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Dahlan NH, Sitohang IBS, Indriatmi W, Wibowo H, Enggy LE. Correlation Between Reduced IL-1β Levels in Acne Lesions and the Decrease in Acne Inflammatory Lesions Following Topical Vitamin D Administration: A Double-Blind Randomized Controlled Trial. Clin Cosmet Investig Dermatol 2024; 17:2183-2195. [PMID: 39372262 PMCID: PMC11453130 DOI: 10.2147/ccid.s475068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Accepted: 09/14/2024] [Indexed: 10/08/2024]
Abstract
Background The inflammatory process in acne vulgaris (AV) is characterized by the upregulation of specific pro-inflammatory cytokines, including interleukin (IL)-1β, IL-6, and IL-8, within sebocytes and keratinocytes. Sebocytes have been identified as target cells for bioactive vitamin D. Experimental studies on animal models have demonstrated the potent comedolytic effects of topical vitamin D. However, further research is required to specifically evaluate the impact of vitamin D on inflammatory lesions in acne vulgaris (AV). Objective To evaluate the effectiveness of topical vitamin D in treating acne vulgaris (AV) lesions by investigating its anti-inflammatory effects on pro-inflammatory cytokine modulation, specifically assessing the correlation between IL-1β levels in acne lesions and the reduction in AV severity. Materials and Methods This study is a double-blind, randomized, placebo-controlled clinical trial with a 2-arm design over an 8-week intervention period. Participants were randomly assigned to either the topical vitamin D group (cholecalciferol 50 mcg) or the topical placebo group, with each group comprising 32 subjects. All participants received concomitant treatment with topical adapalene 0.1%. Cytokine levels within acne lesions were assessed using Luminex Polystyrene Screening Assays to detect and quantify IL-1β levels. The effectiveness of the treatment was evaluated by monitoring the reduction in the number of inflammatory lesions, while the safety of topical vitamin D was assessed by documenting and analyzing any reported side effects. Results The study found a significant correlation between the reduction in IL-1β levels within acne lesions and the decrease in moderate and severe inflammatory lesions in acne vulgaris (p = 0.028). The topical application of vitamin D led to a significant reduction in inflammatory AV lesions (p = 0.045). No significant topical side effects were observed in either the vitamin D or placebo groups. Conclusion This study demonstrates that the topical administration of vitamin D in acne vulgaris (AV) lesions is effective in reducing pro-inflammatory cytokine levels within acne lesions and in decreasing the severity of AV. Trial Registration NCT05758259. September 5, 2022.
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Affiliation(s)
- Nelly Herfina Dahlan
- Department of Dermatology and Venereology, Faculty of Medicine, University of Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Irma Bernadette S Sitohang
- Department of Dermatology and Venereology, Faculty of Medicine, University of Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Wresti Indriatmi
- Department of Dermatology and Venereology, Faculty of Medicine, University of Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Heri Wibowo
- Department of Integrated Laboratory, Faculty of Medicine, University of Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
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Koch W, Zagórska J, Michalak-Tomczyk M, Karav S, Wawruszak A. Plant Phenolics in the Prevention and Therapy of Acne: A Comprehensive Review. Molecules 2024; 29:4234. [PMID: 39275081 PMCID: PMC11397085 DOI: 10.3390/molecules29174234] [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: 08/13/2024] [Revised: 09/02/2024] [Accepted: 09/04/2024] [Indexed: 09/16/2024] Open
Abstract
Plants are a rich source of secondary metabolites, among which phenolics are the most abundant. To date, over 8000 various polyphenolic compounds have been identified in plant species, among which phenolic acids, flavonoids, coumarins, stilbenes and lignans are the most important ones. Acne is one of the most commonly treated dermatological diseases, among which acne vulgaris and rosacea are the most frequently diagnosed. In the scientific literature, there is a lack of a detailed scientific presentation and discussion on the importance of plant phenolics in the treatment of the most common specific skin diseases, e.g., acne. Therefore, the aim of this review is to gather, present and discuss the current state of knowledge on the activity of various plant phenolics towards the prevention and treatment of acne, including in vitro, in vivo and human studies. It was revealed that because of their significant antibacterial, anti-inflammatory and antioxidant activities, phenolic compounds may be used in the treatment of various types of acne, individually as well as in combination with commonly used drugs like clindamycin and benzoyl peroxide. Among the various phenolics that have been tested, EGCG, quercetin and nobiletin seem to be the most promising ones; however, more studies, especially clinical trials, are needed to fully evaluate their efficacy in treating acne.
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Affiliation(s)
- Wojciech Koch
- Department of Food and Nutrition, Medical University of Lublin, 4a Chodźki Str., 20-093 Lublin, Poland
| | - Justyna Zagórska
- Department of Food and Nutrition, Medical University of Lublin, 4a Chodźki Str., 20-093 Lublin, Poland
| | - Magdalena Michalak-Tomczyk
- Department of Animal Physiology and Toxicology, The John Paul II Catholic University of Lublin, Konstantynów 1I Street, 20-708 Lublin, Poland
| | - Sercan Karav
- Department of Molecular Biology and Genetics, Canakkale Onsekiz Mart University, Canakkale 17000, Türkiye
| | - Anna Wawruszak
- Department of Biochemistry and Molecular Biology, Medical University of Lublin, 20-093 Lublin, Poland
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Aneri V, Catarino A, Eguren C, Hernández I, Merino N, Nogués S, Obón L, Salleras M. Iberia Consensus on Strategies to Prevent and Manage Irritation by Topical Retinoids in Facial and Trunk Acne. ACTAS DERMO-SIFILIOGRAFICAS 2024; 115:791-800. [PMID: 38663728 DOI: 10.1016/j.ad.2024.03.032] [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: 11/02/2023] [Revised: 02/20/2024] [Accepted: 03/13/2024] [Indexed: 06/07/2024] Open
Abstract
OBJECTIVE To assess the level of agreement on various prevention and management strategies for irritation caused by topical retinoids in facial and trunk acne in an attempt to alleviate it and minimize treatment discontinuations as much as possible. METHOD After reviewing the scientific medical literatura currently available, 4 different areas of uncertainty in the management of irritation caused by topical retinoids in acne were identified. A questionnaire with 34 recommendations was created and evaluated by a group of 133 dermatologists (Delphi methodology). RESULTS In 82.3% of the recommendations (28 out of 34), some level of agreement was reached (≥85% agreement in 22 recommendations and≥70% agreement in 6). The results with the highest level of agreement focused on specific patient education strategies (explaining that irritation is an expected reaction at the beginning of treatment and tends to decrease over time), gradual and/or spaced application of topical retinoids (at night time to prevent and/or reduce skin irritation), and the importance of using adjuvant products, specific for acne-prone skin, hydration, photoprotection, and skin cleansing. These recommendations reflect a comprehensive approach to managing irritation associated with topical retinoids and promoting long-term adherence. CONCLUSIONS Skin irritation caused by topical retinoids in facial and trunk acne is an expected, mild, and controllable reaction if proper prevention and management guidelines are followed, meaning that it should not be a reason for treatment discontinuation.
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Affiliation(s)
- V Aneri
- Consulta Privada-Dermoclinic, Málaga, España.
| | - A Catarino
- Hospital Egas Moniz, Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal
| | | | - I Hernández
- Centro de especialidades Ricardo Trénor, Hospital La Fe, Valencia, España
| | - N Merino
- Dermamedicin Clínicas, Santa Cruz de Tenerife, España
| | - S Nogués
- Centro Médico Sanitas Milenium, Tarragona, España
| | - L Obón
- C.E. Juan Llorens, Valencia, España
| | - M Salleras
- Servicio de Dermatología, Hospital Sagrat Cor, Grupo Quironsalud, Barcelona, España
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Aneri V, Catarino A, Eguren C, Hernández I, Merino N, Nogués S, Obón L, Salleras M. [Translated article] Iberia Consensus on Strategies to Prevent and Manage Irritation by Topical Retinoids in Facial and Trunk Acne. ACTAS DERMO-SIFILIOGRAFICAS 2024; 115:T791-T800. [PMID: 38972576 DOI: 10.1016/j.ad.2024.07.010] [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: 11/02/2023] [Revised: 02/20/2024] [Accepted: 03/13/2024] [Indexed: 07/09/2024] Open
Abstract
OBJECTIVE To assess the level of agreement on various prevention and management strategies for irritation caused by topical retinoids in facial and trunk acne in an attempt to alleviate it and minimize treatment discontinuations as much as possible. METHOD After reviewing the scientific medical literatura currently available, 4 different areas of uncertainty in the management of irritation caused by topical retinoids in acne were identified. A questionnaire with 34 recommendations was created and evaluated by a group of 133 dermatologists (Delphi methodology). RESULTS In 82.3% of the recommendations (28 out of 34), some level of agreement was reached (≥85% agreement in 22 recommendations and≥70% agreement in 6). The results with the highest level of agreement focused on specific patient education strategies (explaining that irritation is an expected reaction at the beginning of treatment and tends to decrease over time), gradual and/or spaced application of topical retinoids (at night time to prevent and/or reduce skin irritation), and the importance of using adjuvant products, specific for acne-prone skin, hydration, photoprotection, and skin cleansing. These recommendations reflect a comprehensive approach to managing irritation associated with topical retinoids and promoting long-term adherence. CONCLUSIONS Skin irritation caused by topical retinoids in facial and trunk acne is an expected, mild, and controllable reaction if proper prevention and management guidelines are followed, meaning that it should not be a reason for treatment discontinuation.
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Affiliation(s)
- V Aneri
- Consulta Privada-Dermoclinic, Málaga, Spain.
| | - A Catarino
- Hospital Egas Moniz, Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal
| | | | - I Hernández
- Centro de especialidades Ricardo Trénor, Hospital La Fe, Valencia, Spain
| | - N Merino
- Dermamedicin Clínicas, Santa Cruz de Tenerife, Spain
| | - S Nogués
- Centro Médico Sanitas Milenium, Tarragona, Spain
| | - L Obón
- C.E. Juan Llorens, Valencia, Spain
| | - M Salleras
- Servicio de Dermatología, Hospital Sagrat Cor, Grupo Quironsalud, Barcelona, Spain
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Chun SI. A Novel Treatment of Acne Vulgaris Using a 1927 nm Fractional Thulium Laser: A Case Series. Clin Cosmet Investig Dermatol 2024; 17:1931-1942. [PMID: 39220290 PMCID: PMC11365500 DOI: 10.2147/ccid.s468326] [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: 04/15/2024] [Accepted: 07/29/2024] [Indexed: 09/04/2024]
Abstract
Background and Aims Acne vulgaris remains one of the most common and problematic dermatological conditions. Recently, a fractional 1927 nm thulium laser has been developed with specific water absorption characteristics which may be of interest in the treatment of acne. Subjects and Methods Nine consecutive Korean subjects, 6 females and 3 males, ages ranging from 13 to 33 yr, presented with a mixture of inflammatory and noninflammatory acne. Baseline clinical photography, image analysis and lesion counts were performed. A fractional 1927 nm thulium laser (FTL) delivered 6 treatment sessions in 5 subjects and 5 sessions in 4 subjects, 4 weeks between sessions. Pain during treatment was assessed. At 32 weeks after the last treatment session, an independent Investigator Global Assessment (IGA) performed lesion counts and graded the severity of the acne at baseline and the final assessment on a quintile scale. Data were analyzed statistically. Results All 9 subjects completed the study with significant reductions in the inflammatory and noninflammatory lesions (P values 0.0012 and 0.0081, respectively) with overall lesion counts at the final assessment ranging from 60% to 97.1%, and acne grades in the IGA dropping by an average of 1.67 (range 1 to 3 grades). There was no significant difference in lesion counts or acne grades between the subjects who had 6 treatments and those who had 5 (P = 0.7695). Mild pain was reported during treatment, and no adverse events were reported by either the subjects or investigator. Conclusions The FTL at the parameters used in the present study caused disruption to the upper portion of the affected follicles and sebaceous glands under an intact stratum corneum, thereby destroying or damaging the causative Cutibacterium acnes. The superficial controlled coagulation additionally induced follicular remodeling and tissue regeneration, potentially contributing to the noticeable results in inflammatory and noninflammatory acne lesions.
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Affiliation(s)
- Soo Il Chun
- Chun Aesthetic and Laser Clinic, Seoul, South Korea
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Barbieri JS, Ellenberg S, Grice E, Tierney A, VanderBeek SB, Papadopoulos M, Mason J, Mason A, Dattilo J, Margolis DJ. Challenges in designing a randomized, double-blind noninferiority trial for treatment of acne: The SD-ACNE trial. Clin Trials 2024:17407745241265094. [PMID: 39066638 DOI: 10.1177/17407745241265094] [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: 07/30/2024]
Abstract
BACKGROUND/AIMS Excessive use of antibiotics has led to development of antibiotic resistance and other antibiotic-associated complications. Dermatologists prescribe more antibiotics per clinician than any other major specialty, with much of this use for acne. Alternative acne treatments are available but are used much less often than antibiotics, at least partially because dermatologists feel that they are less effective. Spironolactone, a hormonal therapy with antiandrogen effects that can address the hormonal pathogenesis of acne, may represent a therapeutic alternative to oral antibiotics for women with acne. However, the comparative effects of spironolactone and oral antibiotics in the treatment of acne have not been definitively studied. The Spironolactone versus Doxycycline for Acne: A Comparative Effectiveness, Noninferiority Evaluation (SD-ACNE) trial aims to answer whether spironolactone, in addition to standard topical therapy, is noninferior to doxycycline (an oral antibiotic) for women with acne. Several interesting challenges arose in the development of this study, including determining acceptability of the comparative regimens to participating dermatologists, identifying data to support a noninferiority margin, and establishing a process for unblinding participants after they completed the study while maintaining the blind for study investigators. METHODS We present the scientific and clinical rationale for the decisions made in the design of the trial, including input from key stakeholders through a Delphi consensus process. RESULTS The Spironolactone versus Doxycycline for Acne: A Comparative Effectiveness, Noninferiority Evaluation trial (NCT04582383) is being conducted at a range of community and academic sites in the United States. To maximize external validity and inform clinical practice, the study is designed with broad eligibility criteria and no prohibition of use of topical medications. Participants in the trial will be randomized to receive either spironolactone 100 mg/day or doxycycline hyclate 100 mg/day for 16 weeks. The primary outcome is the absolute decrease in inflammatory lesion count, and we have established a noninferiority margin of four inflammatory lesions. Secondary outcomes include the percentage of participants achieving Investigator Global Assessment success, change in quality of life, and microbiome changes and diversity. CONCLUSIONS The Spironolactone versus Doxycycline for Acne: A Comparative Effectiveness, Noninferiority Evaluation trial will have substantial implications for the treatment of acne and antibiotic stewardship. In addition, this study will provide important information on the effect of these systemic agents on the development of changes to the microbiome and antibiotic resistance in a healthy population of patients.
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Affiliation(s)
- John S Barbieri
- Department of Dermatology, Brigham and Women's Hospital, Boston, MA, USA
| | - Susan Ellenberg
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Elizabeth Grice
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Ann Tierney
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Suzette Baez VanderBeek
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Maryte Papadopoulos
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Jennifer Mason
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Anabel Mason
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - James Dattilo
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - David J Margolis
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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Kostrzębska A, Junka A, Brożyna M, Musiał W. The Assessment of Physicochemical and Antimicrobial Properties of Hydrophilic Gels Containing Tetracycline Hydrochloride and Various Concentrations of Ethanol. Pharmaceutics 2024; 16:830. [PMID: 38931950 PMCID: PMC11207367 DOI: 10.3390/pharmaceutics16060830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Revised: 06/10/2024] [Accepted: 06/15/2024] [Indexed: 06/28/2024] Open
Abstract
The high prevalence of acne, which affects nearly 85% of adolescents and young adults, underscores the importance of exploring new therapeutic solutions. The aim of the present study was to design a stable hydrogel formulation containing tetracycline hydrochloride (TC) in the presence of ethanol at various concentration levels. The antibiotic stability was assessed over a period of 84 days using the HPLC method. The rheological properties of the formulations and their microbiological activity were also evaluated. Hydrogels without ethanol and those containing 5% and 25% alcohol showed similar rheological properties and high stability of the antibiotic throughout the observation period. The formulation with the highest ethanol content of 50% differed significantly from the others in terms of rheological properties. Although the flow and viscosity curves were like those of the other formulations, the viscosity values were significantly lower. The stability of tetracycline in this formulation was also significantly lower, and by the 84th day of observation, the concentration of the drug had decreased to almost 45% of its initial content. The formulations containing the highest concentration of ethanol displayed the highest activity against the biofilm of the acne-causing agent, Cutibacterium acnes. The study demonstrated the possibility of developing stable and antimicrobial effective hydrogel formulations with tetracycline and ethanol as a substance enhancing drug penetration into the hair follicles.
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Affiliation(s)
- Agnieszka Kostrzębska
- Department of Physical Chemistry and Biophysics, Pharmaceutical Faculty, Wroclaw Medical University, Borowska 211, 50-556 Wroclaw, Poland;
| | - Adam Junka
- Platform for Unique Models Application P.U.M.A., Department of Pharmaceutical Microbiology and Parasitology, Wroclaw Medical University, Borowska 211, 50-556 Wroclaw, Poland
| | - Malwina Brożyna
- Platform for Unique Models Application P.U.M.A., Department of Pharmaceutical Microbiology and Parasitology, Wroclaw Medical University, Borowska 211, 50-556 Wroclaw, Poland
| | - Witold Musiał
- Department of Physical Chemistry and Biophysics, Pharmaceutical Faculty, Wroclaw Medical University, Borowska 211, 50-556 Wroclaw, Poland;
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Fang M, Lei J, Zhang Y, Zhang B. Repurposing lipid-lowering drugs as potential treatment for acne vulgaris: a Mendelian randomization study. Front Med (Lausanne) 2024; 11:1385948. [PMID: 38903813 PMCID: PMC11187329 DOI: 10.3389/fmed.2024.1385948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Accepted: 05/20/2024] [Indexed: 06/22/2024] Open
Abstract
Background Acne vulgaris, a chronic inflammatory skin condition predominantly seen in teenagers, impacts more than 640 million people worldwide. The potential use of lipid-lowering medications as a treatment for acne vulgaris remains underexplored. This study seeks to investigate the impact of lipid-lowering therapies on the risk of developing acne vulgaris using two-sample Mendelian randomization (MR) analysis. Method The two-sample MR method was employed for analysis, and information on lipid-lowering drugs was obtained from the DrugBank and ChEMBL databases. The summary data for blood low-density lipoprotein (LDL) and triglycerides were sourced from the Global Lipids Genetics Consortium, while genome-wide association studies (GWAS) summary data for acne vulgaris were obtained from the FinnGen database. Heterogeneity was examined using the Q-test, horizontal pleiotropy was assessed using MR-Presso, and the robustness of analysis results was evaluated using leave-one-out analysis. Results The MR analysis provided robust evidence for an association between lowering LDL cholesterol through two drug targets and acne vulgaris, with PCSK9 showing an odds ratio (OR) of 1.782 (95%CI: 1.129-2.812, p = 0.013) and LDL receptor (LDLR) with an OR of 1.581 (95%CI: 1.071-2.334, p = 0.021). Similarly, targeting the lowering of triglycerides through lipoprotein lipase (LPL) was significantly associated with an increased risk of acne vulgaris, indicated by an OR of 1.607 (95%CI: 1.124-2.299, p = 0.009). Conclusion The current MR study presented suggestive evidence of a positive association between drugs targeting three genes (PCSK9, LDLR, and LPL) to lower lipids and a reduced risk of acne vulgaris.
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Affiliation(s)
- Man Fang
- Department of Plastic and Cosmetic Surgery, Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, China
| | - Jing Lei
- College of Computer, Chengdu University, Chengdu, Sichuan, China
| | - Yue Zhang
- Xiangya Hospital, Central South University, Changsha, China
| | - Bo Zhang
- Department of Plastic and Cosmetic Surgery, Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, China
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Gern A, Walter J, Xu S, Vakharia PP. A randomized controlled double-blinded split-face prospective clinical trial to assess the efficacy, safety, and tolerability of a novel 3-step routine compared to benzoyl peroxide for the treatment of mild to moderate acne vulgaris. Arch Dermatol Res 2024; 316:230. [PMID: 38787441 DOI: 10.1007/s00403-024-02874-9] [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: 02/20/2024] [Revised: 02/20/2024] [Accepted: 04/07/2024] [Indexed: 05/25/2024]
Abstract
Adult acne vulgaris affects up to 43-51% of individuals. While there are numerous treatment options for acne including topical, oral, and energy-based approaches, benzoyl peroxide (BPO) is a popular over the counter (OTC) treatment. Although BPO monotherapy has a long history of efficacy and safety, it suffers from several disadvantages, most notably, skin irritation, particularly for treatment naïve patients. In this prospective, randomized, controlled, split-face study, we evaluated the comparative efficacy, safety, and tolerability of a novel 3-step azelaic acid, salicylic acid, and graduated retinol regimen versus a common OTC BPO-based regimen over 12 weeks. A total of 37 adult subjects with self-reported mild to moderate acne vulgaris were recruited. A total of 21 subjects underwent a 2-week washout period and completed the full study with 3 dropping out due to product irritation from the BPO routine, and 13 being lost to follow-up. Detailed tolerability surveys were conducted at Week 4. Additional surveys on tolerability and product preferences were collected monthly, at Week 4, Week 8, and Week 12. A blinded board-certified dermatologist objectively scored the presence and type of acne lesions (open or closed comedones, papules, pustules, nodules, and cysts) at baseline, Week 4, Week 8, and Week 12. Patients photographed themselves and uploaded the images using personal mobile phones. Detailed Week 4 survey results showed across 25 domains of user-assessed product performance, the novel routine outperformed the BPO routine in 19 (76%) which included domains in preference (e.g. "I would use this in the future) and performance ("my skin improved" and "helped my acne clear up faster"). Users of the novel routine reported less facial redness, itching, and burning, though differences did not reach statistical significance. In terms of efficacy, both products performed similarly, reducing total acne lesions by 36% (novel routine) and 40% (BPO routine) by Week 12. Overall, accounting for user preferences and tolerability the novel routine was more preferred than the BPO routine in 79% of domains (22/28). Differences in objective acne lesion reduction were not statistically significant (p = 0.97). In a randomized split-face study, a 3-step azelaic acid, salicylic acid, and graduated retinol regimen delivered similar acne lesion reduction, fewer user dropouts, greater user tolerability, and higher use preference compared to a 3-step BPO routine based in a cohort of participants with mild-to-moderate acne vulgaris.
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Affiliation(s)
- Alison Gern
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Jessica Walter
- Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Shuai Xu
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
- Department of Pediatrics (Dermatology), Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
- Sibel Health Inc., Chicago, IL, USA.
| | - Paras P Vakharia
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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10
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Emtenani S, Abdelghaffar M, Ludwig RJ, Schmidt E, Kridin K. Risk and timing of isotretinoin-related laboratory disturbances: a population-based study. Int J Dermatol 2024. [PMID: 38702860 DOI: 10.1111/ijd.17225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Accepted: 04/22/2024] [Indexed: 05/06/2024]
Abstract
INTRODUCTION Uncertainty surrounds the optimal routine laboratory monitoring in acne patients treated with isotretinoin. OBJECTIVE Our aim was to evaluate the risk of mild and severe laboratory abnormalities in patients with acne starting isotretinoin versus oral antibiotic treatment. METHODS A global population-based retrospective cohort study assigned two groups of patients with acne-prescribed isotretinoin (n = 79,012) and oral antibiotics (n = 79,012). Comprehensive propensity-score matching was conducted. RESULTS Compared to acne patients treated with oral antibiotics, those under isotretinoin demonstrated an increased risk of grade ≥3 hypertriglyceridemia (hazard ratio [HR], 7.85; 95% confidence interval [CI], 5.58-11.05; P < 0.001) and grade ≥3 elevated aspartate transaminase (AST) levels (HR, 1.45; 95% CI, 1.13-1.85; P = 0.003) within the initial 3 months of treatment. The absolute risk of these abnormalities among isotretinoin initiators was 0.4% and 0.2%, respectively. The risk difference of these findings was clinically marginal: 3 and 1 additional cases per 1,000 patients starting isotretinoin, respectively. There was no significant risk of grade ≥3 impairment in cholesterol, alanine transaminase, gamma-glutamyl transferase, or creatinine levels under isotretinoin. Most laboratory abnormalities were documented 1-3 months after drug initiation in time-stratified analysis. CONCLUSION Isotretinoin is associated with a clinically marginal increased risk of severe hypertriglyceridemia and hypertransaminasemia. Routine blood testing should be performed 1-3 months after commencing therapy.
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Affiliation(s)
- Shirin Emtenani
- Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany
| | | | - Ralf J Ludwig
- Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany
- Department of Dermatology, University Hospital of Schleswig Holstein (UKSH), Campus Lübeck, Lübeck, Germany
| | - Enno Schmidt
- Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany
- Department of Dermatology, University Hospital of Schleswig Holstein (UKSH), Campus Lübeck, Lübeck, Germany
| | - Khalaf Kridin
- Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany
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11
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Tempark T, Shem A, Lueangarun S. Efficacy of ceramides and niacinamide-containing moisturizer versus hydrophilic cream in combination with topical anti-acne treatment in mild to moderate acne vulgaris: A split face, double-blinded, randomized controlled trial. J Cosmet Dermatol 2024; 23:1758-1765. [PMID: 38299457 DOI: 10.1111/jocd.16212] [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: 11/10/2023] [Revised: 01/16/2024] [Accepted: 01/23/2024] [Indexed: 02/02/2024]
Abstract
INTRODUCTION Topical therapy is the mainstay treatment of acne, and topical retinoids such as tretinoin, tazarotene, and adapalene are recommended as the first-line therapy for mild to moderate acne. However, the cutaneous irritations may occur, and the dermocosmetics are recommended to prevent side effects of anti-acne drugs and adhere to treatment. Thus, this study aims to compare the efficacy and tolerability of ceramides and niacinamide-containing moisturizer (CCM) versus hydrophilic cream in combination with topical anti-acne treatment in mild to moderate acne vulgaris. METHODS This was an 8-week, randomized, double-blinded, split face study in 40 patients assigned for topical anti-acne medications (5% benzoyl peroxide and 0.1% adapalene gel), then randomly applied CCM or hydrophilic cream. All patients were followed at week 0, 2, 4, and 8 for acne improvement, adverse reactions, biometric, and biophysical evaluation. RESULTS CCM could significantly improve the non-inflammatory, inflammatory, and total acne lesions compared with hydrophilic cream after week 8 of treatment. Interestingly, there was an improvement of global worst score, hemoglobin index, melanin index, TEWL, skin hydration, sebum production, and skin surface pH, with no statistically significant differences between the two treatments. No serious side effects from clinical application of CCM and hydrophilic cream in mild to moderate acne vulgaris patients. CONCLUSION Ceramide and niacinamide-containing moisturizer in combination with anti-acne medication can significantly improve acne lesions and decrease cutaneous irritations toward a satisfactory treatment outcome of mild to moderate acne vulgaris.
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Affiliation(s)
- Therdpong Tempark
- Department of Pediatrics, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, Thailand
| | - Andrew Shem
- M. Yamin Clinic and Pharmacy JI. M. Yamin, Samarinda, Indonesia
| | - Suparuj Lueangarun
- Department of Aesthetic Medicine, College of Integrative Medicine, Dhurakij Pundit University, Bangkok, Thailand
- Division of Dermatology, DeMed Clinic Center, Bangkok, Thailand
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12
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Khaing EM, Jitrangsri K, Chomto P, Phaechamud T. Nitrocellulose for Prolonged Permeation of Levofloxacin HCl-Salicylic Acid In Situ Gel. Polymers (Basel) 2024; 16:989. [PMID: 38611247 PMCID: PMC11014302 DOI: 10.3390/polym16070989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 03/28/2024] [Accepted: 04/03/2024] [Indexed: 04/14/2024] Open
Abstract
Currently, the application of solvent exchange-induced in situ gel is underway for drug delivery to the body target site. Nitrocellulose was attempted in this research as the matrix-forming agent in solvent exchange-induced in situ gel for acne and periodontitis treatments. The gel incorporated a combination of 1% w/w levofloxacin HCl and 2% w/w salicylic acid as the active compounds. In order to facilitate formulation development, the study explored the matrix-forming behavior of different concentrations of nitrocellulose in N-methyl pyrrolidone (NMP). Consequently, their physicochemical properties and matrix-forming behavior, as well as antimicrobial and anti-inflammatory activities, were evaluated using the agar cup diffusion method and thermal inhibition of protein denaturation in the egg albumin technique, respectively. All prepared formulations presented as clear solutions with Newtonian flow. Their contact angles on agarose gel were higher than on a glass slide due to matrix formation upon exposure to the aqueous phase of agarose, with an angle of less than 60° indicating good spreadability. Nitrocellulose concentrations exceeding 20% initiated stable opaque matrix formation upon contact with phosphate buffer pH 6.8. The high hardness and remaining force of the transformed gel indicated their robustness after solvent exchange. Fluorescence tracking using sodium fluorescein and Nile red confirmed the retardation of NMP and water diffusion by the nitrocellulose matrix. From the Franz cell permeation study, these drugs could permeate through neonate porcine skin and tissue of porcine buccal from the nitrocellulose in situ forming gel. Their accumulation in these tissues might enable the inhibition of the invading bacterial pathogens. The developed in situ gels effectively inhibited Staphylococcus aureus, Staphylococcus epidermidis, Propionibacterium acnes, and Porphyromonas gingivalis. Furthermore, the formulations demonstrated an anti-inflammatory effect. The low viscosity of LvSa25Nc makes it appropriate for injectable treatments targeting periodontitis, while the higher viscosity of LvSa40Nc renders it appropriate for topical applications in acne treatment. Therefore, the nitrocellulose in situ gel loaded with combined levofloxacin HCl and salicylic acid emerges as a promising dosage form for treating acne and periodontitis.
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Affiliation(s)
- Ei Mon Khaing
- Department of Industrial Pharmacy, Faculty of Pharmacy, Silpakorn University, Nakhon Pathom 73000, Thailand; (E.M.K.); (P.C.)
| | - Kritamorn Jitrangsri
- Department of Chemical Engineering and Pharmaceutical Chemistry, School of Engineering and Technology, Walailak University, Nakhon Srithammarat 80160, Thailand;
- Natural Bioactive and Material for Health Promotion and Drug Delivery System Group (NBM), Faculty of Pharmacy, Silpakorn University, Nakhon Pathom 73000, Thailand
| | - Parichart Chomto
- Department of Industrial Pharmacy, Faculty of Pharmacy, Silpakorn University, Nakhon Pathom 73000, Thailand; (E.M.K.); (P.C.)
- Natural Bioactive and Material for Health Promotion and Drug Delivery System Group (NBM), Faculty of Pharmacy, Silpakorn University, Nakhon Pathom 73000, Thailand
| | - Thawatchai Phaechamud
- Department of Industrial Pharmacy, Faculty of Pharmacy, Silpakorn University, Nakhon Pathom 73000, Thailand; (E.M.K.); (P.C.)
- Natural Bioactive and Material for Health Promotion and Drug Delivery System Group (NBM), Faculty of Pharmacy, Silpakorn University, Nakhon Pathom 73000, Thailand
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13
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Dreno B, Dekio I, Baldwin H, Demessant AL, Dagnelie MA, Khammari A, Corvec S. Acne microbiome: From phyla to phylotypes. J Eur Acad Dermatol Venereol 2024; 38:657-664. [PMID: 37777343 DOI: 10.1111/jdv.19540] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 07/12/2023] [Indexed: 10/02/2023]
Abstract
Acne vulgaris is a chronic inflammatory skin disease with a complex pathogenesis. Traditionally, the primary pathophysiologic factors in acne have been thought to be: (1) altered sebum production, (2) inflammation, (3) excess keratinization and (4) colonization with the commensal Cutibacterium acnes. However, the role of C. acnes has been unclear, since virtually all adults have C. acnes on their skin yet not all develop acne. In recent years, understanding of the role of C. acnes has expanded. It is still acknowledged to have an important place in acne pathogenesis, but evidence suggests that an imbalance of individual C. acnes phylotypes and an alteration of the skin microbiome trigger acne. In addition, it is now believed that Staphylococcus epidermidis is also an actor in acne development. Together, C. acnes and S. epidermidis maintain and regulate homeostasis of the skin microbiota. Antibiotics, which have long been a staple of acne therapy, induce cutaneous dysbiosis. This finding, together with the long-standing public health edict to spare antibiotic use when possible, highlights the need for a change in acne management strategies. One fertile direction of study for new approaches involves dermocosmetic products that can support epidermal barrier function and have a positive effect on the skin microbiome.
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Affiliation(s)
- Brigitte Dreno
- Dermatology Department, INSERM, CNRS, Immunology and New Concepts in ImmunoTherapy, INCIT, UMR 1302/EMR6001, Nantes Université, Nantes, France
| | - Itaru Dekio
- Department of Dermatology, The Jikei University School of Medicine, Tokyo, Japan
| | - Hilary Baldwin
- Acne Treatment and Research Center, Morristown, New Jersey, USA
| | | | - Marie-Ange Dagnelie
- Dermatology Department, INSERM, CNRS, Immunology and New Concepts in ImmunoTherapy, INCIT, UMR 1302/EMR6001, Nantes Université, Nantes, France
| | - Amir Khammari
- Dermatology Department, INSERM, CNRS, Immunology and New Concepts in ImmunoTherapy, INCIT, UMR 1302/EMR6001, Nantes Université, Nantes, France
| | - Stephane Corvec
- CHU Nantes, Bacteriology Department, INCIT, UMR 1302, University Nantes, Nantes, France
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Nahm WJ, Badiavas EV, Kirsner RS, Boyd CJ, Arthur AA, Bae S, Shen J. Atypical Fibroxanthoma Treated with a Topical Combination of Imiquimod, Tazarotene, and 5-Fluorouracil. Dermatol Ther (Heidelb) 2024; 14:1049-1056. [PMID: 38467988 PMCID: PMC11052744 DOI: 10.1007/s13555-024-01127-x] [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: 12/05/2023] [Accepted: 02/21/2024] [Indexed: 03/13/2024] Open
Abstract
This case report describes an 80-year-old man who presented with a growing erythematous nodule with erosion, measuring 0.6 cm × 0.6 cm, on his right temple. This lesion was later diagnosed as atypical fibroxanthoma (AFX). Instead of undergoing Mohs surgery, the gold standard treatment, the patient opted to pursue a topical treatment regimen because of financial costs associated with surgical removal and repair. This topical regimen consisted of tazarotene cream, imiquimod cream, and 5-fluorouracil solution, applied for 30 days. The patient was directed to use this combination 5 days per week for 6 weeks. The specified dosage for each medication was a fifth of a packet of imiquimod 5% cream, an equivalent amount of tazarotene 0.1% cream, and a single drop of 5-fluorouracil 2% solution. These were combined on a bandage and placed on the lesion overnight. Following the treatment, a 3-week post-application examination revealed an erosion, 1.0 cm × 0.9 cm, amidst erythema. A subsequent incisional biopsy with histopathology and stains for CD10 and CD99, 3 weeks after treatment, and three punch biopsies with histopathology and stains for CD10 and CD99, 1-year post-treatment, confirmed the absence of AFX. AFX is a superficial variant of pleomorphic dermal sarcoma (PDS), which shares histologic similarities, yet the exact relationship between AFX/PDS and undifferentiated pleomorphic sarcoma is still not well understood. Previous studies have indicated a genomic similarity between AFX/PDS and cutaneous squamous cell carcinoma (cSCC), which suggests the potential efficacy of cSCC-targeted treatments for AFX/PDS. This case marks the first recorded instance of successful topical medical treatment of AFX, offering an alternative for patients who may opt out of surgical intervention. Continued research to assess the broader efficacy of this approach is encouraged.
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Affiliation(s)
- William J Nahm
- New York University Grossman School of Medicine, New York, NY, USA.
| | - Evangelos V Badiavas
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Robert S Kirsner
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
- Sylvester Comprehensive Cancer Center, Miami, FL, USA
| | - Carter J Boyd
- Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, NY, USA
| | - Anita A Arthur
- Department of Dermatology, University of Florida College of Medicine, Gainesville, FL, USA
| | - Sean Bae
- Institute for Cancer Genetics, Columbia University, New York, NY, USA
| | - John Shen
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University Miami Miller School of Medicine, Miami, FL, USA
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15
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Patel HA, Guo L, Feldman SR. The impact of current investigational drugs for acne on future treatment strategies. Expert Opin Investig Drugs 2024; 33:127-132. [PMID: 38369920 DOI: 10.1080/13543784.2024.2313091] [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: 06/01/2023] [Accepted: 01/28/2024] [Indexed: 02/20/2024]
Abstract
INTRODUCTION Acne vulgaris is one of the most prevalent diseases worldwide with a considerably high cost and a burden on quality of life. There are currently many topical and systemic therapies for acne; however, many are limited by their local adverse event profile. This review provides an update on current, novel Phase I and II trials for acne vulgaris. AREAS COVERED This review searched the National Institutes of Health US National Library of Medicine online database of clinical trials (ClinicalTrials.gov) for ongoing Phase I and II trials. Only papers discussing novel therapies were discussed, and combinations of previously FDA-approved drugs were excluded. EXPERT OPINION The current investigational approaches to acne treatment reflect an attempt to mitigate the underlying cause of acne pathogenesis. By targeting key mechanisms involved, studies aim to show long-term improvement with less frequent treatment use. This provides potential for more tolerable treatments with better patient adherence, in turn leading to increased efficacy.
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Affiliation(s)
- Heli A Patel
- Center for Dermatology Research, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Lily Guo
- Rosalind Franklin University of Medicine and Science Chicago Medical School, North Chicago, IL, USA
| | - Steven R Feldman
- Center for Dermatology Research, Wake Forest School of Medicine, Winston-Salem, NC, USA
- Wake Forest School of Medicine, Dermatology, Pathology, and Public Health Sciences, Winston-Salem, NC, USA
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16
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Huang L, Yang S, Yu X, Fang F, Zhu L, Wang L, Zhang X, Yang C, Qian Q, Zhu T. Association of different cell types and inflammation in early acne vulgaris. Front Immunol 2024; 15:1275269. [PMID: 38357543 PMCID: PMC10864487 DOI: 10.3389/fimmu.2024.1275269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 01/17/2024] [Indexed: 02/16/2024] Open
Abstract
Acne vulgaris, one of the most common skin diseases, is a chronic cutaneous inflammation of the upper pilosebaceous unit (PSU) with complex pathogenesis. Inflammation plays a central role in the pathogenesis of acne vulgaris. During the inflammatory process, the innate and adaptive immune systems are coordinately activated to induce immune responses. Understanding the infiltration and cytokine secretion of differential cells in acne lesions, especially in the early stages of inflammation, will provide an insight into the pathogenesis of acne. The purpose of this review is to synthesize the association of different cell types with inflammation in early acne vulgaris and provide a comprehensive understanding of skin inflammation and immune responses.
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Affiliation(s)
- Lei Huang
- Department of Dermatology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Shuyun Yang
- Department of Dermatology, The People’s Hospital of Baoshan, Baoshan, Yunnan, China
| | - Xiuqin Yu
- Department of Dermatology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Fumin Fang
- Department of Dermatology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Liping Zhu
- Department of Dermatology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Lu Wang
- Department of Dermatology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Xiaoping Zhang
- Department of Dermatology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Changzhi Yang
- Department of Dermatology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Qihong Qian
- Department of Dermatology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Tingting Zhu
- Department of Dermatology, The First Affiliated Hospital of Soochow University, Suzhou, China
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17
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Dessinioti C, Katsambas A. The Microbiome and Acne: Perspectives for Treatment. Dermatol Ther (Heidelb) 2024; 14:31-44. [PMID: 38183614 PMCID: PMC10828138 DOI: 10.1007/s13555-023-01079-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 11/28/2023] [Indexed: 01/08/2024] Open
Abstract
The skin microbiome consists of the microorganisms populating the human skin. Cutibacterium acnes (C. acnes, formerly named Propionibacterium acnes) is recognized as a key factor in acne development, regulating inflammatory and immune pathways. Dysbiosis has been described as the imbalance in skin microbiome homeostasis and may play a role in acne pathogenesis. Microbial interference has been shown to be a contributor to healthy skin homeostasis and staphylococcal strains may exclude acne-associated C. acnes phylotypes. In this review we present an update on the skin microbiome in acne and discuss how current acne treatments such as benzoyl peroxide, orally administered isotretinoin, and antibiotics may affect the skin microbiome homeostasis. We highlight the collateral damage of acne antibiotics on the skin microbiome, including the risk of antimicrobial resistance and the dysregulation of the microbiome equilibrium that may occur even with short-term antibiotic courses. Consequently, the interest is shifting towards new non-antibiotic pharmacological acne treatments. Orally administered spironolactone is an emerging off-label treatment for adult female patients and topical peroxisome proliferator-activated receptor gamma (PPARγ) modulation is being studied for patients with acne. The potential application of topical or oral probiotics, bacteriotherapy, and phage therapy for acne are further promising areas of future research.
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Affiliation(s)
- Clio Dessinioti
- 1st Department of Dermatology, Andreas Sygros Hospital, University of Athens, 5, Dragoumi Str, 16 121, Athens, Greece.
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18
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AbouSamra MM, Farouk F, Abdelhamed FM, Emam KAF, Abdeltawab NF, Salama AH. Synergistic approach for acne vulgaris treatment using glycerosomes loaded with lincomycin and lauric acid: Formulation, in silico, in vitro, LC-MS/MS skin deposition assay and in vivo evaluation. Int J Pharm 2023; 646:123487. [PMID: 37805147 DOI: 10.1016/j.ijpharm.2023.123487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 09/23/2023] [Accepted: 10/04/2023] [Indexed: 10/09/2023]
Abstract
This study aims to develop a pharmaceutical formulation that combines the potent antibacterial effect of lincomycin and lauric acid against Cutibacterium acnes (C. acnes), a bacterium implicated in acne. The selection of lauric acid was based on an in silico study, which suggested that its interaction with specific protein targets of C. acnes may contribute to its synergistic antibacterial and anti-inflammatory effects. To achieve our aim, glycerosomes were fabricated with the incorporation of lauric acid as a main constituent of glycerosomes vesicular membrane along with cholesterol and phospholipon 90H, while lincomycin was entrapped within the aqueous cavities. Glycerol is expected to enhance the cutaneous absorption of the active moieties via hydrating the skin. Optimization of lincomycin-loaded glycerosomes (LM-GSs) was conducted using a mixed factorial experimental design. The optimized formulation; LM-GS4 composed of equal ratios of cholesterol:phospholipon90H:Lauric acid, demonstrated a size of 490 ± 17.5 nm, entrapment efficiency-values of 90 ± 1.4 % for lincomycin, and97 ± 0.2 % for lauric acid, and a surface charge of -30.2 ± 0.5mV. To facilitate its application on the skin, the optimized formulation was incorporated into a carbopol hydrogel. The formed hydrogel exhibited a pH value of 5.95 ± 0.03 characteristic of pH-balanced skincare and a shear-thinning non-Newtonian pseudoplastic flow. Skin deposition of lincomycin was assessed using an in-house developed and validated LC-MS/MS method employing gradient elution and electrospray ionization detection. Results revealed that LM-GS4 hydrogel exhibited a two-fold increase in skin deposition of lincomycin compared to lincomycin hydrogel, indicating improved skin penetration and sustained release. The synergistic healing effect of LM-GS4 was evidenced by a reduction in inflammation, bacterial load, and improved histopathological changes in an acne mouse model. In conclusion, the proposed formulation demonstrated promising potential as a topical treatment for acne. It effectively enhanced the cutaneous absorption of lincomycin, exhibited favorable physical properties, and synergistic antibacterial and healing effects. This study provides valuable insights for the development of an effective therapeutic approach for acne management.
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Affiliation(s)
- Mona M AbouSamra
- Pharmaceutical Technology Department, National Research Centre, Dokki, Cairo 12622, Egypt.
| | - Faten Farouk
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Ahram Canadian University, 6(th) of October City, Cairo, Egypt
| | - Farah M Abdelhamed
- Department of Microbiology and Immunology, Faculty of Pharmacy, Cairo University, Cairo, Egypt
| | - Khloud A F Emam
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Cairo University, Cairo, Egypt
| | - Nourtan F Abdeltawab
- Department of Microbiology and Immunology, Faculty of Pharmacy, Cairo University, Cairo, Egypt
| | - Alaa H Salama
- Pharmaceutical Technology Department, National Research Centre, Dokki, Cairo 12622, Egypt; Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Ahram Canadian University, 6(th) of October City, Cairo, Egypt.
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Sermswan P, Sriharat R, Saithong S, Laowansiri M, Amornruk N, Chiewchengchol D, Noppakun N, Asawanonda P, Chatsuwan T, Kumtornrut C. A cross-sectional study examining the prevalence of antibiotic-resistant Cutibacterium acnes isolated from patients with acne in Bangkok, Thailand. J Dermatol 2023. [PMID: 37183535 DOI: 10.1111/1346-8138.16823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 04/08/2023] [Accepted: 04/23/2023] [Indexed: 05/16/2023]
Abstract
Cutibacterium acnes is associated with the pathogenesis of acne vulgaris (AV). The relationship between antibiotic-resistant C. acnes and AV remains unclear. The authors aimed to determine the prevalence of antibiotic-resistant C. acnes and investigate the association of acne severity with topical and systemic treatments in patients with acne. Samples were collected of inflammatory and noninflammatory acne, including closed and open comedones and erythematous papules/pustules from the face of patients with mild to severe acne. The samples were cultured under anaerobic conditions for the isolation of C. acnes. Antibiotic susceptibility tests for erythromycin, tetracycline, doxycycline, clindamycin, and trimethoprim/sulfamethoxazole were performed using the agar dilution method. From 153 patients, 143 viable C. acnes samples were isolated (93.5%). They were found resistant to trimethoprim/sulfamethoxazole (143/143, 100%), clindamycin (108/143, 75.5%), erythromycin (105/143, 73.4%), tetracycline (74/143, 51.7%), and doxycycline (73/143, 51.1%). There was no significant correlation between the prevalence of antibiotic resistance and acne severity. High-level resistant C. acnes correlated with higher clinical severity of acne in patients taking doxycycline (τb = 0.3). The present prevalence of antibiotic-resistant C. acnes was high in Thailand. Antibiotic stewardship in AV treatment should be encouraged to prevent further antibiotic resistance crises.
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Affiliation(s)
- Peerada Sermswan
- Faculty of Medicine, King Mongkut's Institute of Technology Ladkrabang, Bangkok, Thailand
| | - Rakwaree Sriharat
- Department of Microbiology, Faculty of Medicine, Chulalongkorn, Bangkok, Thailand
- Center of Excellence in Immunology and Immune-Mediated Diseases, Department of Microbiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Supichcha Saithong
- Center of Excellence in Immunology and Immune-Mediated Diseases, Department of Microbiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Matchima Laowansiri
- Department of Microbiology, Faculty of Medicine, Chulalongkorn, Bangkok, Thailand
- Center of Excellence in Immunology and Immune-Mediated Diseases, Department of Microbiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Nutchaya Amornruk
- Center of Excellence in Immunology and Immune-Mediated Diseases, Department of Microbiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Direkrit Chiewchengchol
- Department of Microbiology, Faculty of Medicine, Chulalongkorn, Bangkok, Thailand
- Center of Excellence in Immunology and Immune-Mediated Diseases, Department of Microbiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Nopadon Noppakun
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok, Thailand
| | - Pravit Asawanonda
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok, Thailand
| | - Tanittha Chatsuwan
- Department of Microbiology, Faculty of Medicine, Chulalongkorn, Bangkok, Thailand
- Center of Excellence in Antimicrobial Resistance and Stewardship, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Chanat Kumtornrut
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok, Thailand
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Truncal Acne and Scarring: A Comprehensive Review of Current Medical and Cosmetic Approaches to Treatment and Patient Management. Am J Clin Dermatol 2023; 24:199-223. [PMID: 36539678 DOI: 10.1007/s40257-022-00746-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/27/2022] [Indexed: 12/24/2022]
Abstract
Acne vulgaris is one of the most common skin disorders worldwide. It typically affects skin areas with a high density of sebaceous glands such as the face, upper arms, chest, and/or back. Historically, the majority of research efforts have focused on facial acne vulgaris, even though approximately half of patients with facial lesions demonstrate truncal involvement. Truncal acne vulgaris is challenging to treat and poses a significant psychosocial burden on patients. Despite these characteristics, studies specifically examining truncal acne vulgaris are limited, with treatment guidelines largely derived from facial protocols. Therefore, truncal acne remains an understudied clinical problem. Here, we provide a clinically focused review on the epidemiology, evaluation, and available treatment options for truncal acne vulgaris. In doing so, we highlight knowledge gaps with the goal of spurring further investigation into the management of truncal acne vulgaris.
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Shin JH, Kim SS, Seo SR. Pyrrolidine Dithiocarbamate Suppresses Cutibacterium acnes-Induced Skin Inflammation. Int J Mol Sci 2023; 24:ijms24054444. [PMID: 36901873 PMCID: PMC10003320 DOI: 10.3390/ijms24054444] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 02/20/2023] [Accepted: 02/21/2023] [Indexed: 02/27/2023] Open
Abstract
Cutibacterium acnes (C. acnes), a Gram-positive anaerobic bacterium, proliferates in hair follicles and pores and causes inflammation in the skin of young people. The rapid growth of C. acnes triggers macrophages to secrete proinflammatory cytokines. Pyrrolidine dithiocarbamate (PDTC) is a thiol compound that exerts antioxidant and anti-inflammatory effects. Although the anti-inflammatory function of PDTC in several inflammatory disorders has been reported, the effect of PDTC on C. acnes-induced skin inflammation remains unexplored. In the present study, we examined the effect of PDTC on C. acnes-induced inflammatory responses and determined the mechanism by using in vitro and in vivo experimental models. We found that PDTC significantly inhibited the expression of C. acnes-induced proinflammatory mediators, such as interleukin-1β (IL-1β), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), cyclooxygenase-2 (COX-2), inducible nitric oxide synthase (iNOS), and NOD-like receptor (NLR) pyrin domain-containing 3 (NLRP3), in mouse-bone-marrow-derived macrophage (BMDM) cells. PDTC suppressed C. acnes-induced activation of nuclear factor-kappa B (NF-κB), which is the major transcription factor for proinflammatory cytokine expression. In addition, we found that PDTC inhibited caspase-1 activation and IL-1β secretion through suppressing NLRP3 and activated the melanoma 2 (AIM2) inflammasome but not the NLR CARD-containing 4 (NLRC4) inflammasome. Moreover, we found that PDTC improved C. acnes-induced inflammation by attenuating C. acnes-induced IL-1β secretion in a mouse acne model. Therefore, our results suggest that PDTC has potential therapeutic value for the amelioration of C. acnes-induced skin inflammation.
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Affiliation(s)
- Jin Hak Shin
- Department of Molecular Bioscience, College of Biomedical Science, Kangwon National University, Chuncheon 24341, Republic of Korea
| | - Seon Sook Kim
- Department of Molecular Bioscience, College of Biomedical Science, Kangwon National University, Chuncheon 24341, Republic of Korea
- Institute of Life Science, Kangwon National University, Chuncheon 24341, Republic of Korea
| | - Su Ryeon Seo
- Department of Molecular Bioscience, College of Biomedical Science, Kangwon National University, Chuncheon 24341, Republic of Korea
- Institute of Bioscience & Biotechnology, Kangwon National University, Chuncheon 24341, Republic of Korea
- Correspondence: ; Tel.: +82-33-250-8541; Fax: +82-33-241-4627
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22
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Effect of Hydrogel Substrate Components on the Stability of Tetracycline Hydrochloride and Swelling Activity against Model Skin Sebum. Int J Mol Sci 2023; 24:ijms24032678. [PMID: 36768998 PMCID: PMC9916833 DOI: 10.3390/ijms24032678] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 01/23/2023] [Accepted: 01/24/2023] [Indexed: 02/01/2023] Open
Abstract
Due to its high instability and rapid degradation under adverse conditions, tetracycline hydrochloride (TC) can cause difficulties in the development of an effective but stable formulation for the topical treatment of acne. The aim of the following work was to propose a hydrogel formulation that would ensure the stability of the antibiotic contained in it. Additionally, an important property of the prepared formulations was the activity of the alcoholamines contained in them against the components of the model sebum. This feature may help effectively cleanse the hair follicles in the accumulated sebum layer. A series of formulations with varying proportions of anionic polymer and alcoholamine and containing different polymers have been developed. The stability of tetracycline hydrochloride contained in the hydrogels was evaluated for 28 days by HPLC analysis. Formulations containing a large excess of TRIS alcoholamine led to the rapid degradation of TC from an initial concentration of about 10 µg/mL to about 1 µg/mL after 28 days. At the same time, these formulations showed the highest activity against artificial sebum components. Thanks to appropriately selected proportions of the components, it was possible to develop a formulation that assured the stability of tetracycline for ca. one month, while maintaining formulation activity against the components of model sebum.
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23
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Arung ET, Syafrizal, Kusuma IW, Paramita S, Amen Y, Kim YU, Naibaho NM, Ramadhan R, Ariyanta HA, Fatriasari W, Shimizu K. Antioxidant, anti-inflammatory and anti-acne activities of stingless bee (Tetragonula biroi) propolis. Fitoterapia 2023; 164:105375. [PMID: 36511341 DOI: 10.1016/j.fitote.2022.105375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 11/23/2022] [Accepted: 11/25/2022] [Indexed: 11/27/2022]
Abstract
We collected stingless bee propolis Tetragonula biroi in order to find materials for medicine and cosmetics applications from tropical rainforest resources. Even though this bee has some biological functions including a cancer cell line, hair growth promotion, asthma remedy, α-glucosidase enzyme inhibition, and antiviral action, the investigation on anti-acne has not been reported yet. This study was to focus on propolis Tetragonula biroi extracts and leads us to isolate active compounds for antioxidant, anti-inflammatory, and anti-acne. We used methanol to obtain the extract from this propolis and assayed it with antioxidants, anti-inflammation, and anti-acne. The extract showed strong activity in antioxidants by DPPH radical scavenging activity (82.31% in 6.25 μg/ml). Via a column chromatography and Reveleris PREP purification system, we isolated 3'-O-methyldiplacone, nymphaeol A, and 5,7,3',4'-tetrahydroxy-6-geranyl flavonol. These compounds showed potential biological activity with IC50 for antioxidant 6.33, 15.49, 17.32 μM; and antiinflammatory 121.54, 121.20, 117.31 μM. The isolated compounds showed anti-acne properties with properties 0.00, 14.11, and 13.78 mm for the inhibition zone (at a concentration of 1 μg/well), respectively. The results indicated that the propolis extract of Tetragonula biroi has the potential to be developed as a cosmetic agent; however, further work needs to be done to clarify its application.
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Affiliation(s)
- Enos Tangke Arung
- Laboratory of Forest Product Chemistry, Faculty of Forestry, Mulawarman University, Samarinda, Indonesia; Research Center for Medicine and Cosmetic from Tropical Rainforest Resources, Mulawarman University, Samarinda, Indonesia; Research Collaboration Center for Biomass-Based Nano Cosmetics, in Collaboration with Mulawarman University and BRIN, Samarinda, East Kalimantan 75119, Indonesia.
| | - Syafrizal
- Mathematics and Science Faculty, Mulawarman University, Samarinda, Indonesia
| | - Irawan Wijaya Kusuma
- Laboratory of Forest Product Chemistry, Faculty of Forestry, Mulawarman University, Samarinda, Indonesia; Research Center for Medicine and Cosmetic from Tropical Rainforest Resources, Mulawarman University, Samarinda, Indonesia
| | - Swandari Paramita
- Research Center for Medicine and Cosmetic from Tropical Rainforest Resources, Mulawarman University, Samarinda, Indonesia; Faculty of Medicine, Mulawarman University, Samarinda, Indonesia
| | - Yhiya Amen
- Department of Pharmacognosy, Faculty of Pharmacy, Mansoura University, Mansoura 35516, Egypt
| | - Yong-Ung Kim
- Department of Pharmaceutical Engineering, Daegu Haany University, Gyeongsan, South Korea
| | - Netty Maria Naibaho
- Department of Plantation Processing Technology, State Agricultural Polytechnic of Samarinda, Jl. Samratulangi PO Box 75131, Samarinda, Indonesia
| | - Rico Ramadhan
- Division for Exploration and Synthesis of Bioactive Compounds, CoE-University Research Center for Bio-Molecule Engineering, Universitas Airlangga, Surabaya 60115, Indonesia; Department of Chemistry, Faculty of Science and Technology, Universitas Airlangga, Surabaya 60115, Indonesia
| | - Harits Atika Ariyanta
- Research Center for Biomass and Bioproducts, National Research and Innovation Agency, Bogor 16911, Indonesia; Research Collaboration Center for Biomass-Based Nano Cosmetics, in Collaboration with Mulawarman University and BRIN, Samarinda, East Kalimantan 75119, Indonesia; Department of Pharmacy, University of Gunadarma, Depok, Indonesia
| | - Widya Fatriasari
- Research Center for Biomass and Bioproducts, National Research and Innovation Agency, Bogor 16911, Indonesia; Research Collaboration Center for Biomass-Based Nano Cosmetics, in Collaboration with Mulawarman University and BRIN, Samarinda, East Kalimantan 75119, Indonesia
| | - Kuniyoshi Shimizu
- Department of Agro-Environmental Sciences, Faculty of Agriculture, Kyushu University, Fukuoka, Japan; Kyushu University Institute for Asian and Oceanian Studies, Fukuoka, Japan.
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24
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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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25
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Fermented Cosmetics and Metabolites of Skin Microbiota—A New Approach to Skin Health. FERMENTATION-BASEL 2022. [DOI: 10.3390/fermentation8120703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The skin covers our entire body and is said to be the “largest organ of the human body”. It has many health-maintaining functions, such as protecting the body from ultraviolet rays and dryness and maintaining body temperature through energy metabolism. However, the number of patients suffering from skin diseases, including atopic dermatitis, is increasing due to strong irritation of the skin caused by detergents that are spread by the development of the chemical industry. The skin is inhabited by about 102–107 cells/cm2 and 1000 species of commensal bacteria, fungi, viruses, and other microorganisms. In particular, metabolites such as fatty acids and glycerol released by indigenous skin bacteria have been reported to have functional properties for the health of the skin. Therefore, skin-domesticating bacteria and the metabolites derived from those bacteria are used in many skincare product ingredients and function as probiotic cosmetics. Japanese traditional fermented stuff, used as foods in Japan for over 1300 years, are now being applied as fermented cosmetics. Fermented cosmetics are expected to have multifaceted health functionality and continue to grow as products in the natural skincare product market. In this review, we consider approaches to skin health using fermented cosmetics and modulation of skin microflora metabolites.
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26
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Hollingshead N, Hodax JK, Boos MD. Management of acne in transgender and gender diverse youth Part 2: Unique considerations and strategies in medical treatment. Pediatr Dermatol 2022; 39:870-875. [PMID: 35973559 DOI: 10.1111/pde.15114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 07/31/2022] [Indexed: 11/28/2022]
Abstract
Acne vulgaris is among the most common skin disorders afflicting adolescents worldwide, and though well-established guidelines of care exist for acne management, these guidelines do not uniformly consider or address the unique psychosocial and medical needs of transgender and gender diverse (TGD) youth. Part 2 of this two-part review provides guidance on a stepwise approach to the medical treatment of acne in TGD youth, with an emphasis on safety, efficacy, and the delivery of medical care in a culturally humble, thoughtful, and gender-affirming manner.
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Affiliation(s)
| | - Juanita K Hodax
- Division of Endocrinology, Department of Pediatrics, University of Washington School of Medicine and Seattle Children's Hospital, Seattle, Washington, USA
| | - Markus D Boos
- Division of Dermatology, Department of Pediatrics, University of Washington School of Medicine and Seattle Children's Hospital, Seattle, Washington, USA
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27
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Ho HH, Chen CW, Yi TH, Huang YF, Kuo YW, Lin JH, Chen JF, Tsai SY, Chan LP, Liang CH. Novel application of a Co-Fermented postbiotics of TYCA06/AP-32/CP-9/collagen in the improvement of acne vulgaris-A randomized clinical study of efficacy evaluation. J Cosmet Dermatol 2022; 21:6249-6260. [PMID: 35818134 DOI: 10.1111/jocd.15228] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Accepted: 07/07/2022] [Indexed: 12/27/2022]
Abstract
BACKGROUND Acne vulgaris is a chronic inflammatory skin disease. If skin lesions are not treated well in time, they can leave a permanent impact on the appearance and a negative influence on personal confidence. The common therapy for acne symptom includes antibiotics, benzoyl peroxide, and azeleic acid. However, those medications have side effects, and the long-term use should be cautious. Therefore, it is necessary to develop a safe and effective material, which is more suitable for daily use. OBJECTIVE Collagen was selected to co-ferment with three probiotic strains TYCA06/AP-32/CP-9 (TAC) due to its excellent feature on wound healing. The fermented material was added into cosmetic gel and applied on subjects' acne lesions. The antimicrobial activity against Propionibacterium acnes and anti-inflammation effect around lesion area were investigated in a 4-week clinical study. MATERIAL AND METHODS An anti-P. acnes assay, a keratinocytes HaCaT cell-based wound healing assay, and a cytokine assay on thymic stromal lymphopoietin (TSLP) and interleukin (IL)-33 were used to evaluate the function of the fermented material in vitro. The TAC/Collagen formula was further incorporated into a cosmetic gel, and the human clinical trial was carried out by applying this gel on 20 volunteers' face with acne vulgaris. The moisture score, sebum content, inflammation, porphyrins numbers, and brown spot number of whole face were observed and recorded. RESULTS The postbiotics of the TAC/Collagen displayed a good growth inhibition against P. acnes and reduced TSLP and IL-33 inflammation in vitro. This TAC/Collagen formula enhanced the wound healing in HaCaT cell culture. The result of the clinical trial showed the TAC/Collagen gel improved the moisture score and inflammation index of the skin in vivo. In addition, this TAC/Collagen gel also improved the wound healing of acne symptom in volunteers with acne vulgaris. Moreover, this TAC/Collagen gel reduced the number of the porphyrins and brown spots on facial skin. CONCLUSION These postbiotics of TAC/Collagen have beneficial effects on skin health and are able to ameliorate the redness, inflammation, and acne symptom in acne vulgaris patients.
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Affiliation(s)
| | | | | | | | - Yi-Wei Kuo
- Glac Biotech Co., Ltd., Tainan City, Taiwan
| | | | | | | | - Leong-Perng Chan
- Department of Otorhinolaryngology-Head and Neck Surgery, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chia-Hua Liang
- Department of Cosmetic Science and Institute of Cosmetic Science, Chia Nan University of Pharmacy and Science, Tainan, Taiwan
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28
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Abdelhamed FM, Abdeltawab NF, ElRakaiby MT, Shamma RN, Moneib NA. Antibacterial and Anti-Inflammatory Activities of Thymus vulgaris Essential Oil Nanoemulsion on Acne Vulgaris. Microorganisms 2022; 10:microorganisms10091874. [PMID: 36144477 PMCID: PMC9503056 DOI: 10.3390/microorganisms10091874] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 09/02/2022] [Accepted: 09/14/2022] [Indexed: 11/16/2022] Open
Abstract
Antibiotics are frequently used in acne treatment and their prolonged use has led to an emergence of resistance. This study aimed to investigate the use of natural antimicrobials as an alternative therapy. The antimicrobial and anti-inflammatory activities of five commonly used essential oils (EOs) (tea tree, clove, thyme, mentha and basil EOs), and their possible mechanisms of action against Cutibacterium acnes and Staphylococcus epidermidis, were explored. The effect of the most potent EO on membrane permeability was elucidated and its anti-inflammatory action, when formulated as nanoemulsion, was tested in an in vivo acne model. The in vitro studies showed that thyme EO had the most potent antimicrobial and antibiofilm activity, with phenolics and terpenoids as main antimicrobial constituents of EO. Thyme EO affected cell membrane permeability of both bacterial species, evident by the detection of the leakage of intracellular ions and membrane integrity by the leakage of nucleic acids. Morphological alteration in bacterial cells was confirmed by transmission electron microscopy. Thyme EO nanoemulsion led to the suppression of an inflammatory response in acne animal models along with a bacterial load decrease and positive histopathological changes. Collectively, thyme EO nanoemulsion showed potent antimicrobial and anti-inflammatory effects compared to the reference antibiotics, suggesting its effectiveness as a natural alternative in acne treatment.
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Affiliation(s)
- Farah M. Abdelhamed
- Department of Microbiology and Immunology, Faculty of Pharmacy, Cairo University, Cairo 11562, Egypt
- Correspondence: (F.M.A.); (N.F.A.)
| | - Nourtan F. Abdeltawab
- Department of Microbiology and Immunology, Faculty of Pharmacy, Cairo University, Cairo 11562, Egypt
- Correspondence: (F.M.A.); (N.F.A.)
| | - Marwa T. ElRakaiby
- Department of Microbiology and Immunology, Faculty of Pharmacy, Cairo University, Cairo 11562, Egypt
| | - Rehab N. Shamma
- Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Cairo University, Cairo 11562, Egypt
| | - Nayera A. Moneib
- Department of Microbiology and Immunology, Faculty of Pharmacy, Cairo University, Cairo 11562, Egypt
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29
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Rudzińska J, Głąbska D. Influence of Selected Food Product Groups Consumption Frequency on Acne-Related Quality of Life in a National Sample of Polish Female Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11670. [PMID: 36141942 PMCID: PMC9517132 DOI: 10.3390/ijerph191811670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 09/10/2022] [Accepted: 09/14/2022] [Indexed: 06/16/2023]
Abstract
Acne vulgaris affects over 80% of adolescents, mainly female ones, and may reduce their general quality of life, so its prevention and treatment are becoming necessary, while among the options for acne management, the potential influence of diet is indicated. The aim of the study was to assess the influence of selected food product groups consumption frequency on acne-related quality of life in a national sample of Polish female adolescents. The studied population of 1370 Polish female adolescents was gathered using random quota sampling of secondary schools representative of the whole country. The acne-related quality of life was assessed using the Acne Quality of Life (AQoL) Scale with the calculated Social Quality of Life (SOCQOL) Score, as well as the Acne Disability Questionnaire (ADQ) with the calculated Cardiff Acne Disability Index (CADI). The acne-related food product groups' consumption frequency was assessed using the Acne-specific Food Frequency Questionnaire (Acne-FFQ). There were no differences in food product consumption between subgroups stratified by the acne-related quality of life (p > 0.05), and there was no correlation between food product consumption and the results of the SOCQOL Score (p > 0.05). For the CADI, positive correlations were indicated for fast foods (p = 0.0450; R = 0.0688), salty snacks (p = 0.0342; R = 0.0727), and chocolate confectionary (p = 0.0147; R = 0.0837), while a negative correlation was indicated for dairy beverages other than milk (p = 0.0414; R = -0.0701). In the studied group of Polish female adolescents, fast foods, salty snacks, and chocolate confectionary were indicated as potential acne-promoting factors, while dairy beverages other than milk were indicated as a potential acne-protective factor.
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Affiliation(s)
| | - Dominika Głąbska
- Department of Dietetics, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (WULS-SGGW), 159C Nowoursynowska Street, 02-776 Warsaw, Poland
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30
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Novel topical drug delivery systems in acne management: Molecular mechanisms and role of targeted delivery systems for better therapeutic outcomes. J Drug Deliv Sci Technol 2022. [DOI: 10.1016/j.jddst.2022.103595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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31
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Li X, Luo S, Chen X, Li S, Hao L, Yang D. Adipose-derived stem cells attenuate acne-related inflammation via suppression of NLRP3 inflammasome. Stem Cell Res Ther 2022; 13:334. [PMID: 35871079 PMCID: PMC9308350 DOI: 10.1186/s13287-022-03007-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 12/02/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Acne is a chronic facial disease caused by Propionibacterium acnes, which proliferates within sebum-blocked skin follicles and increases inflammatory cytokine production. Several therapeutic drugs and products have been proposed to treat acne, yet no single treatment that ensures long-term treatment efficacy for all patients is available. Here, we explored the use of facial autologous fat transplant of adipose-derived stem cells (ADSCs) to dramatically reduce acne lesions. METHODS THP-1 cells were treated with active P. acnes for 24 h at different multiplicities of infection, and alterations in inflammatory factors were detected. To study the effect of THP-1 on inflammasome-related proteins, we first co-cultured ADSCs with THP-1 cells treated with P. acnes and evaluated the levels of these proteins in the supernatant. Further, an acne mouse model injected with ADSCs was used to assess inflammatory changes. RESULTS Propionibacterium acnes-mediated stimulation of THP-1 cells had a direct correlation with the expression of active caspase-1 and interleukin (IL)-1β in an infection-dependent manner. ADSCs significantly reduced the production of IL-1β induced by P. acnes stimulation through the reactive oxygen species (ROS)/Nod-like receptor family pyrin domain-containing 3 (NLRP3)/caspase-1 pathway. The results showed that ADSCs inhibit the skin inflammation induced by P. acnes by blocking the NLRP3 inflammasome via reducing the secretion of IL-1β in vivo. CONCLUSIONS Our findings suggest that ADSCs can alter IL-1β secretion by restricting the production of mitochondria ROS, thereby inhibiting the NLRP3/caspase-1 pathway in P. acnes-induced inflammatory responses. This study indicates that anti-acne therapy can potentially be developed by targeting the NLRP3 inflammasome.
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Affiliation(s)
- Xiaoxi Li
- The 1st Affiliated Hospital of Harbin Medical University, No. 23, YouZheng Rd, NanGang Dist, Harbin, Heilongjiang, China
| | - Sai Luo
- The 1st Affiliated Hospital of Harbin Medical University, No. 23, YouZheng Rd, NanGang Dist, Harbin, Heilongjiang, China
| | - Xinyao Chen
- The 1st Affiliated Hospital of Harbin Medical University, No. 23, YouZheng Rd, NanGang Dist, Harbin, Heilongjiang, China
| | - Shasha Li
- The 1st Affiliated Hospital of Harbin Medical University, No. 23, YouZheng Rd, NanGang Dist, Harbin, Heilongjiang, China
| | - Lijun Hao
- The 1st Affiliated Hospital of Harbin Medical University, No. 23, YouZheng Rd, NanGang Dist, Harbin, Heilongjiang, China.
| | - Dan Yang
- Harbin Medical University, No. 157, BaoJian Rd, NanGang Dist, Harbin, Heilongjiang, China.
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Comparative Analysis of Chemical Composition andAntibacterial and Anti-Inflammatory Activities of theEssential Oils from Chrysanthemum morifolium ofDifferent Flowering Stages and Different Parts. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:5954963. [PMID: 35707466 PMCID: PMC9192287 DOI: 10.1155/2022/5954963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 05/17/2022] [Indexed: 11/22/2022]
Abstract
The inflorescence of Chrysanthemum morifolium Ramat., a well-known traditional Chinese herb, has been proved to have a certain inhibitory effect on some bacteria; however, its main components and acne bacteria inhibition effect remain to be elucidated. In this study, GC-MS was used to analyze the components of different flowering stages and different parts and to study the inhibitory effects of six essential oils on S. aureus and P. acnes and their alleviating effects on THP-1 cell inflammation. GC-MS combined with relative retention index method analyzed results stated that the 5 samples of C. morifolium to detect the 124 kinds of volatile components, including (E)-tibetin spiroether, are first detected in the volatile oil of the C. morifolium, and the content of (E)-tibetin spiroether is higher in immature inflorescence of C. morifolium and decreases as it extends its flowering period. Furthermore, the research results of inhibiting common acne-causing bacteria showed that the bacteriostatic effect of essential oils from JH at different flowering stages was better than that from JM and TJ, while the bacteriostatic effect of essential oil from stem and leaf of C. morifolium (SLC) at different parts was better than the roots of C. morifolium (RC). Finally, it was proved that the essential oil from SLC and C. morifolium could alleviate the inflammation of THP-1 cells induced by P. acnes. In conclusion, the antibacterial and anti-inflammatory effects of C. morifolium essential oil may be related to heterospiroolefins compounds, and the antibacterial activity decreases with the prolongation of flowering stage. It was suggested that volatile oil from C. morifolium and SLC could be used as effective components of antibacterial and anti-inflammatory cosmetics.
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33
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Haftek M, Abdayem R, Guyonnet-Debersac P. Skin Minerals: Key Roles of Inorganic Elements in Skin Physiological Functions. Int J Mol Sci 2022; 23:ijms23116267. [PMID: 35682946 PMCID: PMC9181837 DOI: 10.3390/ijms23116267] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 05/31/2022] [Accepted: 06/01/2022] [Indexed: 02/04/2023] Open
Abstract
As odd as it may seem at first glance, minerals, it is what we are all about…or nearly. Although life on Earth is carbon-based, several other elements present in the planet’s crust are involved in and often indispensable for functioning of living organisms. Many ions are essential, and others show supportive and accessory qualities. They are operative in the skin, supporting specific processes related to the particular situation of this organ at the interface with the environment. Skin bioenergetics, redox balance, epidermal barrier function, and dermal remodeling are amongst crucial activities guided by or taking advantage of mineral elements. Skin regenerative processes and skin ageing can be positively impacted by adequate accessibility, distribution, and balance of inorganic ions.
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Affiliation(s)
- Marek Haftek
- CNRS Laboratory of Tissue Biology and Therapeutic Engineering (LBTI), UMR5305 CNRS–University of Lyon1, 69367 Lyon, France
- Correspondence:
| | - Rawad Abdayem
- L’Oréal Research and Innovation, 94550 Chevilly-Larue, France;
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34
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Warner AJ, Hathaway-Schrader JD, Lubker R, Davies C, Novince CM. Tetracyclines and bone: Unclear actions with potentially lasting effects. Bone 2022; 159:116377. [PMID: 35248788 PMCID: PMC9035080 DOI: 10.1016/j.bone.2022.116377] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 02/11/2022] [Accepted: 02/28/2022] [Indexed: 01/11/2023]
Abstract
Tetracyclines are a broad-spectrum class of antibiotics that have unclear actions with potentially lasting effects on bone metabolism. Initially isolated from Streptomyces, tetracycline proved to be an effective treatment for Gram +/- infections. The emergence of resistant bacterial strains commanded the development of later generation agents, including minocycline, doxycycline, tigecycline, sarecycline, omadacycline, and eravacycline. In 1957, it was realized that tetracyclines act as bone fluorochrome labels due to their high affinity for the bone mineral matrix. Over the course of the next decade, researchers discerned that these compounds are retained in the bone matrix at high levels after the termination of antibiotic therapy. Studies during this period provided evidence that tetracyclines could disrupt prenatal and early postnatal skeletal development. Currently, tetracyclines are most commonly prescribed as a long-term systemic therapy for the treatment of acne in healthy adolescents and young adults. Surprisingly, the impact of tetracyclines on physiologic bone modeling/remodeling is largely unknown. This article provides an overview of the pharmacology of tetracycline drugs, summarizes current knowledge about the impact of these agents on skeletal development and homeostasis, and reviews prior work targeting tetracyclines' effects on bone cell physiology. The need for future research to elucidate unclear effects of tetracyclines on the skeleton is addressed, including drug retention/release mechanisms from the bone matrix, signaling mechanisms at bone cells, the impact of newer third generation tetracycline antibiotics, and the role of the gut-bone axis.
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Affiliation(s)
- Amy J Warner
- Department of Oral Health Sciences, College of Dental Medicine, Medical University of South Carolina, Charleston, SC 29425, USA; Department of Stomatology-Division of Periodontics, College of Dental Medicine, Medical University of South Carolina, Charleston, SC 29425, USA; Department of Pediatrics-Division of Endocrinology, College of Medicine, Medical University of South Carolina, Charleston, SC 29425, USA.
| | - Jessica D Hathaway-Schrader
- Department of Oral Health Sciences, College of Dental Medicine, Medical University of South Carolina, Charleston, SC 29425, USA; Department of Stomatology-Division of Periodontics, College of Dental Medicine, Medical University of South Carolina, Charleston, SC 29425, USA; Department of Pediatrics-Division of Endocrinology, College of Medicine, Medical University of South Carolina, Charleston, SC 29425, USA.
| | - Rena Lubker
- Medical University of South Carolina Libraries, Medical University of South Carolina, Charleston, SC 29425, USA; Department of Stomatology-Division of Population Oral Health, College of Dental Medicine, Medical University of South Carolina, Charleston, SC 29425, USA.
| | - Christopher Davies
- Department of Oral Health Sciences, College of Dental Medicine, Medical University of South Carolina, Charleston, SC 29425, USA; Department of Biochemistry & Molecular Biology, College of Medicine, Medical University of South Carolina, Charleston, SC 29425, USA.
| | - Chad M Novince
- Department of Oral Health Sciences, College of Dental Medicine, Medical University of South Carolina, Charleston, SC 29425, USA; Department of Stomatology-Division of Periodontics, College of Dental Medicine, Medical University of South Carolina, Charleston, SC 29425, USA; Department of Pediatrics-Division of Endocrinology, College of Medicine, Medical University of South Carolina, Charleston, SC 29425, USA.
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35
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Borghi-Pangoni FB, Bassi da Silva J, Dos Santos RS, Trevisan AP, Hott FCDC, Gonçalves MC, Kobayashi RK, de Souza MVF, Consolaro MEL, Castro-Hoshino LVD, Baesso ML, Bruschi ML. Thermosensitive gel based on cellulose derivative for topical delivery of propolis in acne treatment. Pharm Dev Technol 2022; 27:490-501. [PMID: 35587564 DOI: 10.1080/10837450.2022.2080221] [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: 10/18/2022]
Abstract
Thermosensitive bioadhesive formulations can display increased retention time, skin permeation, and improve the topical therapy of many drugs. Acne is an inflammatory process triggered by several factors like the proliferation of the bacteria Propionibacterium acnes. Aiming a new alternative treatment with a natural source, propolis displays great potential due to its antibiotic, anti-inflammatory and healing properties. This study describes the development of bioadhesive thermoresponsive platform with cellulose derivatives and poloxamer 407 for propolis skin delivery. Propolis ethanolic extract (PES) was added to the formulations with sodium carboxymethylcellulose (CMC) or hydroxypropyl methylcellulose (HPMC) and poloxamer 407 (Polox). The formulations were characterized as rheology, bioadhesion and mechanical analysis. The selected formulations were investigated as in vitro propolis release, cytotoxicity, ex vivo skin permeation by Fourier Transform Infrared Photoacoustic Spectroscopy, and the activity against P. acnes. Formulations showed suitable sol-gel transition temperature, shear-thinning behavior and texture profile. CMC presence decreased cohesiveness and adhesiveness of formulations. Polox/HPMC/PES system displayed less cytotoxicity, modified propolis release governed by anomalous transport, skin permeation and activity against P. acnes. These results indicate important advantages in the topical treatment of acne and suggest a potential formulation for clinical evaluation.
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Affiliation(s)
- Fernanda Belincanta Borghi-Pangoni
- Laboratory of Research and Development of Drug Delivery Systems, Postgraduate Program in Pharmaceutical Sciences, Department of Pharmacy, State University of Maringa, 87020-900, Maringa, Parana, Brazil
| | - Jéssica Bassi da Silva
- Laboratory of Research and Development of Drug Delivery Systems, Postgraduate Program in Pharmaceutical Sciences, Department of Pharmacy, State University of Maringa, 87020-900, Maringa, Parana, Brazil
| | - Rafaela Said Dos Santos
- Laboratory of Research and Development of Drug Delivery Systems, Postgraduate Program in Pharmaceutical Sciences, Department of Pharmacy, State University of Maringa, 87020-900, Maringa, Parana, Brazil
| | - Ana Paula Trevisan
- Laboratory of Research and Development of Drug Delivery Systems, Postgraduate Program in Pharmaceutical Sciences, Department of Pharmacy, State University of Maringa, 87020-900, Maringa, Parana, Brazil
| | - Francyelle Carolyne de Castro Hott
- Laboratory of Research and Development of Drug Delivery Systems, Postgraduate Program in Pharmaceutical Sciences, Department of Pharmacy, State University of Maringa, 87020-900, Maringa, Parana, Brazil
| | - Marcelly Chue Gonçalves
- Laboratory of basic and applied bacteriology NIP3, Department of Microbiology, Center of Biological Sciences, State University of Londrina, 86057-970, Londrina, Parana, Brazil
| | - Renata KatsukoTakayama Kobayashi
- Laboratory of basic and applied bacteriology NIP3, Department of Microbiology, Center of Biological Sciences, State University of Londrina, 86057-970, Londrina, Parana, Brazil
| | - Maria Vitória Felipe de Souza
- Laboratory of Clinical Cytology, building B09, Department of Clinical Analysis, Center of Health Sciences, State University of Maringa, 87020-900, Maringa, Parana, Brazil
| | - Marcia Edilaine Lopes Consolaro
- Laboratory of Clinical Cytology, building B09, Department of Clinical Analysis, Center of Health Sciences, State University of Maringa, 87020-900, Maringa, Parana, Brazil
| | | | - Mauro Luciano Baesso
- Postgraduate Program in Physics, Department of Physics, State University of Maringa, 87020-900, Maringa, Parana, Brazil
| | - Marcos Luciano Bruschi
- Laboratory of Research and Development of Drug Delivery Systems, Postgraduate Program in Pharmaceutical Sciences, Department of Pharmacy, State University of Maringa, 87020-900, Maringa, Parana, Brazil
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36
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Peyravian N, Deo S, Daunert S, Jimenez JJ. The Anti-Inflammatory Effects of Cannabidiol (CBD) on Acne. J Inflamm Res 2022; 15:2795-2801. [PMID: 35535052 PMCID: PMC9078861 DOI: 10.2147/jir.s355489] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 03/18/2022] [Indexed: 01/21/2023] Open
Affiliation(s)
- Nadia Peyravian
- Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Sapna Deo
- Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Sylvia Daunert
- Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Joaquin J Jimenez
- Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, FL, USA
- Phillip Frost Department of Dermatology & Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
- Correspondence: Joaquin J Jimenez, Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, FL, USA, Tel +1 305 243 6586, Email
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37
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Wu X, Yang Y, Wang Y, Wang H, Zheng Y, Chen J, Xu H. Treatment of refractory acne using selective sebaceous gland electro-thermolysis combined with non-thermal plasma. J COSMET LASER THER 2022; 23:188-194. [PMID: 35388729 DOI: 10.1080/14764172.2022.2050760] [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: 10/18/2022]
Abstract
Acne is one of the most common skin diseases whose disfiguring results may cause psychological problems. Despite of the various choices in the treatment of acne, new therapy with fewer complications and lower relapse rate is still in need. In this study, we aim to evaluate the clinical efficacy of a new therapy using selective sebaceous gland electro-thermolysis and non-thermal plasma (NTP) in refractory acne patients. Treatments were given at a monthly interval for three times. The last visit was set at 3 months after the third treatment. Thirty-six moderate to very severe acne patients were enrolled. All the patients got more than 50% clearance after the third treatment. The excellent response rate was 44% at 1 month after the third treatment and 50% at 3 months after the third treatment. Porphyrin and erythema values were significantly reduced after the third treatment. No irreversible complication was reported. Selective sebaceous gland electro-thermolysis combined with NTP can be a safe and effective new option in the treatment of acne.
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Affiliation(s)
- Xiaojin Wu
- Department of Dermatology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yali Yang
- Department of Dermatology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.,Department of Laser and Aesthetic Medicine, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yutong Wang
- Department of Dermatology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Haoyu Wang
- Department of Dermatology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Ying Zheng
- Department of Dermatology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Jun Chen
- Department of Dermatology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.,Department of Laser and Aesthetic Medicine, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Hui Xu
- Department of Dermatology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.,Department of Laser and Aesthetic Medicine, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
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Mi Aung W, Songkro S, Songkharak S, Kaewnopparat N, Wungsintaweekul J. Preparation, characterization, and antibacterial activity of plaunotol and plaunoi extracts complexed with hydroxypropyl-β-cyclodextrin. Saudi Pharm J 2022; 30:679-692. [PMID: 35812138 PMCID: PMC9257859 DOI: 10.1016/j.jsps.2022.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Accepted: 04/01/2022] [Indexed: 11/03/2022] Open
Abstract
Croton stellatopilosus (Plaunoi) leaves accumulate several diterpenes and possess various pharmacological activities. The present study aimed to prepare, characterize and assess the antibacterial activity of inclusion complexes prepared by mixing plaunotol (PL) or plaunoi extract (PE) with cyclodextrins (CD), including α-CD, β-CD, γ-CD, and hydroxypropyl-β-cyclodextrin (HP-β-CD). The inclusion complexes were characterized using SEM, XRD, DSC, and FT-IR and evaluated for aqueous solubility and thermal stability. The PL and PE lyophilized complexes with HP-β-CD were further evaluated for their antibacterial activity against acne-causing bacteria. The minimum inhibitory concentration (MIC) and the minimum bactericidal concentration (MBC) of PL, PE, and the inclusion complexes evaluated using the agar dilution method revealed that the MIC and MBC values of the inclusion complexes were lower than those of PL or PE alone. Interestingly, the complexes had a synergistic activity with clindamycin after testing with checkerboard assay. The hydrogel containing the inclusion complex and clindamycin were assessed for antibacterial activity using the agar well diffusion method. The results indicated that the hydrogels showed significant inhibition of bacterial growth. In conclusion, the prepared solid dispersion of PL or PE with HP-β-CD could enhance antibacterial activity by increasing the drug solubility. The hydrogels containing PL or PE complex and clindamycin could be considered as a candidate for the treatment of acne vulgaris.
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Ye D, Xue H, Huang S, He S, Li Y, Liu J, Wang Z, Zeng W. A prospective, randomized, split-face study of concomitant administration of low-dose oral isotretinoin with 30% salicylic acid chemical peeling for the treatment of acne vulgaris in Asian population. Int J Dermatol 2022; 61:698-706. [PMID: 35285944 DOI: 10.1111/ijd.16127] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Revised: 11/27/2021] [Accepted: 01/11/2022] [Indexed: 01/09/2023]
Abstract
BACKGROUND Acne vulgaris (AV) is a common dermatosis. For moderate to severe AV, isotretinoin is the first-line treatment. Chemical peeling with supramolecular salicylic acid (SSA) was developed with water solubility and advanced skin penetration properties. In the present study, we investigated the efficacy and safety of oral low-dose isotretinoin combined with 30% SSA chemical peeling. METHODS Thirty-three moderate-to-severe acne patients were enrolled and received oral low-dose (0.2-0.4 mg/kg/d) isotretinoin and were then randomly assigned to receive 30% SSA or not on each side of the face with 2-week intervals for four sessions. Photos, the number of lesions, GAGS score, skin indices (melanin, erythema, pore, and texture), hydration, and transepidermal water loss (TEWL) were assessed at 0, 2, 4, 6, and 10 weeks. Side effects, efficacy, and satisfactory rates were recorded. RESULTS A total of 29 patients completed the study. Oral isotretinoin combined with SSA decreased response time compared to isotretinoin monotherapy, with significantly improved GAGS score, count of lesions, and efficacy (%) at 4-6 weeks. Skin indices of melanin, erythema, pore, and texture evaluated at week 10 were improved as well. Oral isotretinoin with or without SSA was effective by the lesion clearance; only SSA significantly improved the TEWL. All the side effects were temporary and tolerable, and no adverse effects were observed. CONCLUSION Oral low-dose isotretinoin combined with 30% SSA is safe and effective, which advanced the onset of action and improves lesion clearance.
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Affiliation(s)
- Dan Ye
- Department of Dermatology, The Second Affiliated Hospital, Northwest Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Huan Xue
- Department of Dermatology, The Second Affiliated Hospital, Northwest Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Shiliu Huang
- Department of Dermatology, The Second Affiliated Hospital, Northwest Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Shujuan He
- Department of Dermatology, The Second Affiliated Hospital, Northwest Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Youbao Li
- Department of Dermatology, The Second Affiliated Hospital, Northwest Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Jing Liu
- Department of Dermatology, The Second Affiliated Hospital, Northwest Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Zhao Wang
- Department of Dermatology, The Second Affiliated Hospital, Northwest Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Weihui Zeng
- Department of Dermatology, The Second Affiliated Hospital, Northwest Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, China
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40
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Treating Acne in Transgender Persons Receiving Testosterone: A Practical Guide. Am J Clin Dermatol 2022; 23:219-229. [PMID: 35018581 PMCID: PMC8751660 DOI: 10.1007/s40257-021-00665-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/07/2021] [Indexed: 11/13/2022]
Abstract
Transgender persons who undergo masculinizing hormone therapy experience a wide array of dermatologic effects as they initiate and maintain testosterone therapy. Acne is one of the most common adverse effects for many transmasculine patients receiving testosterone. Acne can worsen body image and mental health, with significant impact on quality of life in transgender patients. Specific training and awareness are needed for a clinically and culturally competent encounter while providing care for the transgender patient. This article provides a practical guide for the treatment of testosterone-induced acne in transmasculine patients. Recommendations on creating a welcoming clinical setting, taking a gender-inclusive history, and conducting a patient-centered physical examination relevant to acne care are provided. Assessment of reproductive potential and the appropriate contraceptive methods before prescribing acne treatment with teratogenic potential in transmasculine patients are examined. Interactions between acne treatments with gender-affirming therapies are explored. For patients with severe or treatment-refractory acne, indications, contraindications, and barriers to isotretinoin prescription, such as the US iPLEDGE program, are examined. Multidisciplinary approaches to acne care, involving mental health, reproductive health, gender-affirming hormone therapy and surgeries, are adopted to guide isotretinoin treatment.
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41
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Chen L, Lu L, Tu S, Zhang T, Du X, Chen L, Zhang M, Li L, Lin H. Efficacy and Safety of 5% Glycolic Acid-based Gel Essence in the Treatment of Mild to Moderate Acne. J Cosmet Dermatol 2022; 21:4482-4489. [PMID: 35182003 DOI: 10.1111/jocd.14865] [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: 12/31/2021] [Revised: 02/12/2022] [Accepted: 02/15/2022] [Indexed: 11/28/2022]
Abstract
The efficacy and safety of commercial low-concentration glycolic acid products on acne were evaluated by recruiting volunteers accompanying mild to moderate acne of different ages and genders, which is a clinical practice for acne. We recruited a total of 30 volunteers according to the inclusion criteria, conducting clinical evaluation and skin physiological index testing, VISIA skin analysis, distributing products, and informing the trial method. Clinical testing and assessment will be carried out in weeks 0, 1, 2, and 4. 27 acne volunteers finished the entire trial. After 4 weeks of using low-concentration glycolic acid products, most subjects experienced significant improvement in their skin lesions and the GAGS score. At the same time, the VISIA test showed that the subjects had an obvious amelioration in facial porphyrins, which was statistically significant, and there was a slight improvement in residual spots and erythema. The skin physiological indexes showed that the skin hydration value increased from 236.2 ± 98.05 to 278.2 ± 90.26 after 14 days. At the end of the test, the skin hydration value dropped to 234.6 ± 81.88. Regarding the melanin and erythema, the value decreased in the 4th week significantly. Repeated use of 5% low-concentration glycolic acid improves the appearance and chromaticity of the treatment site. It increases the brightness L* and reduces the redness a*. This study shows that low concentrations of glycolic acids have a good effect on the treatment of mild to moderate acne. It may pay the way to carry out further large-scale clinical research.
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Affiliation(s)
- Linjiao Chen
- Shenzhen Hospital, Beijing University of Chinese Medicine (Longgang), Shenzhen, 518100, P.R.China
| | - Lingling Lu
- Henan University of Chinese Medicine, Zhengzhou, 450000, P.R.China
| | - Shaozhong Tu
- Shenzhen Hospital, Beijing University of Chinese Medicine (Longgang), Shenzhen, 518100, P.R.China
| | - Tao Zhang
- Shenzhen Hospital, Beijing University of Chinese Medicine (Longgang), Shenzhen, 518100, P.R.China
| | - Xianni Du
- Shenzhen Hospital, Beijing University of Chinese Medicine (Longgang), Shenzhen, 518100, P.R.China
| | - Lifen Chen
- Shenzhen Hospital, Beijing University of Chinese Medicine (Longgang), Shenzhen, 518100, P.R.China
| | - Milin Zhang
- Shenzhen Hospital, Beijing University of Chinese Medicine (Longgang), Shenzhen, 518100, P.R.China
| | - Lihao Li
- Shenzhen Hospital, Beijing University of Chinese Medicine (Longgang), Shenzhen, 518100, P.R.China
| | - Huaner Lin
- Shenzhen Hospital, Beijing University of Chinese Medicine (Longgang), Shenzhen, 518100, P.R.China
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42
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Maskne: The Epidemic within the Pandemic: From Diagnosis to Therapy. J Clin Med 2022; 11:jcm11030618. [PMID: 35160071 PMCID: PMC8836723 DOI: 10.3390/jcm11030618] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 01/17/2022] [Accepted: 01/24/2022] [Indexed: 02/04/2023] Open
Abstract
Maskne, a newly coined term deriving from the contraction of mask-related acne, is a form of mechanical acne resulting from continuous textile–skin adherence and friction. Prolonged mask use heats up the face environment, thus modifying skin microbiota and sebum production. Although effective prevalence is unknown, since the pandemic began and the prolonged use of masks was extended to the general population, maskne has been a frequent topic of consultation among dermatologists. This term has been successfully introduced into common language, with more than 200,000 hashtags on social media, where it is also possible to find “home remedies” that can worsen this dermatosis. The aim of this paper is to discuss the pathogenesis, address clinicians on the correct differential diagnoses among facial dermatoses, and move towards the correct therapy.
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43
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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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Kim CK, Kim H, Kim HJ, Cho SB. Antibacterial and anticandidal effects of atmospheric-pressure, non-thermal, nitrogen- and argon-plasma pulses. Dermatol Ther 2021; 35:e15222. [PMID: 34820982 DOI: 10.1111/dth.15222] [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: 10/18/2021] [Revised: 11/12/2021] [Accepted: 11/22/2021] [Indexed: 11/28/2022]
Abstract
Atmospheric-pressure, non-thermal plasma destroys microorganisms by directly reacting with hydrocarbon molecules in the cell wall and/or by damaging the cytoplasmic membrane, proteins, and DNA with charged particles and reactive species. The aim of our study was to evaluate the antibacterial and anticandidal effects of atmospheric-pressure, non-thermal, nitrogen- and argon-plasma pulses on various pathogen preparations. The resultant antibacterial and anticandidal effects were assessed by evaluating percent and log reduction values for pathogen colonies. Nitrogen-plasma pulses emitted at an energy of 1.5 J and argon-plasma pulses generated at 0.5 J elicited remarkable antibacterial effects on Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Staphylococcus aureus, and methicillin-resistant Staphylococcus aureus (MRSA) and anticandidal effects on Candida albicans. Nitrogen-plasma pulses at a pulse count of five elicited remarkable antibacterial effects on Cutibacterium acnes at the energy settings of 1.75, 2.5, and 3 J, but not at 1 J. Meanwhile, argon-plasma pulses showed antibacterial effects on C. acnes at an energy of 0.5 and 0.65 J. Nitrogen- or argon-plasma pulses exert antibacterial and anticandidal effects on bacterial and fungal pathogens.
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Affiliation(s)
- Chang Ki Kim
- Research Institute of Bacterial Resistance, Yonsei University College of Medicine, Seoul, South Korea.,Seoul Clinical Laboratories, Yongin, South Korea
| | - Heesu Kim
- Yonsei New Dermatology and Laser Clinic, Incheon, South Korea
| | | | - Sung Bin Cho
- Yonsei Seran Dermatology and Laser Clinic, Seoul, South Korea
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Todea A, Deganutti C, Spennato M, Asaro F, Zingone G, Milizia T, Gardossi L. Azelaic Acid: A Bio-Based Building Block for Biodegradable Polymers. Polymers (Basel) 2021; 13:4091. [PMID: 34883592 PMCID: PMC8659112 DOI: 10.3390/polym13234091] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 11/05/2021] [Accepted: 11/19/2021] [Indexed: 11/17/2022] Open
Abstract
Azelaic acid is a dicarboxylic acid containing nine C atoms, industrially obtained from oleic acid. Besides its important properties and pharmacological applications, as an individual compound, azelaic acid has proved to be a valuable bio-based monomer for the synthesis of biodegradable and sustainable polymers, plasticizers and lubricants. This review discusses the studies and the state of the art in the field of the production of azelaic acid from oleic acid, the chemical and enzymatic synthesis of bio-based oligo and polyester and their properties, including biodegradability and biocompostability.
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Affiliation(s)
- Anamaria Todea
- Department of Chemical and Pharmaceutical Sciences, University of Trieste, Via L. Giorgieri 1, 34127 Trieste, Italy; (A.T.); (C.D.); (M.S.); (F.A.); (G.Z.)
| | - Caterina Deganutti
- Department of Chemical and Pharmaceutical Sciences, University of Trieste, Via L. Giorgieri 1, 34127 Trieste, Italy; (A.T.); (C.D.); (M.S.); (F.A.); (G.Z.)
| | - Mariachiara Spennato
- Department of Chemical and Pharmaceutical Sciences, University of Trieste, Via L. Giorgieri 1, 34127 Trieste, Italy; (A.T.); (C.D.); (M.S.); (F.A.); (G.Z.)
| | - Fioretta Asaro
- Department of Chemical and Pharmaceutical Sciences, University of Trieste, Via L. Giorgieri 1, 34127 Trieste, Italy; (A.T.); (C.D.); (M.S.); (F.A.); (G.Z.)
| | - Guglielmo Zingone
- Department of Chemical and Pharmaceutical Sciences, University of Trieste, Via L. Giorgieri 1, 34127 Trieste, Italy; (A.T.); (C.D.); (M.S.); (F.A.); (G.Z.)
| | | | - Lucia Gardossi
- Department of Chemical and Pharmaceutical Sciences, University of Trieste, Via L. Giorgieri 1, 34127 Trieste, Italy; (A.T.); (C.D.); (M.S.); (F.A.); (G.Z.)
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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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Ethosomes-based gel formulation of karanjin for treatment of acne vulgaris: in vitro investigations and preclinical assessment. 3 Biotech 2021; 11:456. [PMID: 34631355 DOI: 10.1007/s13205-021-02978-3] [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: 12/20/2020] [Accepted: 08/27/2021] [Indexed: 01/09/2023] Open
Abstract
The aim of the present study was to develop and characterize karanjin-loaded ethosomes-based gel formulation for enhanced topical delivery and effective therapy of skin acne. Karanjin-loaded ethosomes (K-ETH) presented a nanometric size of 140.87 ± 2.35 nm, entrapment of 71.41 ± 2.74% and enhanced permeation with 1.9 times increase in the flux and 2.4 times higher skin deposition compared to the hydro-ethanolic solution of karanjin. The DSC analysis confirmed successful entrapment of the karanjin within the ethosomes. The developed ethosomes were incorporated in the carbopol gel for adequate application on the skin surface. The ethosomal gel (K-EGF) also exhibited greater penetration in the rat skin as revealed by CLSM. The optimized K-EGF formulation was non-irritant to the skin as evident by Draize score test and histopathological examination. The highest zone of inhibition, 30.0 ± 1.52 mm and 36.22 ± 0.57 mm was produced by the K-EGF against Propionibacterium acnes and Staphylococcus epidermidis, respectively, indicating substantial antibacterial properties of the K-EGF. DPPH assay indicated its potent antioxidant effects. Substantial anti-inflammatory effects in the carrageenan-induced edema in the rat paw were evident with inhibition of rat paw edema by 66.66% and 70.37% upon application of K-EGF and standard anti-inflammatory agent, respectively. Anti-acne effects were also evident with K-EGF treatment with significant decrease in number and size of sebaceous gland units in dermis. Overall, the above findings vouch for a therapeutic opportunity to improve topical delivery of karanjin in acne treatment employing ethosomal gels as the promising carrier system. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s13205-021-02978-3.
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AlJasser R, AlAqeely R, AlZahrani A, AlKenani M, AlQahtani S, AlSarhan M, AlOtaibi D, Lambarte R. Antimicrobial Effect of Isotretinoin Therapy on Periodontal Pathogens: A Case-Control Study. Antibiotics (Basel) 2021; 10:1286. [PMID: 34827224 PMCID: PMC8615252 DOI: 10.3390/antibiotics10111286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 10/11/2021] [Accepted: 10/13/2021] [Indexed: 11/16/2022] Open
Abstract
Isotretinoin (INN), a drug used to treat severe acne, has anti-inflammatory and antibacterial properties. INN may affect periodontal pathogenic bacteria, so we aimed to study the effect of INN on intraoral microbial profiles of periodontal disease and healthy periodontium. Our case-control study divided 180 subjects into six groups according to periodontal health status and INN usage as follows: healthy periodontium receiving INN (HINN; n = 30); those with generalized plaque-induced gingivitis receiving INN (GINN; n = 30); and those with stage I generalized periodontitis receiving INN (PINN; n = 30). Subjects not taking INN, were categorized in the same manner: those with a healthy periodontium (HC; n = 30); those with generalized plaque-induced gingivitis (GC; n = 30); and those with generalized periodontitis stage I (PC; n = 30). Plaque samples were collected to determine the prevalence of four periodontal pathogens (Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, and Fusobacterium nucleatum) in each study group using real-time polymerase chain reaction. Data were analyzed using IBM SPSS software, and multiple regression analysis was performed for each parameter tested in each group at a significance level of 0.05. All INN groups showed significantly lower levels of P. gingivalis, T. forsythia, and T. denticola and higher levels of F. nucleatum (p < 0.001). INN had an observable antimicrobial effect on the periodontal pathogen count in patients with plaque-induced gingivitis and chronic periodontitis. INN may have a potential additive antimicrobial value in the treatment of periodontal disease.
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Affiliation(s)
- Reham AlJasser
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia; (R.A.); (M.A.); (D.A.)
| | - Razan AlAqeely
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia; (R.A.); (M.A.); (D.A.)
| | | | - Manal AlKenani
- Saudi Board of Periodontics, Riyadh 11545, Saudi Arabia; (M.A.); (S.A.)
| | - Sadeem AlQahtani
- Saudi Board of Periodontics, Riyadh 11545, Saudi Arabia; (M.A.); (S.A.)
| | - Mohammed AlSarhan
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia; (R.A.); (M.A.); (D.A.)
| | - Dalal AlOtaibi
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia; (R.A.); (M.A.); (D.A.)
| | - Rhodanne Lambarte
- Molecular and Cell Biology Laboratory, Prince Naif Bin AbdulAziz Health Research Center, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia;
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Rokni GR, Mohammadnezhad F, Saeedi M, Shadi S, Sharma A, Sandhu S, Gupta A, Goldust M. Efficacy, tolerability, and safety of montelukast versus finasteride for the treatment of moderate acne in women: A prospective, randomized, single-blinded, active-controlled trial. J Cosmet Dermatol 2021; 20:3580-3585. [PMID: 34648685 DOI: 10.1111/jocd.14462] [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: 07/13/2021] [Revised: 07/23/2021] [Accepted: 07/30/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Acne is a chronic inflammatory skin disease which involves the pilosebaceous unit. Tissue inflammation isone of the crucial mechanisms, amongst others. Of the various cytokines, leukotriene B4 (LT-B4) is the most potentleucocyte chemotactic mediator. Montelukast is an antagonist of the LT-B4 receptor. Finasteride is an antiandrogen whichspecifically inhibits the 5α-reductase enzyme. AIMS This study aimed at comparing the efficacy, tolerability and safety of montelukast versus finasteride in the treatmentof moderate acne in women. PATIENTS/METHOD This randomized, single-blinded, prospective trial over 12 weeks recruited 65 female subjects with moderate acne vulgaris (Global Acne Grading System Scale) for evaluation. One group (n = 30) received oral montelukast (10 mg PO daily), while the second group (n = 25) received oral finasteride (2.5 mg PO daily) in combination with topical clindamycin 2% solution. Lesion count and acne severity were evaluated at time intervals of 0 (baseline), 4, 8, and 12 weeks. Adverse effects of the drugs were noted. RESULTS Both lesion count and severity of acne decreased significantly after treatment in both the groups as compared to the baseline. The acne severity score reached from 33.93 in time zero to 20.6 in the 12th week and 35.71 at baseline to 16.43 at the end of treatment in the Montelukast and Finasteride groups, respectively. Side effects were noted in 3 patients and 2 patients in the monteleukast and finasteride group, respectively, which were transient and non-serious in nature proving the satisfactory tolerability and safety of these two drugs. CONCLUSION The results of this study show that both montelukast and finasteride have good efficacy in the treatment of acne. Finasteride has more efficacy than montelukast for treating moderate acne in normo-androgenic women.
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Affiliation(s)
- Ghasem Rahmatpour Rokni
- Department of Dermatology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Farzaneh Mohammadnezhad
- Department of Dermatology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Majid Saeedi
- Department of Pharmaceutics, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran
| | - Shiva Shadi
- Department of Dermatology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Aseem Sharma
- Dermatology Unit, Skin Saga Centre for Dermatology, Mumbai, India
| | | | | | - Mohamad Goldust
- Department of Dermatology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
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Noaimi A, Al-Saadi SR. Treatment of Acne Vulgaris by Topical Spironolactone Solution Compared With Clindamycin Solution. Cureus 2021; 13:e17606. [PMID: 34646657 PMCID: PMC8483163 DOI: 10.7759/cureus.17606] [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] [Accepted: 08/31/2021] [Indexed: 01/14/2023] Open
Abstract
Background: Acne vulgaris is a common skin problem that is encountered in daily clinical work, affecting mostly the adolescent and young adult age group. Many topical therapies have been used in the treatment of mild to moderate types of acne vulgaris. However, none of these modalities is uniformly effective; furthermore, acne vulgaris is also associated with relapse and many topical side effects. Objective: To compare the effectiveness and side effects of topical 2% spironolactone solution and 1.5% clindamycin solution in the treatment of mild to moderate acne vulgaris. Material and methods: This was a single-blinded therapeutic clinical comparative study conducted at the Dermatology Center at Medical City in Baghdad, Iraq, from April 2019 to March 2020. Sixty-eight patients with mild to moderate acne vulgaris on the face were included. All sociodemographic data related to the disease were recorded for each patient. Patients were divided into two groups according to the type of therapy: group A (35 patients) used 2% spironolactone solution and group B(33 patients) used 1.5% clindamycin solution. All cases in both groups were instructed to use the solutions twice a day for 12 weeks in the same manner. Patients were seen every two weeks to evaluate the response to therapy and to report any topical side effects; then, follow-up was carried out for one month after cessation of therapy to evaluate relapse. Results: Spironolactone solution significantly decreased comedone count (p < 0.0001), while the clindamycin solution had no effect on comedones. Although spironolactone was slower than clindamycin solution in reaching the maximum therapeutic effect, the reduction in papules was comparable to that of clindamycin, but it exhibited a greater reduction of pustules (p > 0.05) and the Acne Severity Index (ASI; p > 0.05). Patients in the spironolactone group were more satisfied than those in the clindamycin group. Only minimal local side effects were reported in both groups that did not require cessation of therapy. Conclusion: Spironolactone solution is an effective and well-tolerated topical treatment for mild to moderate acne vulgaris and is superior to clindamycin solution.
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Affiliation(s)
- Adil Noaimi
- Department of Dermatology and Venereology, College of Medicine, Baghdad University, Baghdad, IRQ
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