(MR)-responsive cell lines. RESULTS We confirmed that NG and its metabolite were progestogen partial agonists (EC50 of 13 and 11.1 nM) and ERα selective agonists (EC50 of 30.4 and 43.4 nM), as well as full antagonists of low affinity for GR (IC50 of 325 and 255 nM) and moderate affinity for MR (IC50 of 81.2 and 83.7). CONCLUSION We demonstrated that NG and dNG have full progestogen and weak estrogenic (through ERα) properties, which could explain in part the efficacy of NG in association with EE for the treatment of moderate acne in women. Moreover, their antagonist MR activity might have a favorable impact on cardiovascular risk, atherosclerosis and lipid profiles.
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Affiliation(s)
- Françoise Paris
- INSERM U896, Institut de Recherche en Cancérologie de Montpellier (IRCM) Parc Euromédecine - ICM F-34298 , Montpellier , France
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Silverberg N. Pediatric dermatology, part II: More hot topics in pediatric dermatology. Clin Dermatol 2015; 33:269-70. [DOI: 10.1016/j.clindermatol.2014.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Das S, Reynolds RV. Recent advances in acne pathogenesis: implications for therapy. Am J Clin Dermatol 2014; 15:479-88. [PMID: 25388823 DOI: 10.1007/s40257-014-0099-z] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Acne pathogenesis is a multifactorial process that occurs at the level of the pilosebaceous unit. While acne was previously perceived as an infectious disease, recent data have clarified it as an inflammatory process in which Propionibacterium acnes and innate immunity play critical roles in propagating abnormal hyperkeratinization and inflammation. Alterations in sebum composition, and increased sensitivity to androgens, also play roles in the inflammatory process. A stepwise approach to acne management utilizes topical agents for mild to moderate acne (topical retinoid as mainstay ± topical antibiotics) and escalation to oral agents for more resistant cases (oral antibiotics or hormonal agents in conjunction with a topical retinoid or oral isotretinoin alone for severe acne). Concerns over antibiotic resistance and the safety issues associated with isotretinoin have prompted further research into alternative medications and devices for the treatment of acne. Radiofrequency, laser, and light treatments have demonstrated modest improvement for inflammatory acne (with blue-light photodynamic therapy being the only US FDA-approved treatment). However, limitations in study design and patient follow-up render these modalities as adjuncts rather than standalone options. This review will update readers on the latest advancements in our understanding of acne pathogenesis and treatment, with emphasis on emerging treatment options that can help improve patient outcomes.
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