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Wiraputranto MC, Sitohang IBS, Sampurna AT, Ilyas M. Effectiveness of Standard Therapy for Acne Vulgaris Based on Clinical Practice Guidelines in Indonesia. Clin Cosmet Investig Dermatol 2024; 17:2165-2175. [PMID: 39364260 PMCID: PMC11447280 DOI: 10.2147/ccid.s469143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2024] [Accepted: 09/04/2024] [Indexed: 10/05/2024]
Abstract
Purpose To evaluate the effectiveness of standard therapy for acne vulgaris based on Indonesian guidelines. Patients and Methods New patients with acne vulgaris at Dr. Cipto Mangunkusumo National Central General Hospital, the national referral center in Indonesia, who met the criteria were included in this study. Patients were treated with standard therapy for acne vulgaris based on the 2017 guidelines of Dr. Cipto Mangunkusumo Hospital, depending on severity. Changes in the number of non-inflammatory, inflammatory, and total lesions and the proportion of acne severity after three months of therapy were analyzed retrospectively. Results Among the 131 subjects, 63.4% had moderate acne; 20.6% had mild acne, and 16% had severe acne at baseline. Most patients (29 (22.2%)) received a combination of retinoic acid, benzoyl peroxide, and topical or oral antibiotics. Standard therapies reduced the median of non-inflammatory (25 (5-135) vs 8 (0-53)), inflammatory (10 (0-93) vs 2 (0-22)), and total lesions (41 (10-160) vs 10 (1-71)) at week 12 (all p < 0.001). The proportion of acne severity differed significantly after three months, with an increasing proportion of mild acne (20.6% vs 93.1%) and a decreasing percentage of moderate and severe acne (moderate = 63.6% vs 6.1%; severe, 16% vs 0.8%; p < 0.001). Conclusion Standard therapy for acne vulgaris based on the clinical practice guidelines in Indonesia improved acne lesions and severity after 12 weeks. These results support the implementation of national guidelines for acne management in Indonesia, with the practice of improving antimicrobial stewardship.
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Affiliation(s)
- Maria Clarissa Wiraputranto
- Department of Dermatology and Venereology, Faculty of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo National Central General Hospital, Jakarta, Indonesia
| | - Irma Bernadette S Sitohang
- Department of Dermatology and Venereology, Faculty of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo National Central General Hospital, Jakarta, Indonesia
| | - Adhimukti Tathyahita Sampurna
- Department of Dermatology and Venereology, Faculty of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo National Central General Hospital, Jakarta, Indonesia
| | - Muhammad Ilyas
- Department of Community Medicine, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
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Liu YT, Wang YW, Tu C, Ren JW, Huo J, Nan XJ, Dou JH, Peng ZH, Zeng WH. Recommendations for managing adult acne and adolescent acne based on an epidemiological study conducted in China. Sci Rep 2024; 14:16327. [PMID: 39009634 PMCID: PMC11251184 DOI: 10.1038/s41598-024-67215-2] [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: 03/10/2024] [Accepted: 07/09/2024] [Indexed: 07/17/2024] Open
Abstract
There are numerous differences between adult acne and adolescent acne in terms of causes, distribution, and characteristics of skin lesions, as well as treatment. This paper aims to summarize the differences between adult and adolescent acne in China, in order to propose more suitable ways to improve their quality of life. We collected basic information, acne-related information, acne-affecting factors, quality of life scores and treatment-related information of acne patients. A total of 552 questionnaires were collected. Adult acne is typically predominant on the cheeks, similar to adolescent acne, with a relatively lower incidence in other areas, apart from the jawline. Pigmentation and depressed scars are present in nearly half of acne patients, while hypertrophic scars are less frequently observed. Teenagers often have a higher consumption of dairy products, sugary drinks, and high-sugar and high-fat foods. Eczema is more common in adult acne. Additionally, more adults than teenagers experience stress and poor quality of life related to acne. Adolescents are more likely to seek treatment online and on social media. Clinicians must thoroughly evaluate diverse risk factors and formulate personalized acne management strategies for patients with different types of acne.
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Affiliation(s)
- Yan-Ting Liu
- Department of Dermatology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, Shaanxi, China
| | - Ya-Wen Wang
- Department of Dermatology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, Shaanxi, China
| | - Chen Tu
- Department of Dermatology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, Shaanxi, China
| | - Jian-Wen Ren
- Department of Dermatology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, Shaanxi, China
| | - Jia Huo
- Department of Dermatology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, Shaanxi, China
| | - Xiao-Juan Nan
- Department of Dermatology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, Shaanxi, China
| | - Jia-Hao Dou
- Health Science Center, Xi'an Jiaotong University, Xi'an, 710004, Shaanxi, China
| | - Zi-He Peng
- Health Science Center, Xi'an Jiaotong University, Xi'an, 710004, Shaanxi, China
| | - Wei-Hui Zeng
- Department of Dermatology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, Shaanxi, China.
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Li T, Ma X, Li Z, Yu N, Song J, Ma Z, Ying H, Zhou B, Huang J, Wu L, Long X. Facial adult female acne in China: An analysis based on artificial intelligence over one million. Skin Res Technol 2024; 30:e13693. [PMID: 38572573 PMCID: PMC10993051 DOI: 10.1111/srt.13693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 02/19/2024] [Indexed: 04/05/2024]
Abstract
BACKGROUND To further clarify the acne profile of Chinese adult women, we included 1,156,703 adult women. An artificial intelligence algorithm was used to analyze images taken by high-resolution mobile phones to further explore acne levels in Chinese adult women. METHOD In this study, we assessed the severity of acne by evaluating patients' selfies through a smartphone application. Furthermore, we gathered basic user information through a questionnaire, including details such as age, gender, skin sensitivity, and dietary habits. RESULTS This study showed a gradual decrease in acne severity from the age of 25 years. A trough was reached between the ages of 40 and 44, followed by a gradual increase in acne severity. In terms of skin problems and acne severity, we have found that oily skin, hypersensitive skin, frequent makeup application and unhealthy dietary habits can affect the severity of acne. For environment and acne severity, we observed that developed city levels, cold seasons and high altitude and strong radiation affect acne severity in adult women. For the results of the AI analyses, the severity of blackheads, pores, dark circles and skin roughness were positively associated with acne severity in adult women. CONCLUSIONS AI analysis of high-res phone images in Chinese adult women reveals acne severity trends. Severity decreases after 25, hits a low at 40-44, then gradually rises. Skin type, sensitivity, makeup, diet, urbanization, seasons, altitude, and radiation impact acne. Blackheads, pores, dark circles, and skin roughness are linked to acne severity. These findings inform personalized skincare and public health strategies for adult women.
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Affiliation(s)
- Tian‐Hao Li
- Department of Plastic and Reconstructive SurgeryPeking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Xu‐Da Ma
- Department of Plastic and Reconstructive SurgeryPeking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Zi‐Ming Li
- Department of Plastic and Reconstructive SurgeryPeking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Nan‐Ze Yu
- Department of Plastic and Reconstructive SurgeryPeking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Jin‐Yan Song
- Hangzhou C2H4 Internet Technology Co., LtdHangzhou C2H4 Internet Technology Co., LtdHangzhouChina
| | - Zi‐Tao Ma
- Hangzhou C2H4 Internet Technology Co., LtdHangzhou C2H4 Internet Technology Co., LtdHangzhouChina
| | - Han‐Ting Ying
- Hangzhou C2H4 Internet Technology Co., LtdHangzhou C2H4 Internet Technology Co., LtdHangzhouChina
| | - Beibei Zhou
- Hangzhou C2H4 Internet Technology Co., LtdHangzhou C2H4 Internet Technology Co., LtdHangzhouChina
| | - Jiu‐Zuo Huang
- Department of Plastic and Reconstructive SurgeryPeking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Liang Wu
- Hangzhou C2H4 Internet Technology Co., LtdHangzhou C2H4 Internet Technology Co., LtdHangzhouChina
| | - Xiao Long
- Department of Plastic and Reconstructive SurgeryPeking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
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Alfahl SO, Almehmadi LA, Alamri RS, Almalki DS, Alnakhli F. Impact of Acne Vulgaris and Vitiligo on Quality of Life and Self-Esteem in the Patient Population of Madinah, Saudi Arabia. Cureus 2024; 16:e52586. [PMID: 38371097 PMCID: PMC10874647 DOI: 10.7759/cureus.52586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2024] [Indexed: 02/20/2024] Open
Abstract
BACKGROUND Acne vulgaris and vitiligo are skin disorders that can have a negative impact on a person's self-esteem and quality of life (QoL). The purpose of this study is to look into the impact of acne and vitiligo on the self-esteem and QoL of the patient population in Madinah, Saudi Arabia. METHODS A cross-sectional survey of 171 Saudi adults (141 individuals with acne vulgaris (9.4%) and 30 with vitiligo (1.5%) between the ages of 16 and 35 was conducted in Madinah. A self-reported questionnaire with four domains was used: socio-demographic data, lifestyle and coexisting pathologic factors or diseases, Rosenberg's self-esteem scale, and the dermatology life quality index (DLQI). RESULTS Acne patients had a mean total score of 20.3 on the self-esteem scale, with 5% (n = 7) having low self-esteem, 48.2% (n = 68) having medium self-esteem, and 46.8% (n = 66) having high self-esteem. Females had higher self-esteem (75.29) than males (56.95). The mean DLQI score for acne patients was 5.4, with 30.5% (n = 47) unaffected, 29.1% (n = 45) mildly affected, 23.4% (n = 35) moderately affected, 5.6% (n = 10) severely affected, and 1.4% (n = 4) severely affected. Vitiligo patients had a mean self-esteem scale score of 13.7, with 63.3% (n = 19) having low self-esteem, 30% (n = 9) having medium self-esteem, and 6.7% (n = 2) having high self-esteem. The mean DLQI was 15.2, with 6.7% (n = 2) reporting that vitiligo had no effect on their lives, 10% (n = 3) reporting a moderate effect, 66.7% (n = 20) reporting a severe effect, and 16.7% (n = 5) reporting a very severe effect. CONCLUSIONS Our research confirms that acne vulgaris and vitiligo have a negative impact on self-esteem and quality of life. Along with medical treatment, effective treatment and psychological improvement of the patient should be prioritized.
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Affiliation(s)
- Samah O Alfahl
- Family Medicine, College of Medicine, Taibah University, Madinah, SAU
| | | | - Ranad S Alamri
- Medicine, College of Medicine, Taibah University, Madinah, SAU
| | - Dalia S Almalki
- Medicine, College of Medicine, Taibah University, Jeddah, SAU
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Sermswan P, Sriharat R, Saithong S, Laowansiri M, Amornruk N, Chiewchengchol D, Noppakun N, Asawanonda P, Chatsuwan T, Kumtornrut C. A cross-sectional study examining the prevalence of antibiotic-resistant Cutibacterium acnes isolated from patients with acne in Bangkok, Thailand. J Dermatol 2023. [PMID: 37183535 DOI: 10.1111/1346-8138.16823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 04/08/2023] [Accepted: 04/23/2023] [Indexed: 05/16/2023]
Abstract
Cutibacterium acnes is associated with the pathogenesis of acne vulgaris (AV). The relationship between antibiotic-resistant C. acnes and AV remains unclear. The authors aimed to determine the prevalence of antibiotic-resistant C. acnes and investigate the association of acne severity with topical and systemic treatments in patients with acne. Samples were collected of inflammatory and noninflammatory acne, including closed and open comedones and erythematous papules/pustules from the face of patients with mild to severe acne. The samples were cultured under anaerobic conditions for the isolation of C. acnes. Antibiotic susceptibility tests for erythromycin, tetracycline, doxycycline, clindamycin, and trimethoprim/sulfamethoxazole were performed using the agar dilution method. From 153 patients, 143 viable C. acnes samples were isolated (93.5%). They were found resistant to trimethoprim/sulfamethoxazole (143/143, 100%), clindamycin (108/143, 75.5%), erythromycin (105/143, 73.4%), tetracycline (74/143, 51.7%), and doxycycline (73/143, 51.1%). There was no significant correlation between the prevalence of antibiotic resistance and acne severity. High-level resistant C. acnes correlated with higher clinical severity of acne in patients taking doxycycline (τb = 0.3). The present prevalence of antibiotic-resistant C. acnes was high in Thailand. Antibiotic stewardship in AV treatment should be encouraged to prevent further antibiotic resistance crises.
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Affiliation(s)
- Peerada Sermswan
- Faculty of Medicine, King Mongkut's Institute of Technology Ladkrabang, Bangkok, Thailand
| | - Rakwaree Sriharat
- Department of Microbiology, Faculty of Medicine, Chulalongkorn, Bangkok, Thailand
- Center of Excellence in Immunology and Immune-Mediated Diseases, Department of Microbiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Supichcha Saithong
- Center of Excellence in Immunology and Immune-Mediated Diseases, Department of Microbiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Matchima Laowansiri
- Department of Microbiology, Faculty of Medicine, Chulalongkorn, Bangkok, Thailand
- Center of Excellence in Immunology and Immune-Mediated Diseases, Department of Microbiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Nutchaya Amornruk
- Center of Excellence in Immunology and Immune-Mediated Diseases, Department of Microbiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Direkrit Chiewchengchol
- Department of Microbiology, Faculty of Medicine, Chulalongkorn, Bangkok, Thailand
- Center of Excellence in Immunology and Immune-Mediated Diseases, Department of Microbiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Nopadon Noppakun
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok, Thailand
| | - Pravit Asawanonda
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok, Thailand
| | - Tanittha Chatsuwan
- Department of Microbiology, Faculty of Medicine, Chulalongkorn, Bangkok, Thailand
- Center of Excellence in Antimicrobial Resistance and Stewardship, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Chanat Kumtornrut
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok, Thailand
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Meena AK, Mendiratta V, Goyal R, Bisherwal K, Yadav V, Prasadh V. Biochemical and hormonal abnormalities in adult female acne. J Cosmet Dermatol 2023; 22:1392-1399. [PMID: 36606389 DOI: 10.1111/jocd.15588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 11/27/2022] [Accepted: 12/12/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND Prevalence of adult patients with acne is increasing and women comprise majority of the cases. There is lack of data on biochemical and hormonal abnormalities in adult female acne (AFA). AIMS To evaluate biochemical and hormonal parameters in 60 patients of AFA. METHODS A cross-sectional observational study conducted from November 2018 to March 2020 in Dermatology outpatient department of a tertiary care hospital in North India. Adult females (age > 25 years) with a clinical diagnosis of acne were included in the study. RESULTS 60 cases of AFA were included. The age ranged between 26-41 years with mean age at presentation being 29.45 years. 53.3% patients had persistent acne while 46.7% had late-onset acne. 50% patients had history of premenstrual flare-up of their acne. Raised FBG was found in 25% patients. 10% had raised serum insulin levels. HOMA-IR index was deranged in 55% patients. At least one lipid alteration was reported in 91.6% of patients. In hormonal parameters, raised TT was present in 6.7%, LH in 3.3%, FSH in 18.3%, prolactin in 3.3%, and TSH in 15%. No association was found between acne severity and biochemical and hormonal parameters. CONCLUSIONS Our study highlighted the importance of measuring lipid profile in AFA and calculating HOMA-IR index for measuring insulin resistance rather than simply measuring serum insulin levels. In our study, additional parameter deranged in significant number of patients was FBG. Hence, we recommend routine screening of lipid profile, FBG and calculation of HOMA-IR index in AFA.
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Affiliation(s)
- Amit Kumar Meena
- Department of Dermatology and STD, Lady Hardinge Medical College, New Delhi, India
| | - Vibhu Mendiratta
- Department of Dermatology and STD, Lady Hardinge Medical College, New Delhi, India
| | - Rajeev Goyal
- Department of Biochemistry, Lady Hardinge Medical College, New Delhi, India
| | - Kavita Bisherwal
- Department of Dermatology and STD, Lady Hardinge Medical College, New Delhi, India
| | - Vidya Yadav
- Department of Dermatology and STD, Lady Hardinge Medical College, New Delhi, India
| | - Vivin Prasadh
- Department of Dermatology and STD, Lady Hardinge Medical College, New Delhi, India
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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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Exploring the Differences in the Gut Microbiome in Atopic Dermatitis According to the Presence of Gastrointestinal Symptoms. J Clin Med 2022; 11:jcm11133690. [PMID: 35806975 PMCID: PMC9267706 DOI: 10.3390/jcm11133690] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 06/24/2022] [Accepted: 06/24/2022] [Indexed: 02/04/2023] Open
Abstract
(1) Background: Atopic dermatitis (AD) is a multifactorial chronic allergic skin disease. Gastrointestinal (GI) functions have been suggested to be associated with its incidence or severity. As modulators of the gut–skin axis, gut microbes might affect the pathophysiology of AD. (2) Methods: We divided a cohort of patients with AD according to their GI symptoms as follows: AD with epigastric fullness (ADwEF), AD with epigastric rigidity (ADwER), and AD without GI symptoms (ADw/oGI). The gut microbial profiles were analyzed using 16S rRNA amplicon sequencing. (3) Results: The microbiota of the ADwER group showed low diversity indices in richness and evenness and formed a separate cluster to the other groups. In the ADwER group, the proportion of Bacteroides increased, while that of Prevotella decreased; functional pathways related to phosphotransferase systems were not abundant relative to those in the ADw/oGI group. Taken together, patients with AD with GI symptoms have a different microbiome from patients with simple AD. (4) Conclusions: In an exploratory study aimed at evaluating the relationship between AD and GI symptoms, the gut microbiome in patients with AD with GI symptoms differed from that in patients with simple AD, and this result could serve as a basis for further gut–skin axis studies.
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Say YH, Sio YY, Heng AHS, Ng YT, Matta SA, Pang SL, Teh KF, Wong YR, Rawanan Shah SM, Reginald K, Chew FT. Golgin A7 Family Member B (GOLGA7B) is a plausible novel gene associating high glycaemic index diet with acne vulgaris. Exp Dermatol 2022; 31:1208-1219. [PMID: 35416335 DOI: 10.1111/exd.14575] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 01/30/2022] [Accepted: 04/10/2022] [Indexed: 11/29/2022]
Abstract
While the IGF1/FoxO1/mTORC1 signalling pathway is a well-established nutrigenomic link between high glycaemic index (GI)/glycaemic load (GL) diet and acne vulgaris, other signalling pathways remain elusive. Therefore, we aimed to investigate other genes that are involved in the high GI/GL diet-acne link, using our Singapore/Malaysia population epidemiological, genomics and transcriptomics data. High GI/GL dietary habit of 3,207 acne cases (1,869 and 1,341 further classified into severity and scarring grades, respectively) and 2,521 controls were evaluated based on Quality of Diet based on Glycaemic Index Score (QDGIS). Overlapping concordant differentially expressed genes (DEGs) between acne case-controls and QDGIS poor-moderate/good classes were identified from whole-transcriptome sequencing data of PBMC of a subset of participants. Finally, we assessed the expression quantitative trait loci (eQTL) association of single nucleotide polymorphisms (SNPs) of the concordant DEGs. Daily intake of fruits significantly reduced the risk of acne presentation, severity and scarring by up to 48.5%. Those with good QDGIS had significantly lower risk of mild and moderate/severe acne, and grade 1/2 acne scarring. Sequential filtering identified four overlapping concordant DEGs that were significantly associated with acne and QDGIS, namely GOLGA7B, SNCB, LOC102723849 and LOC283683. Combining transcriptome and genetic association data, we identified intronic SNP rs1953947 in GOLGA7B as an eQTL for acne. In conclusion, we identified GOLGA7B as a plausible novel gene that links high GI/GL with acne, and hence propose a model for the involvement of Golga7b in high GI/GL diet-acne pathogenesis, which includes palmitoyl acyltransferase zDHHC5, fatty acid translocase CD36 and palmitic acid.
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Affiliation(s)
- Yee-How Say
- Department of Biological Sciences, Faculty of Science, National University of Singapore, Singapore
| | - Yang Yie Sio
- Department of Biological Sciences, Faculty of Science, National University of Singapore, Singapore
| | - Anna Hwee Sing Heng
- Department of Biological Sciences, Faculty of Science, National University of Singapore, Singapore
| | - Yu Ting Ng
- Department of Biological Sciences, Faculty of Science, National University of Singapore, Singapore
| | - Sri Anusha Matta
- Department of Biological Sciences, Faculty of Science, National University of Singapore, Singapore
| | - Sze Lei Pang
- Department of Biological Sciences, Faculty of Science, National University of Singapore, Singapore
| | - Keng Foo Teh
- Department of Biological Sciences, School of Medical and Life Sciences, Sunway University, Malaysia
| | - Yi Ru Wong
- Department of Biological Sciences, School of Medical and Life Sciences, Sunway University, Malaysia
| | - Smyrna Moti Rawanan Shah
- Department of Biological Sciences, School of Medical and Life Sciences, Sunway University, Malaysia
| | - Kavita Reginald
- Department of Biological Sciences, School of Medical and Life Sciences, Sunway University, Malaysia
| | - Fook Tim Chew
- Department of Biological Sciences, Faculty of Science, National University of Singapore, Singapore
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Rueda LJ, Porras A, Rico A. Prevalence of adult female acne in Colombia: A population-based study. Int J Womens Dermatol 2022; 7:727-730. [PMID: 35028372 PMCID: PMC8714581 DOI: 10.1016/j.ijwd.2021.06.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 04/29/2021] [Accepted: 06/16/2021] [Indexed: 11/29/2022] Open
Abstract
Background Acne is a common inflammatory skin disease with adolescents being the most affected by this condition; however, acne also occurs frequently in the adult population. Adult acne is defined as late-onset acne or acne that persists beyond age 25 years. In terms of epidemiologic data, reports of adult female acne prevalence range from 5.5% to 61.5% around the world. Objective The aim of this study was to estimate the prevalence and trace the trend of adult female acne in Colombia over the last 5 years. Methods Using nationwide data from the General System of Social Security and Health in Colombia through the Sistema Integrado de Información de la Protección Social database and International Classification of Diseases, 10th Revision, diagnostic codes, a cross-sectional study was conducted to estimate the prevalence of adult female acne in outpatients in Colombia from 2015 to 2019. Results For the 5-year study period, overall acne prevalence was 2.14 per 1000 population. The highest annual prevalence (2.94 per 1000 population) was in 2019 and the lowest prevalence (1.71 per 1000 population) was in 2015. Prevalence peaked in patients age 25 to 29 years, and decreased to <1 per 1000 population in those age <50 years. Conclusion This nationwide study of adult female acne in Colombia suggests an increasing trend in prevalence over the last 5 years. We recommend further studies to determine risk factors involved in this condition.
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Affiliation(s)
- Lili J Rueda
- Universidad El Bosque, Dermatología Clínica e Infecciosa, Bogotá, Colombia
| | - Alexandra Porras
- Universidad El Bosque, Medicina Comunitaria y Salud Colectiva, Bogotá, Colombia
| | - Alejandro Rico
- Universidad El Bosque, Medicina Comunitaria y Salud Colectiva, Bogotá, Colombia
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Murlistyarini S, Nugroho ARL, Sari DT, Mandasari S. Precipitating Factors of Acne Vulgaris at Dr. Saiful Anwar Hospital Malang. JURNAL BERKALA EPIDEMIOLOGI 2021. [DOI: 10.20473/jbe.v9i32021.257-265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background: Acne vulgaris (AV) is an inflammatory disease of the pilosebaceous unit, which often causes stress and disrupts quality of life. Correctly identifying precipitating factors and preventing disease development will holistically increase the effectiveness of acne therapy, enabling better therapeutic outcomes to be achieved. Purpose: The objective of this study is to identify the clinical profile and precipitating factors of AV patients who visited Dr. Saiful Anwar Hospital between 2015 until 2017. Methods: This was a descriptive study, using a retrospective case study approach. The sample data was collected from medical records of AV patients from the period of 2015–2017 who met the following inclusion criteria: new AV cases with a complete medical record including gender, age, and precipitating factors. The dependent variable of this study was new AV patients, while the independent variables were the patient clinical profile and precipitating factors. Results: This study included 930 samples, with the number of female patients significantly higher (75.48%) than the number of males. The highest AV prevalence was found in the 15–24 years age group. The most common precipitating factors in females were hormonal issues, stress, and cosmetics; in males, these were stress, genetics, and dietary factors. Conclusion: The incidence of AV at Dr. Saiful Anwar Hospital mostly occurs in the 15–24 years age group, with varying trigger factors. The most frequent AV trigger factor in female patients was hormonal issues; in males, this was stress.
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Chanyachailert P, Chularojanamontri L, Chantrapanichkul P, Tuchinda P, Wongwananuruk T, Sardod P, Kulthanan K. Adult female acne: Clinical characteristics and factors significantly associated with polycystic ovary syndrome. Australas J Dermatol 2021; 62:e532-e538. [PMID: 34423850 DOI: 10.1111/ajd.13700] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 07/16/2021] [Accepted: 08/09/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND Adult female acne (AFA) may be different from adolescent acne, and may be a sign of polycystic ovary syndrome (PCOS). The objective of the study was to investigate the clinical characteristics of AFA, and the factors significantly associated with PCOS in AFA. METHODS AFA patients aged 25 years or older were enrolled. History taking and dermatologic examinations were performed by dermatologists. PCOS was diagnosed by gynaecologists. Perimenopausal acne (aged 45 years or older) and the Dermatology Life Quality Index (DLQI) were also evaluated. RESULTS Among 208 patients, mean age was 31.8 ± 7.1 years and 47.1%, 26.9%, and 26% had persistent, late-onset, and recurrent acne, respectively. The common aggravating factors included pre-menstruation (72.6%) and stress (53.8%). Recurrent acne was significantly aggravated by cosmetic products. Higher body mass index (BMI) was positively correlated with acne severity. Acne lesions were predominately located on both cheeks (87.0%) and at the perioral area (81.7%). PCOS was identified in 48.1%. Younger age (≥25 to <33 years), premenstrual flare, and irregular menstruation, but not hirsutism or androgenetic alopecia, were associated with PCOS in univariate and multivariate analysis. Perimenopausal acne was identified in 6.7%. The total mean DLQI score was 8.0 ± 5.4 (range from 0 to 23). CONCLUSIONS Persistent acne with moderate severity was common in AFA patients and higher BMI was associated with acne severity. PCOS should be screened in AFA patients with younger age, premenstrual flare, and irregular menstruation.
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Affiliation(s)
- Pattriya Chanyachailert
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Leena Chularojanamontri
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Panicha Chantrapanichkul
- Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Papapit Tuchinda
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Thanyarat Wongwananuruk
- Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Phatcharee Sardod
- Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Kanokvalai Kulthanan
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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Molla A, Alrizqi H, Alharbi E, Alsubhi A, Alrizqi S, Shahada O. Assessment of Anxiety and Depression in Patients with Acne Vulgaris in Medina: A Case-Control Study. Clin Cosmet Investig Dermatol 2021; 14:999-1007. [PMID: 34385831 PMCID: PMC8354339 DOI: 10.2147/ccid.s302311] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 05/05/2021] [Indexed: 11/23/2022]
Abstract
Purpose Acne vulgaris is a common dermatological disease in adolescents that show high prevalence rates of anxiety and depression that may lead to consequences that affect quality of life. This study aimed to assess and compare anxiety and depression in patients with acne and a control group and to determine their correlation with other demographic data. Patients and Methods This was a case-control study conducted in 2019 for 3 months at the derma-tology department of Ohud Hospital and two other private clinics in the Medina region of Saudi Arabia. For this study, 296 consecutive patients in the age group of 12 to 60 years who were diagnosed as having acne vulgaris were enrolled and matched with a control group. Data were collected through a self-administered questionnaire, including sociodemographic data and Hospital Anxiety and Depression Scale scores. Results We found no significant differences between the two groups regarding sex, age group, nationality, and educational level, but found a significant difference in marital status (p < 0.001). Most (62.5%) of the acne cases were moderate in severity. The overall anxiety score in the acne group was 7.68 ± 4.90, with a significant difference with the control group (p = 0.031), whereas the anxiety level and depression score showed no significant difference (p = 0.082 and p = 0.656, respectively). Moreover, a strong correlation was found between anxiety and depression in the acne group (r = 0.732, p < 0.001). Conclusion A positive correlation was found between the anxiety and depression scores in the patients with acne, which was not related to age group or educational level. However, the anxiety scores of the patients with acne showed a significant relationship with sex.
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Affiliation(s)
- Amr Molla
- Department of Medicine, Taibah University, Medina, Saudi Arabia
| | | | | | - Arwa Alsubhi
- Department of Dermatology, King Saud Medical City, Riyadh, Saudi Arabia
| | - Saad Alrizqi
- College of Medicine, Taibah University, Medina, Saudi Arabia
| | - Omar Shahada
- College of Medicine, Taibah University, Medina, Saudi Arabia
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14
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Anaba EL, Oaku IR. Adult female acne: A cross-sectional study of diet, family history, body mass index, and premenstrual flare as risk factors and contributors to severity. Int J Womens Dermatol 2021; 7:265-269. [PMID: 34222581 PMCID: PMC8243155 DOI: 10.1016/j.ijwd.2020.11.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Revised: 11/01/2020] [Accepted: 11/22/2020] [Indexed: 11/25/2022] Open
Abstract
Background The risk factors for adult female acne (AFA) and their influence on severity are unclear. The aim of this study was to document the role of diet, body mass index (BMI), premenstrual flare, and family history of acne as risk factors and cause of severity of AFA. Methods This was a prospective, cross-sectional, case-control study of 112 women age ≥25 years. The women were clinically evaluated. Sociodemographic data (age, family history of acne, premenstrual flare, weight, and height) and dietary habits were documented. Age, weight, height, and dietary habits of controls were also documented. Data were analyzed using SPSS, version 22. Results The mean age of the 56 patients with AFA was 33.4 ± 8.2 years (controls: 24.5 ± 4.4 years). Premenstrual flare of acne was noted in 58.9% of patients, a family history of acne was present in 51.8% of patients, and the mean BMI was 25.2 ± 4.9 (32.1%). A risk factor for AFA was a family history of acne (p ≤ 0.001). Dietary habits (chicken, p = 0.457; beef, p = 0.845; cakes and sweets, p = 0.956; starchy food, p = 0.361; and type of milk, p = 0.919) and BMI (p = 0.486) were not risk factors for AFA. Premenstrual flare (p = 0.178), BMI (p = 0.206), family history of acne (p = 0.592), and diet did not contribute to the severity of AFA. Conclusion Diet and BMI are not risk factors for AFA, but a family history of acne is. Severity of AFA is independent of premenstrual flares, diet, BMI, and a family history of acne.
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Affiliation(s)
- Ehiaghe L Anaba
- Department of Medicine, Lagos State University Teaching Hospital, Lagos, Nigeria
| | - Itohan R Oaku
- Department of Medicine, Lagos State University Teaching Hospital, Lagos, Nigeria
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15
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Bagatin E, Rocha MADD, Freitas THP, Costa CS. Treatment challenges in adult female acne and future directions. Expert Rev Clin Pharmacol 2021; 14:687-701. [PMID: 33957838 DOI: 10.1080/17512433.2021.1917376] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Introduction: Acne is a chronic, inflammatory, and immune-mediated disease of the pilosebaceous unit, highly prevalent in adolescents. However, an increasing number of adults over 25 years old with facial acne, particularly women, have been observed. It is considered a different disease when compared to acne vulgaris. Face is the mainly involved area with inflammatory lesions and more sensitive skin, pointing out the need of a holistic approach.Areas covered: We performed a comprehensive literature search on PubMed database, up to January 2021, regarding adult female acne. We synthesized data about pathogenesis; differences compared to acne vulgaris; and treatment, with focus in the management challenges and perspectives.Expert opinion: It is essential to value the negative impact on quality of life of adult female acne, independently of severity. The disease has prolonged evolution, and patient might be resilient once the improvement, regardless of the treatment option, will just be noticeable after 3 months. Aggravating factors should be clearly discussed, such as the need of changing many habits, especially lesions manipulation. The therapeutic regimen includes make-up and tailored skin care (considering proneness to sensitivity), while anti-acne drugs should be chosen in accordance with desire to be pregnant, presence of pregnancy or breastfeeding.
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Affiliation(s)
| | | | | | - Caroline Sousa Costa
- Department of Specialized Medicine, Discipline of Dermatology - Universidade Federal Do Piauí, Teresina, Brazil
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Mizuno K, Sakaue H, Kohsaka K, Takeda H, Hayashi N, Sato T. An increase in normetanephrine in hair follicles of acne lesions through the sympatho-adrenal medullary system in acne patients with anxiety. J Dermatol 2021; 48:1281-1285. [PMID: 33963607 DOI: 10.1111/1346-8138.15935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 04/07/2021] [Accepted: 04/09/2021] [Indexed: 12/01/2022]
Abstract
Acne vulgaris, a chronic inflammatory skin disease, has been associated with not only sebaceous gland dysfunction but also various endogenous and exogenous stresses. Since sebaceous glands are under neuroendocrine control, including the hypothalamic-pituitary-adrenal axis and neuro-autocrine mechanisms, it remains unclear how psychological stress relates to the pathogenesis of acne. In this study, we investigated the relationship between psychological stress and catecholamine in acne lesions from 18 patients with mild or moderate acne. The State-Trait Anxiety Inventory (STAI) revealed that all patients were anxious, with six having low anxiety and 12 high anxiety. Salivary α-amylase activity (sAA), which is regulated by the sympatho-adrenal medullary (SAM) system, positively correlated with the STAI State Anxiety scores (STAI-S) and was significantly detectable in acne patients with high rather than low anxiety. In addition, the level of normetanephrine, but not metanephrine, both of which are catecholamine metabolites, in hair follicles of acne lesions also positively correlated with the STAI-S. Furthermore, the normetanephrine level was higher in patients with high rather than low anxiety, whereas there was no change in metanephrine in the hair follicles of the acne lesions. Moreover, neither the sAA nor metanephrine and normetanephrine in the acne lesions was related to acne severity in the patients. Thus, these results provide novel evidence that a SAM system-associated increase of normetanephrine level in hair follicles is involved in the acne pathology of patients with anxiety.
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Affiliation(s)
- Koji Mizuno
- Department of Biochemistry, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan
| | - Hiroaki Sakaue
- Department of Biochemistry, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan
| | - Keita Kohsaka
- Department of Biochemistry, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan
| | - Hidetomo Takeda
- Department of Biochemistry, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan
| | | | - Takashi Sato
- Department of Biochemistry, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan
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Say YH, Heng AHS, Reginald K, Wong YR, Teh KF, Rawanan Shah SM, Sio YY, Ng YT, Matta SA, Pang SL, Chew FT. Modifiable and non-modifiable epidemiological risk factors for acne, acne severity and acne scarring among Malaysian Chinese: a cross-sectional study. BMC Public Health 2021; 21:601. [PMID: 33773591 PMCID: PMC8005239 DOI: 10.1186/s12889-021-10681-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 03/23/2021] [Indexed: 11/16/2022] Open
Abstract
Background Acne vulgaris, a highly prevalent multifactorial inflammatory skin disease, can be categorised into different severity and scarring grades based on the type, number, and severity of lesions. While many epidemiology studies have investigated the risk factors for acne presentation, fewer studies have specifically studied the risk factors for acne severity and scarring. Therefore, this study investigated the prevalence of acne, acne severity and scarring grades, and their associated non-modifiable and modifiable epidemiological risk factors among Malaysian Chinese. Methods A total of 1840 subjects (1117 cases/723 controls) completed an investigator-administered questionnaire as part of a cross-sectional study, which include socio-demographics, familial history, lifestyle factors, dietary habits, and acne history. Acne cases were further evaluated for their severity (n = 1051) and scarring (n = 1052) grades by a trained personnel. Results Majority of the acne cases (up to 69%) had mild acne or Grade 1/2 scarring, while 21.6% had moderate/severe acne and 5.5% had Grade 3/4 scarring. Males had significantly higher risk of presenting with higher grades of acne scarring. Those who had acne, regardless of severity and scarring grades, had strong positive familial history (either in parents and/or sibling). Frequent consumption (most or all days) of foods that are commonly consumed during breakfast (butter, probiotic drinks, cereals and milk) decreased the risk for acne presentation and higher acne scarring, while periodic consumption (once/twice per week) of nuts and burgers/fast food decreased the risk for higher acne severity. Alcohol drinking was significantly associated with increased risk for acne presentation, while paternal, parental and household smoking were associated with reduced risk of more severe acne. Conclusions In conclusion, positive familial history is a strong predisposing factor in influencing acne presentation, severity and scarring. Frequent consumption of foods that are commonly consumed during breakfast is protective against acne presentation. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10681-4.
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Affiliation(s)
- Yee-How Say
- Department of Biological Sciences, Faculty of Science, National University of Singapore, Allergy and Molecular Immunology Laboratory, Lee Hiok Kwee Functional Genomics Laboratories, Block S2, Level 5, 14 Science Drive 4, Lower Kent Ridge Road, Singapore, 117543, Singapore
| | - Anna Hwee Sing Heng
- Department of Biological Sciences, Faculty of Science, National University of Singapore, Allergy and Molecular Immunology Laboratory, Lee Hiok Kwee Functional Genomics Laboratories, Block S2, Level 5, 14 Science Drive 4, Lower Kent Ridge Road, Singapore, 117543, Singapore
| | - Kavita Reginald
- Department of Biological Sciences, School of Medical and Life Sciences, Sunway University, 47500, Petaling Jaya, Selangor, Malaysia
| | - Yi Ru Wong
- Department of Biological Sciences, School of Medical and Life Sciences, Sunway University, 47500, Petaling Jaya, Selangor, Malaysia
| | - Keng Foo Teh
- Department of Biological Sciences, School of Medical and Life Sciences, Sunway University, 47500, Petaling Jaya, Selangor, Malaysia
| | - Smyrna Moti Rawanan Shah
- Department of Biological Sciences, School of Medical and Life Sciences, Sunway University, 47500, Petaling Jaya, Selangor, Malaysia
| | - Yang Yie Sio
- Department of Biological Sciences, Faculty of Science, National University of Singapore, Allergy and Molecular Immunology Laboratory, Lee Hiok Kwee Functional Genomics Laboratories, Block S2, Level 5, 14 Science Drive 4, Lower Kent Ridge Road, Singapore, 117543, Singapore
| | - Yu Ting Ng
- Department of Biological Sciences, Faculty of Science, National University of Singapore, Allergy and Molecular Immunology Laboratory, Lee Hiok Kwee Functional Genomics Laboratories, Block S2, Level 5, 14 Science Drive 4, Lower Kent Ridge Road, Singapore, 117543, Singapore
| | - Sri Anusha Matta
- Department of Biological Sciences, Faculty of Science, National University of Singapore, Allergy and Molecular Immunology Laboratory, Lee Hiok Kwee Functional Genomics Laboratories, Block S2, Level 5, 14 Science Drive 4, Lower Kent Ridge Road, Singapore, 117543, Singapore
| | - Sze Lei Pang
- Department of Biological Sciences, Faculty of Science, National University of Singapore, Allergy and Molecular Immunology Laboratory, Lee Hiok Kwee Functional Genomics Laboratories, Block S2, Level 5, 14 Science Drive 4, Lower Kent Ridge Road, Singapore, 117543, Singapore
| | - Fook Tim Chew
- Department of Biological Sciences, Faculty of Science, National University of Singapore, Allergy and Molecular Immunology Laboratory, Lee Hiok Kwee Functional Genomics Laboratories, Block S2, Level 5, 14 Science Drive 4, Lower Kent Ridge Road, Singapore, 117543, Singapore.
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Shah N, Shukla R, Chaudhari P, Patil S, Patil A, Nadkarni N, Goldust M. Prevalence of acne vulgaris and its clinico-epidemiological pattern in adult patients: Results of a prospective, observational study. J Cosmet Dermatol 2021; 20:3672-3678. [PMID: 33655630 DOI: 10.1111/jocd.14040] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 02/02/2021] [Accepted: 02/23/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND Acne is a common disorder in adolescents. The prevalence of acne in adults is also increasing. There are only a few Indian studies on the prevalence and clinical features of adult acne. AIMS To evaluate the prevalence and possible etiological and aggravating factors of acne in adult population. METHODS Adult patients more than 25 years with acne were enrolled, and detailed history and examination were recorded. Type of acne, age, gender, area of involvement, and associated factors were noted. RESULTS Out of 24,056 adult patients, 180 had acne, with the prevalence of 0.74%. Mean age of patients with acne was 30.1 years. A total of 81.7% patients with acne were female and 68.3% had persistent type of acne. Inflammatory papular acne (72.8%) was the most common type of acne in our study population. Cheek (85%) was the predominant site of involvement; 62.8% patients developed scarring. Underlying chronic stress was present in 23.9% and family history of acne in 60.6%. A total of 43.5% patients reported aggravation with cosmetics and 42.8% provided history of oily and high glycemic food conduction. Premenstrual flare and hirsutism were seen in 61.9% and 16.3% female patients, respectively. CONCLUSION Acne is more common in people with 25-35 years of age with female preponderance and a gradual decline in the prevalence is seen thereafter. Inflammatory nature is more common with cheeks being commonest site of affection. Facial scarring is more common that emphasizes the importance of early and adequate intervention.
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Affiliation(s)
- Nidhi Shah
- Department of Dermatology, Cooper Hospital, Mumbai, India
| | - Ratnakar Shukla
- Department of Dermatology, Mayo Institute of Medical Sciences, Barabanki, India
| | - Parag Chaudhari
- Department of Dermatology, DY Patil Deemed to be University, School of Medicine, Navi Mumbai, India
| | - Sharmila Patil
- Department of Dermatology, DY Patil Deemed to be University, School of Medicine, Navi Mumbai, India
| | - Anant Patil
- Department of Pharmacology, DY Patil Deemed to be University, School of Medicine, Navi Mumbai, India
| | - Nitin Nadkarni
- Department of Dermatology, DY Patil Deemed to be University, School of Medicine, Navi Mumbai, India
| | - Mohamad Goldust
- Department of Dermatology, University Medical Center Mainz, Mainz, Germany
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Dall'Oglio F, Nasca MR, Fiorentini F, Micali G. Diet and acne: review of the evidence from 2009 to 2020. Int J Dermatol 2021; 60:672-685. [PMID: 33462816 DOI: 10.1111/ijd.15390] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 11/17/2020] [Accepted: 12/02/2020] [Indexed: 01/11/2023]
Abstract
BACKGROUND Dietary habits may play a non-negligible role in the development, duration, and severity of acne, as shown in past critical review articles on such association. METHODS The aim of this systematic review is to supplement data available on scientific literature spanning the last 10 years by inserting the keywords "acne" or "acne vulgaris" and "diet", "nutrition", "food", "chocolate", "dairy", "whey protein", "fatty acid", or "drink" in the timeframe "January 2009-April 2020" within the PubMed database. RESULTS Fifty-three reviewed articles met eligibility criteria. They included 11 interventional clinical trials (seven randomized controlled trials and four uncontrolled open label studies) and 42 observational studies (17 case-control and 22 cross-sectional studies, and three descriptive studies). CONCLUSIONS This review reinforces the notion of a rapidly growing exponential trend of interest in this subject by the scientific community. Acne-promoting factors include high GI/GL food, dairy products, fat food, and chocolate, whereas acne-protective factors include fatty acids, fruit, and vegetable intake. The role played by specific dietary components pertaining to different foods, as done for milk (full-fat/whole, reduced-fat, low-fat/skim milk), dairy products (milk cream, ice cream, yogurt, cheese, etc.), or chocolate (cocoa, dark/milk chocolate), remains an unsolved issue and objective of future research.
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20
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Pektas SD, Cinar N, Duman DD, Kara A, Batu J, Karakas-Celik S, Aksoy DY. The relationship among androgens, insulin resistance and ghrelin polymorphisms in post-adolescent male patients with severe acne vulgaris. Postepy Dermatol Alergol 2020; 37:800-809. [PMID: 33240024 PMCID: PMC7675091 DOI: 10.5114/ada.2020.100492] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Accepted: 04/01/2019] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION Ghrelin has anti-inflammatory and immunomodulatory activities. Data about the role of ghrelin and ghrelin polymorphisms in the development of acne vulgaris in post-adolescent male patients are limited. AIM To evaluate the role of serum androgens, insulin resistance, ghrelin and ghrelin polymorphisms in severe acne vulgaris. MATERIAL AND METHODS Thirty-five post-adolescent male patients with a mean age of 28.0 ±5.4 years and 33 age-and BMI-matched controls were enrolled. Serum androgens, lipids, insulin sensitivity parameters and ghrelin levels were determined. The PCR method was used for GHRL polymorphisms (rs27647, rs696217 and rs34911341 genotypes). RESULTS Patients had similar anthropometric measures to controls, except a significantly higher WHR in patients (0.92 ±0.06 vs. 0.86 ±0.08, p < 0.05). Also, FPG, HOMA-IR values, lipid profile and serum androgen levels were similar. Interestingly, patients had significantly lower ghrelin levels than controls (4.5 ±5.8 vs. 101.2 ±86.5 pg/ml, p < 0.001). The frequencies of rs696217 and rs34911341 genotypes were similar whereas the distribution of rs27647 alleles was significantly different between the groups (p < 0.05). GA and GG genotypes of GHRL rs27647 polymorphism indicated an increased risk of developing acne vulgaris (OR = 11.156, 95% CI: 2.864-43.464, OR = 5.312, 95% CI: 1.269-22.244, respectively; p < 0.05). Patients with rs27647-AA polymorphism had significantly lower GAGS scores than other groups (AA genotype 6.7 ±14.1 vs. GA genotype 24.6 ±15.7 and GG genotype 19.4 ±17.9, p < 0.001). None of the polymorphisms had a significant effect on metabolic parameters, insulin sensitivity and serum ghrelin levels. CONCLUSIONS Decreased ghrelin levels and GA and GG genotypes of GHRL gene rs27647 polymorphism may have a role in the pathogenesis of acne vulgaris.
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Affiliation(s)
- Suzan Demir Pektas
- Department of Dermatology, Faculty of Medicine, Mugla Sitki Kocman University, Mugla, Turkey
| | - Nese Cinar
- Department of Endocrinology and Metabolic Diseases, Faculty of Medicine, Mugla Sitki Kocman University, Mugla, Turkey
| | | | - Ahmet Kara
- Department of Family Medicine, Faculty of Medicine, Mugla Sitki Kocman University, Mugla, Turkey
| | | | - Sevim Karakas-Celik
- Department of Molecular Biology and Genetic, Faculty of Science, Bulent Ecevit University, Zonguldak, Turkey
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Bansal P, Sardana K, Vats G, Sharma L, Garga UC, Khurana A. A Prospective Study Examining Trigger Factors and Hormonal Abnormalities in Adult Female Acne. Indian Dermatol Online J 2020; 11:544-550. [PMID: 32832440 PMCID: PMC7413461 DOI: 10.4103/idoj.idoj_500_19] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 12/13/2019] [Accepted: 01/06/2020] [Indexed: 11/23/2022] Open
Abstract
Background: Numerous triggers have been implicated in adult female acne including endogenous (hormonal dysfunction and genetic predisposition) and exogenous causes (drugs, cosmetics, sunscreens, stress, and smoking). Aims: To evaluate the role of various trigger factors in adult female acne and to analyze the androgenic hormone pattern including anti-Mullerian hormone (AMH) in these patients. Materials and Methods: Patients having acne of age ≥25 years were analyzed using a pre devised proforma to elicit trigger factors while the severity was graded using the Global Acne Grading System (GAGS). A detailed hormonal assessment was undertaken that assessed total testosterone (TT), sex hormone-binding globulin (SHBG), free androgen index (FAI), AMH, 17-hydroxyprogesterone (17-OHP), dehydroepiandrosterone sulfate (DHEAS), follicle-stimulating hormone (FSH), luteinizing hormone (LH), thyroid-stimulating hormone (TSH), and prolactin. Results: Out of the 165 cases seen and sub-analyzed for triggers, premenstrual flare, diet, cosmetics, and stress were the most commonly implicated causes. Among cosmetics, fairness creams and foundations were implicated. The hormonal analysis revealed deranged values of all hormones with the most common being 17-OHP and AMH. Almost 42.8% patients with DHEAS derangement and 58.75% females with raised 17-OHP suffered from moderate to severe stress. Limitations: A prospective cohort correlation study of the implicated triggers is needed to confirm the association with adult female acne. Conclusions: Adult female acne may be triggered by diet, stress, and cosmetics and there is a distinct hormonal milieu that accounts for hyperandrogenemia. We noted high levels of adrenal androgens which have been known to be associated with stress and sleep deprivation. Our study shows the value of counseling adult female acne patients about various acne triggers.
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Affiliation(s)
- Prekshi Bansal
- Department of Dermatology, Venereology and Leprosy, Dr Ram Manohar Lohia Hospital and Post Graduate Institute of Medical Education and Research, New Delhi, India
| | - Kabir Sardana
- Department of Dermatology, Venereology and Leprosy, Dr Ram Manohar Lohia Hospital and Post Graduate Institute of Medical Education and Research, New Delhi, India
| | - Gauri Vats
- Department of Dermatology, Venereology and Leprosy, Dr Ram Manohar Lohia Hospital and Post Graduate Institute of Medical Education and Research, New Delhi, India
| | - Lokesh Sharma
- Department of Biochemistry, Dr Ram Manohar Lohia Hospital and Post Graduate Institute of Medical Education and Research, New Delhi, India
| | - Umesh Chandra Garga
- Department of Radiodiagnosis, Dr Ram Manohar Lohia Hospital and Post Graduate Institute of Medical Education and Research, New Delhi, India
| | - Ananta Khurana
- Department of Dermatology, Venereology and Leprosy, Dr Ram Manohar Lohia Hospital and Post Graduate Institute of Medical Education and Research, New Delhi, India
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22
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Kutlu Ö, Karadağ AS, Ünal E, Kelekçi KH, Yalçınkaya İyidal A, Topaloğlu Demir F, Aksoy B, Çölgeçen E, Tosun M, Emre S, Tatlıparmak A, Demirseren DD, Kaya Özden H, Öztürk M, Özlü E, Chen W. Acne in pregnancy: A prospective multicenter, cross-sectional study of 295 patients in Turkey. Int J Dermatol 2020; 59:1098-1105. [PMID: 32562263 DOI: 10.1111/ijd.14999] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 05/06/2020] [Accepted: 05/12/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND There are only a few studies on acne in pregnancy. This study was aimed to investigate the demographic, clinical, and familial characteristics of acne in pregnancy, triggering factors including endocrine diseases, and association of these findings with acne in different trimesters of pregnancy. METHODS Pregnant women aged 18 years and older with acne at any stage of pregnancy were consecutively interviewed at the participating centers during the study period from 2016 to 2019. Acne severity was evaluated using the Comprehensive Acne Severity Scale. RESULTS A total of 295 pregnant women with acne were included, with 167 (56.6%) patients showing mild, 87 (29.5%) moderate, six (12.2%) severe, and five (1.7%) very severe acne. Truncal acne was significantly higher in the third trimester than in the other stages (P < 0.001). Onset of acne before pregnancy, prepubertal, pubertal or adult onset, or acne history in previous pregnancies did not influence acne severity in pregnancy. Women with irregular menstruation before pregnancy, polycystic ovary syndrome, hirsutism, and higher body weight index tended to show severe acne in pregnancy. CONCLUSIONS Severe acne during pregnancy is generally uncommon, while severity of facial acne, truncal acne, and hirsutism is higher in the third trimester than in other trimesters. Acne in pregnancy shares many characteristics with female adult acne. Substantial changes in different kinds of hormones play a more complex role in acne during pregnancy, but the pathogenesis remains to be determined.
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Affiliation(s)
- Ömer Kutlu
- Department of Dermatology and Venereology, School of Medicine, Uşak University, Uşak Training and Research Hospital, Uşak, Turkey
| | - Ayşe Serap Karadağ
- Department of Dermatology and Venereology, School of Medicine, Istanbul Medeniyet University, Goztepe Training and Research Hospital, Istanbul, Turkey
| | - Emine Ünal
- Department of Dermatology and Venereology, Lokman Hekim Hospital, Ankara, Turkey
| | - Kıymet Handan Kelekçi
- Department of Dermatology and Venereology, İzmir Katip Çelebi University, İzmir, Turkey
| | | | - Filiz Topaloğlu Demir
- Department of Dermatology and Venereology, School of Medicine, Medipol University, İstanbul, Turkey
| | - Berna Aksoy
- Department of Dermatology and Venereology, School of Medicine, Bahçeşehir University, Istanbul, Turkey
| | - Emine Çölgeçen
- Department of Dermatology and Venereology, School of Medicine, Yozgat Bozok University, Yozgat, Turkey
| | - Mustafa Tosun
- Department of Dermatology and Venereology, Konya Training and Research Hospital, Konya, Turkey
| | - Selma Emre
- Department of Dermatology and Venereology, School of Medicine, Yıldırım Beyazıt University, Ankara, Turkey
| | - Aslı Tatlıparmak
- Department of Dermatology and Venereology, School of Medicine, Bahçeşehir University, Istanbul, Turkey
| | | | - Hatice Kaya Özden
- Department of Dermatology and Venereology, Kocaeli Derince Training and Research Hospital, Kocaeli, Turkey
| | - Murat Öztürk
- Department of Dermatology and Venereology, Van Training and Research Hospital, Health Sciences University, Van, Turkey
| | - Emin Özlü
- Department of Dermatology and Venereology, School of Medicine, Düzce, Turkey
| | - Wenchieh Chen
- Department of Dermatology and Allergy, Technische Universität München, Munich, Germany.,Department of Dermatology, Pingtung Hospital, Ministry of Health and Welfare, Taiwan
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23
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Heng AHS, Chew FT. Systematic review of the epidemiology of acne vulgaris. Sci Rep 2020; 10:5754. [PMID: 32238884 PMCID: PMC7113252 DOI: 10.1038/s41598-020-62715-3] [Citation(s) in RCA: 144] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 03/16/2020] [Indexed: 12/18/2022] Open
Abstract
A systematic review was conducted on epidemiology studies on acne obtained from a Web of Science search to study risk factors associated with acne presentation and severity. A strong association was observed between several risk factors – family history, age, BMI and skin type – and acne presentation or severity in multiple studies. The pooled odds ratio of 2.36 (95% CI 1.97–2.83) for overweight/obese BMI with reference to normal/underweight BMI and the pooled odds ratio of 2.91 (95% CI 2.58–3.28) for family history in parents with reference to no family history in parents demonstrate this strong association. In addition, a pooled odds ratio of 1.07 (95% CI 0.42–2.71) was obtained for sex (males with reference to females). However, the association between other factors, such as dietary factors and smoking, and acne presentation or severity was less clear, with inconsistent results between studies. Thus, further research is required to understand how these factors may influence the development and severity of acne. This study summarizes the potential factors that may affect the risk of acne presentation or severe acne and can help researchers and clinicians to understand the epidemiology of acne and severe acne. Furthermore, the findings can direct future acne research, with the hope of gaining insight into the pathophysiology of acne so as to develop effective acne treatments.
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Affiliation(s)
- Anna Hwee Sing Heng
- Department of Biological Sciences, National University of Singapore, Singapore, Singapore
| | - Fook Tim Chew
- Department of Biological Sciences, National University of Singapore, Singapore, Singapore.
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24
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Bansal P, Sardana K, Sharma L, Garga UC, Vats G. A prospective study examining isolated acne and acne with hyperandrogenic signs in adult females. J DERMATOL TREAT 2019; 32:752-755. [PMID: 31868042 DOI: 10.1080/09546634.2019.1708245] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND Adult female acne (AFA) occurs beyond 25 years of age and can present either as isolated acne or with hyperandrogenic signs. METHODS 120 females aged ≥ 25 years were evaluated for acne, hirsutism and androgenetic alopecia. Hormonal assessment included total testosterone (TT), sex hormone binding globulin (SHBG), free androgen index (FAI), Anti Mullerian Hormone (AMH), 17-hydroxyprogesterone (17-OHP), dehydroepiandrosterone sulfate (DHEAS), follicle stimulating hormone (FSH), luteinizing hormone (LH), thyroid stimulating hormone (TSH) and prolactin. Polycystic ovary syndrome (PCOS) was diagnosed using Rotterdam's criteria. RESULTS The mean GAGS score was 15.57 ± 4.04.71.66% females had acne with hyperandrogenic signs (hirsutism, 55.81%; hyperseborrhoea, 65.12%; irregular menses, 36.05%) and 18.33% had increased androgen levels. The group with hyperandrogenic signs had longer duration of disease, truncal acne, significant adolescent acne history, stress, inappropriate diet and PCOS compared to the isolated acne group. The mean androgen levels were higher in the former but the difference was statistically insignificant. CONCLUSIONS Adult female acne can be associated with hyperandrogenic features though routine hormonal tests may not reveal an underlying abnormality except PCOS. End-organ hypersensitivity is the most plausible explanation and thus justifies the use of antiandrogens in its management.
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Affiliation(s)
- Prekshi Bansal
- Department of Dermatology, Dr. Ram Manohar Lohia Hospital & Post Graduate Institute of Medical Education and Research New Delhi, New Delhi, India
| | - Kabir Sardana
- Department of Dermatology, Dr. Ram Manohar Lohia Hospital & Post Graduate Institute of Medical Education and Research New Delhi, New Delhi, India
| | - Lokesh Sharma
- Department of Biochemistry, Dr. Ram Manohar Lohia Hospital & Post Graduate Institute of Medical Education and Research New Delhi, New Delhi, India
| | - Umesh Chandra Garga
- Department of Radiodiagnosis, Dr. Ram Manohar Lohia Hospital & Post Graduate Institute of Medical Education and Research New Delhi, New Delhi, India
| | - Gauri Vats
- Department of Dermatology, Dr. Ram Manohar Lohia Hospital & Post Graduate Institute of Medical Education and Research New Delhi, New Delhi, India
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25
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Kanwar IL, Haider T, Kumari A, Dubey S, Jain P, Soni V. Models for acne: A comprehensive study. Drug Discov Ther 2019; 12:329-340. [PMID: 30674767 DOI: 10.5582/ddt.2018.01079] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Acne vulgaris (AV) is the familiar chronic skin ailment affecting most of the individuals. This multifarious, disease involves the bacterium gram-positive, anaerobic Propionibacterium acnes (P. acnes) which resides on skin microflora, and participated in acne inflammation and acne lesions. The object of this review is to discuss presently available in vitro, ex vivo, and in vivo models to evaluate the cosmetic formulations that are developed for dealing and prevention of acne formation. These various available models offer new chances for further research on biologically active materials, drugs & pharmaceutical as well as cosmetics for acne treatment.
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Affiliation(s)
- Indu Lata Kanwar
- Department of Pharmaceutical Sciences, Dr. Harisingh Gour University
| | - Tanweer Haider
- Department of Pharmaceutical Sciences, Dr. Harisingh Gour University
| | - Anju Kumari
- Department of Pharmaceutical Sciences, Dr. Harisingh Gour University
| | - Sandeep Dubey
- Department of Pharmaceutical Sciences, Dr. Harisingh Gour University
| | - Priyanka Jain
- Department of Pharmaceutical Sciences, Dr. Harisingh Gour University
| | - Vandana Soni
- Department of Pharmaceutical Sciences, Dr. Harisingh Gour University
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26
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Wallace TC, Bailey RL, Blumberg JB, Burton-Freeman B, Chen CYO, Crowe-White KM, Drewnowski A, Hooshmand S, Johnson E, Lewis R, Murray R, Shapses SA, Wang DD. Fruits, vegetables, and health: A comprehensive narrative, umbrella review of the science and recommendations for enhanced public policy to improve intake. Crit Rev Food Sci Nutr 2019; 60:2174-2211. [DOI: 10.1080/10408398.2019.1632258] [Citation(s) in RCA: 115] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Taylor C. Wallace
- Department of Nutrition and Food Studies, George Mason University, Fairfax, Virginia, USA
- Think Healthy Group, Inc., Washington, DC, USA
| | - Regan L. Bailey
- Department of Nutrition Science, Purdue University, West Lafayette, Indiana, USA
| | - Jeffrey B. Blumberg
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, USA
| | - Britt Burton-Freeman
- Center for Nutrition Research, Institute for Food Safety and Health, Illinois Institute of Technology, Bedford Park, Illinois, USA
| | - C-y. Oliver Chen
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, USA
- Biofortis Research, Merieux NutriSciences, Addison, Illinois, USA
| | | | - Adam Drewnowski
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
| | - Shirin Hooshmand
- School of Exercise and Nutritional Sciences, San Diego State University, San Diego, California, USA
| | - Elizabeth Johnson
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, USA
| | - Richard Lewis
- Bone and Body Composition Laboratory, College of Family and Consumer Sciences, University of Georgia, Athens, Georgia, USA
| | - Robert Murray
- College of Education and Human Ecology, The Ohio State University, Columbus, Ohio, USA
| | - Sue A. Shapses
- Department of Nutritional Sciences, Rutgers University, New Brunswick, New Jersey, USA
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27
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Aalemi AK, Anwar I, Chen H. Dairy consumption and acne: a case control study in Kabul, Afghanistan. Clin Cosmet Investig Dermatol 2019; 12:481-487. [PMID: 31303778 PMCID: PMC6611707 DOI: 10.2147/ccid.s195191] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Accepted: 05/27/2019] [Indexed: 12/18/2022]
Abstract
Background Previous observational studies suggest that the development of acne may be triggered by dairy intake. Objective This study aimed to investigate the association of dairy intake and acne in Kabul citizens. Methods From February to September 2018, 279 acne patients and 279 controls aged 10–24 years were enrolled in a case control study at the dermatologic outpatient department of Maiwand Teaching Hospital in Kabul City, Afghanistan. The acne severity was determined by a dermatologist using the Global Acne Severity Scale. Results The consumption of whole milk 3 days or more per week was associated with moderate to severe acne (OR =2.36, 95% CI, 1.39–4.01). The association for low fat milk was less marked than for whole milk (OR 1.95 CI, 1.10–3.45). The risk was increased in those with a family history of acne in siblings (OR =4.13, 95% CI, 2.55–6.69). The risk was reduced in subjects doing physical exercise. No association with smoking emerged. A protective effect was associated with chicken consumption (OR =0.27, 95% CI, 0.15–0.49). Consumption of chocolate and chips was positively associated with acne. Conclusion This study showed an association between high intakes of dairy products and acne in adolescence suggesting that dairy intake may be a factor contributing to acne.
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Affiliation(s)
- Ahmad Khalid Aalemi
- Department of Dermatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.,Department of Epidemiology, Kabul University of Medical Sciences, Kabul 1001, Afghanistan
| | - Idris Anwar
- Department of Environmental Health, Kabul University of Medical Sciences, Kabul 1001, Afghanistan
| | - Hongxiang Chen
- Department of Dermatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
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28
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Claudel J, Auffret N, Leccia M, Poli F, Dréno B. Reply to comments made by M. Donnarumma
et al
. Comment on “Acne and nutrition: hypotheses, myths and facts” published by our expert group in 2018. J Eur Acad Dermatol Venereol 2019; 33:e420. [DOI: 10.1111/jdv.15722] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
| | | | - M.T. Leccia
- Department of Dermatology, Allergology and Photobiology CHU A Michallon Grenoble France
| | - F. Poli
- Private Practice Paris France
| | - B. Dréno
- Department of Dermato‐Cancerology Nantes University Hospital Nantes France
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29
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Mehta A, Hasija Y. Meta-analyses of associations of obesity with risk of melanoma and acne based on case-control studies. BIOMEDICAL DERMATOLOGY 2019. [DOI: 10.1186/s41702-019-0041-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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30
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Juhl CR, Bergholdt HKM, Miller IM, Jemec GBE, Kanters JK, Ellervik C. Dairy Intake and Acne Vulgaris: A Systematic Review and Meta-Analysis of 78,529 Children, Adolescents, and Young Adults. Nutrients 2018; 10:nu10081049. [PMID: 30096883 PMCID: PMC6115795 DOI: 10.3390/nu10081049] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2018] [Revised: 08/04/2018] [Accepted: 08/07/2018] [Indexed: 12/14/2022] Open
Abstract
A meta-analysis can help inform the debate about the epidemiological evidence on dairy intake and development of acne. A systematic literature search of PubMed from inception to 11 December 2017 was performed to estimate the association of dairy intake and acne in children, adolescents, and young adults in observational studies. We estimated the pooled random effects odds ratio (OR) (95% CI), heterogeneity (I²-statistics, Q-statistics), and publication bias. We included 14 studies (n = 78,529; 23,046 acne-cases/55,483 controls) aged 7⁻30 years. ORs for acne were 1.25 (95% CI: 1.15⁻1.36; p = 6.13 × 10-8) for any dairy, 1.22 (1.08⁻1.38; p = 1.62 × 10-3) for full-fat dairy, 1.28 (1.13⁻1.44; p = 8.23 × 10-5) for any milk, 1.22 (1.06⁻1.41; p = 6.66 × 10-3) for whole milk, 1.32 (1.16⁻1.52; p = 4.33 × 10-5) for low-fat/skim milk, 1.22 (1.00⁻1.50; p = 5.21 × 10-2) for cheese, and 1.36 (1.05⁻1.77; p = 2.21 × 10-2) for yogurt compared to no intake. ORs per frequency of any milk intake were 1.24 (0.95⁻1.62) by 2⁻6 glasses per week, 1.41 (1.05⁻1.90) by 1 glass per day, and 1.43 (1.09⁻1.88) by ≥2 glasses per day compared to intake less than weekly. Adjusted results were attenuated and compared unadjusted. There was publication bias (p = 4.71 × 10-3), and heterogeneity in the meta-analyses were explained by dairy and study characteristics. In conclusion, any dairy, such as milk, yogurt, and cheese, was associated with an increased OR for acne in individuals aged 7⁻30 years. However, results should be interpreted with caution due to heterogeneity and bias across studies.
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Affiliation(s)
- Christian R Juhl
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, 2100 Copenhagen, Denmark.
| | - Helle K M Bergholdt
- Department of Production, Research, and Innovation, Region Zealand, 4180 Sorø, Denmark.
| | - Iben M Miller
- Department of Dermatology, Zealand University Hospital, 4000 Roskilde, Denmark.
| | - Gregor B E Jemec
- Department of Dermatology, Zealand University Hospital, 4000 Roskilde, Denmark.
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, 2100 Copenhagen, Denmark.
| | - Jørgen K Kanters
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, 2100 Copenhagen, Denmark.
| | - Christina Ellervik
- Department of Production, Research, and Innovation, Region Zealand, 4180 Sorø, Denmark.
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, 2100 Copenhagen, Denmark.
- Department of Laboratory Medicine, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA.
- Department of Pathology, Harvard Medical School, Boston, MA 02115, USA.
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31
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Lactase Persistence, Milk Intake, and Adult Acne: A Mendelian Randomization Study of 20,416 Danish Adults. Nutrients 2018; 10:nu10081041. [PMID: 30096803 PMCID: PMC6115808 DOI: 10.3390/nu10081041] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2018] [Revised: 07/30/2018] [Accepted: 08/03/2018] [Indexed: 12/20/2022] Open
Abstract
Whether there is a causal relationship between milk intake and acne is unknown. We tested the hypothesis that genetically determined milk intake is associated with acne in adults using a Mendelian randomization design. LCT-13910 C/T (rs4988235) is associated with lactase persistence (TT/TC) in Northern Europeans. We investigated the association between milk intake, LCT-13910 C/T (rs4988235), and acne in 20,416 adults (age-range: 20⁻96) from The Danish General Suburban Population Study (GESUS). The adjusted observational odds ratio for acne in any milk intake vs. no milk intake was 0.93(95% confidence interval: 0.48⁻1.78) in females and 0.49(0.22⁻1.08) in males aged 20⁻39 years, and 1.15(95% confidence interval: 0.66⁻1.99) in females and 1.02(0.61⁻1.72) in males above 40 years. The unadjusted odds ratio for acne in TT+TC vs. CC was 0.84(0.43⁻1.62) in the age group 20⁻39 years, and 0.99(0.52⁻1.88) above 40 years. We did not find any observational or genetic association between milk intake and acne in our population of adults.
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32
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Claudel JP, Auffret N, Leccia MT, Poli F, Dréno B. Acne and nutrition: hypotheses, myths and facts. J Eur Acad Dermatol Venereol 2018; 32:1631-1637. [PMID: 29633388 DOI: 10.1111/jdv.14998] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 03/15/2018] [Indexed: 12/28/2022]
Abstract
Acne is an inflammatory and multifactorial skin disease. Different external and internal factors, including air pollution, aggressive skincare products, medication, mechanical, hormonal and familial factors and, more recently, lifestyle and stress, have been suggested as having an impact on acne. Moreover, for many years nutrition was believed to cause or worsen acne. Over the last decades, however, it has become a dermatological doctrine that there is no direct association between diet and acne. Even if recent research has allowed to identify certain nutritional elements and behaviour that may impact on acne, including the excessive intake of dairy products and hyperglycaemic food, modern lifestyle nutrition, obesity and eating disorders, knowledge about the role of nutrition in the physiopathology of acne still remains sparse and hypotheses and myths continue to dominate the debate. Thus, further clinical and translational research is necessary to investigate and confirm the association between nutrition and acne.
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Affiliation(s)
| | | | - M T Leccia
- Department of Dermatology, Allergology and Photobiology, CHU A Michallon, Grenoble, France
| | - F Poli
- Private Practice, Paris, France
| | - B Dréno
- Department of Dermatology, CIC 1413, CRCINA Inserm 1232, Nantes University Hospital, Nantes, France
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33
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Dessinioti C, Tzanetakou V, Zisimou C, Platsidaki E, Koukkou E, Katsambas A, Antoniou C. A study of androgenic signs and disorders in Greek female patients with acne. J Eur Acad Dermatol Venereol 2018; 32:e279-e282. [PMID: 29377293 DOI: 10.1111/jdv.14817] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Affiliation(s)
- C Dessinioti
- Department of Dermatology, Andreas Syggros Hospital, University of Athens, 5, I.Dragoumi street, 16121, Athens, Greece
| | - V Tzanetakou
- Department of Dermatology, Andreas Syggros Hospital, University of Athens, 5, I.Dragoumi street, 16121, Athens, Greece
| | - C Zisimou
- Department of Dermatology, Andreas Syggros Hospital, University of Athens, 5, I.Dragoumi street, 16121, Athens, Greece
| | - E Platsidaki
- Department of Dermatology, Andreas Syggros Hospital, University of Athens, 5, I.Dragoumi street, 16121, Athens, Greece
| | - E Koukkou
- Department of Endocrinology, "Elena Venizelou" Maternity Hospital, 2, Elenas Venizelou square, 11521, Athens, Greece
| | - A Katsambas
- University of Athens, 18, Tetrapoleos street, 11527, Athens, Greece
| | - C Antoniou
- Department of Dermatology, Andreas Syggros Hospital, University of Athens, 5, I.Dragoumi street, 16121, Athens, Greece
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34
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Dessinioti C, Platsidaki E, Zisimou C, Tzanetakou V, Katsambas A, Antoniou C. A cross-sectional study of the perceptions about triggering factors in acne patients. J Eur Acad Dermatol Venereol 2017; 32:e137-e139. [DOI: 10.1111/jdv.14628] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- C. Dessinioti
- 1st Department of Dermatology; A. Syggros Hospital; University of Athens; 5, Dragoumi Str, 16 121 Kaisariani, Athens Greece
| | - E. Platsidaki
- 1st Department of Dermatology; A. Syggros Hospital; University of Athens; 5, Dragoumi Str, 16 121 Kaisariani, Athens Greece
| | - C. Zisimou
- 1st Department of Dermatology; A. Syggros Hospital; University of Athens; 5, Dragoumi Str, 16 121 Kaisariani, Athens Greece
| | - V. Tzanetakou
- 1st Department of Dermatology; A. Syggros Hospital; University of Athens; 5, Dragoumi Str, 16 121 Kaisariani, Athens Greece
| | - A. Katsambas
- National & Kapodestrian University of Athens; 35, Skoufa str, 10 673, Athens Greece
| | - C. Antoniou
- 1st Department of Dermatology; A. Syggros Hospital; University of Athens; 5, Dragoumi Str, 16 121 Kaisariani, Athens Greece
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35
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Kim K, Ha I, Kim E, Kim K. A comparative study of biological and metabolic biomarkers between healthy individuals and patients with acne vulgaris: A cross-sectional study protocol. Medicine (Baltimore) 2017; 96:e8554. [PMID: 29137071 PMCID: PMC5690764 DOI: 10.1097/md.0000000000008554] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Acne is a multifactorial dermatosis, which is influenced not only by hormones but also by the biochemical relationship between them and the pilosebaceous unit. Inflammatory cytokines, chemokines, active oxygen, and zinc are known to be associated with the development of acne. Further, steroid metabolism is known as one of the important factors related to sebum secretion and comedone formation in acne. However, there is a lack of studies comparing these human biomarkers between healthy individuals and patients with acne. In particular, no study has investigated the relationship between human biomarkers and patterns of acne yet.The purpose of this study is to investigate diagnostic human biomarkers in acne by comparing the biological and metabolic biomarkers between healthy individuals and patients with acne and identify the relationship between human biomarkers and patterns of acne.This study is a protocol for a cross-sectional study. Forty healthy participants and 60 patients with acne will be recruited at 1 center. We will collect their blood samples and analyze the molecular biological and metabolic biomarkers (cytokines, chemokines, reactive oxygen species, corticotropin-releasing hormone, zinc, amino acid, 1-carbon metabolite, lipid metabolite, etc.). Further, we will administer questionnaires regarding their diet, sleep, stress, and other factors relating to acne and measure their skin elasticity.The study protocol was approved by the Institutional Review Board of Oriental Medical Hospital at Kyung Hee Medical Center (KOMCIRB-161118-HR-062). Written informed consent will be obtained from all the participants. The trial was registered in the Clinical Research Information Service, Republic of Korea: KCT0002212.This trial will provide evidence regarding diagnostic human biomarkers in acne and the relationship between the human biomarkers and patterns of acne.
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Affiliation(s)
- Kyuseok Kim
- Department of Ophthalmology, Otolaryngology and Dermatology, College of Korean Medicine, Kyung Hee University
- Korean Medicine Clinical Trial Center, Kyung Hee University Korean Medicine Hospital
| | - Injin Ha
- Korean Medicine Clinical Trial Center, Kyung Hee University Korean Medicine Hospital
| | - Eunok Kim
- Korean Medicine Clinical Trial Center, Kyung Hee University Korean Medicine Hospital
- College of Korean Medicine, Kyung Hee University
| | - Kyunglee Kim
- Department of Education, College of Education, Ewha Womans University, Seoul, Republic of Korea
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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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