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Wang X, Fan MJ, Yu YF, Fan XY, Chen J, Lai YF, Liu Y, Ye HY, Zhang ZY, Zhao Y, Wang YF, Xiang LH, He M, Ma Y. Acromegaly presented with acne vulgaris: a retrospective study with 123 cases. J Endocrinol Invest 2024; 47:1467-1476. [PMID: 38112910 DOI: 10.1007/s40618-023-02254-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Accepted: 11/20/2023] [Indexed: 12/21/2023]
Abstract
BACKGROUND Acne vulgaris is a prevalent skin condition. We have found that some acromegaly patients have acne. However, no study has examined the relationship between acromegaly and acne. OBJECTIVE To explore prevalence and correlation of adult acne in patients with acromegaly. METHODS For this cross-sectional study, we collected questionnaires, clinical information, and laboratory test results of acromegaly patients from January 2022 to December 2022 at Huashan Hospital. Of the 133 questionnaires returned, 123 had valid responses. RESULTS Of the 123 patients with acromegaly enrolled in this study, 54.5% had adult acne. No statistically significant difference was found in prevalence between male and female patients. 61.2% of adult acne patients reported late-onset acne. Late-onset acne patients first developed acne years before acromegaly diagnosis (mean of 5.6 years for male and 4.5 years for female patients). Some acne patients have received traditional anti-acne treatment. Moreover, 31% of the patients reported no improvement, and only 3.5% of patients claimed complete resolution of acne after treatment. Before acromegaly treatment, the prevalence of adult acne was 51.2%, with mild acne accounting for 73.0%, moderate acne accounting for 23.8%, and severe acne accounting for 3.2%. After acromegaly treatment, the prevalence of adult acne was significantly decreased to 37.4% (P = 0.007). An overall decrease in acne severity was noted, with 93.5%, 6.5%, and 0% having mild, moderate, and severe acne, respectively. A total of 83.6% of the patients had self-assessed acne remission, and 33.3% of the patients reported complete acne resolution. However, 9.0% of patients reported that their condition had worsened after acromegaly treatment. After treatment, GH, IGF-1, IGF-1 index, insulin levels, and HOMA-IR decreased significantly in all patients with acromegaly (P < 0.05). Acne remission correlated positively with IGF-1 levels, but not with GH levels. The relationship between acromegaly and acne remains to be elucidated. CONCLUSIONS Our findings provide preliminary evidence of the high prevalence of adult acne in acromegaly patients, and a high rate of late-onset acne as well. Traditional anti-acne treatments are less effective. Acne could be considerably relieved by treating acromegaly. Acne remission positively correlated with IGF-1 decline as well, which revealed the correlation between acne and IGF-1.
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Affiliation(s)
- X Wang
- Department of Dermatology, Huashan Hospital, Fudan University, 12 Wulumuqi Zhong Road, Shanghai, 200040, People's Republic of China
| | - M J Fan
- Department of Dermatology, Huashan Hospital, Fudan University, 12 Wulumuqi Zhong Road, Shanghai, 200040, People's Republic of China
| | - Y F Yu
- Department of Endocrine, Huashan Hospital, Fudan University, 12 Wulumuqi Zhong Road, Shanghai, 200040, People's Republic of China
| | - X Y Fan
- Department of Dermatology, Huashan Hospital, Fudan University, 12 Wulumuqi Zhong Road, Shanghai, 200040, People's Republic of China
| | - J Chen
- Department of Dermatology, Huashan Hospital, Fudan University, 12 Wulumuqi Zhong Road, Shanghai, 200040, People's Republic of China
| | - Y F Lai
- Department of Dermatology, Huashan Hospital, Fudan University, 12 Wulumuqi Zhong Road, Shanghai, 200040, People's Republic of China
| | - Y Liu
- Department of Dermatology, Huashan Hospital, Fudan University, 12 Wulumuqi Zhong Road, Shanghai, 200040, People's Republic of China
| | - H Y Ye
- Department of Endocrine, Huashan Hospital, Fudan University, 12 Wulumuqi Zhong Road, Shanghai, 200040, People's Republic of China
| | - Z Y Zhang
- Department of Endocrine, Huashan Hospital, Fudan University, 12 Wulumuqi Zhong Road, Shanghai, 200040, People's Republic of China
| | - Y Zhao
- Department of Neurosurgery, Huashan Hospital, Fudan University, 12 Wulumuqi Zhong Road, Shanghai, 200040, People's Republic of China
| | - Y F Wang
- Department of Neurosurgery, Huashan Hospital, Fudan University, 12 Wulumuqi Zhong Road, Shanghai, 200040, People's Republic of China
| | - L H Xiang
- Department of Dermatology, Huashan Hospital, Fudan University, 12 Wulumuqi Zhong Road, Shanghai, 200040, People's Republic of China
| | - M He
- Department of Endocrine, Huashan Hospital, Fudan University, 12 Wulumuqi Zhong Road, Shanghai, 200040, People's Republic of China.
| | - Y Ma
- Department of Dermatology, Huashan Hospital, Fudan University, 12 Wulumuqi Zhong Road, Shanghai, 200040, People's Republic of China.
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Bungau AF, Tit DM, Bungau SG, Vesa CM, Radu AF, Marin RC, Endres LM, Moleriu LC. Exploring the Metabolic and Endocrine Preconditioning Associated with Thyroid Disorders: Risk Assessment and Association with Acne Severity. Int J Mol Sci 2024; 25:721. [PMID: 38255795 PMCID: PMC10815585 DOI: 10.3390/ijms25020721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 12/28/2023] [Accepted: 01/03/2024] [Indexed: 01/24/2024] Open
Abstract
Metabolic preconditioning, characterized by conditions like obesity and insulin resistance syndrome, disrupts hormonal balance. Elevated androgen levels stimulate excessive sebum production and follicular cell proliferation, leading to acne lesions. Similarly, thyroid hormone imbalances affect sebaceous gland activity, epidermal lipid composition, and skin cell turnover, impacting acne occurrence and severity. This study aimed to assess the potential contribution of metabolic and endocrine preconditions to acne development. A total of 389 patients diagnosed with acne were included and divided into three groups: the metabolic precondition group (MPG, N = 163, 41.9%), the endocrine precondition group (EPG, N = 162, 41.65%), and the control group (CG, N = 89, 22.88%). Data related to the degree of acne severity and comorbidities of interest were collected from the patients' medical records. In the groups with concomitant diseases, moderate and severe acne were significantly more prevalent (56.44% and 41.10% in MPG, and 35.80% and 61.11% in EPG) compared to the control group (5.61% and 4.89%). The most prevalent preconditions observed were insulin resistance syndrome in MPG (63.8%) and autoimmune thyroiditis in EPG (95.06%). Significant age-related differences in acne severity were found across all study groups (p < 0.05). In MPG, the age variable was significantly higher in the presence of mild acne, while in EPG, the age variable was significantly lower for the mild acne group. A positive association was observed between the severity of acne and insulin resistance syndrome, obesity, autoimmune thyroiditis, and hypothyroidism (p < 0.05). Risk analysis indicated a significantly higher risk (RR > 1, 95% CI RR > 1, p < 0.001) of developing moderate and severe acne in the presence of these preconditions. The presence of both metabolic and endocrine preconditions significantly increased the likelihood of developing severe acne, leading to the hypothesis that both conditions may be contributing factors to the development of acne.
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Affiliation(s)
- Alexa Florina Bungau
- Doctoral School of Biomedical Sciences, Faculty of Medicine and Pharmacy, University of Oradea, 410087 Oradea, Romania; (A.F.B.); (D.M.T.); (A.-F.R.)
- Department of Preclinical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania
| | - Delia Mirela Tit
- Doctoral School of Biomedical Sciences, Faculty of Medicine and Pharmacy, University of Oradea, 410087 Oradea, Romania; (A.F.B.); (D.M.T.); (A.-F.R.)
- Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, 410028 Oradea, Romania
| | - Simona Gabriela Bungau
- Doctoral School of Biomedical Sciences, Faculty of Medicine and Pharmacy, University of Oradea, 410087 Oradea, Romania; (A.F.B.); (D.M.T.); (A.-F.R.)
- Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, 410028 Oradea, Romania
| | - Cosmin Mihai Vesa
- Doctoral School of Biomedical Sciences, Faculty of Medicine and Pharmacy, University of Oradea, 410087 Oradea, Romania; (A.F.B.); (D.M.T.); (A.-F.R.)
- Department of Preclinical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania
| | - Andrei-Flavius Radu
- Doctoral School of Biomedical Sciences, Faculty of Medicine and Pharmacy, University of Oradea, 410087 Oradea, Romania; (A.F.B.); (D.M.T.); (A.-F.R.)
- Department of Preclinical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania
| | | | - Laura Maria Endres
- Department of Psycho-Neurosciences and Recovery, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania;
| | - Lavinia-Cristina Moleriu
- Department III of Functional Sciences, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
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Kashyap S, Besra L, Kar HK. Evaluation of Risk Factors Associated With Adult-Onset Acne in Patients Attending a Tertiary Care Center in East India: A Case-Control Study. Cureus 2024; 16:e53296. [PMID: 38435859 PMCID: PMC10906343 DOI: 10.7759/cureus.53296] [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: 01/29/2024] [Indexed: 03/05/2024] Open
Abstract
BACKGROUND In recent years, the aesthetic appearance of the skin has emerged as a crucial factor influencing perceptions of beauty and contributing to self-confidence. The pursuit of flawless skin represents a prevalent focus within beauty regimens. Adult-onset acne (AOA) is the development of acne between the ages of 26 to 50 and it is emerging as a prevalent dermatological concern among this population. Individuals perceiving their skin as falling short of an 'ideal' standard may let it affect their quality of life. Significant gaps in our understanding persist regarding the contributing risk factors for AOA. OBJECTIVE The study aims to assess both established and novel risk factors potentially influencing the onset of adult acne. Additionally, it seeks to calculate the odds ratio (OR) for AOA in both females and males exposed to the surveyed risk factors over a 24-month period. MATERIALS AND METHODS Various risk factors were assessed, including stress, hormonal markers, psychological factors, environmental exposures, dietary habits, and cosmetic use. A total of 140 participants, consisting of 70 healthy individuals were selected. Discordant groups were analyzed for AOA. Detailed interviews were conducted to obtain a comprehensive medical history, focusing on potential risk factors, for patients diagnosed with acne. The OR was calculated to determine the likelihood of association between risk factors and the development of AOA. A proper protocol was devised, and statistical data was analyzed using Statistical Package for Social Sciences (SPSS; IBM Corp., Armonk, NY, USA). RESULTS The most significant risk factors in the development of AOA in the Indian population based on OR and confidence interval (CI) were positive personal history of acne (OR 3.12 [95% CI 1.20 - 8.03]), positive family history of acne (OR 10.24 [95% CI 2.89 - 36.1]), overweight BMI (OR 6.16 [95% CI 2.56 - 14.76]), hormonal imbalance (OR 9.27 [95% CI 2.03 - 42.29]), menstrual irregularity in females (OR 12.94 [95% CI 3.59 - 46.53]), exposure to mineral oil or halogenated hydrocarbon use (OR 4.13 [95% CI 1.28 - 13.24]), less than six hours of sleep (OR 4.16 [95% CI 1.10 - 15.64]), chemical peels in females (OR 11.28 [95% CI 2.45 - 51.90]), diet consisting mainly of carbohydrates, high salt, saturated fats (OR 29.97 [95% CI 3.84 - 227.25]) and less than 2 liters of water intake in patients (OR 19.18 [95% CI 1.08 - 339.04]). Risk factors that were associated with a decreased likelihood of AOA included normal menstruation (OR 0.03 [95% CI 0.01 - 0.12]), healthy oral intake (OR 0.04 [95% CI 0.00 - 0.17]), no psychological stressors/depression/anxiety (OR 0.43 [95% CI 0.21 - 0.85]), no environmental factors (OR 0.07 [95% CI 0.02 - 0.24]), no associated cosmetic use (OR 0.45 [95% CI 0.22 - 0.90]), normal BMI (OR 0.18 [95% CI 0.07 - 0.39]), no history of acne (OR 0.12 [95% CI 0.05 - 0.26]). CONCLUSION AOA is a complex and multifactorial condition, and most of the risk factors mentioned in this study on Indian skin type contribute to its development. The approach for AOA should be holistic. In addition to following a recommended treatment protocol, education should be provided about lifestyle modification, stress management, exercise, and environmental factors to help prevent and manage AOA.
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Affiliation(s)
- Surbhi Kashyap
- Department of Dermatology, Venereology and Leprosy, Kalinga Institute of Medical Sciences, Bhubaneswar, IND
| | - Laxman Besra
- Department of Dermatology, Venereology and Leprosy, Kalinga Institute of Medical Sciences, Bhubaneswar, IND
| | - Hemanta K Kar
- Department of Dermatology, Venereology and Leprosy, Kalinga Institute of Medical Sciences, Bhubaneswar, IND
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Patel P, Pal R, Butani K, Singh S, Prajapati BG. Nanomedicine-fortified cosmeceutical serums for the mitigation of psoriasis and acne. Nanomedicine (Lond) 2023; 18:1769-1793. [PMID: 37990979 DOI: 10.2217/nnm-2023-0147] [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] [Indexed: 11/23/2023] Open
Abstract
Cosmetics have a long history of use for regenerative and therapeutic purposes that are appealing to both genders. The untapped potential of nanotechnology in cosmeceuticals promises enhanced efficacy and addresses the issues associated with conventional cosmetics. In the field of cosmetics, the incorporation of nanomedicine using various nanocarriers such as vesicle and solid lipid nanoparticles significantly enhances product effectiveness and promotes satisfaction, especially in tackling prevalent skin diseases. Moreover, vesicle-fortified serum is known for high skin absorption with the capacity to incorporate and deliver various therapeutics. Additionally, nano-embedded serum-based cosmeceuticals hold promise for treating various skin disorders, including acne and psoriasis, heralding potential therapeutic advancements. This review explores diverse nanotechnology-based approaches for delivering cosmetics with maximum benefits.
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Affiliation(s)
- Priya Patel
- Department of Pharmaceutical Sciences, Saurashtra University, Rajkot, Gujarat, 360005, India
| | - Rohit Pal
- Department of Pharmaceutical Sciences, Saurashtra University, Rajkot, Gujarat, 360005, India
| | - Krishna Butani
- Department of Pharmaceutical Sciences, Saurashtra University, Rajkot, Gujarat, 360005, India
| | - Sudarshan Singh
- Department of Pharmaceutical Sciences, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, 50200, Thailand
- Office of Research Administration, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Bhupendra G Prajapati
- Department of Pharmaceutics & Pharmaceutical Technology, Shree S.K. Patel College of Pharmaceutical Education & Research, Ganpat University, Mehsana, Gujarat, 384012, India
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Chang J, Nock MR, Cohen JM, Bunick CG. Acne accounts for an almost 2.5-fold higher proportion of dermatology visits among adult females compared to adult males in the United States: A study of the national ambulatory medical care survey from 2002-2016. PLoS One 2023; 18:e0290763. [PMID: 37733776 PMCID: PMC10513303 DOI: 10.1371/journal.pone.0290763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 08/15/2023] [Indexed: 09/23/2023] Open
Abstract
BACKGROUND Acne vulgaris affects a significant number of females into adulthood. Juvenile acne and adult acne have different presentations and potentially distinctive pathogeneses. However, patterns in treatments specifically related to the adult female population have previously not been studied. METHODS Retrospective database analysis of healthcare utilization and medications prescribed for acne using the National Ambulatory Medical Care Survey (NAMCS) data from 2002-2016 was performed. RESULTS After age 20, acne accounted for an almost 2.5-fold higher proportion of dermatology visits among females compared to males (10.1% vs. 4.1%, P < 0.001). Tetracycline-class antibiotics were the most prescribed therapy within all age groups of females between 2002-2016. However, there was also a substantial rise in prescriptions of spironolactone beginning in 2012. CONCLUSION A significantly greater proportion of dermatology visits by adult females are for acne in comparison to adult males. Tetracycline-class antibiotics remain the most prescribed therapy in adult age groups despite a potentially different pathogenesis of adult acne. Therefore, there is a need for further studies comparing the effectiveness of therapies specifically for adult female acne.
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Affiliation(s)
- Jungsoo Chang
- Department of Dermatology, Yale School of Medicine, New Haven, Connecticut, United States of America
| | - Michael R. Nock
- Department of Dermatology, Yale School of Medicine, New Haven, Connecticut, United States of America
| | - Jeffrey M. Cohen
- Department of Dermatology, Yale School of Medicine, New Haven, Connecticut, United States of America
| | - Christopher G. Bunick
- Department of Dermatology, Yale School of Medicine, New Haven, Connecticut, United States of America
- Program in Translational Biomedicine, Yale School of Medicine, New Haven, Connecticut, United States of America
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Santosa A, Choi E, Chandran NS. Impact of Hand Hygiene and Mask-Wearing Practices on Hand Eczema and Facial Acne Incidence in Healthcare Workers during COVID-19 Outbreak. Ann Dermatol 2023; 35:313-317. [PMID: 37550232 PMCID: PMC10407335 DOI: 10.5021/ad.20.189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 02/19/2021] [Accepted: 04/13/2021] [Indexed: 08/09/2023] Open
Affiliation(s)
- Adinia Santosa
- Division of Dermatology, National University Hospital, Singapore
| | - Ellie Choi
- Division of Dermatology, National University Hospital, Singapore
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Liu L, Xue Y, Chen Y, Chen T, Zhong J, Shao X, Chen J. Prevalence and risk factors of acne scars in patients with acne vulgaris. Skin Res Technol 2023; 29:e13386. [PMID: 37357642 PMCID: PMC10240192 DOI: 10.1111/srt.13386] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Accepted: 05/25/2023] [Indexed: 06/27/2023]
Abstract
BACKGROUND Acne scar is a persistent complication of acne vulgaris. However, the prevalence and risk factors are still unclear. This study aimed to assess the global prevalence and risk factors of acne scars in patients with acne. MATERIALS AND METHODS A systematic search of published studies in three databases was performed and the meta-analyses were conducted. RESULTS Finally, we included 37 studies involving 24 649 acne patients. And, the pooled prevalence of acne scars in these patients was 47% (95% confidence interval [CI]: 38-56%). Besides, the differences in prevalence were observed based on the subgroup analysis for age, gender, acne severity, source of patients, and so on. Subsequently, we quantified the relationship of three risk factors with acne scars: male gender (odds ratio [OR]: 1.58, 95% CI: 1.19-2.09), positive family history of acne (OR: 2.73, 95% CI: 1.26-5.91), and acne severity (OR for moderate acne: 2.34, 95% CI: 1.54-3.57; OR for severe acne: 5.51, 95% CI: 2.45-12.41). CONCLUSION Herein, we found that 47% of acne patients suffered from acne scars and identified three risk factors: male gender, positive family history of acne, and acne severity. In order to reduce acne scarring, attention and effective therapy early in the course of acne is important.
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Affiliation(s)
- Lin Liu
- Department of DermatologyThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
| | - Yuzhou Xue
- Department of Cardiology and Institute of Vascular MedicinePeking University Third HospitalBeijingChina
| | - Yangmei Chen
- Department of DermatologyThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
| | - Tingqiao Chen
- Department of DermatologyThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
| | - Judan Zhong
- Department of DermatologyThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
| | - Xinyi Shao
- Department of DermatologyThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
| | - Jin Chen
- Department of DermatologyThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
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Alharbi NM, AlGhofaili FA, Alsaud JS, Asiri LM, Almutairi SM, Alruqayi DM, Alharbi MK. The Relationship Between Nutritional Anemia and Acne: A Case-Control Study. Cureus 2023; 15:e39109. [PMID: 37332462 PMCID: PMC10272486 DOI: 10.7759/cureus.39109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/16/2023] [Indexed: 06/20/2023] Open
Abstract
Background In the past decade, there has been growing interest in identifying the relationship between nutritional status and acne. Many dietary factors have been studied, including milk, fast food, and chocolate. However, nutritional anemia, which is a common problem in young individuals, has not been well investigated. Objectives The objective of this study was to determine the relationships between acne and nutritional anemia among people in the Qassim Region of Saudi Arabia. Methods This study used a case-control design. It targeted people aged from 15 to 25 years old in the Qassim Region of Saudi Arabia. This study was conducted using a database of Electronic Health Records (EHR) data from the Qassim University outpatient department (OPD). Data analysis was conducted by using SPSS (IBM Inc., Armonk, New York). Results A total of 114 of the study population were involved in this study. The acne group represented was identical to the control group. The mean age of study participants was 23.1 ± 4.19 years old, and the majority of them were females (86%). Moreover, the patient group had relatively lower levels of mean corpuscular volume (MCV), vitamin B12, ferritin, mean corpuscular hemoglobin (MCH), and hemoglobin than the control group without any significant correlation, whereas the patient group had higher levels of mean corpuscular hemoglobin concentration (MCHC) and red cell distribution width (RDW) without significant difference. Our results showed that the prevalence of anemia among respondents was 17.5%, and a higher prevalence of anemia was observed in the control group without significant differences. Furthermore, the patient group had a significantly higher prevalence of vitamin B12 deficiency (38.6%) than the control group (p=0.041). Conclusion Our results concluded that patients with acne vulgaris in the Qassim Region of Saudi Arabia had a significantly higher rate of vitamin B12 deficiency. Additional studies are needed to confirm this association.
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Affiliation(s)
| | | | | | - Lina M Asiri
- College of Medicine, Qassim University, Qassim, SAU
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Aslan Kayıran M, Karadağ AS, Alyamaç G, Çevirgen Cemil B, Demirseren DD, Taş Demircan Y, Aksoy H, Kılıç S, Kara Polat A, İnan Yüksel E, Kalkan G, Elibüyük Aksaç S, Kutlu Ö, Altıntaş Kakşi S, Şikar Aktürk A, Özkök Akbulut T, Sarıkaya Solak S, Oğuz Topal İ, Yazıcı S, Kaya Özden H, Koska MC, Uzunçakmak TK, Ataseven A, Işık B, Alpsoy E. Rates of skincare product and cosmetic procedure use in patients with acne vulgaris and the effective factors: A multicenter study with 1,755 patients. J Cosmet Dermatol 2021; 21:2566-2576. [PMID: 34520610 DOI: 10.1111/jocd.14439] [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: 06/29/2021] [Revised: 08/21/2021] [Accepted: 08/26/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Skincare products and cosmetic procedures are used as an adjunct or complementary to conventional drug therapy for acne vulgaris (AV). OBJECTIVE To evaluate the use of skincare products and the frequency of cosmetic procedures in AV treatment. METHODS A total of 1,755 patients with AV completed the survey prepared by the researchers and the Cardiff Acne Disability Index (CADI) questionnaire. The clinical findings and the Food and Drug Administration (FDA) severity scores were recorded by the dermatologists. RESULTS For AV, 66.7% of the patients stated that they used skincare products and 26.7% had undergone cosmetic procedures. The use of skincare products was statistically significantly higher in women (female: 74.5%, male: 57.7%, p < 0.0001); older people (users: 22 ± 7.6years, non-users: 21.2 ± 5.7 years, p < 0.0001); patients with a higher CADI score (users: 7 ± 3.7, non-users: 6.9 ± 4.3, p = 0.010); FDA severity score 2 and 3 (FDA-1: 58.1%; FDA-2: 72.4%, FDA-3: 73%, FDA-4: 67%, p < 0.0001); long-term disease (users: 57 ± 43 months; non-users: 47.7 ± 42.3 months, p < 0.0001); facial involvement (present: 70.2%, absent: 51.4%, p = 0.017); high income levels (users: 73.5%; non-users: 26.5%, p = 0.001); and graduate or post-graduate degrees (undergraduate≤%62.8, graduate≥%76.8, p < 0.0001). The rate of cosmetic procedures was higher in those with higher CADI scores (users: 7.8 ± 3.8; non-users: 7.1 ± 3.96, p < 0.0001); older patients (users: 22.7 ± 10.7 years; non-users: 21.3 ± 5 years, p < 0.0001); high school (25.6%); and graduate (28.9%) education (p = 0.043), those with lower disease severity (FDA-1: 31.1%; FDA-2: 28.5%, FDA-3: 27.1%, FDA-4: 20.4%, p = 0.022); smokers (smokers: 32.5%; non-smokers: 25.5%, p = 0.020), and those with AV in the family (present: 29.8%; absent: 24.2%, p = 0.009). The patients most frequently used cleansers (85.2%) as cosmetic products, and most commonly underwent skincare treatment (71%) as an interventional procedure. They mostly learned about such products and methods from the Internet, and 33.3% of the participants had undergone procedures performed by non-physicians. CONCLUSION The patients generally choose skincare products as a result of their Internet search and sometimes have these procedures performed by non-physicians. Dermatologists should be aware of this situation and inform their patients about appropriate products and procedures.
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Affiliation(s)
- Melek Aslan Kayıran
- Department of Dermatology, Istanbul Medeniyet University, Göztepe Prof. Dr. Süleyman Yalçın City Hospital, Istanbul, Turkey
| | | | - Gökçen Alyamaç
- Department of Dermatology, Private Medicana Bursa Hospital, Bursa, Turkey
| | - Bengü Çevirgen Cemil
- Department of Dermatology, Health Sciences University, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | | | | | - Hasan Aksoy
- Department of Dermatology, Istanbul Medeniyet University, Göztepe Prof. Dr. Süleyman Yalçın City Hospital, Istanbul, Turkey
| | - Sevilay Kılıç
- Faculty of Medicine, Department of Dermatology, Çanakkale 18 Mart University, Çanakkale, Turkey
| | - Asude Kara Polat
- Department of Dermatological and Venereal Diseases, Health Sciences University, İstanbul Training and Research Hospital, Istanbul, Turkey
| | - Esma İnan Yüksel
- Faculty of Medicine, Department of Dermatology, Fırat University, Elazığ, Turkey
| | - Göknur Kalkan
- Department of Dermatology, Health Sciences University, Ankara City Hospital, Ankara, Turkey
| | | | - Ömer Kutlu
- Faculty of Medicine, Department of Dermatology, Uşak University, Uşak, Turkey
| | - Sümeyye Altıntaş Kakşi
- Department of Dermatology, Istanbul Medeniyet University, Göztepe Prof. Dr. Süleyman Yalçın City Hospital, Istanbul, Turkey
| | - Aysun Şikar Aktürk
- Faculty of Medicine, Department of Dermatology, Kocaeli University, Kocaeli, Turkey
| | - Tuğba Özkök Akbulut
- Department of Dermatological and Venereal Diseases, Health Sciences University, Haseki Training and Research Hospital, Istanbul, Turkey
| | - Sezgi Sarıkaya Solak
- Faculty of Medicine, Department of Dermatology, Trakya University, Edirne, Turkey
| | - İlteriş Oğuz Topal
- Department of Dermatological and Venereal Diseases, Health Sciences University, Prof. Dr. Cemil Taşçıoğlu Hospital, Istanbul, Turkey
| | - Serkan Yazıcı
- Faculty of Medicine, Department of Dermatology, Uludağ University, Bursa, Turkey
| | - Hatice Kaya Özden
- Department of Dermatology, Kocaeli Derince Training and Research Hospital, Kocaeli, Turkey
| | - Mahmut Can Koska
- Department of Dermatology, Artvin State Hospital, Artvin, Turkey
| | - Tuğba Kevser Uzunçakmak
- Cerrahpaşa Faculty of Medicine, Department of Dermatology, İstanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Arzu Ataseven
- Meram Medical Faculty, Department of Dermatology, Necmettin Erbakan University, Konya, Turkey
| | - Begüm Işık
- Meram Medical Faculty, Department of Dermatology, Necmettin Erbakan University, Konya, Turkey
| | - Erkan Alpsoy
- Faculty of Medicine, Department of Dermatology, Akdeniz University, Antalya, Turkey
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10
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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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11
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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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12
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Cunha MGD, Moraes C, Cebrian G, Silva RFD, Reple SIF, Machado Filho CD, Fonseca FLA. Dosages of androgenic hormones in adolescent patients with severe acne. ACTA ACUST UNITED AC 2020; 66:36-41. [PMID: 32130379 DOI: 10.1590/1806-9282.66.1.36] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 09/01/2019] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Acne vulgaris in female adolescents, when severe or accompanied by other signs of androgenization, may represent a sign of hyperandrogenemia often underdiagnosed, which will have harmful consequences for adult life. The objective of this cross-sectional and retrospective study was to demonstrate the incidence of hormonal changes in the cases of female adolescents with severe or extensive acne, with or without other signs of hyperandrogenism, and propose a hormonal research pattern which should be indicated in order to detect early hyperandrogenemia. METHODS The medical records of 38 female patients aged between 9 and 15 years old with grade II and/or III acne were analyzed. The dehydroepiandrosterone sulfate, dehydroepiandrostenedione, and androstenedione, total testosterone, and dihydrotestosterone sulfate hormones were required prior to initiation of treatment. The hormonal dosages were performed in the serum after at least 3 hours of fasting by means of radioimmunoassay tests. RESULTS Of the 38 patients included, 44.7% presented changes in androgen levels (hyperandrogenemia), and the two most frequently altered hormones were DHEA and androstenedione, with the same incidence (23.6%). CONCLUSIONS The correct and early diagnosis provides an effective and agile approach, including antiandrogen therapy, with the purpose of avoiding the reproductive and metabolic repercussions, besides controlling the inflammatory picture and avoid aesthetic complications.
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Affiliation(s)
- Marisa Gonzaga da Cunha
- . Disciplina de Dermatologia da Faculdade de Medicina do ABC, Av. Príncipe de Gales, 821, CEP 09060-650, Santo André, SP, Brasil
| | - Caio Moraes
- . Disciplina de Dermatologia da Faculdade de Medicina do ABC, Av. Príncipe de Gales, 821, CEP 09060-650, Santo André, SP, Brasil
| | - Giovana Cebrian
- . Disciplina de Dermatologia da Faculdade de Medicina do ABC, Av. Príncipe de Gales, 821, CEP 09060-650, Santo André, SP, Brasil
| | - Rafaela Ferreira da Silva
- . Disciplina de Dermatologia da Faculdade de Medicina do ABC, Av. Príncipe de Gales, 821, CEP 09060-650, Santo André, SP, Brasil
| | - Sônia Isabel Friedlaender Reple
- . Laboratório de Análises Clínicas da Faculdade de Medicina do ABC, Av. Príncipe de Gales, 821, CEP 09060-650, Santo André, SP, Brasil
| | | | - Fernando Luiz Affonso Fonseca
- . Laboratório de Análises Clínicas da Faculdade de Medicina do ABC, Av. Príncipe de Gales, 821, CEP 09060-650, Santo André, SP, Brasil.,. Departamento de Ciências Farmacêuticas, Universidade Federal de São Paulo, R. Prof. Artur Riedel, 275, CEP 09972-270, Diadema, SP, Brasil
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13
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Sardana K, Bansal P, Sharma LK, Garga UC, Vats G. A study comparing the clinical and hormonal profile of late onset and persistent acne in adult females. Int J Dermatol 2020; 59:428-433. [DOI: 10.1111/ijd.14748] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 11/07/2019] [Accepted: 11/22/2019] [Indexed: 02/06/2023]
Affiliation(s)
- Kabir Sardana
- Department of Dermatology Dr Ram Manohar Lohia Hospital & Post Graduate Institute of Medical Education and Research New Delhi India
| | - Prekshi Bansal
- Department of Dermatology Dr Ram Manohar Lohia Hospital & Post Graduate Institute of Medical Education and Research New Delhi India
| | - Lokesh K. Sharma
- Department of Biochemistry Dr Ram Manohar Lohia Hospital & Post Graduate Institute of Medical Education and Research New Delhi India
| | - Umesh C. Garga
- Department of Radiodiagnosis Dr Ram Manohar Lohia Hospital & Post Graduate Institute of Medical Education and Research New Delhi India
| | - Gauri Vats
- Department of Dermatology Dr Ram Manohar Lohia Hospital & Post Graduate Institute of Medical Education and Research New Delhi India
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Bondade S, Hosthota A, Basavaraju V. Stressful life events and psychiatric comorbidity in acne-a case control study. Asia Pac Psychiatry 2019; 11:e12340. [PMID: 30406964 DOI: 10.1111/appy.12340] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 09/18/2018] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Possibility of a causal influence of emotional stress, on the course of various skin diseases, has been postulated. However, it is still inconclusive about the role of stressful life events in acne. In this background, the present study was carried out to know its role in acne. METHODS Consecutive one hundred patients who were diagnosed with acne vulgaris in the age group of 12 to 45 years were included. Age and sex matched controls were taken. A semistructured proforma was used to collect sociodemographic details. Stressful life events were assessed using presumptive stressful life event scale. Anxiety was evaluated using Hamilton Anxiety Rating scale and Depression by Hamilton Depression Rating Scale. RESULTS There was no difference in total stressful life events in past one year between patients and controls. The undesirable life event was present in 65 patients and 50 controls, this difference was statistically significant. Getting married or appearing for exams were the most common stressful life event in patients. Forty patients had comorbid psychiatric illness whereas in controls comorbidity was in 24 and this difference was statistically significant. DISCUSSION The undesirable stressful life events and psychiatric comorbidity were more in acne patients than in controls.
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Affiliation(s)
- Swapna Bondade
- Department of Psychiatry, The Oxford Medical College, Hospital and Research Center, Bangalore, India
| | - Abhineetha Hosthota
- Department of Dermatology, The Oxford Medical College, Hospital and Research Center, Bangalore, India
| | - Vinay Basavaraju
- Department of Psychiatry, The Oxford Medical College, Hospital and Research Center, Bangalore, India
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15
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Adult female acne and associated risk factors: Results of a multicenter case-control study in Italy. J Am Acad Dermatol 2016; 75:1134-1141.e1. [DOI: 10.1016/j.jaad.2016.06.060] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Revised: 06/29/2016] [Accepted: 06/30/2016] [Indexed: 12/20/2022]
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16
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Han XD, Oon HH, Goh CL. Epidemiology of post-adolescence acne and adolescence acne in Singapore: a 10-year retrospective and comparative study. J Eur Acad Dermatol Venereol 2016; 30:1790-1793. [PMID: 27400809 DOI: 10.1111/jdv.13743] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Accepted: 03/31/2016] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Acne vulgaris commonly affects adolescents. But recent reports suggest a rising prevalence of post-adolescence acne. While there are few reports on post-adolescence acne, there are even fewer reports comparing adolescence acne and post-adolescence. METHODS Epidemiological data of adolescence (<25 years) and post-adolescence (≥25 years) acne patients diagnosed between 2004 and 2013 in a tertiary dermatology referral centre was analysed. From the pool of patients seen in 2010, 80 adolescence and 84 post-adolescence acne patients' epidemiological characteristics and treatment responses were analysed. RESULTS During the 10-year study period, there was an increase in the number and proportion of acne cases. In 2004, 4447 (5.77%) of all new diagnoses made were of acne vulgaris. The proportion rose to 5723 (8.13%) in 2013. There were consistently more female than male acne patients. The proportion of post-adolescent cases remained constant at about 30% of all acne patients seen. Mean age of acne vulgaris patients decreased from 23.1 years in 2004 to 22.6 years in 2013. In the subgroup analysis, there were more males than females with adolescence acne (61.3% vs. 38.8%, P < 0.01) and more females with post-adolescence acne (69.0% vs. 31.0%, P < 0.01). Thirty-four (40.5%) post-adolescence acne patients had acne from adolescence persisting into adulthood. Comedonal acne was more prevalent in the adolescence acne patients (58.8% vs. 40.5%, P = 0.019), whereas cystic acne was more prevalent in post-adolescence patients (18.1% vs. 7.5%, P = 0.044). Systemic retinoids were more often used for treatment in the adolescence acne patients than post-adolescence acne patients (23.8% vs. 10.7%, P = 0.027). CONCLUSION Acne predominantly affects adolescents but post-adolescence acne is not uncommon. For post-adolescence acne, females predominate over males. Inflammatory and cystic acne tends to be more predominant in post-adolescence acne patients, whereas comedonal acne is more often seen in adolescence acne patients.
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Affiliation(s)
- X D Han
- The National Skin Centre (NSC), 1 Mandalay Rd, 308205, Singapore.
| | - H H Oon
- The National Skin Centre (NSC), 1 Mandalay Rd, 308205, Singapore
| | - C L Goh
- The National Skin Centre (NSC), 1 Mandalay Rd, 308205, Singapore
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17
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Dréno B. Treatment of adult female acne: a new challenge. J Eur Acad Dermatol Venereol 2016; 29 Suppl 5:14-9. [PMID: 26059821 DOI: 10.1111/jdv.13188] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Accepted: 04/14/2015] [Indexed: 12/15/2022]
Abstract
Acne is affecting an increasing number of adult females and so can no longer be considered as a disease of adolescence. The disease has a greater negative impact on the quality of life of adult females than their younger counterparts. Adult female acne may persist from adolescence or may have its first occurrence once adulthood has been reached. The clinical presentation and pathogenesis of adult female acne may be somewhat different to that of adolescent acne and this may require a different treatment approach. Genetic and hormonal factors are thought to play key roles in the pathogenesis of adult female acne and the disease is characterized by a chronic evolution with frequent relapses requiring long-term maintenance therapy. Fixed-dose retinoid/antimicrobial combinations may be of interest for the treatment of adult female acne given that subgroup analysis of clinical trials has indicated that they are effective against both inflammatory and non-inflammatory lesions in these patients. These treatments may also be of interest, given the chronic course of the disease in adult females, the high likelihood of the presence of antibiotic-resistant P. acnes and the poor adherence of patients to other long-term therapies. Oral hormonal treatment or isotretinoin may be required in patients with severe acne or disease that is refractory to other treatments. Additional clinical studies of acne treatments specifically conducted in adult female patients are required to increase the evidence base on which future treatment recommendations can be based.
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Affiliation(s)
- B Dréno
- Department of Dermato-Cancerology, University of Nantes, Nantes, France
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18
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Auffret N, Claudel JP, Leccia MT, Poli F, Farhi D, Dréno B. AFAST - Adult Female Acne Scoring Tool: an easy-to-use tool for scoring acne in adult females. J Eur Acad Dermatol Venereol 2015; 30:824-8. [PMID: 26642798 DOI: 10.1111/jdv.13518] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Accepted: 09/17/2015] [Indexed: 12/31/2022]
Abstract
BACKGROUND Acne is a concern in adults, especially in women. The specifications in current acne grading systems are not applicable to this particular population. OBJECTIVE To develop and validate a measurement tool (AFAST: adult female acne scoring tool) for acne in women by taking into account the specific locations of adult female acne, and to evaluate the impact of the photographic modalities on rating reproducibility. METHODS Six experts in dermatology rated pictures of 54 women with a phototype from I to IV during two sessions, with an interval of 24 h. They rated the acne severity on the face using the GEA scale (Score 1) together with a new scale to assess acne on the mandibular zone (Score 2). Pictures of 30 women were taken using a standardized photographic device; pictures of the other 24 women were taken by their own dermatologists during daily practice. RESULTS At session 1, the inter-rater's reproducibility was good for Score 1 with an ICC of 0.77 [0.72-0.83], and excellent for Score 2 with an ICC of 0.87 [0.82-0.91]. Between sessions 1 and 2, the mean intra-rater's reproducibility was excellent for both scores with an ICC of 0.88 [0.84-0.92] for Score 1, and an ICC of 0.87 [0.78-0.92] for Score 2. Photographic modalities had no significant effect on the inter- and intra-rater's reproducibility. CONCLUSION For the first time, it has been demonstrated that AFAST can accurately rate acne severity in women. It is a promising, easy-to-use tool for both daily practice and clinical investigation.
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Affiliation(s)
| | | | - M-T Leccia
- Clinique de Dermatologie, Allergologie et Photobiologie, CHU A Michallon, Grenoble, France
| | - F Poli
- Private Practice, Paris, France
| | - D Farhi
- Private Practice, Paris, France
| | - B Dréno
- Clinique de Dermatologie, Hôtel Dieu, Place Alexis Ricordeau, Nantes, France
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Thielitz A, Lux A, Wiede A, Kropf S, Papakonstantinou E, Gollnick H. A randomized investigator-blind parallel-group study to assess efficacy and safety of azelaic acid 15% gel vs. adapalene 0.1% gel in the treatment and maintenance treatment of female adult acne. J Eur Acad Dermatol Venereol 2014; 29:789-96. [PMID: 25399481 DOI: 10.1111/jdv.12823] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2013] [Accepted: 10/06/2014] [Indexed: 12/14/2022]
Abstract
BACKGROUND Growing numbers of post-adolescent females are suffering from treatment-resistant or relapsing adult acne forms, therefore requiring the definition of safe and effective treatment options for this burdening disease. OBJECTIVES To assess the efficacy of azelaic acid 15% gel (AzA) vs. no treatment during maintenance therapy of female adult acne and to compare its efficacy and safety vs. adapalene 0.1% gel (AD) during a 9-month period (3-month treatment and 6-month maintenance treatment). METHODS A total of 55 women between 18 and 45 years with adult acne were included in this investigator-blind trial and randomized into three groups receiving AzA gel b.i.d. for 9 months (AzA9M, n = 17) or AzA gel b.i.d. for 3 months followed by a 6-month observational phase (AzA3M, n = 19) or AD gel once daily for 9 months (AD9M, n = 19). Parameters of efficacy, safety and patient-related factors were analysed. RESULTS The reduction in lesion counts, severity and Dermatology Life Quality Index score was significant (P < 0.05) and comparable between groups during the treatment phase, while dryness and scaling were significantly lower (P < 0.05) in group AzA9M vs. AD9M. During maintenance, AzA9M was superior to AzA3M in the control of inflammatory lesions (P = 0.008) and total lesions (P = 0.014) at week 24. From week 12 to week 36, a mild relative increase in inflammatory lesions could be observed in all groups. In AzA3M, this increase exceeded that of AzA9M by 23.1% (P = 0.109), while the difference of total lesions diverged to 30.8% (P = 0.038). No significant differences could be detected between AzA9M and AD9M. Group AzA9M was non-inferior to AD9M (non-inferiority margin of 50% for the confidence limit for the relative effect) in the control of inflammatory acne lesions. CONCLUSIONS AzA15% gel is a safe and effective treatment and maintenance treatment of female adult acne with non-inferior efficacy to AD 0.1% gel in the control of inflammatory acne.
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Affiliation(s)
- A Thielitz
- Department of Dermatology and Venereology, Otto-von-Guericke University, Magdeburg, Germany
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20
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Lu PH, Hsu CH. Body mass index is negatively associated with acne lesion counts in Taiwanese women with post-adolescent acne. J Eur Acad Dermatol Venereol 2014; 29:2046-50. [PMID: 25266447 DOI: 10.1111/jdv.12754] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2014] [Accepted: 08/18/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND Acne in adult women tends to be chronic, refractory to treatment and associated with psychosocial problems. Body mass index (BMI) has been reported to be a risk factor for acne in school children and adolescents, but not in adult women. OBJECTIVES The aim of this study was to demonstrate the relationship between BMI and acne lesion counts in women with post-adolescent acne. METHODS Hundred and four women between 25 and 45 years of age, with moderate or severe acne vulgaris were enrolled in this study. The main outcome evaluated was the number of acne lesions, which were then assessed using multiple linear regression analysis. RESULTS The coefficients of multiple regression analysis with stepwise model showed that BMI (β = -0.36; p = 0.001) and family history (β = 0.21; p = 0.04) were the main predictors of the number of acne lesions. CONCLUSION Initial findings indicate that BMI is negatively associated with the number of acne lesions in Taiwanese women with moderate to severe post-adolescent acne.
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Affiliation(s)
- P H Lu
- Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Dermatology, Far Eastern Memorial Hospital, Taipei, Taiwan
| | - C H Hsu
- Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Branch of Linsen and Chinese Medicine, Taipei City Hospital, Taipei, Taiwan
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21
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Cinar N, Cetinozman F, Aksoy DY, Elcin G, Yildiz BO. Comparison of adrenocortical steroidogenesis in women with post-adolescent severe acne and polycystic ovary syndrome. J Eur Acad Dermatol Venereol 2014; 29:875-80. [PMID: 25176476 DOI: 10.1111/jdv.12696] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Accepted: 07/17/2014] [Indexed: 11/26/2022]
Abstract
BACKGROUND Increased adrenocortical production appears to be associated with acne and hirsutism in acne and polycystic ovary syndrome (PCOS). However, the aetiological role of androgens in the pathogenesis of acne per se is far from being clear. OBJECTIVE We aimed to evaluate adrenocortical function in women with post-adolescent severe acne in comparison with patients with PCOS and healthy women. METHODS The study included 32 women with post-adolescent severe acne, 32 women with PCOS and 32 age and body mass index (BMI)-matched healthy controls (age 17-34 years, BMI: 20.8 ± 1.9 kg/m²). Women with acne did not have hirsutism or ovulatory dysfunction whereas all PCOS patients had androgen excess and ovulatory dysfunction. Measurements included basal testosterone (T), sex hormone-binding globulin (SHBG) and dehydroepiandrosterone sulphate (DHEAS) levels and serum 17-hydroxyprogesterone (17-OHP), androstenedione (A4), DHEA and cortisol levels in response to corticotropin (ACTH) stimulation. RESULTS T, free androgen index, DHEAS levels, basal and AUC (area under the curve) values for A4 were significantly higher in PCOS than women with acne and controls (P < 0.05 for all), whereas three groups did not differ for basal or AUC values of DHEA and cortisol. Women with PCOS and those with severe acne had significantly and similarly higher AUC values of 17-OHP compared to controls (P < 0.05). CONCLUSION Women with isolated post-adolescent severe acne do not have increased levels of adrenal androgens basally or in response to ACTH. However, these women have similar secretion pattern of 17-OHP with PCOS patients suggesting increased enzymatic activity in this pathway.
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Affiliation(s)
- N Cinar
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Hacettepe University School of Medicine, Hacettepe, Ankara, 06100, Turkey
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Abstract
Acne in the adult female often presents as a chronic condition that can have a considerable negative psychological, social and emotional impact on the affected individual. Estimated prevalence rates of adult female acne vary widely according to study type. Case reports and clinical examinations estimate the prevalence of clinical acne at 10-12%, while survey estimates of physiological disease states are as high as 54%. Two subtypes of adult female acne may be defined according to time of onset: 'persistent' and 'late-onset', accounting for approximately 80 and 20% of cases, respectively. Postadolescent acne is generally mild-to-moderate in severity and presents with more inflammatory lesions and fewer comedones compared to adolescent acne. Furthermore, the impact of acne on the quality of life is often greater in adult females than in younger individuals. Despite these important differences, the key principles of acne treatment in the adult female do not differ significantly from those of other age groups. However, specific characteristics relating to the adult female should be considered when selecting a treatment regimen.
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Affiliation(s)
- R Holzmann
- Global Medical Affairs Dermatology, Bayer Pharma AG, Berlin, Germany
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Seirafi H, Farnaghi F, Vasheghani-Farahani A, Alirezaie NS, Esfahanian F, Firooz A, Ghodsi SZ. Assessment of androgens in women with adult-onset acne. Int J Dermatol 2007; 46:1188-91. [DOI: 10.1111/j.1365-4632.2007.03411.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Capitanio B, Sinagra JL, Ottaviani M, Bordignon V, Amantea A, Picardo M. 'Smoker's acne': a new clinical entity? Br J Dermatol 2007; 157:1070-1. [PMID: 17877769 DOI: 10.1111/j.1365-2133.2007.08164.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Sellheyer K, Krahl D. Response to letter to the editor regarding Hidradenitis suppurativa is acne inversa. Int J Dermatol 2007. [DOI: 10.1111/j.1365-4632.2007.02873.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Xu SX, Wang HL, Fan X, Sun LD, Yang S, Wang PG, Xiao FL, Gao M, Cui Y, Ren YQ, Du WH, Quan C, Zhang XJ. The familial risk of acne vulgaris in Chinese Hans ? a case-control study. J Eur Acad Dermatol Venereol 2007; 21:602-5. [PMID: 17447973 DOI: 10.1111/j.1468-3083.2006.02022.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Acne is a chronic inflammatory disease of the pilosebaceous follicles. Recent studies bring us increasing evidences that hereditary factors play an important but indirect role in acne. OBJECTIVE To investigate the possible role of genetic factors in the pathogenesis of acne vulgaris in Chinese Han ethnic group. PATIENTS AND METHODS Volunteers of 975 acne cases and 580 controls were included, contributing 3009 and 1825 first-degree relatives, respectively. One thousand and eighty-five first-degree relatives of acne cases were affected with facial acne. This compared with 223 first-degree relatives of non-acne controls. The odds ratio was used to estimate the relative risk for acne vulgaris associated with having an affected first-degree relative. RESULTS The risk of acne vulgaris occurring in a relative of a patient with acne vulgaris was significantly greater than for the relative of an unaffected individual (odds ratio 4.05, 95% confidence interval (CI): 3.45-4.76, P<0.001). CONCLUSION Our study suggests that familial factors are important in determining individual susceptibility to acne vulgaris.
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Affiliation(s)
- S X Xu
- Institute of Dermatology & Department of Dermatology at No.1 Hospital, Anhui Medical University, Hefei, China, and Key Laboratory of Genome Research in Hefei, Anhui Province, China
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Abstract
More than a cosmetic nuisance, acne can produce anxiety, depression, and other psychological problems that affect patients' lives in ways comparable to life-threatening or disabling diseases. Emotional problems due to the disease should be taken seriously and included in the treatment plan. A purely dermatological therapy by itself may not achieve its purpose. Even mild to moderate disease can be associated with significant depression and suicidal ideation, and psychologic change does not necessarily correlate with disease severity. Acne patients suffer particularly under social limitations and reduced quality of life. Psychological comorbidities in acne are probably greater than generally assumed. Attention should be paid to psychosomatic aspects especially if depressive-anxious disorders are suspected, particularly with evidence of suicidal tendencies, body dysmorphic disorders, or also in disrupted compliance.Therefore, patients who report particularly high emotional distress or dysmorphic tendencies due to the disease should be treated, if possible, by interdisciplinary therapy. The dermatologist should have some knowledge of the basics of psychotherapy and psychopharmacology, which sometimes must be combined with systemic and topical treatment of acne in conjunction with basic psychosomatic treatment.
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Affiliation(s)
- Volker Niemeier
- Dept. of Dermatology and Andrology, Justus Liebig University, Giessen, Germany
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Ballanger F, Baudry P, N'Guyen JM, Khammari A, Dréno B. Heredity: a prognostic factor for acne. Dermatology 2006; 212:145-9. [PMID: 16484821 DOI: 10.1159/000090655] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2005] [Accepted: 09/09/2005] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The role of heredity in acne severity and therapeutic response remains unclear. OBJECTIVE A prospective epidemiologic study was performed to compare clinical and evolutive features of acne and response to treatment in 151 patients with acne with (A+) or without (A-) family history of acne. METHODS A+ and A- patients were compared on clinical and therapeutic criteria. A+ patients were then distributed into subgroups (M+, F+, M+F+) following the origin of family history (father: F, mother: M). RESULTS The clinical profile was similar in the A+ and A- populations. Acne occurred earlier and more often before puberty in the A+ population, in which oral treatments and relapse after isotretinoin were more frequent. Retentional lesions (number and extent) were more important in the M+ and M+F+ populations. CONCLUSION This study confirms the importance of heredity as a prognostic factor for acne. Family history of acne is associated with earlier occurrence of acne, increased number of retentional lesions and therapeutic difficulties.
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Affiliation(s)
- F Ballanger
- Department of Dermatology, Hôtel-Dieu, FR-44035 Nantes, France
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Galobardes B, Davey Smith G, Jefferys M, McCarron P. Has acne increased? Prevalence of acne history among university students between 1948 and 1968. The Glasgow Alumni Cohort Study. Br J Dermatol 2005; 152:824-5. [PMID: 15840138 DOI: 10.1111/j.1365-2133.2005.06527.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Abstract
This study was carried out to determine whether slow nail growth is a predisposing factor for onychomycosis or if onychomycosis results in slow nail growth. Forty-nine patients with unilateral onychomycosis of the great toenail were enrolled and classified in two groups according to the size of affected area, i.e. more than half or less than half of the toenail. The growth rates of affected and unaffected great toenails of all patients were measured. Before a normal appearance was reached, the growth rates of affected great toenails, when the affected area occupied more than half of total nail plate, was slower than that of the unaffected great toenails. After a normal appearance was achieved, there were no differences in growth rates between affected and unaffected great toenails. Therefore, this study of patients with unilateral toenail onychomycosis did not support the hypothesis that slow nail growth rate is a predisposing factor for onychomycosis.
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Affiliation(s)
- H-J Yu
- Department of Dermatology, Hanyang University College of Medicine, Hanyang University Guri Hospital, Guri City, Gyunggi-do 471-701, South Korea.
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Poli F, Dreno B, Verschoore M. An epidemiological study of acne in female adults: results of a survey conducted in France. J Eur Acad Dermatol Venereol 2001; 15:541-5. [PMID: 11843213 DOI: 10.1046/j.1468-3083.2001.00357.x] [Citation(s) in RCA: 151] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Acne is usually perceived as a disease of teenagers, and most epidemiological studies have focused on adolescents. OBJECTIVE The primary objective was to investigate the prevalence of acne in a representative sample of French females. Information about skin type, life-style factors influencing acne and quality of life were also recorded. METHODS A self-administered questionnaire was sent to 4,000 adult women aged 25-40 years, after a validation test by three dermatologists. A definition of acne severity, according to questionnaire answers, was established before the questionnaire was sent out. RESULTS A total of 3394 women completed the questionnaire of which 3,305 were useable. The data showed a prevalence of acne in 17% of the population, and physiological acne in 24%. Thus, the total acne prevalence was 41%. Forty-nine per cent of the acne patients had acne sequelae (scars and/or pigmented macules). Forty-one per cent of adult acne patients had not experienced acne during their adolescence. A premenstrual flare and stress was recorded as causing acne in 78% and 50%, respectively. Twenty-two per cent of acne subjects were currently receiving therapy. For most patients, acne did not severely impair their quality of life. CONCLUSION This study shows a prevalence of acne in 41% of women in the general population. A high proportion of these acne cases are late onset acne.
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Affiliation(s)
- F Poli
- Hĵpital Henri Mondor, Service de Dermatologie, Creteil, France
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Abstract
Acne vulgaris is one of the commonest diseases known to humanity, affecting up to 98% of all adolescents. This review examines important aspects of its epidemiology, aetiology and management in Australia in the year 2000, in comparison with a symposium in the inaugural volume of the Australian Journal of Dermatology in 1951.
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Affiliation(s)
- J J Chan
- Department of Dermatology, Royal Perth Hospital, Australia.
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