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Saeidi S, Ghanadian SM, Poostiyan N, Soltani R. Evaluation of the effectiveness of Berberis integerrima Bunge root extract combined with spearmint essential oil in the treatment of acne vulgaris: A randomized controlled clinical trial. J Cosmet Dermatol 2024; 23:2458-2466. [PMID: 38545754 DOI: 10.1111/jocd.16291] [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: 07/24/2023] [Revised: 03/07/2024] [Accepted: 03/11/2024] [Indexed: 06/21/2024]
Abstract
BACKGROUND Acne vulgaris is one of the most common dermatological disorders. Berberis integerrima Bunge belongs to the Berberidaceae family. Several studies on different Berberis species in addition to B. integerrima have shown antimicrobial, antioxidant, and anti-inflammatory effects. Spearmint essential oil also has antioxidant, antibacterial, and anti-inflammatory activities. This study aimed to evaluate the clinical effectiveness of the topical combination of B. integerrima root extract and spearmint essential oil in the treatment of acne vulgaris. METHODS Patients with mild to moderate facial acne who met the inclusion criteria were randomly assigned to either drug (B. integerrima extract/spearmint essential oil topical solution) or control (clindamycin 1% topical solution) groups. Each group applied the solution twice a day for 4 weeks. Before and at the end of the intervention, the number of lesions and mGAGS (Modified Global Acne Grading Scale) score were recorded. RESULTS Thirty patients in each group of drug and control completed the study. Topical B.integerrima root extract/spearmint essential oil significantly reduced the number of lesions (27.33 ± 26.17 vs. 21.58 ± 21.10; p < 0.001) and mGAGS (18.76 ± 8.61 vs. 13.87 ± 8.14; p < 0.001) at the end of the intervention. However, there was no significant difference between the two groups regarding the number of lesions (p = 0.906) and mGAGS (p = 0.882). CONCLUSIONS B. integerrima root extract combined with spearmint essential oil has significant anti-acne effects, comparable to topical antibiotic clindamycin. It could be considered as a potential treatment for acne vulgaris. However, more studies with larger sample sizes and longer durations are required to confirm this effect.
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Affiliation(s)
- Sara Saeidi
- Students Research Committee, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Syed Mustafa Ghanadian
- Department of Pharmacognosy, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
- Isfahan Pharmaceutical Research Center, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nazila Poostiyan
- Department of Dermatology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
- Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Rasool Soltani
- Department of Clinical Pharmacy and Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
- Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Fang M, Lei J, Zhang Y, Zhang B. Repurposing lipid-lowering drugs as potential treatment for acne vulgaris: a Mendelian randomization study. Front Med (Lausanne) 2024; 11:1385948. [PMID: 38903813 PMCID: PMC11187329 DOI: 10.3389/fmed.2024.1385948] [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] [Received: 02/18/2024] [Accepted: 05/20/2024] [Indexed: 06/22/2024] Open
Abstract
Background Acne vulgaris, a chronic inflammatory skin condition predominantly seen in teenagers, impacts more than 640 million people worldwide. The potential use of lipid-lowering medications as a treatment for acne vulgaris remains underexplored. This study seeks to investigate the impact of lipid-lowering therapies on the risk of developing acne vulgaris using two-sample Mendelian randomization (MR) analysis. Method The two-sample MR method was employed for analysis, and information on lipid-lowering drugs was obtained from the DrugBank and ChEMBL databases. The summary data for blood low-density lipoprotein (LDL) and triglycerides were sourced from the Global Lipids Genetics Consortium, while genome-wide association studies (GWAS) summary data for acne vulgaris were obtained from the FinnGen database. Heterogeneity was examined using the Q-test, horizontal pleiotropy was assessed using MR-Presso, and the robustness of analysis results was evaluated using leave-one-out analysis. Results The MR analysis provided robust evidence for an association between lowering LDL cholesterol through two drug targets and acne vulgaris, with PCSK9 showing an odds ratio (OR) of 1.782 (95%CI: 1.129-2.812, p = 0.013) and LDL receptor (LDLR) with an OR of 1.581 (95%CI: 1.071-2.334, p = 0.021). Similarly, targeting the lowering of triglycerides through lipoprotein lipase (LPL) was significantly associated with an increased risk of acne vulgaris, indicated by an OR of 1.607 (95%CI: 1.124-2.299, p = 0.009). Conclusion The current MR study presented suggestive evidence of a positive association between drugs targeting three genes (PCSK9, LDLR, and LPL) to lower lipids and a reduced risk of acne vulgaris.
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Affiliation(s)
- Man Fang
- Department of Plastic and Cosmetic Surgery, Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, China
| | - Jing Lei
- College of Computer, Chengdu University, Chengdu, Sichuan, China
| | - Yue Zhang
- Xiangya Hospital, Central South University, Changsha, China
| | - Bo Zhang
- Department of Plastic and Cosmetic Surgery, Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, China
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Boris K, Faizan M, Bendesky RJ, Davis E, Reaume AG, Cong WN. A Murine Model for Measuring Sebum Production That Can Be Used to Test Therapeutic Agents for the Management of Acne Vulgaris. Curr Protoc 2024; 4:e989. [PMID: 38363064 DOI: 10.1002/cpz1.989] [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] [Indexed: 02/17/2024]
Abstract
Acne vulgaris (acne) effects nearly 90% of all Western teenagers, and the only pharmaceutical class of agents to treat severe forms of this skin condition are the retinoids, which are well-described teratogens. Yet about 50% of the patients receiving this class of therapeutics are women of child-bearing age, in their peak years of reproductive potential. On this basis, there is a significant unmet medical need for agents to treat severe forms of acne that do not carry this liability. As a means to assess potential agents of this type, here we describe methods for estimating the relative amount of sebum that a mouse produces based on the water retention on fur following a thorough wetting procedure. We have shown that a compound that is clinically effective in reducing sebum production demonstrates activity in this model. The method is therefore useful for evaluating therapeutic candidates for reducing sebum production, which would in turn be useful for treating acne. We have broken the entire procedure down into two phases/two protocols, as listed below. © 2024 Wiley Periodicals LLC. Basic Protocol 1: Pre-wash wet weight measurement Basic Protocol 2: Post-wash wet-weight measurement.
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Muacevic A, Adler JR, Alyasin ZT. A Comparative Clinical and Laboratory Study of Adolescent and Adult Acne in Iraqi Women. Cureus 2022; 14:e32866. [PMID: 36694512 PMCID: PMC9867879 DOI: 10.7759/cureus.32866] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/18/2022] [Indexed: 12/24/2022] Open
Abstract
Background Acne vulgaris is a common chronic inflammatory disease of the pilosebaceous units associated with long-term sequelae and complications. Currently, acne in women is classified into adolescent and post-adolescent forms. However, comparative studies evaluating the clinical and laboratory parameters across various age groups in women with acne are lacking. The aim of the study is to compare the clinical and laboratory characteristics of different groups of women with acne vulgaris. Patients and methods Over 3 years (2018-2021), a cross-sectional study was carried out on 340 women with acne consulting the Dermatology and Venereology Outpatient Clinic, Basrah Teaching Hospital, Basrah, Iraq. Eligible patients were carefully evaluated and fully examined, emphasizing on signs of hyperandrogenism and scoring of acne severity. Hormonal assays of serum total testosterone (TST), dehydroepiandrosterone sulfate (DHEAS), luteinizing hormone (LH), follicular stimulating hormone (FSH), and serum prolactin (PRL) were done. Pelvic ultrasonography was performed to identify any pelvic pathology. The patients were classified according to their age of onset. Clinical and laboratory data were compared among groups. Results Three groups were recognized: 160 patients (47%) with adolescent acne (AA) (mean age SD: 17.2±1.6 years), 80 (23.5%) with early adult-onset acne (EA) (mean age SD: 21.4±1.2 years), and 100 (29.4%) with post-adolescent acne (PA) (mean age SD: 28.7±2.9 years), which were further sub-grouped into late-onset acne (40 cases, 11.7%), and persistent acne (60 cases, 17.6%). The mean body mass index was normal in the AA group and overweight in the EA and PA groups. Moderate obesity was more frequent in PA (24%, p=0.03). While 78.5% of AA was mild to moderate acne, 77.5% of EA was moderate to moderately severe, and 72% of PA was moderately severe to severe. Clinical and biochemical markers of hyperandrogenism were seen in all groups, however, they were more frequent in PA and EA groups than in the AA group (p<005). Conclusion Clinical and biochemical hyperandrogenism were present in a significant proportion of women with acne; their prevalence was higher in post-adolescent acne than in adolescent acne. Acne that began between the ages of 20 and 25 was classified as "early adult-onset acne," and showed variable features of hyperandrogenism. A complete evaluation, regardless of age, for every female with acne, including a hormonal analysis and pelvic ultrasound examination to detect hormonal imbalances as early therapy, can help to prevent and reduce the risk of consequences.
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Abstract
Acne vulgaris is the common form of acne that primarily affects adolescents, characterised by an eruption of inflammatory and/or non-inflammatory skin lesions. Accurate evaluation and severity grading of acne play a significant role in precise treatment for patients. Manual acne examination is typically conducted by dermatologists through visual inspection of the patient skin and counting the number of acne lesions. However, this task costs time and requires excessive effort by dermatologists. This paper presents automated acne counting and severity grading method from facial images. To this end, we develop a multi-scale dilated fully convolutional regressor for density map generation integrated with an attention mechanism. The proposed fully convolutional regressor module adapts UNet with dilated convolution filters to systematically aggregate multi-scale contextual information for density maps generation. We incorporate an attention mechanism represented by prior knowledge of bounding boxes generated by Faster R-CNN into the regressor model. This attention mechanism guides the regressor model on where to look for the acne lesions by locating the most salient features related to the understudied acne lesions, therefore improving its robustness to diverse facial acne lesion distributions in sparse and dense regions. Finally, integrating over the generated density maps yields the count of acne lesions within an image, and subsequently the acne count indicates the level of acne severity. The obtained results demonstrate improved performance compared to the state-of-the-art methods in terms of regression and classification metrics. The developed computer-based diagnosis tool would greatly benefit and support automated acne lesion severity grading, significantly reducing the manual assessment and evaluation workload.
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Optimization of entrapment efficiency and release of clindamycin in microsponge based gel. Sci Rep 2021; 11:23345. [PMID: 34857863 PMCID: PMC8639917 DOI: 10.1038/s41598-021-02826-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 11/23/2021] [Indexed: 11/19/2022] Open
Abstract
The aim of the present study was to formulate clindamycin (CLN) as a microsponge based gel to release the drug in a controlled manner and reduce the side effects in the treatment of acne. Since this method requires poor water solubility of the drug to be loaded in particles, therefore, conversion of the hydrochloride salt to free base was done. By using an emulsion solvent diffusion method, we made six different formulations of microsponges containing CLN-free base by changing the proportions of polymer, emulsifier and the pH of the external phase. These formulations were studied for physical characterization and for drug- polymer interactions. The physical characterization showed that microsponge formulations coded by C5, C6 resulted in a better loading efficiency and production yield and their particle size was less than 30 µm. Scanning electron microscopy images showed the microsponges porous and spherical. C5, C6 microsponge formulation was prepared as gel in Carbopol and in vitro evaluated. The microsponge formulation gel C8 was found to be optimized. C8 released 90.38% of drug over 12 h and showed viscosity 20,157 ± 38 cp, pH of 6.3 ± 0.09 and drug content of 99.64 ± 0.04%. Fourier transform infrared spectroscopy and differential scanning calorimetry confirmed no significant interactions between excipients and drug.
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Double-blind, randomized controlled trial comparing the use of microneedling alone versus chemical peeling alone versus a combination of microneedling and chemical peeling in the treatment of atrophic post-acne scars. An assessment of clinical effectiveness and patients' quality-of-life. Postepy Dermatol Alergol 2021; 38:629-635. [PMID: 34658706 PMCID: PMC8501429 DOI: 10.5114/ada.2021.108913] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 03/23/2020] [Indexed: 11/17/2022] Open
Abstract
Introduction Acne vulgaris is a common, chronic disease. One of the most commonly encountered complications of acne is permanent atrophic scarring. Treatment of atrophic scars includes fillers, dermabrasion, laser resurfacing, microneedling and peelings and it is often difficult to treat. In our double-blind randomized controlled trial (RCT), we investigated the synergistic effect of microneedling with the application of trichloroacetic acid, kojic acid and hydrogen peroxide in the treatment of atrophic acne scars. Aim To assess the clinical effectiveness and patients' quality-of-life (HRQoL) after three types of atrophic post-acne scar treatment, namely microneedling alone (MN) vs chemical peeling alone (CP) vs. a combination of microneedling and chemical peeling (MN + CP). Material and methods A total of 120 patients were enrolled into the study following strict inclusion/exclusion criteria and randomized into the three treatment groups - MN, CP (a combination of trichloroacetic acid, kojic acid and hydrogen peroxide), and MN + CP. According to a preapproved protocol, each patient underwent four treatment sessions, each spread 20 days apart. Both pre- and post-treatment clinical status (using the Goodman-Baron scale; two expert raters blinded to the treatment used) and patients' HRQoL (using the Dermatology Life Quality Index) were assessed. Results During the 5-month recruitment period, a total of 120 patients were approached and agreed to take part in the study (94 females - 78.3% and 26 males) (mean age of 30.14 ±3.64 years; range: 18-45 years). Only in the MN + CP group there was a statistically significant improvement according to the G-B scale post-treatment (2.87 ±0.83 vs. 2.03 ±1.16 respectively; p = 0.0005). Patients in all three treatment groups experienced a statistically significant improvement in their HRQoL post-treatment (all p's < 0.05). Conclusions A combination of microneedling and chemical peeling produces the best, objectively measured effects in the treatment of atrophic post-acne scars. All examined treatments, even if not producing a clinically significant treatment outcome, improve patients' HRQoL.
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Secrest AM, Hopkins ZH, Frost ZE, Taliercio VL, Edwards LD, Biber JE, Chen SC, Chren MM, Ferris LK, Kean J, Hess R. Quality of Life Assessed Using Skindex-16 Scores Among Patients With Acne Receiving Isotretinoin Treatment. JAMA Dermatol 2021; 156:1098-1106. [PMID: 32639529 DOI: 10.1001/jamadermatol.2020.2330] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Importance Acne is a common dermatologic condition and significantly affects psychosocial health and quality of life. An international task force recommended routine use of quality-of-life measures for clinic visits associated with acne management, but this has yet to translate into clinical practice. Objective To assess mean Skindex-16 scores over time among patients with moderate to severe acne receiving isotretinoin treatment. Design, Setting, and Participants A longitudinal, retrospective case series study of Skindex-16 data collected at monthly visits from 57 consecutive patients with acne receiving isotretinoin; data were collected and evaluated between November 23, 2016, and January 22, 2019. Continuous variables were compared using quantile regression. Multivariable linear mixed models evaluated mean (95% CI) score trajectory over time. Main Outcomes and Measure Skindex-16 scores, including normalized scores for the emotional, symptomatic, and functional aspects of having skin disease as well as an overall score. Results Fifty-seven patients (31 [54.4 %] males, with median [interquartile range] age of 17.2 [15.9-18.1] years) in this case series study completed the Skindex-16 at baseline and at least once during follow-up. Baseline Skindex-16 scores were similar by sex but worse with increasing age. Emotional impact was more bothersome to patients with acne requiring isotretinoin treatment than either symptoms or functioning. Improvements of greater than 50% in overall and Emotional domain scores were seen by month 2 of receiving isotretinoin treatment (eg, overall scores decreased from 39.4 to 17.5 by month 2; a decrease of 22.0; P < .001). Qualitatively, Skindex-16 scores reached their nadir between months 3 and 5; at month 4, overall Skindex-16 scores showed a 4.4-fold improvement (from 39.4 at baseline to 8.9; P < .001) and Emotional domain scores showed a 4.8-fold improvement (from 57.7 at baseline to 11.9; P < .001). Conclusions and Relevance The findings of this case series suggest that patients receiving isotretinoin treatment achieve greater than a 50% improvement in quality of life by month 2 and can expect approximately 4-fold to 5-fold improvements from baseline with a full course of isotretinoin. This study shows the potential of routine administration of quality of life measures to assess patient care in dermatology.
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Affiliation(s)
- Aaron M Secrest
- Department of Dermatology, University of Utah, Salt Lake City.,Department of Population Health Sciences, University of Utah, Salt Lake City
| | | | - Zachary E Frost
- Department of Dermatology, University of Utah, Salt Lake City
| | | | - LaVar D Edwards
- Department of Dermatology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Joshua E Biber
- Department of Population Health Sciences, University of Utah, Salt Lake City
| | - Suephy C Chen
- Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia.,Regional TeleHealth Services, Atlanta Veterans Affairs Health Care System, Atlanta, Georgia
| | - Mary-Margaret Chren
- Department of Dermatology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Laura K Ferris
- Department of Dermatology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Jacob Kean
- Department of Population Health Sciences, University of Utah, Salt Lake City
| | - Rachel Hess
- Department of Population Health Sciences, University of Utah, Salt Lake City.,Department of Internal Medicine, University of Utah, Salt Lake City
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Tan J, Beissert S, Cook-Bolden F, Chavda R, Harper J, Hebert A, Lain E, Layton A, Rocha M, Weiss J, Dréno B. Impact of facial and truncal acne on quality of life: A multi-country population-based survey. JAAD Int 2021; 3:102-110. [PMID: 34409378 PMCID: PMC8362284 DOI: 10.1016/j.jdin.2021.03.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/05/2021] [Indexed: 11/26/2022] Open
Abstract
Background Acne confers an increased risk of physical, psychiatric, and psychosocial sequelae, potentially affecting multiple dimensions of health-related quality of life (HRQoL). Morbidity associated with truncal acne is poorly understood. Objective To determine how severity and location of acne lesions impact the HRQoL of those who suffer from it. Methods A total of 694 subjects with combined facial and truncal acne (F+T) and 615 with facial acne only (F) participated in an online, international survey. Participants self-graded the severity of their acne at different anatomical locations and completed the dermatology life quality index (DLQI). Results The F+T participants were twice as likely to report “very large” to “extremely large” impact on HRQoL (ie, DLQI > 10 and children's DLQI [CDLQI] > 12) as compared with the F participants (DLQI: odds ratio [OR] 1.61 [95% confidence interval {CI} 1.02-2.54]; CDLQI: OR 1.86 [95% CI 1.10-3.14]). The impact of acne on HRQoL increased with increasing acne severity on the face (DLQI and CDLQI P values = .001 and .017, respectively), chest (P = .003; P = .008), and back (P = .001; P = .028). Limitations Temporal evaluation of acne impact was not estimated. Conclusions Facial and truncal acne was associated with a greater impact on HRQoL than facial acne alone. Increasing severity of truncal acne increases the adverse impact on HRQoL irrespective of the severity of facial acne.
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Affiliation(s)
- Jerry Tan
- Schulich School of Medicine and Dentistry, Western University Canada, Windsor, Ontario, Canada
| | - Stefan Beissert
- Department of Dermatology, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
| | | | | | - Julie Harper
- The Dermatology and Skin Care Center of Birmingham, Birmingham, Alabama
| | - Adelaide Hebert
- The University of Texas Medical School - Houston, Houston, Texas
| | - Edward Lain
- Austin Institute for Clinical Research, Pflugerville, Texas
| | - Alison Layton
- Hull York Medical School, York University, Heslington, York, United Kingdom
| | - Marco Rocha
- Federal University of São Paulo, São Paulo, Brazil
| | - Jonathan Weiss
- Georgia Dermatology Partners (Formerly, Gwinnett Dermatology, PC), Snellville, Georgia
| | - Brigitte Dréno
- Unité Thérapie Cellulaire et Génique, Faculté de Médecine de Nantes, CHU Nantes - Place Alexis Ricordeau, Nantes, France
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Smith H, Layton AM, Thiboutot D, Smith A, Whitehouse H, Ghumra W, Verma M, Tan J, Jones G, Gilliland K, Patel M, Otchere E, Eady A. Identifying the Impacts of Acne and the Use of Questionnaires to Detect These Impacts: A Systematic Literature Review. Am J Clin Dermatol 2021; 22:159-171. [PMID: 33175359 DOI: 10.1007/s40257-020-00564-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND Acne (syn: acne vulgaris) ranks as the most common inflammatory dermatosis treated worldwide. Acne typically affects adolescents at a time when they are undergoing maximum physical and social transitions, although prevalence studies suggest it is starting earlier and lasting longer, particularly in female patients. According to global burden of disease studies, acne causes significant psychosocial impact. Hence, identifying mechanisms to accurately measure the impact of the disease is important. Adopting an approach to harmonize and standardize measurements is now recognized as an essential part of any clinical evaluation and allows for better comparison across studies and meta-analyses. OBJECTIVE The Acne Core Outcome Research Network (ACORN) has identified relevant domains as part of a core outcome set of measures for use in clinical studies. One of these is health-related quality of life (HRQoL). The aim of this systematic review was to provide information to inform the identification of the impacts most important to people with acne. METHODS A synthesis of available evidence on acne impacts was constructed from a systematic review of the literature, with searches conducted in the MEDLINE, EMBASE and PsychInfo databases. RESULTS We identified 408 studies from 58 countries using 138 different instruments to detect the impacts of acne. Four of the five most commonly used instruments (Dermatology Life Quality Index [DLQI], Cardiff Acne Disability Index [CADI], Acne Quality of Life scale [Acne-QoL], Hospital Anxiety and Depression Scale [HADS] and Skindex-29) do not identify specific impacts but rather quantify to what extent acne affects HRQoL. Other studies identified one or more impacts using open-ended questions or tailor-made questionnaires. CONCLUSION This review serves as a rich data source for future efforts by groups such as ACORN (that include patients and health care providers) to develop a core set of outcome measurements for use in clinical trials.
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Affiliation(s)
- Hayley Smith
- Department of Dermatology, Harrogate and District NHS Foundation Trust, Lancaster Park Road, Harrogate, HG2 7SX, UK
| | - Alison M Layton
- Department of Dermatology, Harrogate and District NHS Foundation Trust, Lancaster Park Road, Harrogate, HG2 7SX, UK.
| | - Diane Thiboutot
- Department of Dermatology, Penn State University, Hershey, PA, USA
| | - Abbey Smith
- Department of Dermatology, Harrogate and District NHS Foundation Trust, Lancaster Park Road, Harrogate, HG2 7SX, UK
| | - Heather Whitehouse
- Department of Dermatology, Harrogate and District NHS Foundation Trust, Lancaster Park Road, Harrogate, HG2 7SX, UK
| | - Waseem Ghumra
- Department of Dermatology, Harrogate and District NHS Foundation Trust, Lancaster Park Road, Harrogate, HG2 7SX, UK
| | - Meenakshi Verma
- Department of Dermatology, Harrogate and District NHS Foundation Trust, Lancaster Park Road, Harrogate, HG2 7SX, UK
| | - Jerry Tan
- Schulich School of Medicine and Dentistry, Western University, Windsor, ON, Canada
| | - Georgina Jones
- School of Social Sciences, Leeds Beckett University, Leeds, UK
| | | | - Megha Patel
- Department of Radiology, Penn State University, Hershey, PA, USA
| | - Elaine Otchere
- Department of Dermatology, Duke University, Durham, NC, USA
| | - Anne Eady
- Department of Dermatology, Harrogate and District NHS Foundation Trust, Lancaster Park Road, Harrogate, HG2 7SX, UK
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Zhao J, Wang Y, Jiang L, Mu YZ. The application of skin care product in acne treatment. Dermatol Ther 2020; 33:e14287. [PMID: 32897611 DOI: 10.1111/dth.14287] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 08/09/2020] [Accepted: 08/10/2020] [Indexed: 11/29/2022]
Abstract
Acne is a kind of chronic inflammatory skin disease, which is common in the hair follicle and sebaceous gland of teenagers. It often recurs and affects the quality of life of patients. Acne itself can cause the damage of skin barrier function. On the other hand, common acne treatment methods, such as external drugs, systemic drugs, physical, and chemical treatment, can also lead to the damage of skin barrier function and affect the treatment effect. The application of skin care in the adjuvant treatment of acne has been widely concerned. Due to their high safety, good tolerance, and the effect of improving the damaged skin barrier, medical skin care products are a hot spot in the treatment of cosmetic skin diseases in recent years. It can not only increase the curative effect, reduce the side effects, but also increase the compliance of patients when combined with conventional acne treatment. In this article, skin care products and their application in acne treatment were reviewed.
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Affiliation(s)
- Jianmei Zhao
- Department of Dermatology, The Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan Province, China
| | - Yu Wang
- Department of Dermatology, The Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan Province, China
| | - Lu Jiang
- Department of Dermatology, The Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan Province, China
| | - Yun-Zhu Mu
- Department of Dermatology, The Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan Province, China
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Putative Genes and Pathways Involved in the Acne Treatment of Isotretinoin via Microarray Data Analyses. BIOMED RESEARCH INTERNATIONAL 2020; 2020:5842795. [PMID: 32685503 PMCID: PMC7341380 DOI: 10.1155/2020/5842795] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 04/18/2020] [Indexed: 11/19/2022]
Abstract
Acne is the eighth most common disease worldwide. Disease burden of acne such as anxiety, reduced self-esteem, and facial scarring lowers the life quality of acne patients. Isotretinoin is the most potent treatment for moderate-severe acne. However, the adverse events of isotretinoin especially teratogenicity limit its use. This study aims at investigating the therapeutical mechanisms of isotretinoin using bioinformatics analysis. Differentially expressed genes (DEGs) were filtered from microarray datasets GSE10432, GSE10433, and GSE11792. Functional and pathway enrichment analyses of DEGs were performed. Protein–protein interaction (PPI) network and module analyses were also conducted based on DEGs. Using isotretinoin for 1 week, LCN2, PTGES, and GDF15 were upregulated and might mediate sebocytes apoptosis and thus decreased sebum production; CCL2 originated from activated TNF signaling pathway and S100A7 could be related with “acne-flare”. While treating with isotretinoin for 8 weeks, key genes were downregulated, including HMGCS1, HMGCR, FDFT1, MVD, IDI1, and FDPS, which may be associated with decreased sebum synthesis; HMGCS1, HMGCR, and FDFT1 also probably associated with apoptosis of sebocytes. There were only two common genes including ACSBG1 and BCAT2 which worked in both 1 week and 8 weeks and could associate with decreased sebum synthesis and apoptosis of sebocytes, respectively. These results indicate potential therapeutics and side effect mechanisms of isotretinoin in the acne treatment and provide a research direction to further investigate the therapeutic mechanism of isotretinoin and thus develop retinoid-like compounds with similar curative effect and without teratogenicity.
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13
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Estrella Porter J, Camacho M, Viteri MI, Aguilar K, Belhadi D, Bettoli V, Buestán ADR, Dréno B, Endara P, Layton A, Machado N, Mateus R, Tan J, Terán E, Yépez P, Guillemot J. Pilot study for the evaluation and adaptation of a Four Item-Acne-Scar Risk Assessment Tool (4-ASRAT): a resource to estimate the risk of acne-induced scars. F1000Res 2020; 9:651. [PMID: 32850122 PMCID: PMC7431969 DOI: 10.12688/f1000research.23737.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/11/2020] [Indexed: 11/20/2022] Open
Abstract
Background: Acne-induced scarring is associated with a similar burden as acne, i.e. diminished quality of life, and may be avoided if patients receive appropriate and timely acne treatment. In 2017, a four item-Acne-Scar Risk Assessment Tool (4-ASRAT) was designed by Tan
et al. to categorise patients with acne into lower-risk or higher-risk for acne scarring. Its applicability outside the initial study population (France, Brazil and United States) remains to be determined. Methods: A study protocol was developed to create a systematic approach for validating and adapting 4-ASRAT to different populations, Ecuador in this case. The protocol was reviewed by 11 local and international dermatologists and pilot-tested in an Ecuadorian population using a sample of 10 participants who currently had or had had acne. Feedback from the pilot study was used to improve the study protocol. The results of the pilot study are included here, and the final study protocol is available as extended data. Results: The protocol proved to be applicable. Images taken of participants were a valuable resource for dermatological evaluation about the presence or absence of acne scars. Tangential light is necessary for this evaluation. Although dermatological assessments varied, we concluded that assessment by three local dermatologists for each participant was adequate for reaching a consensus on the presence or absence of acne scars. Conclusions: Considering the morbidity related to acne and acne scars, tools designed as prevention that alert patients about risk of developing scarring are necessary. The proposed protocol shows a feasible way of validating and adapting 4-ASRAT to different populations.
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Affiliation(s)
- Jorge Estrella Porter
- Escuela de Medicina, Universidad San Francisco de Quito USFQ, Quito, Pichincha, 170901, Ecuador.,Health Research Group, Universidad San Francisco de Quito USFQ, Quito, Pichincha, 170901, Ecuador
| | - Mikaela Camacho
- Escuela de Medicina, Universidad San Francisco de Quito USFQ, Quito, Pichincha, 170901, Ecuador.,Health Research Group, Universidad San Francisco de Quito USFQ, Quito, Pichincha, 170901, Ecuador
| | - María Isabel Viteri
- Escuela de Medicina, Universidad San Francisco de Quito USFQ, Quito, Pichincha, 170901, Ecuador.,Health Research Group, Universidad San Francisco de Quito USFQ, Quito, Pichincha, 170901, Ecuador
| | - Katherine Aguilar
- SISTEMAS MÉDICOS SIME, Universidad San Francisco de Quito USFQ, Quito, Pichincha, 170157, Ecuador
| | - Drifa Belhadi
- Hôpitaux Universitaires Paris Nord Val de Seine (Bichât Claude Bernard), Paris, 75018, France
| | - Vincenzo Bettoli
- Azienda Ospedaliero-Universitaria di Ferrara, Ferrara, 44122, Italy
| | - Anita Del Rocío Buestán
- SISTEMAS MÉDICOS SIME, Universidad San Francisco de Quito USFQ, Quito, Pichincha, 170157, Ecuador
| | - Brigitte Dréno
- Centre Hospitalier Universitaire de Nantes, Nantes, 44000, France
| | - Pablo Endara
- Escuela de Medicina, Universidad San Francisco de Quito USFQ, Quito, Pichincha, 170901, Ecuador
| | - Alison Layton
- Harrogate and District NHS Foundation Trust, Harrogate, HG2 7SX, UK
| | - Nelly Machado
- SISTEMAS MÉDICOS SIME, Universidad San Francisco de Quito USFQ, Quito, Pichincha, 170157, Ecuador
| | - Rosa Mateus
- SISTEMAS MÉDICOS SIME, Universidad San Francisco de Quito USFQ, Quito, Pichincha, 170157, Ecuador
| | - Jerry Tan
- University of Western Ontario, London, N6A 5B9, Canada
| | - Enrique Terán
- Escuela de Medicina, Universidad San Francisco de Quito USFQ, Quito, Pichincha, 170901, Ecuador
| | - Paola Yépez
- Escuela de Medicina, Universidad San Francisco de Quito USFQ, Quito, Pichincha, 170901, Ecuador.,Health Research Group, Universidad San Francisco de Quito USFQ, Quito, Pichincha, 170901, Ecuador
| | - Jonathan Guillemot
- Escuela de Medicina, Universidad San Francisco de Quito USFQ, Quito, Pichincha, 170901, Ecuador.,Health Research Group, Universidad San Francisco de Quito USFQ, Quito, Pichincha, 170901, Ecuador.,SISTEMAS MÉDICOS SIME, Universidad San Francisco de Quito USFQ, Quito, Pichincha, 170157, Ecuador
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14
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Vallerand I, Lewinson R, Parsons L, Lowerison M, Frolkis A, Kaplan G, Barnabe C, Bulloch A, Patten S. Risk of depression among patients with acne in the U.K.: a population-based cohort study. Br J Dermatol 2018; 178:e194-e195. [DOI: 10.1111/bjd.16099] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- I.A. Vallerand
- Department of Community Health Sciences; University of Calgary; Calgary Canada
- Leaders in Medicine Program; University of Calgary; Calgary Canada
| | - R.T. Lewinson
- Leaders in Medicine Program; University of Calgary; Calgary Canada
| | - L.M. Parsons
- Division of Dermatology; University of Calgary; Calgary Canada
- Department of Medicine; University of Calgary; Calgary Canada
| | - M.W. Lowerison
- Department of Community Health Sciences; University of Calgary; Calgary Canada
| | - A.D. Frolkis
- Department of Medicine; University of Calgary; Calgary Canada
| | - G.G. Kaplan
- Department of Community Health Sciences; University of Calgary; Calgary Canada
- Department of Medicine; University of Calgary; Calgary Canada
| | - C. Barnabe
- Department of Community Health Sciences; University of Calgary; Calgary Canada
- Department of Medicine; University of Calgary; Calgary Canada
| | - A.G.M. Bulloch
- Department of Community Health Sciences; University of Calgary; Calgary Canada
- Department of Physiology and Pharmacology; University of Calgary; Calgary Canada
- Department of Psychiatry; University of Calgary; Calgary Canada
| | - S.B. Patten
- Department of Community Health Sciences; University of Calgary; Calgary Canada
- Department of Psychiatry; University of Calgary; Calgary Canada
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15
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Vallerand IA, Lewinson RT, Farris MS, Sibley CD, Ramien ML, Bulloch AGM, Patten SB. Efficacy and adverse events of oral isotretinoin for acne: a systematic review. Br J Dermatol 2017; 178:76-85. [PMID: 28542914 DOI: 10.1111/bjd.15668] [Citation(s) in RCA: 83] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/12/2017] [Indexed: 01/01/2023]
Abstract
Despite many years of clinical use of isotretinoin, a comprehensive review of evidence for isotretinoin therapy in patients with acne is lacking. We searched MEDLINE, Embase, Cochrane Central, relevant web pages and bibliographies for randomized controlled trials in acne evaluating isotretinoin vs. control (placebo or other therapy). Data were extracted and summarized descriptively. Eleven trials were identified (total 760 patients randomized), containing mostly men. Mean treatment ages ranged from 18 to 47·9 years and participants generally had moderate-to-severe acne. Across all trials, isotretinoin therapy reduced acne lesion counts by a clinically relevant amount, and always by a greater amount than control, which was either placebo (two studies), oral antibiotics (seven studies) or other control (two studies). Across trials with an overall low risk of bias, two of three demonstrated statistically significant differences between isotretinoin and control. The frequency of adverse events was twice as high with isotretinoin (751 events) than with control (388 events). More than half of all adverse events were dermatological and related to dryness. Adverse events from isotretinoin causing participant withdrawal from trials (12 patients) included Stevens-Johnson syndrome, cheilitis, xerosis, acne flare, photophobia, elevated liver enzymes, decreased appetite, headaches and depressed mood. This review suggests that isotretinoin is effective in reducing acne lesion counts, but adverse events are common. This study was registered with PROSPERO number CRD42015025080.
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Affiliation(s)
- I A Vallerand
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Leaders in Medicine Program, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - R T Lewinson
- Leaders in Medicine Program, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - M S Farris
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - C D Sibley
- Division of Dermatology, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - M L Ramien
- Division of Dermatology, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.,Department of Pediatrics, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - A G M Bulloch
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Physiology & Pharmacology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Mathison Centre for Mental Health Research and Education, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - S B Patten
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Mathison Centre for Mental Health Research and Education, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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16
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Xu X, Zheng Y, Zhao Z, Zhang X, Liu P, Li C. Efficacy of photodynamic therapy combined with minocycline for treatment of moderate to severe facial acne vulgaris and influence on quality of life. Medicine (Baltimore) 2017; 96:e9366. [PMID: 29390528 PMCID: PMC5758230 DOI: 10.1097/md.0000000000009366] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Acne vulgaris is a prevalent skin disorder impairing both physical and psychosocial health. This study was designed to investigate the effectiveness of photodynamic therapy (PDT) combined with minocycline in moderate to severe facial acne and influence on quality of life (QOL). METHODS Ninety-five patients with moderate to severe facial acne (Investigator Global Assessment [IGA] score 3-4) were randomly treated with PDT and minocycline (n = 48) or minocycline alone (n = 47). All patients took minocycline hydrochloride 100 mg/d for 4 weeks, whereas patients in the minocycline plus PDT group also received 4 times PDT treatment 1 week apart. IGA score, lesion counts, Dermatology Life Quality Index (DLQI), and safety evaluation were performed before treatment and at 2, 4, 6, and 8 weeks after enrolment. RESULTS There were no statistically significant differences in characteristics between 2 treatment groups at baseline. Minocycline plus PDT treatment led to a greater mean percentage reduction from baseline in lesion counts versus minocycline alone at 8 weeks for both inflammatory (-74.4% vs -53.3%; P < .001) and noninflammatory lesions (-61.7% vs -42.4%; P < .001). More patients treated with minocycline plus PDT achieved IGA score <2 at study end (week 8: 30/48 vs 20/47; P < .05). Patients treated with minocycline plus PDT got significant lower DLQI at 8 weeks (4.4 vs 6.3; P < .001). Adverse events were mild and manageable. CONCLUSIONS Compared with minocycline alone, the combination of PDT with minocycline significantly improved clinical efficacy and QOL in moderate to severe facial acne patients.
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Affiliation(s)
- Xinghua Xu
- Department of Dermatology
- Department of Neurosurgery, Chinese PLA General Hospital
| | - Yi Zheng
- Department of Dermatology
- Department of Dermatology, Beijing Chao-yang Hospital, Capital Medical University, Beijing, China
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17
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Abstract
Acne vulgaris is a skin disease with a multifactorial and complex pathology. While several twin studies have estimated that acne has a heritability of up to 80%, the genomic elements responsible for the origin and pathology of acne are still undiscovered. Here we performed a twin-based structural equation model, using available data on acne severity for an Australian sample of 4,491 twins and their siblings aged from 10 to 24. This study extends by a factor of 3 an earlier analysis of the genetic factors of acne. Acne severity was rated by nurses on a 4-point scale (1 = absent to 4 = severe) on up to three body sites (face, back, chest) and on up to three occasions (age 12, 14, and 16). The phenotype that we analyzed was the most severe rating at any site or age. The polychoric correlation for monozygotic twins was higher (r MZ = 0.86, 95% CI [0.81, 0.90]) than for dizygotic twins (r DZ = 0.42, 95% CI [0.35, 0.47]). A model that includes additive genetic effects and unique environmental effects was the most parsimonious model to explain the genetic variance of acne severity, and the estimated heritability was 0.85 (95% CI [0.82, 0.87]). We then conducted a genome-wide analysis including an additional 271 siblings - for a total of 4,762 individuals. A genome-wide association study (GWAS) scan did not detect loci associated with the severity of acne at the threshold of 5E-08 but suggestive association was found for three SNPs: rs10515088 locus 5q13.1 (p = 3.9E-07), rs12738078 locus 1p35.5 (p = 6.7E-07), and rs117943429 locus 18q21.2 (p = 9.1E-07). The 5q13.1 locus is close to PIK3R1, a gene that has a potential regulatory effect on sebocyte differentiation.
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18
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Layton AM, Whitehouse H, Eady EA, Cowdell F, Warburton KL, Fenton M. Prioritizing treatment outcomes: How people with acne vulgaris decide if their treatment is working. J Evid Based Med 2017; 10:163-170. [PMID: 28444879 DOI: 10.1111/jebm.12249] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 02/08/2016] [Indexed: 01/11/2023]
Abstract
OBJECTIVE To collect information about how people with acne make day-to-day decisions concerning the effectiveness of their treatment. METHODS Between May and August 2013, an optional question was embedded in the James Lind Alliance Acne Priority Setting Partnership's online survey to collect treatment uncertainties. The question asked people with acne to "Tell us in your own words how you decide if your treatment has been effective." RESULTS A total of 742 respondents specified at least one outcome or means of assessing change (outcome measure). Fewer spots were the most commonly cited outcome, identified by 272 respondents (36.7%). Other frequently mentioned outcomes were in descending order: less redness (19.4%), reduction in spot size (12.1%), and less pain/discomfort (11.4%). Signs were much more commonly used than symptoms and surrogate outcomes such as changes in aspects of life quality were infrequently mentioned. Visual inspection of the skin was the most widely adopted outcome measure (16.3%). CONCLUSIONS Although the most frequently used methods map well onto the outcome measures adopted in the majority of acne trials, namely physician-assessed changes in lesion counts and global acne severity, people with acne often take into account several factors that cannot be assessed by a third party at a single point in time. The minimal use of changes in psychosocial wellbeing and mood may reflect that these are regarded as secondary consequences of improvements in appearance. The robustness of these findings now requires independent evaluation. If confirmed, they could form the basis of a new patient-reported outcome measure.
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Affiliation(s)
- Alison M Layton
- Department of Dermatology, Harrogate and District NHS Foundation Trust, Harrogate, UK
| | - Heather Whitehouse
- Department of Dermatology, Harrogate and District NHS Foundation Trust, Harrogate, UK
| | - E Anne Eady
- Department of Dermatology, Harrogate and District NHS Foundation Trust, Harrogate, UK
| | - Fiona Cowdell
- Faculty of Health, Education and Life Sciences, Birmingham City University, Birmingham, UK
| | | | - Mark Fenton
- National Institute for Health and Clinical Effectiveness, City Tower, Piccadilly Plaza, Manchester, UK
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19
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Kim MR, Kerrouche N. Combination of benzoyl peroxide 5% gel with liquid cleanser and moisturizer SPF 30 in acne treatment results in high levels of subject satisfaction, good adherence and favorable tolerability. J DERMATOL TREAT 2017; 29:49-54. [DOI: 10.1080/09546634.2017.1342758] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Mi-Ran Kim
- Proinnovera GmbH, Center of Dermatology Excellence, Münster, Germany
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20
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Tan J, Thiboutot D, Gollnick H, Kang S, Layton A, Leyden J, Torres V, Guillemot J, Dréno B. Development of an atrophic acne scar risk assessment tool. J Eur Acad Dermatol Venereol 2017; 31:1547-1554. [DOI: 10.1111/jdv.14325] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 04/04/2017] [Indexed: 12/26/2022]
Affiliation(s)
- J. Tan
- Western University; Windsor Campus; Windsor ON Canada
| | - D. Thiboutot
- Department of Dermatology; Pennsylvania State University College of Medicine; Hershey PA USA
| | - H. Gollnick
- Universitätsklinik für Dermatologie und Venerologie; Otto-von-Guericke Universität; Magdeburg Germany
| | - S. Kang
- Johns Hopkins School of Medicine; Baltimore MD USA
| | - A. Layton
- Department of Dermatology; Harrogate and District NHS Foundation Trust; Harrogate UK
| | - J.J. Leyden
- Perelman School of Medicine; University of Pennsylvania; Philadelphia PA USA
| | - V. Torres
- Department of Dermatology; Juarez Hospital Mexico City; Mexico City Mexico
| | - J. Guillemot
- Amaris; London UK
- Universidad San Francisco de Quito (USFQ); School of Medicine; Quito Ecuador
| | - B. Dréno
- Department of Dermatology; Nantes University Hospital; Nantes France
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21
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Ikaraoha CI, Mbadiwe NC, Anyanwu CJ, Odekhian J, Nwadike CN, Amah HC. The Role of Blood Lead, Cadmium, Zinc and Copper in Development and Severity of Acne Vulgaris in a Nigerian Population. Biol Trace Elem Res 2017; 176:251-257. [PMID: 27600928 DOI: 10.1007/s12011-016-0839-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2016] [Accepted: 08/26/2016] [Indexed: 01/09/2023]
Abstract
Acne vulgaris is a very common skin disorder affecting human beings. There is a paucity of report on the role of heavy metals-lead (Pb) and cadmium (Cd)-globally, and trace metals-zinc (Zn) and copper (Cd)-particularly in Nigeria in the development/severity of acne vulgaris. This study is aimed to determine the blood levels of some heavy metals-cadmium and lead-and trace metals-zinc and copper-in acne vulgaris sufferers in a Nigerian population. Venous blood samples were collected from a total number of 90 non-obese female subjects consisting of 30 mild, 30 moderate and 30 severe acne vulgaris sufferers for blood Cd, Pb, Cu and Zn determination. They were age-matched with 60 females without acne vulgaris who served as the control subjects. Acne sufferers had significantly higher blood Cd and Pb (P = 0.0143 and P = 0.0001 respectively) and non-significantly different blood levels of Cu and Zn (P = 0.910 and P = 0.2140 respectively) compared to controls. There were significant progressive increases in blood levels of Cd and Pb (P = 0.0330 and P = 0.0001 respectively) and non-significant differences in the mean blood level of Cu and Zn (P = 0.1821 and P = 0.2728 respectively) from mild to moderate and severe acne vulgaris sufferers. Increases in blood Cd and Pb may play critical roles in the pathogenesis/severity of acne vulgaris, while Cu and Zn seem to play less significant roles in the development of this disorder in this environment.
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Affiliation(s)
- C I Ikaraoha
- Chemical Pathology Unit, Department of Medical Laboratory Science, Faculty of Health Science, Imo State University, Owerri, Imo State, Nigeria.
| | - N C Mbadiwe
- Department of Medicine, University of Nigeria Teaching Hospital, Enugu, Nigeria
| | - C J Anyanwu
- Chemical Pathology Unit, Department of Medical Laboratory Science, Faculty of Health Science, Imo State University, Owerri, Imo State, Nigeria
| | - J Odekhian
- Department of Medical Laboratory Science, Igbinedion University, Okada, Okada, Nigeria
| | - C N Nwadike
- Chemical Pathology Unit, Department of Medical Laboratory Science, Faculty of Health Science, Imo State University, Owerri, Imo State, Nigeria
| | - H C Amah
- Microbiology/Parasitology Unit, Department of Medical Laboratory Science, Faculty of Health Science, Imo State University, Owerri, Imo State, Nigeria
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22
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Richter C, Trojahn C, Hillmann K, Dobos G, Kanti V, Vogt A, Blume-Peytavi U, Kottner J. Sensitivity to change of the Dermatology Life Quality Index in adult females with facial acne vulgaris: a validation study. J Eur Acad Dermatol Venereol 2017; 31:169-174. [PMID: 27393576 DOI: 10.1111/jdv.13757] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Accepted: 03/30/2016] [Indexed: 01/01/2023]
Abstract
BACKGROUND The postadolescent form of acne papulopustulosa, also referred to as 'acne tarda' can have substantial negative impact on Quality of Life, especially in adult female patients. OBJECTIVE Although the Dermatology Life Quality Index (DLQI) is widely used, empirical evidence about its performance in adult female acne patients is lacking. METHODS In this prospective cohort study, we have investigated the sensitivity to change of the DLQI in 53 female adult acne patients with mild to moderate facial acne treated with azelaic acid (AzA) 15% gel twice daily over 24 weeks. RESULTS Mean Investigator Static Global Assessment (ISGA) score was 2.3 (SD 0.5) at baseline and ranged from 0.9 (SD 0.3) to 2.1 (SD 0.4) at the end of the study in the 'Highly Improved' and 'Unchanged' responder groups respectively. The mean baseline DLQI score was 5.1 (SD 4.2). The Effect Size in the responder group 'Highly Improved' was 0.66; in group 'Improved' 0.62 and 0.23 in group 'Unchanged'. At the end of study, the mean DLQI score ranged from 1.1 (SD 1.5) in the 'Highly Improved' group to 3.7 (SD 6.0) in the 'Unchanged' group. CONCLUSION The results support the sensitivity to change of the DLQI in this population.
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Affiliation(s)
- C Richter
- Department of Dermatology and Allergy, Charité-Universitätsmedizin Berlin, Clinical Research Center for Hair and Skin Science, Berlin, Germany
| | - C Trojahn
- Department of Dermatology and Allergy, Charité-Universitätsmedizin Berlin, Clinical Research Center for Hair and Skin Science, Berlin, Germany
| | - K Hillmann
- Department of Dermatology and Allergy, Charité-Universitätsmedizin Berlin, Clinical Research Center for Hair and Skin Science, Berlin, Germany
| | - G Dobos
- Department of Dermatology and Allergy, Charité-Universitätsmedizin Berlin, Clinical Research Center for Hair and Skin Science, Berlin, Germany
| | - V Kanti
- Department of Dermatology and Allergy, Charité-Universitätsmedizin Berlin, Clinical Research Center for Hair and Skin Science, Berlin, Germany
| | - A Vogt
- Department of Dermatology and Allergy, Charité-Universitätsmedizin Berlin, Clinical Research Center for Hair and Skin Science, Berlin, Germany
| | - U Blume-Peytavi
- Department of Dermatology and Allergy, Charité-Universitätsmedizin Berlin, Clinical Research Center for Hair and Skin Science, Berlin, Germany
| | - J Kottner
- Department of Dermatology and Allergy, Charité-Universitätsmedizin Berlin, Clinical Research Center for Hair and Skin Science, Berlin, Germany
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23
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Hazarika N, Rajaprabha RK. Assessment of Life Quality Index Among Patients with Acne Vulgaris in a Suburban Population. Indian J Dermatol 2016; 61:163-8. [PMID: 27057015 PMCID: PMC4817440 DOI: 10.4103/0019-5154.177758] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND AND AIMS Acne vulgaris affects about 85% of adolescents, often extending into adulthood. Psychosocial impact of acne on health-related quality of life (QoL) has been identified, but it remains under-evaluated, especially in Indian patients. This study was aimed to assess the impact of acne and its sequelae on the QoL. MATERIALS AND METHODS This was a hospital-based, prospective, cross-sectional study done between June and November 2014 on 114 consenting patients above 15 years of age with acne vulgaris. Acne vulgaris and its sequelae were graded, and QoL was assessed by using Dermatology Life Quality Index (DLQI) questionnaire. RESULTS Most cases (64%) were between 15 and 20 years. Females (57%) outnumbered males. Facial lesions (61.4%) and grade II acne were most common. Mean DLQI score was 7.22. DLQI scores were statistically influenced by the age of the patient, duration and grade of acne, acne scar, and postacne hyperpigmentation. CONCLUSION This study showed significant impairment of QoL in acne patients. Assurance and counseling along with early treatment of acne vulgaris are important to reduce disease-related psychosocial sequelae and increase the efficacy of treatment.
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Affiliation(s)
- Neirita Hazarika
- Department of Dermatology, Venereology and STD, Tagore Medical College and Hospital, Chennai, Tamil Nadu, India
| | - Radha K Rajaprabha
- Department of Dermatology, Venereology and STD, Tagore Medical College and Hospital, Chennai, Tamil Nadu, India
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24
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Abstract
Acne vulgaris is a chronic condition affecting more than 85% of adolescents and young adults. It is one of the most common diseases affecting humanity and its impact on quality of life (QoL) is important. The impact of acne on QoL in Indian patients remains undocumented. The study was undertaken to detect the impact of acne vulgaris and related factors that may influence the QoL.
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Affiliation(s)
- Priya Cinna T Durai
- Department of Dermatology, Sexually Transmitted Disease and Leprosy, A. J. Institute of Medical Sciences, Kuntikana, Mangalore, Karnataka, India
| | - Dhanya G Nair
- Department of Dermatology, Sexually Transmitted Disease and Leprosy, A. J. Institute of Medical Sciences, Kuntikana, Mangalore, Karnataka, India
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Yang M, Moclair B, Hatcher V, Kaminetsky J, Mekas M, Chapas A, Capodice J. A randomized, double-blind, placebo-controlled study of a novel pantothenic Acid-based dietary supplement in subjects with mild to moderate facial acne. Dermatol Ther (Heidelb) 2014; 4:93-101. [PMID: 24831048 PMCID: PMC4065280 DOI: 10.1007/s13555-014-0052-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION The purpose of this study was to determine the safety, tolerability and effectiveness of daily administration of an orally administered pantothenic acid-based dietary supplement in men and women with facial acne lesions. METHODS A randomized, double-blind, placebo-controlled study of adults previously diagnosed with mild to moderate acne vulgaris was performed. Subjects were randomized to the study agent, a pantothenic acid-based dietary supplement, or a placebo for 12 weeks (endpoint). The primary outcome of the study was the difference in total lesion count between the study agent group versus the placebo group from baseline to endpoint. Secondary measurements included differences in mean non-inflammatory and inflammatory lesions, Investigators Global Assessment and Dermatology Life Quality Index (DLQI) scores between the two groups. Investigator assessment of overall improvement and skin photographs were also taken. Safety and tolerability endpoints were the assessment of adverse events and measurement of serum complete blood count and hepatic function. RESULTS Forty-eight subjects were enrolled and 41 were evaluable. There was a significant mean reduction in total lesion count in the pantothenic acid group versus placebo at week 12 (P = 0.0197). Mean reduction in inflammatory lesions was also significantly reduced and DLQI scores were significantly lower at week 12 in the pantothenic acid group versus placebo. The study agent was safe and well tolerated. CONCLUSIONS The results from this study indicate that the administration of a pantothenic acid-based dietary supplement in healthy adults with facial acne lesions is safe, well tolerated and reduced total facial lesion count versus placebo after 12 weeks of administration. Secondary analysis shows that the study agent significantly reduced area-specific and inflammatory blemishes. Further randomized, placebo-controlled trials are warranted.
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Affiliation(s)
| | | | | | | | - Maria Mekas
- Union Square Laser Dermatology, New York, USA
| | - Anne Chapas
- Union Square Laser Dermatology, New York, USA
| | - Jillian Capodice
- Nutraceutical Medical Research, 60 East 42nd Street, Suite 4700, New York, 10165 USA
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