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Ünal BÜ, Demirbaş A, Erdoğan BG. Social media use as a source of information by acne vulgaris patients. J Cosmet Dermatol 2024; 23:3312-3318. [PMID: 39016682 DOI: 10.1111/jocd.16477] [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: 06/14/2024] [Accepted: 07/05/2024] [Indexed: 07/18/2024]
Abstract
BACKGROUND Social media and internet usage is undeniably high. Misinformation obtained from the internet and wrong treatment methods can cause serious problems in patients with acne vulgaris (AV). In this study, the sociodemographic data of AV patients, their frequency of using the internet as an information source, the relationship between them, and their attitudes and behaviors regarding their disease due to these programs were examined. METHODS 481 patients aged 14 and over diagnosed with AV were included in the study. It was conducted in a descriptive cross-sectional type. Acne severity of all patients included in the study was determined using the Global Acne Grading System. RESULTS 78.3 percent of participants use social media to get information about AV. It was determined that men and single people used social media about their illnesses at a statistically significantly higher rate than women and married people (p = 0.004). In addition, patients aged 13-18 and high school graduates use social media as a source of information about their diseases, and this rate is statistically significantly higher (p < 0.001). CONCLUSION Especially in the last decade, the use of social media tools to spread health messages has increased significantly. Because it has a chronic course and can cause cosmetic problems, AV patients may frequently resort to communication sources such as social media. Considering the possibility of social media misinforming patients, physicians should be aware that their patients with AV frequently use social media and should improve themselves in creating correct awareness on this issue.
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Affiliation(s)
- Bahar Ürün Ünal
- Department of Family Medicine, Faculty of Medicine, Selcuk University, Konya, Turkey
| | - Abdullah Demirbaş
- Department of Dermatology, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Burcu Gök Erdoğan
- Department of Family Medicine, Faculty of Medicine, Selcuk University, Konya, Turkey
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Beig M, Shirazi O, Ebrahimi E, Banadkouki AZ, Golab N, Sholeh M. Prevalence of antibiotic-resistant Cutibacterium acnes (formerly Propionibacterium acnes) isolates, A systematic review and meta-analysis. J Glob Antimicrob Resist 2024:S2213-7165(24)00137-1. [PMID: 39179105 DOI: 10.1016/j.jgar.2024.07.005] [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: 01/27/2024] [Revised: 05/21/2024] [Accepted: 07/12/2024] [Indexed: 08/26/2024] Open
Abstract
OBJECTIVE This study aimed to assess the overall antibiotic susceptibility of Cutibacterium acnes (C. acnes), a bacterium implicated in acne vulgaris, with a particular focus on clindamycin and fluoroquinolones, which are commonly used in inflammatory acne treatment. METHODS A systematic search of Scopus, PubMed, Web of Science, and EMBASE databases was conducted to identify relevant studies. Pooled prevalence estimates were calculated using a random-effects model, and additional analyses included quality assessment, evaluation of publication bias, meta-regression, and subgroup analyses based on antimicrobial susceptibility methods and year of publication. RESULTS The analysis incorporated a total of 39 studies. The random-effects model revealed that the proportion of clindamycin-resistant isolates was 0.031 (95% CI: 0.014-0.071). Additionally, macrolides, including erythromycin (0.366; 95% CI, 0.302-0.434) and azithromycin (0.149; 95% CI, 0.061-0.322), exhibited distinct prevalence rates. Tetracyclines, including doxycycline (0.079; 95% CI, 0.014-0.071), tetracycline (0.062; 95% CI, 0.036-0.107), and minocycline (0.025; 95% CI, 0.012-0.051), displayed varying prevalence estimates. Fluoroquinolones, including ciprofloxacin (0.050; 95% CI, 0.017-0.140) and levofloxacin (0.061; 95% CI, 0.015-0.217), demonstrated unique prevalence rates. Additionally, the prevalence of the combination antibiotic trimethoprim/sulfamethoxazole (SXT) was estimated to be 0.087 (95% CI: 0.033-0.208). CONCLUSION The study findings highlight a concerning increase in antimicrobial-resistant C. acnes with the use of antibiotics in acne treatment. The strategic utilization of appropriate antimicrobials has emerged as a crucial measure to mitigate the emergence of antimicrobial-resistant skin bacteria in acne management.
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Affiliation(s)
- Masoumeh Beig
- Department of Bacteriology, Pasteur Institute of Iran, Tehran, Iran
| | - Omid Shirazi
- Department of Bacteriology, Pasteur Institute of Iran, Tehran, Iran
| | - Elaheh Ebrahimi
- Department of Veterinary medicine, Science and Research Branch, Islamic Azad University, Tehran, Iran; Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Narges Golab
- Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
| | - Mohammad Sholeh
- Department of Bacteriology, Pasteur Institute of Iran, Tehran, Iran.
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Jankowski M, Goroncy A. Anatomical variants of acne differ in their impact on social perception. J Eur Acad Dermatol Venereol 2024; 38:1628-1636. [PMID: 38379351 DOI: 10.1111/jdv.19798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 12/11/2023] [Indexed: 02/22/2024]
Abstract
BACKGROUND Acne negatively affects quality of life, however quality-of-life scores poorly correlate with disease severity scores. Previous research demonstrated existence of facial areas in which skin lesions have greater impact on gaze patterns. Therefore, we hypothesized that anatomical variants of acne may be perceived differently. OBJECTIVES The aim was to investigate effect of anatomical variants of acne on natural gaze patterns and resulting impact on social perception of acne patients. METHODS We tracked eye movements of participants viewing neutral and emotional faces with acne. Images were rated for acne-related visual disturbance, and emotional faces were rated for valence intensity. Respondents of an online survey were asked to rate their perception of pictured individuals' personality traits. RESULTS All faces with acne were perceived as less attractive and received poorer personality judgements with mid-facial acne presenting smallest deviation from healthy faces. T-zone and mixed acne exhibited the least significant difference in respondents gaze behaviour pattern from each other. In addition, there was no significant difference in respondents' grading of acne visual disturbance or ratings for attractiveness, success and trustworthiness. U-zone adult female acne was rated as the most visually disturbing and received the lowest scores for attractiveness. Happy faces with adult female acne were rated as less happy compared to other acne variants and clear-skin faces. CONCLUSIONS Anatomic variants of acne have a distinct impact on gaze patterns and social perception. Adult female acne has the strongest negative effect on recognition of positive emotions in affected individuals, attractiveness ratings and forming social impressions. If perioral acne lesions are absent, frontal lesions determine impact of acne on social perception irrespective of the presence of mid-facial lesions. This perceptive hierarchy should be taken into consideration while deciding treatment goals in acne patients, prioritizing achieving remission in perioral and frontal area.
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Affiliation(s)
- Marek Jankowski
- Department of Dermatology and Venereology, Faculty of Medicine in Bydgoszcz, Nicolaus Copernicus University, Bydgoszcz, Poland
| | - Agnieszka Goroncy
- Department of Mathematical Statistics and Data Mining, Faculty of Mathematics and Computer Science, Nicolaus Copernicus University in Torun, Torun, Poland
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Cho H, Dohi T, Wakai H, Quong WL, Linh NDT, Usami S, Ogawa R. In the face and neck, keloid scar distribution is related to skin thickness and stiffness changes associated with movement. Wound Repair Regen 2024; 32:419-428. [PMID: 38602106 DOI: 10.1111/wrr.13180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 02/25/2024] [Accepted: 04/01/2024] [Indexed: 04/12/2024]
Abstract
Keloid scars tend to occur in high-tension sites due to mechanical stimuli that are involved in their development. To date, a detailed analysis of keloid distribution focused specifically on facial and neck areas has not been reported, and limited literature exists as to the related mechanical factors. To rectify this deficiency of knowledge, we first quantified the facial and neck keloid distribution observed clinically in 113 patients. Subsequently, we performed a rigorous investigation into the mechanical factors and their associated changes at these anatomic sites in healthy volunteers without a history of pathologic scarring. The association between keloid-predilection sites and sebaceous gland-dense and acne-prone sites was also examined. To assess skin stretch, thickness and stiffness, VECTRA, ultrasound and indentometer were utilised. Baseline skin stiffness and thickness were measured, as well as the magnitude of change in these values associated with facial expression and postural changes. Within the face and neck, keloids were most common near the mandibular angle (41.3%) and lateral submental (20.0%) regions. These areas of increased keloid incidence were not associated with areas more dense in sebaceous glands, nor linked consistently with acne-susceptible regions. Binomial logistic regression revealed that changes in skin stiffness and thickness related to postural changes significantly predicted keloid distribution. Skin stiffness and thickness changes related to prolonged mechanical forces (postural changes) are most pronounced at sites of high keloid predilection. This finding further elucidates the means by which skin stretch and tension are related to keloid development. As a more detailed analysis of mechanical forces on facial and neck skin, this study evaluates the nuances of multiple skin-mechanical properties, and their changes in a three-dimensional framework. Such factors may be critical to better understanding keloid progression and development in the face and neck.
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Affiliation(s)
- Hoyu Cho
- Department of Plastic, Reconstructive and Regenerative Surgery, Nippon Medical School, Tokyo, Japan
| | - Teruyuki Dohi
- Department of Plastic, Reconstructive and Regenerative Surgery, Nippon Medical School, Tokyo, Japan
| | - Hanae Wakai
- Department of Plastic, Reconstructive and Regenerative Surgery, Nippon Medical School, Tokyo, Japan
| | - Whitney Laurel Quong
- Department of Plastic, Reconstructive and Regenerative Surgery, Nippon Medical School, Tokyo, Japan
- Department of Plastic, Reconstructive, and Aesthetic Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Nguyen Doan Tien Linh
- Department of Plastic, Reconstructive and Regenerative Surgery, Nippon Medical School, Tokyo, Japan
| | - Satoshi Usami
- Department of Plastic, Reconstructive and Regenerative Surgery, Nippon Medical School, Tokyo, Japan
- Graduate School of Education, The University of Tokyo, Tokyo, Japan
| | - Rei Ogawa
- Department of Plastic, Reconstructive and Regenerative Surgery, Nippon Medical School, Tokyo, Japan
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Ertekin SS, Salici NS, Manav Bas V, Karali MG, Ergün EZ, Avcı EB, Tellal ES, Yüksel EI, Rasulova G, Erdil D. Influence of Social Media and Internet on Treatment Decisions in Adult Female Acne Patients: A Cross-Sectional Survey Study. Dermatol Pract Concept 2024; 14:dpc.1403a156. [PMID: 39122512 PMCID: PMC11314130 DOI: 10.5826/dpc.1403a156] [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: 04/23/2024] [Indexed: 08/12/2024] Open
Abstract
INTRODUCTION Adult female acne is a chronic condition that significantly impacts quality of life. The content on social media can influence patients perception of their disease and serve as a channel through which they may seek or obtain treatment options. OBJECTIVES This study aims to evaluate the impact of social media usage habits on treatment decisions among adult female acne patients. METHODS A cross-sectional, multicenter survey study involved 358 females aged 25 or above, diagnosed with acne. Sociodemographic data were collected, and social media behavior, treatment choices, outcomes, and motivation were explored. RESULTS Among 358 participants, 95.3% used at least 1 social media platform; 72.1% sought acne information online. Top platforms used to seek acne information were Google (75.6%), Instagram (72.3%), YouTube (60%), and TikTok (29.4%). For advice, 67.4% consulted doctor accounts, 53.5% non-medical influencers, 53.5% patient accounts, and 36.1% product promotion accounts. Commonly followed advice included skincare products (88%), dietary changes (42.3%), home remedies (38.8%), exercise (30.3%), topical medications (25.2%), and dietary supplements (17.4%). Notably, 20.9% were willing to alter prescribed treatment by their physician for acne based on social media advice. Patient motivations included quick information access (84.1%) and difficulty in securing dermatologist appointments (54.3%). CONCLUSIONS The study reveals widespread social media use among adult female acne patients, highlighting concerns about potentially misleading information. Dermatologists can enhance the impact of social media by providing reliable sources for patients.
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Affiliation(s)
| | | | - Vildan Manav Bas
- Department of Dermatology, Istanbul Training and Research Hospital, Health Science University, Istanbul, Turkey
| | | | - Ecem Zeliha Ergün
- Dermatology Clinic, Kadıköy Florence Nightingale Hospital, Istanbul, Turkey
| | - Elif Bal Avcı
- Dermatology Clinic, Bayburt State Hospital, Bayburt, Turkey
| | - Ebru Sarıkaya Tellal
- Department of Dermatology, Istanbul Training and Research Hospital, Health Science University, Istanbul, Turkey
| | - Esma Inan Yüksel
- Department of Dermatology, Biruni University, School of Medicine, Istanbul, Turkey
| | - Günel Rasulova
- Department of Dermatology, Koç University School of Medicine, Istanbul, Turkey
| | - Duygu Erdil
- Department of Dermatology, Istanbul Training and Research Hospital, Health Science University, Istanbul, Turkey
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Dias da Rocha MA, Saint Aroman M, Mengeaud V, Carballido F, Doat G, Coutinho A, Bagatin E. Unveiling the Nuances of Adult Female Acne: A Comprehensive Exploration of Epidemiology, Treatment Modalities, Dermocosmetics, and the Menopausal Influence. Int J Womens Health 2024; 16:663-678. [PMID: 38650835 PMCID: PMC11034510 DOI: 10.2147/ijwh.s431523] [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: 02/01/2024] [Accepted: 04/15/2024] [Indexed: 04/25/2024] Open
Abstract
Previously considered a skin disease exclusively affecting adolescents, characterized by inflammatory and non-inflammatory skin lesions, acne vulgaris is now increasingly observed in adult life, including post-menopause. Today, adult female acne (AFA) is a common chronic inflammatory disease of the pilosebaceous unit, with polymorphic lesions presenting as open or closed comedones, papules, pustules, and even nodules or cysts, often with the presence of sequelae. AFA may persist from adolescence or manifest de novo in adulthood. Its etiology is multifactorial, involving genetic, hormonal, dietary, and environmental factors, yet still incompletely understood. Increased sebum production, keratinocyte hyper-proliferation, inflammation, and reduced diversity of Cutibacterium acnes strains are the underlying disease mechanisms. During menopausal transition, a relative increase in androgen levels occurs, just as estrogens begin to decline, which can manifest itself as acne. Whereas most AFA exhibit few acne lesions with normo-androgenic serum levels, baseline investigations including androgen testing panel enable associated comorbidities to be eliminated, such as polycystic ovarian syndrome, congenital adrenal hyperplasia, or tumors. Another interesting feature is AFA's impact on quality of life, which is greater than in adolescents, being similar to other chronic diseases like asthma. The therapeutic approach to AFA depends on its severity and associated features. This review investigates the intricate facets of AFA, with a specific focus on incidence rates, treatment modalities, and the curious impact of menopause. Utilizing insights from contemporary literature and scientific discussions, this article seeks to advance our understanding of AFA, offering new perspectives to shape clinical practices and improve patient outcomes.
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Affiliation(s)
| | - Markéta Saint Aroman
- Corporate Medical Direction Dermocosmetics Care & Personal Care, Pierre Fabre, Toulouse, France
| | - Valérie Mengeaud
- Laboratoires Dermatologiques Ducray, Pierre Fabre Dermo-Cosmétique, Lavaur, France
| | - Fabienne Carballido
- Laboratoires Dermatologiques A-Derma, Pierre Fabre Dermo-Cosmétique, Lavaur, France
| | - Gautier Doat
- Laboratoires Dermatologiques Avène, Pierre Fabre Dermo-Cosmétique, Lavaur, France
| | - Ana Coutinho
- Laboratorios Pierre Fabre do Brasil LTDA, Rio de Janeiro, Brazil
| | - Edileia Bagatin
- Department of Dermatology, Universidade Federal de São Paulo, São Paulo, Brazil
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Dal Belo SE, Kanoun-Copy L, Lambert C, Cornillon C, Muller B, Jouni H, Moreau M, Palamarchuk I, Kerob D, Aguilar L. Efficacy of a multitargeted, salicylic acid-based dermocosmetic cream compared to benzoyl peroxide 5% in Acne vulgaris: Results from a randomized study. J Cosmet Dermatol 2024; 23:891-897. [PMID: 37941097 DOI: 10.1111/jocd.16052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 10/16/2023] [Accepted: 10/18/2023] [Indexed: 11/10/2023]
Abstract
INTRODUCTION Acne vulgaris (acne) is characterized by both inflammatory and non-inflammatory lesions. Benzoyl peroxide (BPO) 5% is approved to treat acne but may cause skin irritation and/or contact allergy. OBJECTIVES To compare the benefit in acne of a multitargeted dermocosmetic cream containing salicylic acid, lipohydroxy acid, niacinamide, 2-oleamido-1,3-octadecanediol, piroctone olamine, zinc, Aqua posae filiformis, and thermal spring water (DC-Eff) to BPO 5% gel. MATERIALS AND METHODS 150 Caucasian subjects (50% female) aged between 18 and 40 years, with mild to moderate acne according to the GEA (Global Evaluation of Acne) grading system were randomized into two parallel groups (DC-Eff or BPO to be applied twice daily for 56 days). IGA (investigator global assessment), GEA, lesion count, clinical signs and symptoms, and subject assessment were evaluated at baseline, and after 28 and 56 days (D28 and D56) of treatment. RESULTS The responder analyses of the IGA and GEA scores showed that 62.2% and 47.3%, respectively, in the DC-Eff, compared with 50.0% and 36.5%, respectively, in the BPO, had improved by at least one point at D56. Inflammatory, non-inflammatory, and total lesion counts significantly (p < 0.0001) decreased with both products from baseline, with no between-group difference. Subjects considered that their skin was smoother and that DC-Eff was easy to apply. DC-Eff was better tolerated than BPO. CONCLUSIONS DC-Eff applied twice daily is as beneficial as BPO in improving mild-to-moderate acne. DC-Eff was better tolerated than BPO and highly appreciated.
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Affiliation(s)
| | | | | | | | | | - Hussein Jouni
- L'Oréal Research and Innovation, Aulnay-Sous-Bois, France
| | - Magali Moreau
- L'Oréal Research and Innovation, Aulnay-Sous-Bois, France
| | | | - Delphine Kerob
- La Roche-Posay Laboratoire Dermatologique, Levallois-Perret, France
| | - Luc Aguilar
- L'Oréal Research and Innovation, Aulnay-Sous-Bois, France
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Dréno B, Nguyen JM, Hainaut E, Machet L, Leccia MT, Beneton N, Claudel JP, Célérier P, Le Moigne M, Le Naour S, Vrignaud F, Poinas A, Dert C, Boisrobert A, Flet L, Korner S, Khammari A. Efficacy of Spironolactone Compared with Doxycycline in Moderate Acne in Adult Females: Results of the Multicentre, Controlled, Randomized, Double-blind Prospective and Parallel Female Acne Spironolactone vs doxyCycline Efficacy (FASCE) Study. Acta Derm Venereol 2024; 104:adv26002. [PMID: 38380975 PMCID: PMC10910526 DOI: 10.2340/actadv.v104.26002] [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: 11/14/2023] [Accepted: 11/28/2023] [Indexed: 02/22/2024] Open
Abstract
Acne in adult females is triggered mainly by hormones. Doxycycline is a reference treatment in acne. Spironolactone targets the androgen receptor of sebaceous glands and is prescribed off-label for female adult acne. This multicentre, controlled, randomized, double-blind prospective and parallel study assessed the efficacy of spironolactone compared with doxycycline in adult female acne. A total of 133 women with moderate acne were randomized to receive treatment with: (i) doxycycline and benzoyl peroxide for 3 months followed by a 3-month treatment with its placebo and benzoyl peroxide, or (ii) spironolactone and benzoyl peroxide for 6 months. Successfully treated patients continued with benzoyl peroxide or spironolactone alone for a further 6 months. Primary endpoints were treatment success at month 4 and month 6 with the AFAST score. At all visits, the ECLA score, lesion counts, local and systemic safety and quality of life were assessed. Spironolactone performed better at month 4 and showed a statistically significant better treatment success after 6 months than doxycycline (p = 0.007). Spironolactone was 1.37-times and 2.87-times more successful compared with doxycycline at respective time-points. AFAST and ECLA scores, as well as lesion counts always improved more with spironolactone. Patients' quality of life was better with spironolactone at month 4 and month 6. Spironolactone was very well tolerated. This is the first study to show that, in female adults with moderate acne, treatment with spironolactone is significantly more successful than doxycycline and very well tolerated.
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Affiliation(s)
- Brigitte Dréno
- Nantes Université, INSERM, CNRS, Immunology and New Concepts in ImmunoTherapy, INCIT, UMR 1302/EMR6001, Nantes, France.
| | - Jean-Michel Nguyen
- Department of Epidemiology and Biostatistics, CHU Nantes, Nantes, France
| | - Ewa Hainaut
- Department of Dermatology, Poitiers University Hospital, Poitiers, France
| | - Laurent Machet
- Department of Dermatology, CHU Tours, INSERM U1253, University of Tours, Tours, France
| | - Marie-Thérèse Leccia
- Department of Dermatology, Allergology and Photobiology, CHU A. Michallon, Grenoble, France
| | | | | | | | - Marie Le Moigne
- Department of Dermatology, Nantes University, CHU Nantes, CIC1413, Nantes, France
| | - Sarah Le Naour
- Department of Dermatology, Nantes University, CHU Nantes, CIC1413, Nantes, France
| | - Florence Vrignaud
- Clinical Investigation Centre CIC1413, CHU Nantes and INSERM, Nantes, France; Nantes University, CHU Nantes, UTCG, Nantes, France
| | - Alexandra Poinas
- Clinical Investigation Centre CIC1413, CHU Nantes and INSERM, Nantes, France
| | - Cécile Dert
- Health Economics Studies and Development of Health Products, Department of Partnership and Innovation, CHU Nantes, Nantes University, Nantes, France
| | - Aurélie Boisrobert
- Department of Dermatology, Nantes University, CHU Nantes, CIC1413, Nantes, France
| | - Laurent Flet
- Department of Pharmacy, CHU Nantes, Nantes University, Nantes, France
| | - Simon Korner
- Vigilances Unit, Department of Research and Innovation, CHU Nantes, Nantes University, Nantes, France
| | - Amir Khammari
- Nantes Université, INSERM, CNRS, Immunology and New Concepts in ImmunoTherapy, INCIT, UMR 1302/EMR6001, Nantes, France; Department of Dermatology, Nantes University, CHU Nantes, CIC1413, Nantes, France
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9
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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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Mahfouz MS, Alqassim AY, Hakami FA, Alhazmi AK, Ashiri AM, Hakami AM, Khormi LM, Adawi YM, Jabrah AA. Common Skin Diseases and Their Psychosocial Impact among Jazan Population, Saudi Arabia: A Cross-Sectional Survey during 2023. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1753. [PMID: 37893471 PMCID: PMC10608052 DOI: 10.3390/medicina59101753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 09/23/2023] [Accepted: 09/26/2023] [Indexed: 10/29/2023]
Abstract
Background and Objectives: Skin problems are a widespread issue that affects people in both developing and wealthy countries, posing significant public health concerns. These disorders can profoundly impact individuals' social and psychological well-being. In this study, we aimed to determine the prevalence of the most common skin diseases in the Jazan region of southwestern Saudi Arabia and investigate their impact on patients' quality of life and psychological and social well-being. Materials and Methods: An observational cross-sectional survey conducted among a random sample of 940 adults ≥ 18 years in the Jazan region, Saudi Arabia. Four standardized questionnaires were used for data collection: Patient Health Questionnaire (PHQ-9), a five-dimension questionnaire (EQ-5D), Rosenberg Self-Esteem Scale, and Loneliness Scale (ULS-8). Results: The most prevalent skin conditions involved hair loss, which was reported by (61.1%) of the study population. These disorders significantly affected a higher percentage of females (71.9%) compared to males (46.3%) (p < 0.001). Melasma was more common in females (14.1%) than in males (4.3%) p < 0.001. The lowest prevalence was found for urticaria. Those with acne and hair loss reported higher mean scores on the PHQ-9 Scale than the group without these conditions (p < 0.05 for all). Patients with alopecia, acne, and melasma also reported significantly lower self-esteem scores compared to those without these skin conditions (p < 0.05 for all). Regarding the activity domain of QoL, participants with skin conditions reported no problems doing usual activities, compared to those without skin problems (p < 0.001). Conclusions: In conclusion, research revealed that the most prevalent skin condition was hair loss. Further, an association was found between skin diseases and the mental and social well-being of those affected, resulting in a negative impact on their quality of life. The results call for improving the condition of patients with skin diseases, improving their quality of life, and providing appropriate interventions.
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Affiliation(s)
- Mohamed Salih Mahfouz
- Family and Community Medicine Department, Faculty of Medicine, Jazan University, Jazan 45142, Saudi Arabia;
| | - Ahmad Y. Alqassim
- Family and Community Medicine Department, Faculty of Medicine, Jazan University, Jazan 45142, Saudi Arabia;
| | - Fanan Adel Hakami
- Faculty of Medicine, Jazan University, Jazan 45142, Saudi Arabia; (F.A.H.); (A.K.A.); (A.M.A.); (A.M.H.); (L.M.K.); (Y.M.A.)
| | - Abrar Khalid Alhazmi
- Faculty of Medicine, Jazan University, Jazan 45142, Saudi Arabia; (F.A.H.); (A.K.A.); (A.M.A.); (A.M.H.); (L.M.K.); (Y.M.A.)
| | - Amjad Mohammed Ashiri
- Faculty of Medicine, Jazan University, Jazan 45142, Saudi Arabia; (F.A.H.); (A.K.A.); (A.M.A.); (A.M.H.); (L.M.K.); (Y.M.A.)
| | - Alaa Marwei Hakami
- Faculty of Medicine, Jazan University, Jazan 45142, Saudi Arabia; (F.A.H.); (A.K.A.); (A.M.A.); (A.M.H.); (L.M.K.); (Y.M.A.)
| | - Linan Mohammed Khormi
- Faculty of Medicine, Jazan University, Jazan 45142, Saudi Arabia; (F.A.H.); (A.K.A.); (A.M.A.); (A.M.H.); (L.M.K.); (Y.M.A.)
| | - Yara Mohammed Adawi
- Faculty of Medicine, Jazan University, Jazan 45142, Saudi Arabia; (F.A.H.); (A.K.A.); (A.M.A.); (A.M.H.); (L.M.K.); (Y.M.A.)
| | - Asmaa Ahmed Jabrah
- Faculty of Medicine, Jazan University, Jazan 45142, Saudi Arabia; (F.A.H.); (A.K.A.); (A.M.A.); (A.M.H.); (L.M.K.); (Y.M.A.)
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11
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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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12
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Scott-Emuakpor R, Vuthaluru K, Nagre A, Jawed I, Patel PA, Sidhu HK. Role of Oral Retinoids in Treatment of Acne Vulgaris With a Bioinformatics-Based Perspective of Personalized Medicine. Cureus 2023; 15:e38019. [PMID: 37228537 PMCID: PMC10207980 DOI: 10.7759/cureus.38019] [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: 04/23/2023] [Indexed: 05/27/2023] Open
Abstract
Acne vulgaris is a skin condition characterized by the inflammation or hyperactivity of sebaceous glands on the skin, which results in the creation of comedones, lesions, nodules, and perifollicular hyperkeratinization. Increased sebum production, follicular blockage, and bacterial colonization may contribute to the disease etiology. Environmental factors, hormonal imbalance, and genetic predisposition can alter the severity of the disease. Its mental and monetary effects can be problematic for the society. In this study, we examined the role of isotretinoin in the treatment of acne vulgaris based on evidence from prior research. This review literature study compiled publications on the treatment of acne vulgaris from 1985 to 2022 based on PubMed and Google Scholar publications. Additional bioinformatics analyses were accompanied by GeneCards, STRING model, and DrugBank databases. These complementary analyses were designed to obtain a better perspective of personalized medicine which is highly required for dose-precise administrations of acne vulgaris treatment. Isotretinoin has been recognized as an effective treatment for acne vulgaris, particularly in cases that have been resistant to previous medications or have resulted in scarring, according to gathered data. Oral isotretinoin inhibits the proliferation of Propionibacterium acne, a critical factor in the development of acne lesions; also, it has been shown to be effective in reducing the number of Propionibacterium-resistant patients and regulating sebum production and reducing sebaceous gland size more effectively than other treatment options resulting in general improvements in skin clarity and acne severity and reduce inflammatory in 90% of patients. In addition to its efficacy, the majority of patients have shown that oral isotretinoin is well tolerated. This review highlights the use of oral retinoids, particularly isotretinoin, as an effective and well-tolerated treatment option for acne vulgaris. It has been proven that oral isotretinoin is useful for achieving long-lasting remission in patients with severe or resistant instances. Despite the fact that oral isotretinoin is related to a number of potential harmful effects, skin dryness was the most common side effect reported by patients that can be managed with the aid of suitable monitoring and drug administration against specific genes identified by genotyping of the susceptible variants of genes involved in TGFβ signaling pathway.
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Affiliation(s)
| | | | - Abhijit Nagre
- Medicine, Topiwala National Medical College & Bai Yamunabai Laxman (BYL) Nair Charitable Hospital, Mumbai, IND
| | - Inshal Jawed
- Internal Medicine, Dow Medical College, Karachi, PAK
| | - Priyansh A Patel
- Medicine, Byramjee Jeejeebhoy (BJ) Medical College, Ahmedabad, IND
- Medicine, Medical College Baroda, Baroda, IND
| | - Harmandeep K Sidhu
- Dermatology, Dayanand Medical College and Hospital, Ludhiana, IND
- Medicine, Indira Gandhi Government Medical College and Hospital, Nagpur, IND
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13
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Mias C, Mengeaud V, Bessou-Touya S, Duplan H. Recent advances in understanding inflammatory acne: Deciphering the relationship between Cutibacterium acnes and Th17 inflammatory pathway. J Eur Acad Dermatol Venereol 2023; 37 Suppl 2:3-11. [PMID: 36729400 DOI: 10.1111/jdv.18794] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 10/18/2022] [Indexed: 02/03/2023]
Abstract
Acne vulgaris is a common chronic inflammatory skin disease of the pilosebaceous units. Four factors contribute to acne: hyperseborrhea and dysseborrhea, follicular hyperkeratinisation, skin microbiome dysbiosis and local immuno-inflammation. Recent key studies have highlighted a better understanding of the important role of Cutibacterium acnes (C. acnes) in the development of acne. Three major findings in the last decade include: (1) the ability of C. acnes to self-organize in a biofilm associated with a more virulent activity, (2) the loss of the C. acnes phylotype diversity and (3) the central role of the Th17 pathway in acne inflammation. Indeed, there is a close link between C. acnes and the activation of the Th17 immuno-inflammatory pathway at the initiation of acne development. These mechanisms are directly linked to the loss of C. acnes phylotype diversity during acne, with a predominance of the pro-pathogenic phylotype IA1. This specifically contributes to the induction of the Th17-mediated immuno-inflammatory response involving skin cells, such as keratinocytes, monocytes and sebocytes. These advancements have led to new insights into the underlying mechanisms which can be harnessed to develop novel treatments and diagnostic biomarkers. A major disadvantage of traditional treatment with topical antibiotics is that they induce cutaneous dysbiosis and antimicrobial resistance. Thus, future treatments would no longer aim to 'kill' C. acnes, but to maintain the skin microbiota balance allowing for tissue homeostasis, specifically, the restoration of C. acnes phylotype diversity. Here, we provide an overview of some of the key processes involved in the pathogenesis of acne, with a focus on the prominent role of C. acnes and the Th17-inflammatory pathways involved.
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Affiliation(s)
- Céline Mias
- Pierre Fabre Dermo-Cosmétique and Personal Care, Toulouse, France
| | | | | | - Hélène Duplan
- Pierre Fabre Dermo-Cosmétique and Personal Care, Toulouse, France
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14
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Carneiro ACA, de Carvalho JF, de Sá DC, Rodrigues CEM. Prevalence of Metabolic Syndrome and Insulin Resistance in Adult Patients with Acne: Association with Traditional Cardiovascular Risk Factors and Acne Severity. Metab Syndr Relat Disord 2023; 21:109-114. [PMID: 36472551 DOI: 10.1089/met.2022.0073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Introduction: Acne is a chronic inflammatory disease that affects the pilosebaceous unit, and there are conflicting evidences regarding its association with metabolic syndrome (MS) and insulin resistance (IR). Methods: A cross-sectional study was performed with 162 acne patients, over 20 years of age, matched for age and sex with 78 healthy controls without acne. The measured parameters included waist circumference (WC), body mass index (BMI), systolic blood pressure, diastolic blood pressure, fasting blood glucose, fasting insulin, high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglycerides (TG), and total cholesterol. Acne severity was determined according to the Global Acne Grading System. The criteria used for the diagnosis of MS were those of the Harmonizing the Metabolic Syndrome Statement, adjusted for South Americans, and the IR was calculated using the HOMA-IR. Results: The prevalence of MS was significantly higher in cases, compared to controls (12.3% vs. 2.6%, P = 0.014), as was the prevalence of IR (11.7% vs. 3.8%, P = 0.047). In addition, MS and IR showed a positive correlation with the degree of acne severity (P = 0.011 and P = 0.021, respectively). HDL levels were significantly lower in cases (P = 0.012) and showed an association with acne severity (P = 0.038). In the logistic regression model, the risk factor that independently influenced both MS and IR in patients with acne was the WC (P = 0.001). Conclusions: Adults with acne, especially the most severe cases, are significantly more likely to have MS, IR, and lower HDL levels, compared to controls without acne.
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Affiliation(s)
| | | | | | - Carlos Ewerton Maia Rodrigues
- Postgraduate Program in Medical Sciences, University of Fortaleza (Unifor), Ceará, Brazil.,Federal University of Ceara (UFC), Ceará, Brazil
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15
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Bagatin E, Thouvenin MD, Bacquey A, Baradat S, Lauze C, Mengeaud V, Soares JLM, Andrade LDSM, Miot HA, Rocha MA. The usefulness of a dermocosmetic containing Myrtus communis extract and azelaic acid for maintenance phase of adult female acne: Results from a randomized exploratory investigator-blinded comparative study. J Eur Acad Dermatol Venereol 2023; 37 Suppl 2:26-30. [PMID: 36729399 DOI: 10.1111/jdv.18795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 11/29/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND Acne is a very common condition. Currently, there are relatively few studies available to help guidance-based decisions for its long-term management, especially studies with cosmetic care products. We have developed a skin care product dedicated to adult female acne. OBJECTIVES Evaluate the efficacy and tolerance of the test product containing Myrtus communis extract and azelaic acid compared with a light moisturizing cream (LCM) in adult females in the acne maintenance phase. METHODS A clinical study was conducted as a Brazilian, multicentre, randomized, investigator-blinded trial in adult females with clear or almost clear facial acne after anti-acne treatment. The test group (26 subjects) applied the test product and the comparative product group (27 subjects) applied LCM. Both groups applied the products twice daily on the whole face. Subjects were evaluated every 4 weeks over 16 weeks. Efficacy was evaluated according to acne relapse; Investigator's Global Assessment (IGA); acne lesions counting; AcneQoL questionnaire; Subject Global change Assessment (SGA) of acne severity; and the number of Post-Inflammatory Hyperpigmentation (PIH) and Post-Inflammatory Erythema (PIE) lesions. Tolerance was assessed according to a 5-point scale. RESULTS Over 16 weeks, the number of acne relapse was more than double in the comparator compared to the test product group (eight subjects vs. three subjects respectively). There was no statistical difference in the evolution of the mean IGA from baseline between the two groups; however, 85% of subjects were assessed as clear or almost clear in the test product group and 67% in the comparative group. CONCLUSIONS This study demonstrated the effectiveness topical application of the test product compared to LCM on acne severity in the maintenance phase of adult female acne. Efficacy results after 16 weeks suggested a trend to limit acne relapses and a benefit of the test product in maintaining long-term remission.
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Affiliation(s)
| | | | - Adeline Bacquey
- Clinical Skin Research and Development Center, Pierre Fabre Dermo-Cosmétique, Toulouse, France
| | - Sophie Baradat
- Clinical Skin Research and Development Center, Pierre Fabre Dermo-Cosmétique, Toulouse, France
| | - Christophe Lauze
- Clinical Skin Research and Development Center, Pierre Fabre Dermo-Cosmétique, Toulouse, France
| | - Valerie Mengeaud
- Medical Department, Ducray Dermatological Laboratories, Les Cauquillous, Lavaur, France
| | | | | | - Helio A Miot
- Botucatu Medical School, Universidade do Estado de Sao Paulo/UNESP (Sao Paulo State University), Botucatu, Brazil
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16
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Meena AK, Mendiratta V, Goyal R, Bisherwal K, Yadav V, Prasadh V. Biochemical and hormonal abnormalities in adult female acne. J Cosmet Dermatol 2023; 22:1392-1399. [PMID: 36606389 DOI: 10.1111/jocd.15588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 11/27/2022] [Accepted: 12/12/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND Prevalence of adult patients with acne is increasing and women comprise majority of the cases. There is lack of data on biochemical and hormonal abnormalities in adult female acne (AFA). AIMS To evaluate biochemical and hormonal parameters in 60 patients of AFA. METHODS A cross-sectional observational study conducted from November 2018 to March 2020 in Dermatology outpatient department of a tertiary care hospital in North India. Adult females (age > 25 years) with a clinical diagnosis of acne were included in the study. RESULTS 60 cases of AFA were included. The age ranged between 26-41 years with mean age at presentation being 29.45 years. 53.3% patients had persistent acne while 46.7% had late-onset acne. 50% patients had history of premenstrual flare-up of their acne. Raised FBG was found in 25% patients. 10% had raised serum insulin levels. HOMA-IR index was deranged in 55% patients. At least one lipid alteration was reported in 91.6% of patients. In hormonal parameters, raised TT was present in 6.7%, LH in 3.3%, FSH in 18.3%, prolactin in 3.3%, and TSH in 15%. No association was found between acne severity and biochemical and hormonal parameters. CONCLUSIONS Our study highlighted the importance of measuring lipid profile in AFA and calculating HOMA-IR index for measuring insulin resistance rather than simply measuring serum insulin levels. In our study, additional parameter deranged in significant number of patients was FBG. Hence, we recommend routine screening of lipid profile, FBG and calculation of HOMA-IR index in AFA.
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Affiliation(s)
- Amit Kumar Meena
- Department of Dermatology and STD, Lady Hardinge Medical College, New Delhi, India
| | - Vibhu Mendiratta
- Department of Dermatology and STD, Lady Hardinge Medical College, New Delhi, India
| | - Rajeev Goyal
- Department of Biochemistry, Lady Hardinge Medical College, New Delhi, India
| | - Kavita Bisherwal
- Department of Dermatology and STD, Lady Hardinge Medical College, New Delhi, India
| | - Vidya Yadav
- Department of Dermatology and STD, Lady Hardinge Medical College, New Delhi, India
| | - Vivin Prasadh
- Department of Dermatology and STD, Lady Hardinge Medical College, New Delhi, India
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17
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Kutlu Ö, Karadağ AS, Wollina U. Adult acne versus adolescent acne: a narrative review with a focus on epidemiology to treatment. An Bras Dermatol 2023; 98:75-83. [PMID: 36253244 PMCID: PMC9837660 DOI: 10.1016/j.abd.2022.01.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 01/02/2022] [Accepted: 01/17/2022] [Indexed: 01/21/2023] Open
Abstract
Acne vulgaris is one of the most common chronic inflammatory diseases and is characterized by papules, pustules, comedones, and nodules. Although adolescence is the preferential age group, acne may affect various age groups. Acne shares different properties in adults and adolescents. These differences extend from epidemiology to treatments. Increased awareness of these two subtypes will allow for better management of the disease. In this review, the authors examined all aspects of acne in adults and adolescents under the light of current literature.
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Affiliation(s)
- Ömer Kutlu
- Department of Dermatology and Venereology, School of Medicine, Tokat Gaziosmanpasa University, Tokat, Turkey,Corresponding author.
| | - Ayşe Serap Karadağ
- Department of Dermatology and Venereology, Memorial Ataşehir Hospital, İstanbul, Turkey
| | - Uwe Wollina
- Department of Dermatology and Allergology, Academic Teaching Hospital Dresden, Dresden, Germany
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18
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Alowairdhi Y, Alrasheed F, Alghubaywi F, Alqirnas MQ, Alajroush WA. Association Between Acne Vulgaris and Body Mass Index in Adult Population: A Tertiary Hospital-Based Retrospective Study in Riyadh, Saudi Arabia. Cureus 2022; 14:e32867. [PMID: 36699779 PMCID: PMC9870603 DOI: 10.7759/cureus.32867] [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: 12/23/2022] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND/OBJECTIVES Acne vulgaris (AV) is the common form of acne, characterized by a polymorphic eruption of inflammatory non-papules, pustules, nodules, blackheads, and whiteheads. Acne was eighth among the top 10 disorders in terms of prevalence in 2010. The objective of this study was to see if there was any association between acne vulgaris and BMI in the young adult population. METHODS This is a single-center retrospective study conducted at King Abdulaziz Medical City, Riyadh, Saudi Arabia. Adult patients diagnosed with acne vulgaris from January 2017 to June 2022 were enrolled. The estimated sample size was reached using consecutive, non-probability sampling. RESULTS A total of 596 participants were selected as a match to the criteria of the research objectives. Of the participants, slightly more than half were males (52.5%) and the rest were females (47.5%). There was a nearly equal number of cases and controls, around 48.7% of the patients had acne while the rest did not. The majority were of the age group 18 to 19 years followed by 22 to 23 years (25.2%). A majority had a normal BMI of 18.5 to 24.9 (40.4%). A significant difference was found between the means of the BMI of the participants who had acne and those who did not (p<0.05). Conclusion: No significant association was found between age group, gender, BMI, and acne. To fully comprehend how dietary factors affect the severity of acne, more studies are required.
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Affiliation(s)
- Yazeed Alowairdhi
- Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | - Faisal Alrasheed
- Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | - Faisal Alghubaywi
- Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | - Muhannad Q Alqirnas
- Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | - Waleed A Alajroush
- Pediatric Dermatology, King Abdullah Specialized Children's Hospital, Riyadh, SAU
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19
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Baird E, Click I, Kotsonis R, Bibb L. Reasons Why Adults Do Not Seek Treatment for Acne: A Survey of University Students and Staff. J DERMATOL TREAT 2022; 33:3188-3190. [PMID: 36000959 DOI: 10.1080/09546634.2022.2116925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
BACKGROUND Acne can be a highly debilitating disease. There is a high prevalence in adults, yet treatment rates in this population are low. OBJECTIVES An online survey was created to determine the main reasons why adults with acne do not seek treatment. METHODS University students and staff 20 years of age and older were emailed a link to an online survey that asked them if they have facial acne, if they see a provider for it, and how they self-treat their acne. RESULTS 1,136 complete surveys were returned. Top reasons for not seeing a provider include not being bothered enough to seek treatment (n = 418, 53.7%), believing that their acne will eventually resolve on its own (n = 351, 45.1%), concerned about costs of treatment (n = 274, 35.2%), and currently satisfied with over-the-counter (OTC) treatment (n = 261, 33.5%). CONCLUSION Most adults with acne do not see providers because they are not bothered enough by it or are satisfied with OTC treatments. However, of the population that has acne and does not seek treatment, a significant portion (n = 234, 30.1%) indicated it was for a reason that could be classified as a treatment barrier.
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Affiliation(s)
- Evan Baird
- East Tennessee State University Quillen College of Medicine, 178 Maple Ave, Mountain Home, TN 37684
| | - Ivy Click
- East Tennessee State University Quillen College of Medicine, 178 Maple Ave, Mountain Home, TN 37684
| | | | - Lorin Bibb
- University of Connecticut, Department of Dermatology, 21 South Rd, 2nd Floor, Farmington, CT 06032
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20
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Dagnelie MA, Poinas A, Dréno B. What is new in adult acne for the last 2 years: focus on acne pathophysiology and treatments. Int J Dermatol 2022; 61:1205-1212. [PMID: 35521784 DOI: 10.1111/ijd.16220] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 02/07/2022] [Accepted: 03/22/2022] [Indexed: 11/27/2022]
Abstract
Acne affects more than 640 million people worldwide, including about 85% of adolescents. This inflammatory dermatosis affects the entire population, from teenagers to adults, which reinforces the need to investigate it. Furthermore, in adults, acne has serious consequences, including a psychological impact, low self-esteem, social isolation, and depression. Over the last years, the understanding of acne pathophysiology has improved, mainly thanks to the identification of the pivotal role of the microbiota. The aim of this review was to screen the most recent scientific literature on adult acne and the newly tested treatments. Clinically, therapeutic innovations for the treatment of acne have been recently developed, including pre/probiotics, new molecules, and innovative formulations associated, however, with fewer side effects. Moreover, clinical trials are underway to use off-label molecules that seem to be proving their value in the fight against adult acne.
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Affiliation(s)
- Marie-Ange Dagnelie
- Nantes Université, Univ Angers, INSERM, Immunology and New Concepts in ImmunoTherapy, INCIT, UMR 1302, Nantes, France
| | - Alexandra Poinas
- Nantes Université, Univ Angers, INSERM, Immunology and New Concepts in ImmunoTherapy, INCIT, UMR 1302, Nantes, France
| | - Brigitte Dréno
- Nantes Université, Univ Angers, INSERM, Immunology and New Concepts in ImmunoTherapy, INCIT, UMR 1302, Nantes, France
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21
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de Vries F, Driessen R, Tjin E, Westenberg A, Vehof H, van de Kerkhof P. The association between acne care provision and quality of life: A cross-sectional survey. Health Sci Rep 2022; 5:e487. [PMID: 35155828 PMCID: PMC8822370 DOI: 10.1002/hsr2.487] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 12/13/2021] [Accepted: 12/19/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND AND AIMS It has been suggested that professional acne care can be effective not only in reducing clinical signs but also in improving quality of life (QOL). This study aims to reach a better understanding of the association between QOL and professional acne care. The study also investigates other factors that might influence QOL such as age, gender, and acne severity. METHODS Between 2019 and 2020, a cross-sectional survey-based study was conducted among 362 acne patients. Data were collected by the Cardiff Acne Disability Index (CADI) and a Global QOL scale. Analysis of covariance (ANCOVA) and post hoc comparisons were conducted to analyze the association between professional acne care and health-related QOL. RESULTS No statistically significant differences were found in QOL measured by CADI among patients visiting the four investigated acne caregivers (mean CADI score: dermatologist, 4.49; GPs, 4.42; dermal therapist, 4.07; beautician, 4.20, P = .24). However, the impact of the treatment on the QOL, which was measured by the level of Global QOL improvement before and after care, demonstrated a statistically significant improvement when attending a dermatologist, compared to the care provided by beauticians (Global QOL improvement: dermatologist, 1.50; GP, 1.01; dermal therapist, 1.10; beautician, 0.54, P = .05). Females experienced a more impaired acne-related QOL than males (P = .05), and increased acne severity was associated with a more impaired QOL (P < .05). CONCLUSIONS This study delineated factors that influence QOL in acne patients. As the QOL was not associated with the type of caregiver, the greatest QOL improvement before and after care was achieved after medical treatment by the dermatologist. Females and individuals dealing with more severe types of acne experienced a more impaired acne-related QOL. It is recommended to take these factors into account in acne management to optimize professional treatment in line with patient needs.
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Affiliation(s)
- Femke de Vries
- Research Group Innovations in Pharmaceutical CareHU University of Applied Sciences UtrechtUtrechtThe Netherlands
- Department of DermatologyRadboud University Medical CenterNijmegenThe Netherlands
| | - Rieke Driessen
- Department of DermatologyRadboud University Medical CenterNijmegenThe Netherlands
| | - Esther Tjin
- Research Group Innovations in Pharmaceutical CareHU University of Applied Sciences UtrechtUtrechtThe Netherlands
| | - Anissa Westenberg
- Research Group Innovations in Pharmaceutical CareHU University of Applied Sciences UtrechtUtrechtThe Netherlands
| | - Hans Vehof
- Research Group Innovations in Pharmaceutical CareHU University of Applied Sciences UtrechtUtrechtThe Netherlands
| | - Peter van de Kerkhof
- Department of DermatologyRadboud University Medical CenterNijmegenThe Netherlands
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22
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Lytvyn Y, McDonald K, Mufti A, Beecker J. Comparing the frequency of isotretinoin-induced hair loss at <0.5-mg/kg/d versus ≥0.5-mg/kg/d dosing in acne patients: A systematic review. JAAD Int 2022; 6:125-142. [PMID: 35199047 PMCID: PMC8841364 DOI: 10.1016/j.jdin.2022.01.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Over 1 million isotretinoin prescriptions are authorized in the United States per year. An insight into the frequency, dose dependency, timing, and reversibility of hair loss associated with isotretinoin treatment for acne vulgaris could help guide dosing regimens and patient counseling. The objective of this systematic review was to assess the frequency of hair loss in patients with acne vulgaris on <0.5 mg/kg/d daily doses of isotretinoin versus the frequency of hair loss in patients with acne vulgaris on ≥0.5 mg/kg/d daily doses of isotretinoin. An Embase and MEDLINE search was conducted on July 15, 2020, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The review focused on acne vulgaris patients. The treatment of acne vulgaris is the most common use of isotretinoin, and the population is typically younger and with fewer comorbidities. Twenty-two studies reported hair loss with oral isotretinoin treatment. A frequency analysis suggested that patients with acne vulgaris on <0.5 mg/kg/d of isotretinoin experienced hair loss at a frequency of 3.2% (n = 18/565) compared with those on ≥0.5 mg/kg/d, who experienced hair loss at a frequency of 5.7% (n = 192/3375). Inferential statistics were not possible. Physicians should consider counseling patients about the risk of telogen effluvium prior to drug initiation, as is commonly done for other side effects. The potential trend of increased hair loss frequency at a higher daily dosing warrants further investigation using higher-quality research.
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Branisteanu DE, Toader MP, Porumb EA, Serban IL, Pinzariu AC, Branisteanu CI, Vicovan A, Dimitriu A, Fartusnic IA, Boda D, Branisteanu DC, Brihan I, Nicolescu AC. Adult female acne: Clinical and therapeutic particularities (Review). Exp Ther Med 2022; 23:151. [PMID: 35069832 PMCID: PMC8753972 DOI: 10.3892/etm.2021.11074] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 11/10/2021] [Indexed: 11/16/2022] Open
Abstract
Acne is a chronic inflammatory condition affecting the pilosebaceous unit that was traditionally viewed as a disease of the adolescence. However, over the past several years, an increasing number of adult women have been reported to suffer from this condition. The prevalence of adult female acne ranges between 12 and 54%. Two clinical types can be distinguished in this population, a 'retentional' and an 'inflammatory' type, which usually tend to overlap. In terms of evolution, three main subtypes can be identified: Persistent acne, which is the most frequent subtype, late-onset acne and recurrent acne. This type of acne is mainly mild-to-moderate in severity and may be refractory to conventional treatment. The etiopathogenesis is complex and has yet to be fully elucidated. It appears to involve an interaction among genetic predisposition, hormonal factors, and chronic activation of the innate immune system overlapping with external factors, such as daily stress, Western-type diet, use of tobacco and cosmetics. The treatment may be challenging and a holistic approach is required, with special attention to the individual needs and particularities of adult women. Both topical and systemic treatments are available, with hormonal therapies being of special value in this population. The aim of the present article was to provide up-to-date, evidence-based information on the clinical presentation, etiopathogenesis and treatment of adult female acne.
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Affiliation(s)
- Daciana Elena Branisteanu
- Department of Dermatology, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Mihaela Paula Toader
- Department of Oral Dermatology, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Elena Andrese Porumb
- Department of Dermatology, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Ionela Lacramioara Serban
- Department of Physiology, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Alin Constantin Pinzariu
- Department of Physiology, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Catalina Ioana Branisteanu
- Department of Faculty of Medicine, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Anastasia Vicovan
- Department of Dermatology, Railway Clinical Hospital, 700506 Iasi, Romania
| | - Andreea Dimitriu
- Department of Dermatology, ‘Arcadia’ Hospitals and Medical Centers, 700620 Iasi, Romania
| | | | - Daniel Boda
- Department of Dermatology, ‘Carol Davila’ University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | | | - Ilarie Brihan
- Department of Dermatology, Dermatology Clinic, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania
| | - Alin Codrut Nicolescu
- Department of Dermatology, ‘Roma’ Medical Center for Diagnosis and Treatment, 011773 Bucharest, Romania
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Rueda LJ, Porras A, Rico A. Prevalence of adult female acne in Colombia: A population-based study. Int J Womens Dermatol 2022; 7:727-730. [PMID: 35028372 PMCID: PMC8714581 DOI: 10.1016/j.ijwd.2021.06.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 04/29/2021] [Accepted: 06/16/2021] [Indexed: 11/29/2022] Open
Abstract
Background Acne is a common inflammatory skin disease with adolescents being the most affected by this condition; however, acne also occurs frequently in the adult population. Adult acne is defined as late-onset acne or acne that persists beyond age 25 years. In terms of epidemiologic data, reports of adult female acne prevalence range from 5.5% to 61.5% around the world. Objective The aim of this study was to estimate the prevalence and trace the trend of adult female acne in Colombia over the last 5 years. Methods Using nationwide data from the General System of Social Security and Health in Colombia through the Sistema Integrado de Información de la Protección Social database and International Classification of Diseases, 10th Revision, diagnostic codes, a cross-sectional study was conducted to estimate the prevalence of adult female acne in outpatients in Colombia from 2015 to 2019. Results For the 5-year study period, overall acne prevalence was 2.14 per 1000 population. The highest annual prevalence (2.94 per 1000 population) was in 2019 and the lowest prevalence (1.71 per 1000 population) was in 2015. Prevalence peaked in patients age 25 to 29 years, and decreased to <1 per 1000 population in those age <50 years. Conclusion This nationwide study of adult female acne in Colombia suggests an increasing trend in prevalence over the last 5 years. We recommend further studies to determine risk factors involved in this condition.
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Affiliation(s)
- Lili J Rueda
- Universidad El Bosque, Dermatología Clínica e Infecciosa, Bogotá, Colombia
| | - Alexandra Porras
- Universidad El Bosque, Medicina Comunitaria y Salud Colectiva, Bogotá, Colombia
| | - Alejandro Rico
- Universidad El Bosque, Medicina Comunitaria y Salud Colectiva, Bogotá, Colombia
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25
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Kayıran M, Karadağ A, Alyamaç G, Cemil B, Demirseren D, Demircan Y, Aksoy H, Kılıç S, Yüksel E, Kalkan G, Aksaç S, Kutlu Ö, Kakşi S, Aktürk A, Solak S, Yazıcı S, Özden H, Koska M, Uzunçakmak T, Ataseven A, Işık B, Alpsoy E. Use of complementary and alternative medicine among patients with acne vulgaris and factors perceived to trigger the disease: A multicentre cross-sectional study with 1571 patients. Indian J Dermatol 2022; 67:311. [DOI: 10.4103/ijd.ijd_745_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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26
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Tan J, Beissert S, Cook-Bolden F, Chavda R, Harper J, Hebert A, Lain E, Layton A, Rocha M, Weiss J, Dréno B. Impact of Facial Atrophic Acne Scars on Quality of Life: A Multi-country Population-Based Survey. Am J Clin Dermatol 2022; 23:115-123. [PMID: 34705166 PMCID: PMC8776674 DOI: 10.1007/s40257-021-00628-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/07/2021] [Indexed: 11/27/2022]
Abstract
Background Acne affects more than 80% of adolescents and young adults, who most often develop acne scars. Supporting data on the effect of acne scars on patient’s health-related quality of life (HRQOL) are limited. Objective The aim was to determine how the severity of acne scars impacts the HRQOL of afflicted individuals. Methods In this population-based cross-sectional study, 723 adults with facial acne scars but without active acne lesions self-completed the Self-assessment of Clinical Acne-Related Scars (SCARS) questionnaire formulated to investigate degree of acne scarring. The Facial Acne Scar Quality of Life (FASQoL), Dermatology Life Quality Index (DLQI), and Dysmorphic Concern Questionnaire (DCQ) were completed to assess the attitude of these patients toward their scars and the impact of scarring on their HRQOL. Results The mean (standard error) DLQI score for facial acne scars was 6.26 (0.22). Acne scars were considered a ‘very large’ or ‘extremely large’ concern by 19.3% of participants with mild scars as compared to 20.1% and 34.0% of participants with moderate and severe/very severe scars, respectively (P = 0.003). Higher FASQoL scores were associated with increased severity of scarring (P = 0.001). In total, 16.9% of participants had clinical features of dysmorphia (i.e., DCQ > 13). DCQ scores were significantly higher among participants with more severe scarring (mean DCQ score of 8.04 [0.28], 8.40 [0.18], and 10.13 [0.08] among participants with mild, moderate, and severe/very severe acne scars, respectively; P = 0.001). Most commonly reported signs of emotional distress were self-consciousness (68.0%) and worry about scars not going away (74.8%). Conclusions This study highlights the significant psychosocial impact of atrophic acne scars in the form of embarrassment and self-consciousness. Individuals with mild scars also expressed significant impact on quality of life that increased with aggravation of scar severity. Patient-reported outcomes provide an insight into the physical, functional, and psychological impact of acne scarring from the patient’s perspective. Supplementary Information The online version contains supplementary material available at 10.1007/s40257-021-00628-1.
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Affiliation(s)
- Jerry Tan
- , 2224 Walker Road, Suite 300, Windsor, ON, N8W 5L7, Canada
| | - Stefan Beissert
- Department of Dermatology, University Hospital Carl Gustav Carus, TU Dresden, Fetscherstrasse 74, 01307, Dresden, Germany
| | - Fran Cook-Bolden
- Mount Sinai Department of Dermatology, 5 East 98th Street, New York, NY, 10029, USA
| | - Rajeev Chavda
- GALDERMA, Rue d'Entre-deux-Villes 10, 1814, La Tour-de-Peilz, Switzerland
| | - Julie Harper
- The Dermatology and Skin Care Center of Birmingham, 2470 Rocky Ridge Rd # 100, Vestavia Hills, AL, 35243, USA
| | - Adelaide Hebert
- The University of Texas Medical School-Houston, 6655 Travis, Suite 980, Houston, TX, 77030, USA
| | - Edward Lain
- Austin Institute for Clinical Research, 1601 E Pflugerville Pkwy Suite 1101, Pflugerville, TX, USA
| | - Alison Layton
- Hull York Medical School, University Rd, Heslington, YO10 5DD, York, UK
| | - Marco Rocha
- Federal University of São Paulo, R. Sena Madureira, 1500-Vila Clementino, São Paulo, SP, 04021-001, Brazil
| | - Jonathan Weiss
- Georgia Dermatology Partners, (Formerly, Gwinnett Dermatology, PC), 2383 Pate St., N, Snellville, GA, 30078, USA
| | - Brigitte Dréno
- Unité Thérapie Cellulaire et Génique, Faculté de Médecine de Nantes, CHU Nantes-Place Alexis Ricordeau, 44093, Nantes Cedex 01, France.
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Valente Duarte de Sousa IC. Guidance for the pharmacological management of acne vulgaris. Expert Opin Pharmacother 2021; 23:49-62. [PMID: 34686076 DOI: 10.1080/14656566.2021.1990263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Many international guidelines and expert consensuses are available to help the clinician diagnose and treat acne vulgaris; however, a simplified practical guidance that integrates current existing published recommendations is still lacking. This article aims to give practical and simplified insight into the treatment of acne. AREAS COVERED Herein, the author discusses the treatment of comedonal, papulopustular, and nodular/cystic/conglobate acne. The author also proposes a simplified treatment escalation strategy that is based on disease severity and extension, starting with topical treatments for mild cases and progressing over to systemic therapies in more severe cases. EXPERT OPINION The ideal acne treatment would simultaneously and safely target all the pathogenic factors implicated in the appearance of acne lesions with minimal side effects. Since no such treatment currently exists, combination therapies are usually recommended for most types of acne. A major limitation in choosing an appropriate treatment plan is the discrepant use of classification systems across the published literature making it difficult to draw clear and succinct conclusions about the recommendations given. Acne is not a traditional infectious disease and so while antibiotics may improve symptoms, they do not reliably resolve the condition. Thus, there is currently a tendency to opt for antibiotic-sparing treatment strategies whenever possible.
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28
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Kirsten N, Mohr N, Augustin M. Prevalence and Cutaneous Comorbidity of Acne Vulgaris in the Working Population. Clin Cosmet Investig Dermatol 2021; 14:1393-1400. [PMID: 34629884 PMCID: PMC8495148 DOI: 10.2147/ccid.s322876] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 08/11/2021] [Indexed: 01/05/2023]
Abstract
Purpose Although acne vulgaris (AV) is a common disease and can persist into adulthood, there are few large-scale epidemiological studies on the prevalence of acne vulgaris in adults. The aim of our study was to characterise the epidemiology and comorbidity of acne vulgaris in working adults in Germany. Patients and Methods Within the framework of a cross-sectional study, a total of 161,269 employees underwent dermatological whole-body examinations in more than 500 German companies between 2001 and 2016. Point prevalence rates for acne vulgaris and further skin diseases and their 95% confidence intervals were calculated and differences between participants with and without acne vulgaris were tested with chi-squared tests. Results Mean age was 43.2 years ± 10.9, 55.5% were male. In total, n = 5311 people (3.3%) with acne vulgaris were identified. Prevalence decreased by age. Controlling for age and gender, acne was significantly associated with folliculitis (OR = 1.91; CI: 1.76–2.07), contact dermatitis (OR = 1.74; CI: 1.08–2.81), rosacea (OR = 1.74; CI: 1.40–2.15), pyoderma (OR = 1.58; 1.22–2.06), seborrheic dermatitis (OR = 1.47; CI: 1.27–1.71), hand eczema (OR = 1.34; CI: 1.00–1.76), verruca vulgaris plantaris (OR = 1.29; CI: 1.09–1.51), tinea pedis (OR = 1.27; CI: 1.10–1.47), spider veins (OR = 1.26; CI: 1.16–1.38) and telangiectasia (OR = 1.15; CI: 1.02–1.30). Conclusion These data underline the importance of acne vulgaris in the adult population. Further studies to better understand the pathophysiology of AV and its comorbidity in different phases of adulthood would be desirable to develop appropriate guidelines and therapy concepts.
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Affiliation(s)
- Natalia Kirsten
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Nicole Mohr
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Matthias Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
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Ren R, Bao S, Qian W, Zhao H. Topical ALA-Photodynamic Therapy Combined with Acne Debridement and Meticulous Nursing for the Treatment of Moderate-Severe Acne in Adolescent Patients. Clin Cosmet Investig Dermatol 2021; 14:1303-1310. [PMID: 34566420 PMCID: PMC8459091 DOI: 10.2147/ccid.s322768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 08/27/2021] [Indexed: 11/25/2022]
Abstract
Objective The present study aims to explore the effect of acne debridement + meticulous nursing on 5-aminolevulinic acid photodynamic therapy (ALA-PDT) in adolescent patients with moderate–severe acne. Methods A total of 60 adolescent patients with moderate–severe acne who were admitted to our plastic surgery outpatient clinic between January 2018 and January 2020 were selected as the subjects of the present retrospective study. The patients were divided into two groups: the observation group and the control group (n = 30, each). Patients in the control group were treated with standardized ALA-PDT and conventional nursing, while patients in the observation group were treated with ALA-PDT and acne debridement + meticulous nursing intervention. The treatment’s therapeutic effect, adverse reaction incidence, and patient satisfaction 6 months after treatment were compared between the two groups. Results The acne debridement + meticulous nursing effectiveness was 86.7% in the observation group and 60% in the control group, and the adverse reaction incidence was 20% in the observation group and 46.7% in the control group. There existed statistically significant differences in the above-stated indicators between the two groups (p < 0.05). The difference in the visual analogue scores (VASs) for pain, which were measured immediately after the operations, between the two groups was not statistically significant (p > 0.05); however, the respective VAS differences between the two groups at 30 min and 60 min after the operation were statistically significant (p < 0.05). There was a statistically significant difference in patient satisfaction between the two groups (p < 0.05). Conclusion In adolescent patients with ALA-PDT-treated moderate–severe acne, the application of acne debridement + meticulous nursing could improve the clinical treatment efficacy and patient comfort as well as reduce the adverse reaction incidence. For these reasons, the treatment method could be worth promoting in clinical practice.
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Affiliation(s)
- Rongxin Ren
- Department of Plastic Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Shiwei Bao
- Department of Plastic Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Wenjiang Qian
- Department of Plastic Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Hongyi Zhao
- Department of Plastic Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
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30
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Uehara Y, Inoue T, Ota N, Ikeda S, Murase T. Non-invasive evaluation of subjective sensitive skin by transcriptomics using mRNA in skin surface lipids. Exp Dermatol 2021; 31:172-181. [PMID: 34510552 DOI: 10.1111/exd.14459] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 08/18/2021] [Accepted: 09/06/2021] [Indexed: 12/11/2022]
Abstract
Sensitive skin is a condition characterized by hypersensitivity to environmental stimuli, and its pathophysiology has not been fully elucidated. Questionnaires based on subjective symptoms, intervention tests, and measuring devices are used to diagnose sensitive skin; however, objective evaluation methods, including biomarkers, remain to be established. This study aimed to investigate the molecular profiles of self-reported sensitive skin, understand its pathophysiology and explore its biomarkers. Here, we analysed RNAs in skin surface lipids (SSL-RNAs), which can be obtained non-invasively by wiping the skin surface with an oil-blotting film, to compare the transcriptome profiles between questionnaire-based "sensitive" (n = 11) and "non-sensitive" (n = 10) skin participants. Exactly 417 differentially expressed genes in SSL-RNAs from individuals with sensitive skin were identified, of which C-C motif chemokine ligand 17 and interferon-γ pathways were elevated, while 50 olfactory receptor (OR) genes were downregulated. The expression of the detectable 101 OR genes was lower in individuals with sensitive skin compared to that in those with non-sensitive skin and was particularly associated with the subjective sensitivity among skin conditions. The receiver operating characteristic (ROC) curve demonstrated that the mean expression levels of OR genes in SSL-RNAs could discriminate subjective skin sensitivity with an area under the ROC curve of 0.836. SSL-RNA profiles suggest a mild inflammatory state in sensitive skin, and overall OR gene expression could be a potential indicator for sensitive skin.
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Affiliation(s)
- Yuya Uehara
- Biological Science Research, Kao Corporation, Tochigi, Japan.,Department of Dermatology and Allergology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Takayoshi Inoue
- Biological Science Research, Kao Corporation, Tochigi, Japan
| | - Noriyasu Ota
- Biological Science Research, Kao Corporation, Tochigi, Japan
| | - Shigaku Ikeda
- Department of Dermatology and Allergology, Juntendo University Graduate School of Medicine, Tokyo, Japan
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31
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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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Cortés H, Rojas-Márquez M, Del Prado-Audelo ML, Reyes-Hernández OD, González-Del Carmen M, Leyva-Gómez G. Alterations in mental health and quality of life in patients with skin disorders: a narrative review. Int J Dermatol 2021; 61:783-791. [PMID: 34403497 DOI: 10.1111/ijd.15852] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 07/13/2021] [Accepted: 07/26/2021] [Indexed: 12/29/2022]
Abstract
The presence of lesions in visible areas of skin may cause emotional troubles in patients, including low self-worth, embarrassment, sorrow, and social isolation. Those alterations may predispose to psychiatric disorders such as anxiety, depression, and even suicidal ideation, severely affecting patients' health state and quality of life (QoL). In this article, we focus on dermatologic patients that present with secondary mental health alterations. Thus, we offer a detailed description of mental disorders observed in patients with acne vulgaris, atopic dermatitis, psoriasis, ichthyosis, vitiligo, and hidradenitis suppurativa. Moreover, we point out the relationship between the severity of the cutaneous symptoms with mental illnesses and QoL decline. Our objective was to highlight the importance of mental health care for patients with skin diseases. The impact of skin alterations on the mental health of dermatological patients should be a central concern. Likewise, the timely identification and treatment of mental disorders are essential for the comprehensive management of these skin diseases.
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Affiliation(s)
- Hernán Cortés
- Laboratorio de Medicina Genómica, Departamento de Genómica, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Mexico City, Mexico
| | - Martín Rojas-Márquez
- Hospital Psiquiátrico Infantil Dr. Juan N. Navarro, Secretaría de Salud, Mexico City, Mexico
| | - María L Del Prado-Audelo
- Departamento de Farmacia, Facultad de Química, Universidad Nacional Autónoma de México, Mexico City, Mexico.,Departamento de Bioingeniería, Escuela de Ingeniería y Ciencias, Tecnológico de Monterrey Campus Ciudad de México, Mexico City, Mexico
| | - Octavio D Reyes-Hernández
- Laboratorio de Biología Molecular del Cáncer, UMIEZ, Facultad de Estudios Superiores Zaragoza, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | | | - Gerardo Leyva-Gómez
- Departamento de Farmacia, Facultad de Química, Universidad Nacional Autónoma de México, Mexico City, Mexico
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Li X, An SJ, Liu XL, Ji AL, Cao Y, Xiang Y, Ma XY, Hu Q, Yuan ZQ, Li YF, Lu YG, Cai TJ. The Association Between Short-Term Air Pollution Exposure and Post-Adolescent Acne: The Evidence from a Time Series Analysis in Xi'an, China. Clin Cosmet Investig Dermatol 2021; 14:723-731. [PMID: 34211290 PMCID: PMC8241005 DOI: 10.2147/ccid.s320248] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 06/09/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND Post-adolescent acne is a common skin disease faced by adults. However, whether air pollution (AP) serves as a risk factor for post-adolescent acne remains elusive. AIM To determine the relationship between short-term AP exposure (within 7 days) and outpatient visits for post-adolescent acne. METHODS Daily outpatient visit data for post-adolescent acne and routinely AP data between 2010 and 2013 were collected from Xi'an, China. A generalized additive regression model was used to analyze the relationship between outpatient visits for post-adolescent acne and short-term ambient AP exposure. The gender-specific analyses were conducted as well. RESULTS Totally, 27,190 outpatient visits for post-adolescent acne were included. The results revealed that a 10 μg/m3 increase in PM10, SO2, and NO2 at lag 0-7 day was associated with the increase of outpatient visits for post-adolescent acne at 0.84% (95% CI: 0.53%, 1.16%), 1.61% (95% CI: 0.12%, 3.10%), and 3.50% (95% CI: 1.60%, 5.40%), respectively. The significant positive associations of PM10, SO2, and NO2 were found at both single-lag models and moving average models. The gender-specific analyses showed that the effect estimates of PM10 was stronger for females than for males, while there was no observed gender difference in the effects of SO2 and NO2. CONCLUSION Short-term exposure to AP was associated with increased outpatient visits for post-adolescent acne, especially for females in the effects of PM10.
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Affiliation(s)
- Xiang Li
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, People’s Republic of China
- Department of Plastic & Cosmetic Surgery, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, People’s Republic of China
| | - Shu-Jie An
- Medical Department, Xijing Hospital, Air Force Medical University (Fourth Military Medical University), Xi’an, People’s Republic of China
| | - Xiao-Ling Liu
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, People’s Republic of China
| | - Ai-Ling Ji
- Department of Preventive Medicine & Chongqing Engineering Research Center of Pharmaceutical Sciences, Chongqing Medical and Pharmaceutical College, Chongqing, People’s Republic of China
| | - Yi Cao
- Department of Health Economics Management, Xijing Hospital, Air Force Medical University (Fourth Military Medical University), Xi’an, People’s Republic of China
| | - Ying Xiang
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, People’s Republic of China
| | - Xiang-Yu Ma
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, People’s Republic of China
| | - Qin Hu
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, People’s Republic of China
| | - Zhi-Quan Yuan
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, People’s Republic of China
| | - Ya-Fei Li
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, People’s Republic of China
| | - Yuan-Gang Lu
- Department of Plastic & Cosmetic Surgery, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, People’s Republic of China
| | - Tong-Jian Cai
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, People’s Republic of China
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Gupta M, Barman KD, Sarkar R. A Comparative Study of Microneedling Alone Versus Along with Platelet-Rich Plasma in Acne Scars. J Cutan Aesthet Surg 2021; 14:64-71. [PMID: 34084010 PMCID: PMC8149985 DOI: 10.4103/jcas.jcas_190_20] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Context: There are several modalities of treating acne scars. The combination of microneedling and platelet-rich plasma (PRP) is a synergistic approach to treat acne scars. Aims: The aim was to compare the efficacy of microneedling alone versus microneedling with PRP in acne scars. Materials and Methods: This was a split face study conducted on 36 patients with acne scars who underwent four sessions of microneedling with PRP on right side and microneedling alone on left side at monthly interval. The total scars with subtypes and Ecchelle D’Evaluation Cliniques des Cicatrices D’Acne (ECCA) score were assessed at baseline and second, fourth, and sixth visits. Visual analog score (VAS) was evaluated by both physicians and patients. Statistical Analysis: The statistical analysis was carried out using Statistical Package for Social Sciences. Paired-t test and Wilcoxon signed rank test were used to compare the results. Results: Mean age was 23.7±3.2 years with 17 male and 19 female patients. The mean total scars on right and left sides declined from 42.14±21.15 to 25.08±14.14 and 43.28+23.08 to 27.17±15.68, respectively, with insignificant differences (P-value = 0.094). ECCA score on right and left sides declined from 88.31±32.78 to 62.92±23.68 and 89.58±32.43 to 66.25±23.89, respectively (P-value = 0.058). VAS evaluated by patient and physician showed maximum improvement at second and third visits, respectively. Conclusions: This study showed no added advantage of topical application of PRP over microneedling in acne scars.
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Affiliation(s)
- Meghna Gupta
- Department of Dermatology, Maulana Azad Medical College, New Delhi, India
| | - Krishna Deb Barman
- Department of Dermatology, Maulana Azad Medical College, New Delhi, India
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35
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Passeron T, Krutmann J, Andersen ML, Katta R, Zouboulis CC. Clinical and biological impact of the exposome on the skin. J Eur Acad Dermatol Venereol 2021; 34 Suppl 4:4-25. [PMID: 32677068 DOI: 10.1111/jdv.16614] [Citation(s) in RCA: 70] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 05/05/2020] [Indexed: 12/29/2022]
Abstract
The skin exposome is defined as the totality of environmental exposures over the life course that can induce or modify various skin conditions. Here, we review the impact on the skin of solar exposure, air pollution, hormones, nutrition and psychological factors. Photoageing, photocarcinogenesis and pigmentary changes are well-established consequences of chronic exposure of the skin to solar radiation. Exposure to traffic-related air pollution contributes to skin ageing. Particulate matter and nitrogen dioxide cause skin pigmentation/lentigines, while ozone causes wrinkles and has an impact on atopic eczema. Human skin is a major target of hormones, and they exhibit a wide range of biological activities on the skin. Hormones decline with advancing age influencing skin ageing. Nutrition has an impact on numerous biochemical processes, including oxidation, inflammation and glycation, which may result in clinical effects, including modification of the course of skin ageing and photoageing. Stress and lack of sleep are known to contribute to a pro-inflammatory state, which, in turn, affects the integrity of extracellular matrix proteins, in particular collagen. Hormone dysregulation, malnutrition and stress may contribute to inflammatory skin disorders, such as atopic dermatitis, psoriasis, acne and rosacea.
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Affiliation(s)
- T Passeron
- Côte d'Azur University, Department of Dermatology, University Hospital Centre Nice, Nice, France.,Côte d'Azur University, INSERM U1065, C3M, Nice, France
| | - J Krutmann
- IUF - Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany.,Medical faculty, Heinrich-Heine-University, Düsseldorf, Germany
| | - M L Andersen
- Department of Psychobiology, Universidade Federal de São Paulo (UNIFESP)/Escola Paulista de Medicina, São Paulo, Brazil
| | - R Katta
- Volunteer Clinical Faculty, Baylor College of Medicine, McGovern Medical School at UT Health, Houston, TX, USA
| | - C C Zouboulis
- Departments of Dermatology, Venereology, Allergology and Immunology, Dessau Medical Center, Brandenburg Medical School Theodor Fontane, Dessau, Germany
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36
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Bagatin E, Rocha MADD, Freitas THP, Costa CS. Treatment challenges in adult female acne and future directions. Expert Rev Clin Pharmacol 2021; 14:687-701. [PMID: 33957838 DOI: 10.1080/17512433.2021.1917376] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Introduction: Acne is a chronic, inflammatory, and immune-mediated disease of the pilosebaceous unit, highly prevalent in adolescents. However, an increasing number of adults over 25 years old with facial acne, particularly women, have been observed. It is considered a different disease when compared to acne vulgaris. Face is the mainly involved area with inflammatory lesions and more sensitive skin, pointing out the need of a holistic approach.Areas covered: We performed a comprehensive literature search on PubMed database, up to January 2021, regarding adult female acne. We synthesized data about pathogenesis; differences compared to acne vulgaris; and treatment, with focus in the management challenges and perspectives.Expert opinion: It is essential to value the negative impact on quality of life of adult female acne, independently of severity. The disease has prolonged evolution, and patient might be resilient once the improvement, regardless of the treatment option, will just be noticeable after 3 months. Aggravating factors should be clearly discussed, such as the need of changing many habits, especially lesions manipulation. The therapeutic regimen includes make-up and tailored skin care (considering proneness to sensitivity), while anti-acne drugs should be chosen in accordance with desire to be pregnant, presence of pregnancy or breastfeeding.
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Affiliation(s)
| | | | | | - Caroline Sousa Costa
- Department of Specialized Medicine, Discipline of Dermatology - Universidade Federal Do Piauí, Teresina, Brazil
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37
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Russo A, Mellergaard M, Pellacani G, Nisticò S, Nielsen MCE. Fluorescent light energy combined with systemic isotretinoin: A 52-week follow-up evaluating efficacy and safety in treatment of moderate-severe acne. Clin Case Rep 2021; 9:2057-2068. [PMID: 33936640 PMCID: PMC8077247 DOI: 10.1002/ccr3.3944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 01/22/2021] [Accepted: 02/02/2021] [Indexed: 12/04/2022] Open
Abstract
Fluorescent light energy therapy combined with low-dose isotretinoin or tetracycline show remarkable clinical effect on 12 cases of moderate-to-severe acne. Treatment was considered safe, well-tolerated, and highly efficacious.
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Affiliation(s)
- Antonio Russo
- Department of MedicalSurgical and Neuro SciencesDermatological SectionUniversity of SienaSienaItaly
| | - Maiken Mellergaard
- ImmunologyFaculty of Health and Medical SciencesUniversity of CopenhagenFrederiksberg CDenmark
- Klox Technologies EuropeDublinIreland
| | - Giovanni Pellacani
- Department of DermatologyUniversity of Modena and Reggio EmiliaModenaItaly
| | - Steven Nisticò
- Department of Health Sciences, Unit of DermatologyMagna Graecia UniversityCatanzaroItaly
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38
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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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39
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Adamski Z, Gornowicz-Porowska J, Sobkowska D, Kaszuba K, Czajkowski R. Acne - therapeutic challenges to the cooperation between a dermatologist and a cosmetologist. Postepy Dermatol Alergol 2021; 38:21-31. [PMID: 34408562 PMCID: PMC8362767 DOI: 10.5114/ada.2021.104273] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Accepted: 07/21/2020] [Indexed: 12/12/2022] Open
Abstract
Acne vulgaris is one of the most common skin diseases in adolescence, causing a significant negative impact on the quality of life of young people who - in a large percentage of cases - do not accept their appearance. The complex pathogenesis of this disease requires appropriate preventive and curative treatment from both a dermatologist and a cosmetologist. The aim of the study was to discuss the methods currently used by dermatologists in local therapy for mild and intermediate forms of acne vulgaris, and to provide an overview of possible preventive and caring activities in the cosmetologist's office. Possible directions of cooperation between the dermatologist and the cosmetologist in the prevention of acne relapse and treatment of possible acne complications were also discussed.
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Affiliation(s)
- Zygmunt Adamski
- Chair and Clinic of Dermatology, Poznan University of Medical Sciences, Poznan, Poland
| | - Justyna Gornowicz-Porowska
- Clinic of Natural Medicinal and Cosmetic Raw Materials, The Laboratory of Practical Cosmetology, Poznan University of Medical Sciences, Poznan, Poland
| | - Daria Sobkowska
- Clinic of Natural Medicinal and Cosmetic Raw Materials, The Laboratory of Practical Cosmetology, Poznan University of Medical Sciences, Poznan, Poland
| | | | - Rafał Czajkowski
- Chair of Dermatology, Department of Dermatology and Venerology, Faculty of Medicine, Ludwik Rydygier Medical College in Bydgoszcz, Nicolaus Copernicus University in Torun, Poland
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40
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Zang H, Xu YN. Effectiveness of CO2 laser therapy in treating acne depressed scar: A protocol of systematic review. Medicine (Baltimore) 2021; 100:e23732. [PMID: 33545938 PMCID: PMC7837843 DOI: 10.1097/md.0000000000023732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 11/17/2020] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND This study is to assess the effectiveness of CO2 laser therapy (COLT) in treating patients with acne depressed scar (ADS). METHODS Relevant randomized controlled trials will be checked by search the electronic databases of Cochrane Library, PUBEMD, EMBASE, Web of Science, Allied and Complementary Medicine Database, VIP Database, CBM database, and China National Knowledge Infrastructure. All potential randomized controlled trials of COLT for patients with ADS will be identified by 2 independent authors by searching all sources from inception to present. Two authors will independently undertake literature selection, data collection and study quality assessment. Any divergences between 2 authors will be settled down by a third author through discussion. RevMan 5.3 software will be used for statistical analysis. RESULTS This study will assess the effectiveness of COLT for patients with ADS. CONCLUSIONS This study may provide helpful evidence to determine whether COLT is an effective intervention for patients with ADS. STUDY REGISTRATION OSF (osf.io/m9ghv).
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Affiliation(s)
- Huan Zang
- Department of Dermatology, Urumqi Maternal and Child Health Hospital, Urumqi, Xinjiang
| | - Ya-nan Xu
- Department of Dermatology, Yan’an People's Hospital, Yan’an, Shaanxi, China
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Tirmizi SS, Iqbal T, Mansoor M, Farooq N, Ather S, Fatima F, Kapadia N, Anwar A, Hashmi AA. Role of Microneedling in Atrophic Post-Acne Scars: An Experience from a Tertiary Care Hospital. Cureus 2021; 13:e12578. [PMID: 33575143 PMCID: PMC7870110 DOI: 10.7759/cureus.12578] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Objective To evaluate the outcomes of microneedling in patients with atrophic post-acne scars. Methodology A retrospective cross-sectional study was conducted at the Department of Dermatology, Patel Hospital for a duration of six months. Patients who were diagnosed with moderate to severe-grade atrophic acne scars were enrolled in the study. Patients with a history of photosensitivity, systemic lupus erythematosus, and xeroderma pigmentosum were excluded from the study. Goodman and Baron’s acne scar-grading system was used to evaluate the degree of atrophic scarring. A total of three sessions divided into four weekly intervals were conducted. The scar-grading was done before the procedure and after three treatment sessions using Goodman and Baron's acne scar grading system. Results A total of 50 patients were included in this study; 36 (72%) were females and 14 (28%) were males, with a mean age of 30.92±6.19 years. A decrease in the acne scar-grade was noted from grade III to grade II after three sessions of treatment. A significantly higher number of patients were in grade II after three-month sessions compared with before treatment (p=0.009), and a significantly lesser number of patients were in grade III (p=0.045). A significantly higher proportion of patients with moderate acne scars, as compared to severe, were in grade II (77.3% vs. 22.7%; p<0.001). Conclusion In this study, we found an improvement in the scar grade after microneedling sessions. However, as the study was retrospective, we suggest prospective randomized controlled trials in our set-up to better uncover the role of microneedling in reducing acne scars.
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Affiliation(s)
| | - Tayyaba Iqbal
- Dermatology, Dow University of Health Sciences, Karachi, PAK
| | - Maria Mansoor
- Dermatology, Dow University of Health Sciences, Karachi, PAK
| | - Nadia Farooq
- Dermatology, Dow University of Health Sciences, Karachi, PAK
| | - Saher Ather
- Dermatology, Saleh al Salamah Polyclinic, Riyadh, SAU
| | - Feroza Fatima
- Dermatology, Primary Health Care Corporation, Doha, QAT
| | | | - Adnan Anwar
- Physiology, Al-Tibri Medical College, Isra University, Karachi, PAK
| | - Atif A Hashmi
- Pathology, Liaquat National Hospital and Medical College, Karachi, PAK
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42
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Bedrick BS, Eskew AM, Chavarro JE, Jungheim ES. Self-Administered Questionnaire to Screen for Polycystic Ovarian Syndrome. WOMEN'S HEALTH REPORTS (NEW ROCHELLE, N.Y.) 2020; 1:566-573. [PMID: 33786523 PMCID: PMC7785063 DOI: 10.1089/whr.2020.0073] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 10/21/2020] [Indexed: 06/12/2023]
Abstract
Background: Polycystic ovary syndrome (PCOS) is a common yet underdiagnosed endocrinopathy with potentially serious sequelae. A screening questionnaire for PCOS can improve early identification and diagnosis. Objective: The purpose of this study was to test the utility of a self-administered questionnaire to help identify women at risk for PCOS. Study Design: We recruited women ages 18-50 with and without PCOS as defined by modified Rotterdam criteria to complete a self-administered survey of common PCOS signs and symptoms. The survey included questions regarding menstrual cycle characteristics and hyperandrogenism as measured by images from the Ferriman-Gallwey (FG) scoring system, and by report of depilatory practices. Results: Fifty-one women with PCOS and 50 women without PCOS participated in this study. Many study participants were current users of hormonal contraceptives making it difficult to discern menstrual cycle characteristics. Hirsutism, defined by a modification of the FG score of ≥3 from the upper lip and abdomen based on self-assessments, provided a sensitivity of 76% and specificity of 70%, whereas report of any depilatory practices provided a sensitivity of 71% and specificity of 74%. The combined sensitivity of these measures was 93% with a specificity of 52%. In multivariate logistic regression, women who used depilatory techniques had an adjusted odds ratio (aOR) of PCOS of 6.6 (95% confidence interval [CI] 2.5-17.3, p = 0.0002). Those with obesity had similar aOR of PCOS (aOR 6.7, 95% CI 2.5-17.9, p = 0.0001). Addition of other variables did not improve model fit and the net sensitivity and specificity of these two variables did not improve those of depilatory practices and hirsutism. Conclusions: Self-report of depilatory practices or hirsutism is sensitive for identifying women with PCOS. Given the prevalence of PCOS in reproductive-age women and the potentially serious health sequelae, it would be worthwhile to include questions about terminal hair growth and depilatory practices when providing general medical care to reproductive-age women to determine if further testing and screening for PCOS are indicated. This tool may also be helpful in populations where complete diagnostic evaluation may not be feasible.
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Affiliation(s)
- Bronwyn S. Bedrick
- Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, Missouri, USA
- Department of Gynecology and Obstetrics, Johns Hopkins University, Baltimore, Maryland, USA
| | - Ashley M. Eskew
- Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, Missouri, USA
- Department of Obstetrics and Gynecology, Atrium Health, Charlotte, North Carolina, USA
| | - Jorge E. Chavarro
- Harvard T. H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
| | - Emily S. Jungheim
- Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
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Finlay AY, Chernyshov PV, Tomas Aragones L, Bewley A, Svensson A, Manolache L, Marron S, Suru A, Sampogna F, Salek MS, Poot F. Methods to improve quality of life, beyond medicines. Position statement of the European Academy of Dermatology and Venereology Task Force on Quality of Life and Patient Oriented Outcomes. J Eur Acad Dermatol Venereol 2020; 35:318-328. [PMID: 33094518 DOI: 10.1111/jdv.16914] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Accepted: 08/21/2020] [Indexed: 12/21/2022]
Abstract
The pharmaceutical approach to skin disease has been hugely successful, but despite effective drugs being available and used, there are still vast numbers of people who continue to have some level of persisting skin disease and continue to experience quality of life (QoL) impairment. So the question that needs to be answered, while we await further advances in our drug-based armamentarium, is how can we improve patients' QoL, beyond drugs? A working group was formed from members of the EADV Task Force on QoL and Patient Oriented Outcomes. Participants were asked to suggest all the ways in which they considered patients' QoL may be improved beyond medicines. Four groups of management approaches that may improve QoL in dermatology were identified: interventions within the dermatology service (hospitalization, multidisciplinary teams, patch testing and establishing relevant allergens and education), external services (corrective make-up, climatotherapy and balneotherapy), psychological (psychological intervention, cognitive therapy, hypnosis), lifestyle (lifestyle behavioural changes, religion and spirituality and music). The ultimate aim of therapy is to eradicate a disease in an individual and return the person's life to normal. But until the day comes when this has been achieved for every skin disease and for every patient there will be a need to support and assist many patients in additional non-pharmaceutical ways. These 'adjuvant' approaches receive too little attention while dermatologists and researchers strive for better pharmacological therapy. The different ways in which patients may benefit have been reviewed in our paper, but the reality is that most have a very poor evidence base. The research challenges that we have to meet are to identify those approaches that might be of value and to provide evidence for their optimal use. In the meantime, clinicians should consider the use of these approaches where QoL remains impaired despite optimal use of standard therapy.
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Affiliation(s)
- A Y Finlay
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - P V Chernyshov
- Department of Dermatology and Venereology, National Medical University, Kiev, Ukraine
| | - L Tomas Aragones
- Department of Psychology, University of Zaragoza, Zaragoza, Spain
| | - A Bewley
- Whipps Cross University Hospital, London, UK.,Queen Mary University Medical School, London, UK
| | - A Svensson
- Department of Dermatology and Venereology, Skane University Hospital, Malmö, Sweden
| | - L Manolache
- Dermatology, Dali Medical, Bucharest, Romania
| | - S Marron
- Department of Dermatology, Aragon Psychodermatology Research Group (GAI+PD), University Hospital Miguel Servet, Zaragoza, Spain
| | - A Suru
- Dermatology Research Unit, Paediatric Dermatology Discipline, Colentina Clinical Hospital, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - F Sampogna
- Clinical Epidemiology Unit, IDI-IRCCS, Rome, Italy
| | - M S Salek
- School of Life & Medical Sciences, University of Hertfordshire, Hatfield, UK
| | - F Poot
- Department of Dermatology, University Hospital Erasme, Brussels, Belgium
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Aslan Kayiran M, Karadag AS, Jafferany M. Psychodermatology of acne: Dermatologist's guide to inner side of acne and management approach. Dermatol Ther 2020; 33:e14150. [DOI: 10.1111/dth.14150] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 07/27/2020] [Accepted: 07/31/2020] [Indexed: 12/12/2022]
Affiliation(s)
- Melek Aslan Kayiran
- Department of Dermatology and Venereology Istanbul Medeniyet University, School of Medicine, Goztepe Training and Research Hospital Istanbul Turkey
| | - Ayse Serap Karadag
- Department of Dermatology and Venereology Istanbul Medeniyet University, School of Medicine, Goztepe Training and Research Hospital Istanbul Turkey
| | - Mohammad Jafferany
- Department of Psychodermatology Central Michigan University Saginaw Michigan USA
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Bansal P, Sardana K, Vats G, Sharma L, Garga UC, Khurana A. A Prospective Study Examining Trigger Factors and Hormonal Abnormalities in Adult Female Acne. Indian Dermatol Online J 2020; 11:544-550. [PMID: 32832440 PMCID: PMC7413461 DOI: 10.4103/idoj.idoj_500_19] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 12/13/2019] [Accepted: 01/06/2020] [Indexed: 11/23/2022] Open
Abstract
Background: Numerous triggers have been implicated in adult female acne including endogenous (hormonal dysfunction and genetic predisposition) and exogenous causes (drugs, cosmetics, sunscreens, stress, and smoking). Aims: To evaluate the role of various trigger factors in adult female acne and to analyze the androgenic hormone pattern including anti-Mullerian hormone (AMH) in these patients. Materials and Methods: Patients having acne of age ≥25 years were analyzed using a pre devised proforma to elicit trigger factors while the severity was graded using the Global Acne Grading System (GAGS). A detailed hormonal assessment was undertaken that assessed total testosterone (TT), sex hormone-binding globulin (SHBG), free androgen index (FAI), AMH, 17-hydroxyprogesterone (17-OHP), dehydroepiandrosterone sulfate (DHEAS), follicle-stimulating hormone (FSH), luteinizing hormone (LH), thyroid-stimulating hormone (TSH), and prolactin. Results: Out of the 165 cases seen and sub-analyzed for triggers, premenstrual flare, diet, cosmetics, and stress were the most commonly implicated causes. Among cosmetics, fairness creams and foundations were implicated. The hormonal analysis revealed deranged values of all hormones with the most common being 17-OHP and AMH. Almost 42.8% patients with DHEAS derangement and 58.75% females with raised 17-OHP suffered from moderate to severe stress. Limitations: A prospective cohort correlation study of the implicated triggers is needed to confirm the association with adult female acne. Conclusions: Adult female acne may be triggered by diet, stress, and cosmetics and there is a distinct hormonal milieu that accounts for hyperandrogenemia. We noted high levels of adrenal androgens which have been known to be associated with stress and sleep deprivation. Our study shows the value of counseling adult female acne patients about various acne triggers.
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Affiliation(s)
- Prekshi Bansal
- Department of Dermatology, Venereology and Leprosy, Dr Ram Manohar Lohia Hospital and Post Graduate Institute of Medical Education and Research, New Delhi, India
| | - Kabir Sardana
- Department of Dermatology, Venereology and Leprosy, Dr Ram Manohar Lohia Hospital and Post Graduate Institute of Medical Education and Research, New Delhi, India
| | - Gauri Vats
- Department of Dermatology, Venereology and Leprosy, Dr Ram Manohar Lohia Hospital and Post Graduate Institute of Medical Education and Research, New Delhi, India
| | - Lokesh Sharma
- Department of Biochemistry, Dr Ram Manohar Lohia Hospital and Post Graduate Institute of Medical Education and Research, New Delhi, India
| | - Umesh Chandra Garga
- Department of Radiodiagnosis, Dr Ram Manohar Lohia Hospital and Post Graduate Institute of Medical Education and Research, New Delhi, India
| | - Ananta Khurana
- Department of Dermatology, Venereology and Leprosy, Dr Ram Manohar Lohia Hospital and Post Graduate Institute of Medical Education and Research, New Delhi, India
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Safety and efficacy of a novel three-step anti-acne regimen formulated specifically for women. Int J Womens Dermatol 2020; 6:419-423. [PMID: 33898711 PMCID: PMC8060657 DOI: 10.1016/j.ijwd.2020.07.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 07/15/2020] [Accepted: 07/30/2020] [Indexed: 12/03/2022] Open
Abstract
Background Due to ambient environmental- and lifestyle-associated stressors, the prevalence of acne in adult women has been increasing. Classical anti-acne treatments using benzoyl peroxide technology are associated with dehydration of the skin, which may accelerate aging and further reduce treatment compliance. The addition of bio-functional actives intended to replenish hydration and improve barrier function may hasten the onset of anti-acne benefits while restoring a healthy appearance and counteracting skin aging effects. Objective The objective of this study was to test the safety and efficacy of a new three-step topical anti-acne regimen designed specifically to improve the overall condition and appearance of the skin in women with acne. Methods Safety and efficacy were tested in an 8-week study of women ages 22 to 44 years with mild to moderate acne. Skin endpoints were monitored at baseline and weeks 1, 4, and 8 by clinical grading, measurement of sebum secretion using a sebumeter, standardized pictures, and self-validation questionnaires. Results A total of 31 women completed the study. Acne severity and lesion counts, including comedones and papules, improved gradually starting from week 1 and continued to improve throughout the study period, reaching statistical and clinical relevance at weeks 4 and 8. Moreover, significant improvements in skin roughness, radiance, overall healthy appearance, and oiliness (further confirmed with decreased sebum production) were observed. Compared with baseline responses, participants reported noticeable improvements in acne lesions and overall healthier-looking skin. Participants also noticed overall younger-looking skin at the end of the study period. Conclusion This three-step regimen provided efficacious anti-acne benefits to the skin that were also gentle, safe, and well tolerated.
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Poinas A, Lemoigne M, Le Naour S, Nguyen JM, Schirr-Bonnans S, Riche VP, Vrignaud F, Machet L, Claudel JP, Leccia MT, Hainaut E, Beneton N, Dert C, Boisrobert A, Flet L, Chiffoleau A, Corvec S, Khammari A, Dréno B. FASCE, the benefit of spironolactone for treating acne in women: study protocol for a randomized double-blind trial. Trials 2020; 21:571. [PMID: 32586344 PMCID: PMC7318446 DOI: 10.1186/s13063-020-04432-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 05/19/2020] [Indexed: 12/19/2022] Open
Abstract
Background Acne vulgaris has increased in women over the past 10 years; it currently affects 20–30% of women. The physiopathology of adult female acne is distinguished from that of teenagers essentially by two factors: hormonal and inflammatory. On a therapeutic plan, the four types of systemic treatment approved for female acne include cyclines (leading to bacterial resistance); zinc salts (less effective than cyclines); and antiandrogens (risks of phlebitis). The last alternative is represented by isotretinoin, but its use in women of childbearing potential is discouraged because of the teratogen risks. In this context, spironolactone could represent an interesting alternative. It blocks the 5-alpha-reductase receptors at the sebaceous gland and inhibits luteinizing hormone (LH) production at the pituitary level. It has no isotretinoin constraints and does not lead to bacterial resistance. Currently, very few studies have been performed in a limited number of patients: the studies showed that at low doses (lower than 200 mg/day), spironolactone can be effective against acne. In that context, it is clearly of interest to perform the first double-blind randomized study of spironolactone versus cyclines, which remains the moderate acne reference treatment, and to demonstrate the superiority of spironolactone’s efficacy in order to establish it as an alternative to cyclines. Methods Two hundred female patients will be included. They must have acne vulgaris with at least 10 inflammatory lesions and no more than 3 nodules. After randomization, the patients will be treated by spironolactone or doxycycline for 3 months and after placebo. The study will be blind for the first 6 months and open for the last 6 months. Discussion The treatment frequently used in female acne is systemic antibiotics with many courses, as it is a chronic inflammatory disease. In the context of the recent World Health Organisation (WHO) revelation about the serious, worldwide threat to public health of antibiotic resistance, this trial could give the physician another alternative in the treatment of adult female acne instead of using isotretinoin, which is more complex to manage. Trial registration ClinicalTrials.gov: NCT03334682. Registered on 7 November 2017.
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Affiliation(s)
- Alexandra Poinas
- Clinical Investigation Centre CIC1413, CHU Nantes and INSERM, Nantes, France.
| | - Marie Lemoigne
- Dermatology Department, CHU Nantes, Nantes University, CRCINA, Nantes, France
| | - Sarah Le Naour
- Dermatology Department, CHU Nantes, Nantes University, CRCINA, Nantes, France
| | - Jean-Michel Nguyen
- Department of Epidemiology and Biostatistics, CHU Nantes, Nantes, France
| | - Solène Schirr-Bonnans
- Service Evaluation Economique et Développement des Produits de Santé, Département Partenariats et Innovation, Centre Hospitalier Universitaire de Nantes, Nantes University, Nantes, France
| | - Valery-Pierre Riche
- Service Evaluation Economique et Développement des Produits de Santé, Département Partenariats et Innovation, Centre Hospitalier Universitaire de Nantes, Nantes University, Nantes, France
| | - Florence Vrignaud
- Clinical Investigation Centre CIC1413, CHU Nantes and INSERM, Nantes, France
| | - Laurent Machet
- Department of Dermatology, CHU Tours, INSERM U1253, University of Tours, Tours, France
| | | | - Marie-Thérèse Leccia
- Department of Dermatology, Allergology and Photobiology, CHU A. Michallon, Grenoble, France
| | - Ewa Hainaut
- Service de Dermatologie, Poitiers University Hospital, Poitiers, France
| | | | - Cécile Dert
- Service Evaluation Economique et Développement des Produits de Santé, Département Partenariats et Innovation, Centre Hospitalier Universitaire de Nantes, Nantes University, Nantes, France
| | - Aurélie Boisrobert
- Clinical Investigation Centre CIC1413, CHU Nantes and INSERM, Nantes, France.,Dermatology Department, CHU Nantes, Nantes University, CRCINA, Nantes, France
| | - Laurent Flet
- Department of Pharmacy, CHU Nantes, Nantes, France
| | - Anne Chiffoleau
- Direction de la Recherche, Département Promotion, Cellule Vigilances, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Stéphane Corvec
- CHU Nantes, Service de Bactériologie-Hygiène Hospitalière, CRCINA, INSERM, U1232, Université de Nantes, Nantes, France
| | - Amir Khammari
- Clinical Investigation Centre CIC1413, CHU Nantes and INSERM, Nantes, France.,Dermatology Department, CHU Nantes, Nantes University, CRCINA, Nantes, France
| | - Brigitte Dréno
- Clinical Investigation Centre CIC1413, CHU Nantes and INSERM, Nantes, France.,Dermatology Department, CHU Nantes, Nantes University, CRCINA, Nantes, France
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48
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Arafa A, Mostafa A, Khamis Y. The association of acne and menstrual symptoms among young women (18-25 years) in Egypt: a population-based cross-sectional study. Int J Adolesc Med Health 2020; 33:463-468. [PMID: 32549185 DOI: 10.1515/ijamh-2019-0220] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 01/09/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Acne and menstrual symptoms are highly prevalent among young women. Since both acne and menstrual symptoms have similar hormonal pathogenesis, it is highly suggested that the two conditions are associated. Herein, we conducted this study to assess the relationship between acne and menstrual symptoms among young women. SUBJECTS AND METHODS In this population-based cross-sectional study, a multi-stage random sampling approach was used to include 3065 young women (18-25 years) from Egypt. Women were interviewed for their socio-demographic characteristics, gynecological history, premenstrual and menstrual symptoms, and history of acne and perimenstrual acne flare during the past 6 months. RESULTS The mean age of women was 21.5 ± 2.2 and their age of menarche was 13.1 ± 1.5 years. During the previous 6 months, 44.8% of participants had acne. After adjusting for socio-demographic and gynecological characteristics, acne was associated with most menstrual symptoms with odds ratios (ORs) and 95% confidence intervals (CIs) as follows: [premenstrual symptoms: 1.23 (1.05-1.44) for irritation or nervousness, 1.45 (1.24-1.68) for fatigue, 1.37 (1.15-1.62) for breast tenderness, 1.48 (1.21-1.80) for abdominal bloating, and 1.36 (1.11-1.66) for nausea or vomiting], [menstrual symptoms: 1.63 (1.19-2.23) for dysmenorrhea and 1.24 (1.06-1.45) for dysmenorrhea requiring drugs], and [symptoms severity: 1.44 (1.24-1.68) for missing events and 1.38 (1.16-1.64) for medical consultation]. Of acne patients, 56.7% reported perimenstrual acne flare: 58.5% before menses, 35% during menses, and 6.5% after menses. CONCLUSION This study supports the concept that acne is associated with menstrual symptoms. Physicians should consider screening for menstrual symptoms among young women with acne.
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Affiliation(s)
- Ahmed Arafa
- Department of Public Health, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
- Department of Public Health, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Alshimaa Mostafa
- Department of Dermatology, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
- Department of Dermatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yasser Khamis
- Department of Gynecology and Obstetrics, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
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Kim HJ, Lee BJ, Kwon AR. The grease trap: uncovering the mechanism of the hydrophobic lid in Cutibacterium acnes lipase. J Lipid Res 2020; 61:722-733. [PMID: 32165394 PMCID: PMC7193963 DOI: 10.1194/jlr.ra119000279] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 03/05/2020] [Indexed: 01/07/2023] Open
Abstract
Acne is one of the most common dermatological conditions, but the details of its pathology are unclear, and current management regimens often have adverse effects. Cutibacterium acnes is known as a major acne-associated bacterium that derives energy from lipase-mediated sebum lipid degradation. C. acnes is commensal, but lipase activity has been observed to differ among C. acnes types. For example, higher populations of the type IA strains are present in acne lesions with higher lipase activity. In the present study, we examined a conserved lipase in types IB and II that was truncated in type IA C. acnes strains. Closed, blocked, and open structures of C. acnes ATCC11828 lipases were elucidated by X-ray crystallography at 1.6-2.4 Å. The closed crystal structure, which is the most common form in aqueous solution, revealed that a hydrophobic lid domain shields the active site. By comparing closed, blocked, and open structures, we found that the lid domain-opening mechanisms of C. acnes lipases (CAlipases) involve the lid-opening residues, Phe-179 and Phe-211. To the best of our knowledge, this is the first structure-function study of CAlipases, which may help to shed light on the mechanisms involved in acne development and may aid in future drug design.
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Affiliation(s)
- Hyo Jung Kim
- College of Pharmacy,Woosuk University, Wanju 55338, Republic of Korea,Research Institute of Pharmaceutical Sciences, College of Pharmacy, Seoul National University, Gwanak-gu, Seoul 151-742, Republic of Korea
| | - Bong-Jin Lee
- Research Institute of Pharmaceutical Sciences, College of Pharmacy, Seoul National University, Gwanak-gu, Seoul 151-742, Republic of Korea
| | - Ae-Ran Kwon
- Department of Beauty Care, College of Medical Science, Deagu Haany University, Gyeongsan 38610, Republic of Korea,To whom correspondence should be addressed. e-mail:
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50
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Hu S, Anand P, Laughter M, Maymone MBC, Dellavalle RP. Holistic dermatology: An evidence-based review of modifiable lifestyle factor associations with dermatologic disorders. J Am Acad Dermatol 2020; 86:868-877. [PMID: 32360717 DOI: 10.1016/j.jaad.2020.04.108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 04/06/2020] [Accepted: 04/20/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Holistic dermatology focuses on treating the human body as a whole and implementing lifestyle changes to enhance the treatment and prognosis of skin disease. Understanding the interplay between modifiable lifestyle factors and patients' dermatologic health will help physicians better inform patients on self-care methods to mitigate the burden of their skin disease(s). OBJECTIVE To review the current scientific literature on the relationship between modifiable lifestyle factors and the dermatologic outcome of skin disorders. METHODS A systematic literature search on PubMed, Cochrane, and Web of Science was conducted to identify research articles examining the relationship between dermatology and 6 major categories of modifiable lifestyle factors: diet, sleep, exercise, stress, alcohol, and smoking. RESULTS A substantial amount of evidence supports the relationship between modifiable lifestyle factors and dermatologic outcomes. There were the most studies on diet, stress, alcohol, and smoking, but all lifestyle factors were supported by some degree of scientific evidence. CONCLUSION All modifiable lifestyle factors explored in this review play a critical role in modulating the onset and progression of skin disease. We anticipate more research studies in the future and an increasing integration of holistic dermatology into patient care.
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Affiliation(s)
- Sophia Hu
- Department of Dermatology, University of Colorado School of Medicine, Aurora, Colorado; University of Colorado School of Medicine, Aurora, Colorado
| | - Pratibha Anand
- Department of Dermatology, University of Colorado School of Medicine, Aurora, Colorado; University of Colorado School of Medicine, Aurora, Colorado
| | - Melissa Laughter
- Department of Dermatology, University of Colorado School of Medicine, Aurora, Colorado; University of Colorado School of Medicine, Aurora, Colorado
| | - Mayra B C Maymone
- Department of Dermatology, University of Colorado School of Medicine, Aurora, Colorado
| | - Robert P Dellavalle
- Department of Dermatology, University of Colorado School of Medicine, Aurora, Colorado; Dermatology Service, US Department of Veterans Affairs, Eastern Colorado Health Care System, Aurora, Colorado; Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado.
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