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Suh DH, Kim T, Lee SJ, Jeong SJ, Baek E, Shin MK. Enhanced Tolerability and Improved Outcomes in Acne Management: A Real-World Study of Dermocosmetic Adjunctive Therapy. J Cosmet Dermatol 2025; 24:e16772. [PMID: 39757973 PMCID: PMC11701793 DOI: 10.1111/jocd.16772] [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: 10/11/2024] [Revised: 11/14/2024] [Accepted: 12/26/2024] [Indexed: 01/07/2025]
Abstract
BACKGROUND Topical retinoids, while renowned for their efficacy in treating acne vulgaris, are often hampered by inter-individual variability in tolerability. This challenge, primarily driven by side effects like erythema, scaling, and dryness, significantly impacts patient adherence and, ultimately, treatment outcomes. AIMS This prospective, multi-center, observational study investigated the novel role of a specific dermocosmetic regimen as adjunctive therapy, focusing on its ability to mitigate retinoid-induced side effects and enhance the overall tolerability of acne treatment regimens in a Korean population. PATIENTS AND METHODS We enrolled 304 patients receiving conventional acne therapies and integrated a standardized dermocosmetic regimen (foaming facial wash and moisturizer) for 12 weeks. Our primary endpoint assessed changes in skin sensitivity scores in both retinoid and non-retinoid users. We incorporated a patient-reported outcome measure evaluating acne's impact on quality of life across different facial areas as a secondary endpoint. RESULTS Our results revealed a significant improvement in skin sensitivity across both patient groups, effectively mitigating the anticipated heightened sensitivity in retinoid users. This finding suggests that dermocosmetics may hold the key to unlocking consistent, age-independent tolerance to retinoid therapy. Furthermore, we observed a compelling correlation between improvements in cheek acne and enhanced quality of life, highlighting the profound psychological impact of this specific facial area. CONCLUSIONS This study pioneers a new understanding of holistic acne management, emphasizing the synergistic potential of dermocosmetics in enhancing treatment adherence, improving long-term outcomes, and ultimately transforming patients' lives.
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Affiliation(s)
- Dong Hye Suh
- DermatologyArumdaun Nara Dermatologic ClinicSeoulKorea
| | - Tae‐Eun Kim
- Department of Dermatology, School of MedicineKyung Hee University HospitalSeoulKorea
| | - Sang Jun Lee
- DermatologyArumdaun Nara Dermatologic ClinicSeoulKorea
| | - Su Jin Jeong
- Statistics Support PartMedical Science Research Institute, Kyung Hee UniversitySeoulKorea
| | - Eunsun Baek
- Medical Affairs, Loreal Dermatological BeautyL'Oréal Korea Ltd.SeoulKorea
| | - Min Kyung Shin
- Department of Dermatology, School of MedicineKyung Hee University HospitalSeoulKorea
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Layton AM, Gupta G, Seukeran D, Maruthappu T, Gaillard S, Whitehouse H, Ali FR, Razzaque A, Al-Niaimi F, Copperwheat S. What's New After NICE Acne Guidelines. Dermatol Ther (Heidelb) 2024; 14:2727-2738. [PMID: 39305432 PMCID: PMC11480286 DOI: 10.1007/s13555-024-01275-0] [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: 06/04/2024] [Accepted: 09/06/2024] [Indexed: 10/17/2024] Open
Abstract
INTRODUCTION Acne remains one of the most common inflammatory dermatoses seen worldwide. There are significant challenges when managing acne relating to a variety of factors, including (1) lack of consensus on the use of the numerous available grading systems and outcome measures, (2) appreciation of the numerous areas that relate to severity, (3) the chronic nature of acne which requires a longitudinal approach to management (including both facial and truncal disease), and (4) the need to target acne early to avoid physical and psychosocial scarring. Consideration of these aspects when managing acne should result in improved outcomes. Acne guidelines review the available evidence based on robust clinical trials and are usually supplemented with some expert opinion when evidence is not available. METHODS In this paper, the UK Acne Working Group reflects on the latest National Institute for Health and Care Excellence (NICE) acne guidelines with a goal of providing additional practical insights. CONCLUSION The group have identified areas where new evidence has now become available since the formulation of the NICE acne guidelines. This publication considers newly approved acne medications in the UK, guidance on assessing acne severity, approaches to managing truncal acne, acne sequelae, and adult female acne with hormonal therapies.
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Affiliation(s)
- Alison M Layton
- Skin Research Centre, University of York, Heslington Road, York, YO10 5DD, UK.
| | - Girish Gupta
- Edinburgh Royal Infirmary, Edinburgh, Scotland, UK
| | - Daron Seukeran
- James Cook University Hospital, Middlesbrough, England, UK
| | | | - Stephanie Gaillard
- Liverpool University Hospital NHS Foundation Trust, Liverpool, England, UK
| | | | - Faisal R Ali
- Mid Cheshire NHS Foundation Trust, Macclesfield, UK
| | | | - Firas Al-Niaimi
- The Tatouk Clinic, London, UK
- Aalborg University Hospital, Aalborg, Denmark
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Satish DA, Aurangabadkar S, Tahiliani ST, Damisetty R, Tiwari A, D S K, Madnani N, Saraswat A, Das A, Sen D, Jadhwar S. Role of Trifarotene in the Management of Acne in Indian Patients: Insights From an Indian Dermatology Experts' Meeting. Cureus 2024; 16:e65800. [PMID: 39219884 PMCID: PMC11362555 DOI: 10.7759/cureus.65800] [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: 07/26/2024] [Indexed: 09/04/2024] Open
Abstract
Acne vulgaris, a prevalent inflammatory skin condition, significantly impacts individuals worldwide, particularly adolescents and adults. Its chronic nature, associated sequelae, and psychosocial impact underscore the substantial burden it poses. Current treatment guidelines primarily address facial acne, with limited guidance on managing truncal acne. Personalized approaches are increasingly recognized as essential for tailoring treatments to individual patient needs. This review integrates insights from an Indian Dermatology Experts' Meeting, featuring perspectives from nine leading dermatologists. Discussions centered on analyzing acne's burden, its effects on quality of life (QoL), unmet needs in management, trifarotene's role in Indian therapy, anticipated challenges, and the importance of ancillary care. The experts highlighted acne's profound impact on patients' QoL and identified gaps in current management guidelines, especially concerning truncal acne. Trifarotene, a fourth-generation topical retinoid approved by the FDA and Drug Controller General of India (DCGI) for facial and truncal acne, demonstrated safety and efficacy across age groups. This synthesis of expert perspectives underscores the need for personalized acne management. Trifarotene emerges as a promising therapeutic option but challenges remain, particularly in optimizing ancillary care to minimize treatment-related adverse effects. Addressing these issues will enhance treatment outcomes and patient satisfaction in acne management, emphasizing the importance of tailored approaches in clinical practice.
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Affiliation(s)
- D A Satish
- Dermatology, Sagar Hospitals, Bengaluru, IND
| | | | | | - Rajetha Damisetty
- Dermatology, Dr. Rajetha's Mohana Skin & Hair Clinic, Hyderabad, IND
| | - Anurag Tiwari
- Dermatology, Anurag Tiwari Skin And Laser Clinic, Bhopal, IND
| | | | | | | | - Anupam Das
- Dermatology, KPC (Kali Pradip Chaudhuri) Medical College and Hospital, Kolkata, IND
| | - Dyotona Sen
- Medical Affairs, Galderma India Pvt Ltd, Mumbai, IND
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Rocha M, Barnes F, Calderón J, Fierro-Arias L, Gomez CEM, Munoz C, Jannell O, Troieli P. Acne treatment challenges - Recommendations of Latin American expert consensus. An Bras Dermatol 2024; 99:414-424. [PMID: 38402012 PMCID: PMC11074621 DOI: 10.1016/j.abd.2023.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 09/05/2023] [Accepted: 09/09/2023] [Indexed: 02/26/2024] Open
Abstract
BACKGROUND Acne is a chronic inflammatory disorder of the pilosebaceous unit that is associated with a negative impact on quality of life, causing anxiety, depression, and poor self-esteem. The treatment of acne is not simple and presents some new challenges. This article addresses important issues faced by dermatologists on their daily, some of them specific for Latin America. OBJECTIVE To discuss daily practice recommendations when managing acne patients. METHODS A literature review was conducted by a group of eight experts with extensive experience in the field of acne. The results of the data review were presented at an initial kick-off meeting to align the consensus topics. Two e-surveys using the Delphi methodology and an interim group webinar meeting were held. RESULTS The expert panel reached a consensus on all proposed key statements, providing scientific support to help dermatologists and healthcare providers make acne management decisions on topics that can be challenging in the everyday practice of dermatology, such as the characteristics of Generation Z or the importance of the maintenance phase of adult acne treatment. CONCLUSION This article provides current recommendations for managing acne patients. The high level of agreement achieved based on the latest evidence supports the best acne therapeutic choices in both established topics and new important issues that have emerged in recent years, such as the impact of social media, Generation Z characteristics, and transgender male patient specifics.
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Affiliation(s)
- Marco Rocha
- Universidade Federal de São Paulo, São Paulo, SP, Brazil; Sociedade Brasileira de Dermatologia, São Paulo, SP, Brazil.
| | - Franz Barnes
- Iberolatin-American College of Dermatology (CILAD), Panamá City, Panama
| | | | - Leonel Fierro-Arias
- Hospital General de Mexico and American British Cowdray (ABC) Medical Center, Mexico City, Mexico; Mexican Society of Dermatologic & Oncologic Surgery, Iberolatin-American College of Dermatology (CILAD), Mexico City, Mexico
| | | | - Carla Munoz
- Clinica Santa Maria, Santiago de Chile, Chile; Sociedad Chilena Dermatología and Iberolatin-American College of Dermatology (CILAD), Santiago de Chile, Chile
| | - Obregón Jannell
- Lima Dermatology Center Clinic and Esthetic, Lima, Peru; Sociedad Peruana de Dermatologia, Lima, Peru
| | - Patricia Troieli
- School of Medicine University of Buenos Aires, Buenos Aires, Argentina; Argentine Dermatology Society, Iberolatin-American College of Dermatology (CILAD), American Academy of Dermatology and European Academy of Dermatology, Buenos Aires, Argentina
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Srivastava S, Huang SF, Jagtap MS. Assessment of the Effect of Rehmannia glutinosa Leaf Extract in Maintaining Skin Health: A Proof-of-Concept, Double-Blind, Randomized, Placebo-Controlled Clinical Trial. Clin Cosmet Investig Dermatol 2024; 17:863-875. [PMID: 38651075 PMCID: PMC11034513 DOI: 10.2147/ccid.s448928] [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: 12/08/2023] [Accepted: 03/24/2024] [Indexed: 04/25/2024]
Abstract
Purpose A double-blind, placebo-controlled, randomized, proof-of-concept trial aimed to evaluate the efficacy and safety of VerbasnolTM [Rehmannia glutinosa Libosch leaf-based extract (RGLE)] in females, with moderate to severe acne vulgaris. Participants and Methods Twenty-two females aged 18 to 35 years having moderate to severe acne with Global Acne Grading System (GAGS) scores of 19 to 38 were included in the study and were randomized in a 1:1 ratio to receive either one capsule (100 mg/day) of RGLE or placebo orally after breakfast for 56 days. The primary outcome was a change in acne severity measured by the GAGS compared to the placebo on day 56. The secondary outcomes were changes in the number of inflammatory acne lesions, facial sebum secretion, quality of life, local pain and itching, skin wrinkle severity, and other skin characteristics, including radiance, luminosity, smoothness, texture, firmness, and hydration. Additionally, the percentage of responders and global tolerability and efficacy were evaluated. Results The mean GAGS score was reduced by 21.72% and 14.20% on day 28 in RGLE (n=10) and placebo groups (n=12), respectively, which further reduced in both groups on day 56. The RGLE group reported better improvement in other skin characteristics on day 56. No safety or tolerability concerns were reported for the extract. RGLE reduced acne and improved the skin quality in females compared to placebo as early as 28 days of supplementation. Conclusion RGLE supplementation at a dose of 100 mg/day has provided a clinically relevant decrease in acne severity and improved the skin hydration and quality of life of the participants with acne after 56 days of dose administration.
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Affiliation(s)
- Shalini Srivastava
- Department of Clinical Development and Strategy, Vedic Lifesciences Pvt. Ltd., Andheri West, Mumbai, Maharashtra, India
| | - Shu Fen Huang
- Department of Biochemistry, NuLiv Holding Inc., Taipei City, Taiwan (Republic of China)
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Dreno B, Dekio I, Baldwin H, Demessant AL, Dagnelie MA, Khammari A, Corvec S. Acne microbiome: From phyla to phylotypes. J Eur Acad Dermatol Venereol 2024; 38:657-664. [PMID: 37777343 DOI: 10.1111/jdv.19540] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 07/12/2023] [Indexed: 10/02/2023]
Abstract
Acne vulgaris is a chronic inflammatory skin disease with a complex pathogenesis. Traditionally, the primary pathophysiologic factors in acne have been thought to be: (1) altered sebum production, (2) inflammation, (3) excess keratinization and (4) colonization with the commensal Cutibacterium acnes. However, the role of C. acnes has been unclear, since virtually all adults have C. acnes on their skin yet not all develop acne. In recent years, understanding of the role of C. acnes has expanded. It is still acknowledged to have an important place in acne pathogenesis, but evidence suggests that an imbalance of individual C. acnes phylotypes and an alteration of the skin microbiome trigger acne. In addition, it is now believed that Staphylococcus epidermidis is also an actor in acne development. Together, C. acnes and S. epidermidis maintain and regulate homeostasis of the skin microbiota. Antibiotics, which have long been a staple of acne therapy, induce cutaneous dysbiosis. This finding, together with the long-standing public health edict to spare antibiotic use when possible, highlights the need for a change in acne management strategies. One fertile direction of study for new approaches involves dermocosmetic products that can support epidermal barrier function and have a positive effect on the skin microbiome.
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Affiliation(s)
- Brigitte Dreno
- Dermatology Department, INSERM, CNRS, Immunology and New Concepts in ImmunoTherapy, INCIT, UMR 1302/EMR6001, Nantes Université, Nantes, France
| | - Itaru Dekio
- Department of Dermatology, The Jikei University School of Medicine, Tokyo, Japan
| | - Hilary Baldwin
- Acne Treatment and Research Center, Morristown, New Jersey, USA
| | | | - Marie-Ange Dagnelie
- Dermatology Department, INSERM, CNRS, Immunology and New Concepts in ImmunoTherapy, INCIT, UMR 1302/EMR6001, Nantes Université, Nantes, France
| | - Amir Khammari
- Dermatology Department, INSERM, CNRS, Immunology and New Concepts in ImmunoTherapy, INCIT, UMR 1302/EMR6001, Nantes Université, Nantes, France
| | - Stephane Corvec
- CHU Nantes, Bacteriology Department, INCIT, UMR 1302, University Nantes, Nantes, France
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Richardson WM, Marson JW, Chen RM, Shah JT, Baldwin HE. Reddit dermatology: a cross-sectional analysis of the r/acne forum. Int J Dermatol 2024; 63:e39-e41. [PMID: 38014473 DOI: 10.1111/ijd.16937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 10/23/2023] [Accepted: 11/14/2023] [Indexed: 11/29/2023]
Affiliation(s)
| | - Justin W Marson
- Department of Dermatology, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Rebecca M Chen
- Department of Dermatology, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Jill T Shah
- New York University Grossman School of Medicine, New York, NY, USA
| | - Hilary E Baldwin
- Department of Dermatology, Rutgers Robert Wood Johnson Medical School, Piscataway, NJ, USA
- Acne Treatment and Research Center, Brooklyn, NY, USA
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Ko JY, Song CH, Kim KJ, Kim NI, Kim JE, Kim HS, Ro YS, Park KY, Park MY, Suh DH, Shin K, Shin MK, Ahn HH, Lee WJ, Lee WJ, Lee JH, Lee JB, Lee HW, Lee HJ, Jang MS, Cheong SH, Cho S, Choi YS, Choi YW, Choi H, Lee MW. Consensus Report on Truncal Acne: The Korean Acne and Rosacea Society Experts Panel. Ann Dermatol 2024; 36:35-43. [PMID: 38325432 PMCID: PMC10861305 DOI: 10.5021/ad.23.057] [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: 06/20/2023] [Revised: 07/19/2023] [Accepted: 08/07/2023] [Indexed: 02/09/2024] Open
Abstract
BACKGROUND More than half of acne patients have truncal acne on their chest, back, and shoulders. However, since most studies on acne have focused on the face, data on clinical characteristics and proper management for truncal acne are insufficient. OBJECTIVE To establish a Korean Acne Rosacea Society (KARS) consensus for experts' perception and treatment patterns of truncal acne. METHODS We conducted two rounds of the Dephi technique to gather expert opinion and reach a consensus on truncal acne. The first round comprised 48 questionnaires focusing on various aspects such as epidemiology, clinical features, diagnosis, treatment, prognosis and more, while second rounds consisted of 26 questionnaires. RESULTS A total of 36 dermatologists (36/38 KARS members, 94.7%) completed this survey. In the first-round survey, consensus was reached on 20 out of the 48 questions (41.7%). In the second-round questionnaire, consensus was achieved on 9 of the 26 questions (34.6%). The most unresponsive lesion to truncal acne treatment was scars (atrophic/hypertrophic). The most commonly used treatments for each non-inflammatory and inflammatory truncal acne lesions were selected to use topical retinoids (78.1% of the responders) and oral antibiotics (93.8% of the responders). CONCLUSION Our study has yielded valuable insights into the epidemiology, clinical manifestations, diagnosis, treatment, and quality of life of patients with truncal acne. We anticipate that this study will inspire further comprehensive research for individuals with truncal acne.
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Affiliation(s)
- Joo Yeon Ko
- Department of Dermatology, Hanyang University Hospital, Hanyang University College of Medicine, Seoul, Korea
| | - Chang Hwa Song
- Department of Dermatology, Hanyang University Hospital, Hanyang University College of Medicine, Seoul, Korea
| | - Kwang Joong Kim
- Department of Dermatology, Hallym University Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Nack In Kim
- Kim Nack-In Dermatology Clinic, Seoul, Korea
| | - Jung Eun Kim
- Department of Dermatology, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - Hei Sung Kim
- Department of Dermatology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea
| | - Young Suck Ro
- Department of Dermatology, Hanyang University Hospital, Hanyang University College of Medicine, Seoul, Korea
| | - Kui Young Park
- Department of Dermatology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea
| | - Mi-Youn Park
- Department of Dermatology, National Medical Center, Seoul, Korea
| | - Dae Hun Suh
- Department of Dermatology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Kihyuck Shin
- Department of Dermatology, Pusan National University Yangsan Hospital, Pusan University College of Medicine, Yangsan, Korea
| | - Min Kyung Shin
- Department of Dermatology, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, Korea
| | - Hyo Hyun Ahn
- Department of Dermatology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Woo Jin Lee
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Weon Ju Lee
- Department of Dermatology, Kyungpook National University School of Medicine, Daegu, Korea
| | - Ju Hee Lee
- Department of Dermatology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Jee Bum Lee
- Department of Dermatology, Chonnam National University Hospital, Chonnam University College of Medicine, Gwangju, Korea
| | | | - Hee Jung Lee
- Department of Dermatology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
| | - Min Soo Jang
- Department of Dermatology, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Korea
| | - Seung Hyun Cheong
- Department of Dermatology, Konyang University Hospital, Konyang University College of Medicine, Daejeon, Korea
| | - Soyun Cho
- Department of Dermatology, Seoul Metropolitan Government - Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Yu Sung Choi
- Department of Dermatology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - You Won Choi
- Department of Dermatology, Ehwa Womans University Medical Center, Ewha Womans University College of Medicine, Seoul, Korea
| | - Hoon Choi
- Department of Dermatology, Chosun University Hospital, Chosun University College of Medicine, Gwangju, Korea
| | - Mi Woo Lee
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
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Szepietowska M, Stefaniak AA, Krajewski PK, Matusiak L. Females May Have Less Severe Acne, but They Suffer More: A Prospective Cross-Sectional Study on Psychosocial Consequences in 104 Consecutive Polish Acne Patients. J Clin Med 2023; 13:4. [PMID: 38202011 PMCID: PMC10779808 DOI: 10.3390/jcm13010004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 12/13/2023] [Accepted: 12/15/2023] [Indexed: 01/12/2024] Open
Abstract
Acne is a common skin condition affecting both adolescents and adults, and it can profoundly impact patients' quality of life and mental well-being. This prospective cross-sectional study aims to explore the differences in psychosocial aspects between male and female acne patients in Poland. A total of 104 consecutive acne patients were included in this study. Clinical severity, patients' quality of life, stigmatization levels, and psychiatric disturbances were evaluated using the following instruments: Investigator Global Assessment (IGA), Dermatology Life Quality Index (DLQI), Cardiff Acne Disability Index (CADI), 6-Item Stigmatization Scale (6-ISS), and Hospital Anxiety and Depression Scale (HADS). This study found that female patients exhibited significantly less severe acne and experienced significantly decreased quality of life and increased levels of stigmatization. Furthermore, anxiety levels among female patients exceeded those observed in their male counterparts. Notably, no disparities in the severity of depression were observed between the two gender groups. Correlations were discerned among all psychosocial parameters in the entire study cohort and in the female subgroup, while such correlations were not uniformly observed among male participants. This study underscores the importance of considering psychosocial aspects and implementing routine measurements in the management of acne to improve patients' well-being.
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Affiliation(s)
| | | | - Piotr K. Krajewski
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, 50-368 Wroclaw, Poland; (M.S.); (A.A.S.); (L.M.)
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10
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Layton AM, Alexis A, Baldwin H, Bettoli V, Del Rosso J, Dirschka T, Dréno B, Gold LS, Harper J, Ko JY, Al Nuaimi K, Oon HH, Rajagopalan M, Rocha M, See JA, Weiss J, Tan J. The Personalized Acne Treatment Tool - Recommendations to facilitate a patient-centered approach to acne management from the Personalizing Acne: Consensus of Experts. JAAD Int 2023; 12:60-69. [PMID: 37274381 PMCID: PMC10236180 DOI: 10.1016/j.jdin.2023.03.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/20/2023] [Indexed: 06/06/2023] Open
Abstract
Background Acne, a commonly treated skin disease, requires patient-centered management due to its varying presentations, chronicity, and impact on health-related quality of life. Despite this, evidence-based clinical guidelines focus primarily on clinical severity of facial acne, omitting important patient- and disease-related factors, including ongoing management. Objectives To generate recommendations to support patient-centered acne management, which incorporate priority and prognostic factors beyond conventional clinical severity, traditionally defined by grading the appearance and extent of visible lesions. Methods The Personalizing Acne: Consensus of Experts consisted of 17 dermatologists who used a modified Delphi approach to reach consensus on statements regarding patient- and treatment-related factors pertaining to patient-centered acne management. Consensus was defined as ≥75% voting "agree" or "strongly agree." Results Recommendations based on factors such as acne sequelae, location of acne, high burden of disease, and individual patient features were generated and incorporated into the Personalized Acne Treatment Tool. Limitations Recommendations are based on expert opinion, which may differ from patients' perspectives. Regional variations in healthcare systems may not be represented. Conclusions The Personalizing Acne: Consensus of Experts panel provided practical recommendations to facilitate individualized management of acne, based on patient features, which can be implemented to improve treatment outcomes, adherence, and patient satisfaction.
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Affiliation(s)
- Alison M. Layton
- Skin Research Centre, York University, York, UK
- Harrogate and District NHS Foundation Trust, Harrogate, UK
| | | | - Hilary Baldwin
- Robert Wood Johnson Medical Center, New Brunswick, New Jersey
- The Acne Treatment and Research Center, Brooklyn, New York
| | - Vincenzo Bettoli
- Dermatology Unit – Teaching Hospital, Azienda Ospedaliera, University of Ferrara, Ferrara, Italy
| | - James Del Rosso
- Advanced Dermatology and Cosmetic Surgery, Maitland, Florida
- JDR Dermatology Research, Las Vegas, Nevada
| | | | | | | | - Julie Harper
- Dermatology and Skin Care Center of Birmingham, Birmingham, Alabama
| | - Joo Yeon Ko
- Department of Dermatology, Hanyang University College of Medicine, Seoul, Republic of Korea
| | - Khaled Al Nuaimi
- Faculty of Medicine, Sharjah University, Sharjah, United Arab Emirates
| | - Hazel H. Oon
- Division of Dermatology, National Skin Centre, Singapore
| | | | - Marco Rocha
- Federal University of São Paulo, São Paulo, Brazil
| | - Jo-Ann See
- Central Sydney Dermatology, Sydney, New South Wales, Australia
| | | | - Jerry Tan
- Windsor Clinical Research Inc, Windsor, Ontario, Canada
- Department of Medicine, University of Western Ontario, Windsor, Ontario, Canada
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11
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Campos-Muñoz L, Belmar Madrid C, Conde-Taboada A, Iglesias Puzas A, Gonzalez Guerra E, López-Bran E. Quality of life in children with skin disease: A Spanish sample. An Pediatr (Barc) 2023; 99:170-175. [PMID: 37658021 DOI: 10.1016/j.anpede.2023.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 06/18/2023] [Indexed: 09/03/2023] Open
Abstract
INTRODUCTION The impact of skin diseases on quality of life varies widely, and some can have an impact similar to that of asthma or cystic fibrosis. MATERIAL AND METHODS We conducted a cross-sectional, observational and descriptive study with the aim of describing the degree to which quality of life was affected in paediatric patients managed in a dermatology clinic by means of the Children's Dermatology Life Quality Index (CDLQI). RESULTS In our study, the skin disease with the greatest impact on quality of life was atopic dermatitis, chiefly on account of symptoms like pruritus and insomnia. It was followed by acne, mainly due to the associated negative feelings (shame, sadness, etc.). Quality of life in patients with viral warts and molluscum contagiosum was mostly affected by the treatment, chiefly based on cryotherapy. Most patients with nevi or café-au-lait spots did not have a decreased quality of life, although up to one third of them had negative feelings in relation to their skin disease. DISCUSSION Atopic dermatitis was the common skin disease that caused the greatest impairment in quality of life in our sample, although other diseases also had an impact on different dimensions of quality of life. We ought to underscore the recommendation to use less painful treatments than cryotherapy for viral warts and molluscum contagiosum, as the impairment in quality of life in paediatric patients with these conditions was mainly due to the treatment.
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Tan J, Chavda R, Baldwin H, Dreno B. Management of Acne Vulgaris With Trifarotene. J Cutan Med Surg 2023; 27:368-374. [PMID: 36927117 PMCID: PMC10486177 DOI: 10.1177/12034754231163542] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 01/25/2023] [Accepted: 02/16/2023] [Indexed: 03/18/2023]
Abstract
Topical retinoids have an essential role in treatment of acne. Trifarotene, a topical retinoid selective for retinoic acid receptor (RAR) γ, is the most recent retinoid approved for treatment of acne. RAR-γ is the most common isoform of RARs in skin, and the strong selectivity of trifarotene for RAR-γ translates to efficacy in low concentration. Trifarotene, like other topical retinoids, acts by increasing keratinocyte differentiation and decreasing proliferation, which reduces hyperkeratinization. Retinoids have also been shown to inhibit inflammatory pathways via effects on leukocyte migration, toll-like receptors, and Activator Protein (AP)-1. Large-scale randomized, controlled clinical trials have demonstrated trifarotene to be safe, well tolerated, and efficacious in reducing both comedones and papules/pustules of acne. However, unlike all other retinoids, trifarotene is the first topical retinoid with rigorous clinical data on safety and efficacy in truncal acne. Data supporting use of trifarotene to manage acne are reviewed in this publication.
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Affiliation(s)
- Jerry Tan
- Windsor Clinical Research Inc, Ontario, Canada
- Department of Medicine, University of Western Ontario, Windsor Campus, Canada
| | | | - Hilary Baldwin
- Robert Wood Johnson Medical Center, New Brunswick, New Jersey, USA
- The Acne Treatment and Research Center, Brooklyn, New York, USA
| | - Brigitte Dreno
- Dermato-cancerology Department, CHU Nantes, University of Nantes, France
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Lagacé F, D’Aguanno K, Prosty C, Laverde-Saad A, Cattelan L, Ouchene L, Oliel S, Genest G, Doiron P, Richer V, Jfri A, O’Brien E, Lefrançois P, Powell M, Moreau L, Litvinov IV, Muntyanu A, Netchiporouk E. The Role of Sex and Gender in Dermatology - From Pathogenesis to Clinical Implications. J Cutan Med Surg 2023; 27:NP1-NP36. [PMID: 37401812 PMCID: PMC10486181 DOI: 10.1177/12034754231177582] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 03/29/2023] [Accepted: 04/09/2023] [Indexed: 07/05/2023]
Abstract
BACKGROUND Sex and gender have increasingly been recognized as significant risk factors for many diseases, including dermatological conditions. Historically, sex and gender have often been grouped together as a single risk factor in the scientific literature. However, both may have a distinct impact on disease incidence, prevalence, clinical presentation, severity, therapeutic response, and associated psychological distress. OBJECTIVES AND PROJECT DESCRIPTION The mechanisms that underlie differences in skin diseases between males, females, men, and women remain largely unknown. The specific objectives of this review paper are:To highlight the biological differences between males and females (sex), as well as the sociocultural differences between men and women (gender) and how they impact the integumentary system.To perform a literature review to identify important sex- and gender-related epidemiological and clinical differences for various skin conditions belonging to a range of disease categories and to discuss possible biological and sociocultural factors that could explain the observed differences.To discuss dermatological skin conditions and gender-affirming treatments within the transgender community, a population of individuals who have a gender identity which is different than the gender identity they were assigned at birth. FUTURE IMPACT With the rising number of individuals that identify as non-binary or transgender within our increasingly diverse communities, it is imperative to recognize gender identity, gender, and sex as distinct entities. By doing so, clinicians will be able to better risk-stratify their patients and select treatments that are most aligned with their values. To our knowledge, very few studies have separated sex and gender as two distinct risk factors within the dermatology literature. Our article also has the potential to help guide future prevention strategies that are patient-tailored rather than using a universal approach.
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Affiliation(s)
- François Lagacé
- Division of Dermatology, Faculty of Medicine, McGill University, Montréal, Québec, Canada
| | | | - Connor Prosty
- Faculty of Medicine, McGill University, Montréal, Québec, Canada
| | - Alexandra Laverde-Saad
- Division of Dermatology, Faculty of Medicine, McGill University, Montréal, Québec, Canada
| | - Leila Cattelan
- Division of Dermatology, Faculty of Medicine, McGill University, Montréal, Québec, Canada
| | - Lydia Ouchene
- Division of Dermatology, Faculty of Medicine, McGill University, Montréal, Québec, Canada
| | - Sarah Oliel
- Faculty of Medicine, McGill University, Montréal, Québec, Canada
| | - Genevieve Genest
- Division of Allergy and Immunology, Faculty of Medicine, McGill University, Montréal, Québec, Canada
| | - Philip Doiron
- Division of Dermatology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Vincent Richer
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, BC, Canada
| | - Abdulhadi Jfri
- Department of Dermatology, Brigham and Women’s Hospital/Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Elizabeth O’Brien
- Division of Dermatology, Faculty of Medicine, McGill University, Montréal, Québec, Canada
| | - Philippe Lefrançois
- Division of Dermatology, Faculty of Medicine, McGill University, Montréal, Québec, Canada
| | - Mathieu Powell
- Division of Dermatology, Faculty of Medicine, McGill University, Montréal, Québec, Canada
| | - Linda Moreau
- Division of Dermatology, Faculty of Medicine, McGill University, Montréal, Québec, Canada
| | - Ivan V. Litvinov
- Division of Dermatology, Faculty of Medicine, McGill University, Montréal, Québec, Canada
| | - Anastasiya Muntyanu
- Division of Dermatology, Faculty of Medicine, McGill University, Montréal, Québec, Canada
| | - Elena Netchiporouk
- Division of Dermatology, Faculty of Medicine, McGill University, Montréal, Québec, Canada
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Truncal Acne and Scarring: A Comprehensive Review of Current Medical and Cosmetic Approaches to Treatment and Patient Management. Am J Clin Dermatol 2023; 24:199-223. [PMID: 36539678 DOI: 10.1007/s40257-022-00746-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/27/2022] [Indexed: 12/24/2022]
Abstract
Acne vulgaris is one of the most common skin disorders worldwide. It typically affects skin areas with a high density of sebaceous glands such as the face, upper arms, chest, and/or back. Historically, the majority of research efforts have focused on facial acne vulgaris, even though approximately half of patients with facial lesions demonstrate truncal involvement. Truncal acne vulgaris is challenging to treat and poses a significant psychosocial burden on patients. Despite these characteristics, studies specifically examining truncal acne vulgaris are limited, with treatment guidelines largely derived from facial protocols. Therefore, truncal acne remains an understudied clinical problem. Here, we provide a clinically focused review on the epidemiology, evaluation, and available treatment options for truncal acne vulgaris. In doing so, we highlight knowledge gaps with the goal of spurring further investigation into the management of truncal acne vulgaris.
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This Month in JAAD International: February 2023: Responsiveness and cutoff values for instruments, scales, and outcome measures. J Am Acad Dermatol 2023; 88:326. [PMID: 36509216 DOI: 10.1016/j.jaad.2022.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 12/06/2022] [Indexed: 12/13/2022]
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16
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Effect of Sarecycline on the Acne Symptom and Impact Scale and Concerns in Moderate-to-Severe Truncal Acne in Open-Label Pilot Study. Antibiotics (Basel) 2023; 12:antibiotics12010094. [PMID: 36671294 PMCID: PMC9854980 DOI: 10.3390/antibiotics12010094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 12/29/2022] [Accepted: 01/04/2023] [Indexed: 01/06/2023] Open
Abstract
Truncal acne is common, and the psychosocial burden may be underestimated as patients most often complain of facial acne. The Acne Symptom and Impact Scale (ASIS) is a 17-item patient-reported outcome (PRO) measure designed to assess the signs and impacts of acne vulgaris. ASIS has previously been validated in a prospective, non-interventional study as a reliable PRO instrument for facial acne. In a pilot study, ASIS, and an additional 10 new questions that focused on the concerns of patients (ASIS-C), were given to 10 patients with moderate-to-severe truncal acne vulgaris who received 3 months of monotherapy with oral sarecycline, a narrow-spectrum tetracycline-class antibiotic. ASIS-C questionnaires were also given to 10 acne-free control subjects. Average ASIS-C answers decreased by 4% for Signs, 15% for Impact, and 16% for Concerns in the 10 patients, with greater decreases of 5% for Signs, 20% for Impact, and 19% for Concerns in the 60% of patients whose truncal acne was clear or almost clear after 12 weeks of sarecycline treatment. In this study, sarecycline was effective in reducing the psychosocial burden associated with truncal acne based on the ASIS-C PRO measures.
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Prevalence and quality of life of facial acne: a cross-sectional study in high school students in Poland. Postepy Dermatol Alergol 2022; 39:1035-1039. [PMID: 36686019 PMCID: PMC9837594 DOI: 10.5114/ada.2021.112765] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 12/08/2021] [Indexed: 01/25/2023] Open
Abstract
Introduction Acne is a frequent chronic inflammatory disease, which affects most commonly adolescents. It might have a negative effect on patients' well-being. Aim To appraise the prevalence of facial acne among adolescents and to assess how acne of different clinical severity influences quality of life in this age group. Material and method This cross-sectional study was conducted on a representative sample of individuals aged 15-19 years in high schools in Poland. A total of 730 students were included in the final analysis. Standardized photographs according to the Investigator's Global Assessment (IGA) were used for self-assessment of both the presence and severity of facial acne. The Dermatology Life Quality Index (DLQI) was employed to evaluate subjects' quality of life (QoL) impairment. Results Facial acne was found in 547 (74.9%) respondents with no significant difference in acne prevalence among females (75.1%) and males (74.6%). The vast majority of acne individuals (90.9%) suffered from minimal and mild acne, moderate acne was reported by 7.3% and severe one by 1.8% of acne students. Acne had a small effect on QoL (DLQI mean score of 2.8 ±3.6 points); females had significantly more decreased QoL than males (3.17 ±3.74 and 1.76 ±2.69 points, respectively). QoL impairment positively correlated with the clinical severity of facial acne. Conclusions Facial acne is a common health problem in adolescents. Although it is not very severe in the majority of subjects it significantly decreases their QoL. Therefore, acne should be treated as a serious skin condition requiring a holistic approach to the patients.
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Tan J, Del Rosso JQ, Weiss JS, Layton AM, Bhatia ND, Arekapudi KL, Hougeir FG, Desai SR. Prevalence and Demographics of Truncal Involvement Among Acne Patients: Survey Data and a Review of the Literature. THE JOURNAL OF CLINICAL AND AESTHETIC DERMATOLOGY 2022; 15:62-67. [PMID: 36312821 PMCID: PMC9586532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
BACKGROUND Truncal acne is frequently underdiagnosed despite affecting around half of those with facial acne. The objective was to provide an overview of the literature on the incidence of truncal acne according to age, gender, and acne severity. METHODS A narrative review of data from recent large surveys and a literature search in PubMed on the incidence of truncal acne across subgroups of age, gender, and acne severity. RESULTS The prevalence of truncal acne alone was low, ranging from <1% to 14%, but approximately 30 to 60 percent of individuals with facial acne also had truncal acne depending on the population. In an online survey in the United States of 2,000 respondents aged between 14 -29 years with self-reported active facial and/or truncal acne, the incidence of truncal acne was lower in the 14-20 years subgroup than in the 21-29 years subgroup (49% vs 54%). The incidence of truncal acne was similar in both males and females, while 46 percent of respondents with self-declared clear and mild acne indicated having truncal involvement compared to 60 percent of those with moderate or severe acne. LIMITATIONS Online surveys have inherent limitations, such as self-reporting and potential confounders. CONCLUSION Data suggests that patients with both facial and truncal involvement have earlier onset of acne and more severe acne. Additional adverse psychological impact may arise from having the impression that the disease is spreading and becoming more severe. Raising awareness of truncal acne prevalence and demographics could improve its clinical management to reduce the negative psychological impact.
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Affiliation(s)
- Jerry Tan
- Dr. Tan is with Windsor Clinical Research Inc. in Windsor, Ontario, Canada, and the Department of Medicine at the University of Western Ontario, London, Ontario, Canada
| | - James Q Del Rosso
- Dr. Del Rosso is with JDR Dermatology Research and Thomas Dermatology in Las Vegas, Nevada and Advanced Dermatology and Cosmetic Surgery in Maitland, Florida
| | - Jonathan S Weiss
- Dr. Weiss is with Georgia Dermatology Partners and Gwinnett Clinical Research Center Inc. in Snellville, Georgia
| | - Alison M Layton
- Dr. Layton is with the Department of Dermatology at Harrogate and District NHS Foundation Trust in Harrogate, United Kingdom
| | - Neal D Bhatia
- Dr. Bhatia is with Therapeutics Clinical Research in San Diego, California
| | | | - Firas G Hougeir
- Dr. Hougeir is with Southeast Dermatology Specialists in Douglasville, Georgia
| | - Seemal R Desai
- Dr. Desai is with the Department of Dermatology at The University of Texas Southwestern Medical Center in Dallas, Texas.Dr. Desai is also with Innovative Dermatology in Plano, Texas
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Del Rosso JQ, Johnson SM, Schlesinger T, Green L, Sanchez N, Lain E, Draelos Z, York JP, Chavda R. A Randomized, Controlled Trial of Trifarotene Plus Doxycycline for Severe Acne Vulgaris. THE JOURNAL OF CLINICAL AND AESTHETIC DERMATOLOGY 2022; 15:E53-E59. [PMID: 35942016 PMCID: PMC9345187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE We evaluated the efficacy and safety of trifarotene plus oral doxycycline in acne. METHODS This was a randomized (2:1 ratio) 12-week, double-blind study of once-daily trifarotene cream 50µg/g plus enteric-coated doxycycline 120mg (T+D) versus trifarotene vehicle and doxycycline placebo (V+P). Patients were aged 12 years or older with severe facial acne (≥20 inflammatory lesions, 30 to 120 non-inflammatory lesions, and ≤4 nodules). Efficacy outcomes included change from baseline in lesion counts and success (score of 0/1 with ≥2 grade improvement) on investigator global assessment (IGA). Safety was assessed by adverse events and local tolerability. RESULTS The study enrolled 133 subjects in the T+D group and 69 subjects in the V+P group. The population was balanced, with an approximately even ratio of adolescent (12-17 years) and adult (≥18 years) subjects. The absolute change in lesion counts from baseline were: -69.1 T+D versus -48.1 V+P for total lesions, -29.4 T+D versus -19.5 V+P for inflammatory lesions, and -39.5 T+D versus -28.2 for non-inflammatory lesions (P<0.0001 for all). Success was achieved by 31.7 percent of subjects in the T+D group versus 15.8 percent in the V+P group (P=0.0107). The safety and tolerability profiles were comparable between the T+D and V+P arms. CONCLUSION T+D was demonstrated to be safe and efficacious as a treatment option for patients with severe acne.
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Affiliation(s)
- James Q Del Rosso
- Dr. Del Rosso is with JDR Dermatology Research in Las Vegas, Nevada and Advanced Dermatology and Cosmetic Surgery Clinical Research in Maitland. Florida
| | | | - Todd Schlesinger
- Dr. Schlesinger is with the Clinical Research Center of the Carolinas in Charleston, South Carolina
| | - Lawrence Green
- Dr. Green is with the George Washington School of Medicine in Washington D.C
| | - Nestor Sanchez
- Dr. Sanchez is with Dermatology and Pathology, at Aibonito Hospital in Aibonito, Puerto Rico
| | - Edward Lain
- Dr. Lain is with the Austin Institute for Clinical Research in Austin, Texas
| | - Zoe Draelos
- Dr. Draelos is with Dermatology Consulting Services, PLLC in High Point, North Carolina
| | - Jean-Philippe York
- Dr. York is with Galderma Laboratories, LP in Fort Worth, Texas, and Galderma SA in Switzerland
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Truncal Acne: An Overview. J Clin Med 2022; 11:jcm11133660. [PMID: 35806952 PMCID: PMC9267677 DOI: 10.3390/jcm11133660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 06/16/2022] [Accepted: 06/22/2022] [Indexed: 02/04/2023] Open
Abstract
Acne is a relatively common disease of the pilosebaceous units. Many aspects of facial acne have been studied. However, there is limited evidence regarding truncal acne. Truncal acne is also observed in a significant number of patients, but it is often ignored by patients and clinicians. Although the pathogenesis of facial and trunk acne is considered to be similar, the characteristics of the skin on the trunk and face are thought to be different. As truncal acne can cause scars on large areas of the body and adversely affect the quality of life of patients, more attention should be given to patients with truncal acne. Although only a few studies have been published to date, the epidemiology, etiology, severity assessment tool, assessments of the quality of life, and new treatments targeting truncal acne are currently being studied. Therefore, in this review, the latest knowledge on truncal acne will be discussed.
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Szepietowska M, Dąbrowska A, Nowak B, Skinderowicz K, Wilczyński B, Krajewski PK, Jankowska-Konsur A. Alexithymia in Adolescents with Acne: Association with Quality of Life Impairment and Stigmatization. J Clin Med 2022; 11:732. [PMID: 35160183 PMCID: PMC8837167 DOI: 10.3390/jcm11030732] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 01/23/2022] [Accepted: 01/24/2022] [Indexed: 12/10/2022] Open
Abstract
Alexithymia seems to be more common among patients with skin diseases. However, studies on acne patients are very limited. We conducted this study to evaluate alexithymia in adolescents with acne. In our cross-sectional study, 730 high school students (mean age: 17.05 ± 1.18 years) were recruited. The Toronto Alexithymia Scale (TAS-20) was used to measure alexithymia, the Dermatology Life Quality Index (DLQI) was employed to study quality of life (QoL), and the 6-item Stigmatization Scale (6ISS) was used to evaluate the level of stigmatization in acne subjects. Alexithymia was found in 31% of adolescents, with similar prevalence among those with and without acne (31.3% and 30.1%, respectively). The mean scoring on the TAS-20 in patients with acne (53.1 ± 12.8 points) was not significantly different from that of the non-acne group (53.5 ± 11.9 points). However, significant correlations between TAS-20 scores and QoL assessments (r = 0.332, p < 0.001) as well as stigmatization level (r = 0.284, p < 0.001) were found. These correlations were also significant for the domains of alexithymia described as difficulty in identifying feelings (DIF) and difficulty in describing feelings (DDF), but not for externally oriented thinking (EOT). The findings clearly showed that acne does not predispose to alexithymia; however, alexithymia in acne subjects is related to impaired QoL and stigmatization.
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Affiliation(s)
- Marta Szepietowska
- Student Research Group of Experimental Dermatology, Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, 50-368 Wroclaw, Poland; (M.S.); (A.D.); (B.N.); (K.S.); (B.W.)
| | - Alicja Dąbrowska
- Student Research Group of Experimental Dermatology, Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, 50-368 Wroclaw, Poland; (M.S.); (A.D.); (B.N.); (K.S.); (B.W.)
| | - Bernadetta Nowak
- Student Research Group of Experimental Dermatology, Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, 50-368 Wroclaw, Poland; (M.S.); (A.D.); (B.N.); (K.S.); (B.W.)
| | - Katarzyna Skinderowicz
- Student Research Group of Experimental Dermatology, Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, 50-368 Wroclaw, Poland; (M.S.); (A.D.); (B.N.); (K.S.); (B.W.)
| | - Bartosz Wilczyński
- Student Research Group of Experimental Dermatology, Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, 50-368 Wroclaw, Poland; (M.S.); (A.D.); (B.N.); (K.S.); (B.W.)
| | - Piotr K. Krajewski
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, 50-368 Wroclaw, Poland;
| | - Alina Jankowska-Konsur
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, 50-368 Wroclaw, Poland;
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Tan J, Alexis A, Baldwin H, Beissert S, Bettoli V, Del Rosso J, Dréno B, Gold LS, Harper J, Lynde C, Thiboutot D, Weiss J, Layton AM. Gaps and recommendations for clinical management of truncal acne from the Personalising Acne: Consensus of Experts panel. JAAD Int 2021; 5:33-40. [PMID: 34816132 PMCID: PMC8593751 DOI: 10.1016/j.jdin.2021.06.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/25/2021] [Indexed: 11/30/2022] Open
Abstract
Background Truncal acne is common and burdensome for patients; however, there is paucity of evidence and guidance for the management of truncal acne. Currently, clinical practice guidelines provide very little guidance on the assessment or management of truncal acne. Objectives To identify unmet needs in truncal acne and make recommendations to address clinical and management gaps using an international consensus. Methods The Personalising Acne: Consensus of Experts panel consisted of 13 dermatologists, who used a modified Delphi approach to reach a consensus on statements related to clinically relevant aspects of truncal acne evaluation and management. A consensus was defined as ≥75% of the panelists voting “agree” or “strongly agree.” The voting was electronic and blinded. Results The panel identified gaps and made recommendations related to truncal acne identification, assessment, and grading; the evaluation of the impact on patients; and treatment goals and factors to be considered for its management. Limitations The recommendations are based on expert opinion, in the absence of high-quality evidence. Conclusions We highlighted addressing not just facial acne but also truncal acne during patient consultations. The recommendations made herein may help facilitate the care of patients who present with truncal acne, with or without facial acne.
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Affiliation(s)
- Jerry Tan
- Windsor Clinical Research Inc, Windsor, Ontario, Canada
- Department of Medicine, University of Western Ontario, Windsor Campus, Windsor, Ontario, Canada
- Correspondence to: Jerry Tan, MD, Windsor Clinical Research Inc, 2224 Walker Rd, Suite 300, Windsor, Ontario, N8W 5L7, Canada.
| | | | - Hilary Baldwin
- Robert Wood Johnson Medical Center, New Brunswick, New Jersey
- The Acne Treatment and Research Center, Brooklyn, New York
| | - Stefan Beissert
- Department of Dermatology, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Vincenzo Bettoli
- Dermatology Unit – Teaching Hospital, Azienda Ospedaliera, University of Ferrara, Ferrara, Italy
| | - James Del Rosso
- Thomas Dermatology, Las Vegas, Nevada
- JDR Dermatology Research, Las Vegas, Nevada
| | - Brigitte Dréno
- Dermato-cancérology Department, CHU Nantes, University of Nantes, Nantes, France
| | | | - Julie Harper
- Dermatology and Skin Care Center of Birmingham, Birmingham, Alabama
| | - Charles Lynde
- Department of Medicine, University of Toronto, Markham, Ontario, Canada
- Lynderm Research Inc, Markham, Ontario, Canada
| | - Diane Thiboutot
- Department of Dermatology, Pennsylvania State University College of Medicine, Hershey, Philadelphia
| | | | - Alison M. Layton
- Hull York Medical School, University of York, York, United Kingdom
- Harrogate and District NHS Foundation Trust, United Kingdom
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Affiliation(s)
- Brigitte Dréno
- Department of Dermatology, CIC 1413, CRCINA, University of Nantes, CHU Nantes, FR-44093 Nantes, France
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Kantor J. July 2021: Quality of life and patient-reported outcome measures in dermatology. J Am Acad Dermatol 2021; 85:35. [PMID: 33965464 DOI: 10.1016/j.jaad.2021.04.094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 04/29/2021] [Indexed: 10/21/2022]
Affiliation(s)
- Jonathan Kantor
- Department of Dermatology, Center for Global Health, and Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia; and Florida Center for Dermatology, PA, St Augustine.
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