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Chernyshov PV, Sampogna F, Raimondi G, Zouboulis CC, Boffa MJ, Marron SE, Manolache L, Pustišek N, Bettoli V, Koumaki D, Bewley AP, Dreno B, Tomas-Aragones L. Development of the acne-specific quality of life questionnaire Quality of Life Relevance-Acne. JAAD Int 2024; 16:9-17. [PMID: 38764481 PMCID: PMC11098948 DOI: 10.1016/j.jdin.2024.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/20/2024] [Indexed: 05/21/2024] Open
Abstract
Background Participating members of the European Academy of Dermatology and Venereology Task Forces on quality of life (QoL) and Patient Oriented Outcomes and Acne, Rosacea and Hidradenitis Suppurativa initiated data collection in 9 European countries and formed the list of the most relevant topics for acne patients. Objective The aim of this study was to develop a new acne-specific health-related QoL instrument based on the list of the most relevant topics for acne patients. Methods After assessment by acne patients (n = 715) on how clear and relevant the items in the prototype questionnaire were, a group of experts on acne and QoL performed discussions on items inclusion, which resulted in a series of 21 items. Then another group of acne patients (n = 1502) filled in the new version of the instrument. A factor analysis was conducted on the 21-item version. Results Three-factor model with 19 items indicated a satisfactory fit. The three dimensions were called: Socioemotional; Symptoms; Stigma and Suicidal thoughts. Limitations Included patients and experts may not fully represent acne patients and health care professionals worldwide. Conclusion A final 19-item version of the Quality of Life Relevance-Acne was developed.
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Affiliation(s)
- Pavel V. Chernyshov
- Department of Dermatology and Venereology, National Medical University, Kiev, Ukraine
| | - Francesca Sampogna
- Clinical Epidemiology Unit, Istituto Dermopatico dell'Immacolata IDI-IRCCS, Rome, Italy
| | - Giulia Raimondi
- Clinical Epidemiology Unit, Istituto Dermopatico dell'Immacolata IDI-IRCCS, Rome, Italy
- Department of Developmental and Social Psychology, Sapienza University of Rome, Rome, Italy
| | - Christos C. Zouboulis
- Departments of Dermatology, Venereology, Allergology and Immunology, Staedtisches Klinikum Dessau, Brandenburg Medical School Theodor Fontane and Faculty of Health Sciences Brandenburg, Dessau, Germany
| | | | - Servando E. Marron
- Department of Dermatology, University Hospital Miguel Servet, Aragon Psychodermatology Research Group associated to Aragon Health Sciences Institute (IACS), Zaragoza, Spain
| | | | | | - Vincenzo Bettoli
- Section of Dermatology, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Dimitra Koumaki
- Department of Dermatology and Venereology, University Hospital of Heraklion, Heraklion, Greece
| | | | - Brigitte Dreno
- Department of Dermato-Oncology, Nantes Université, Univ Angers, INSERM, Immunology and New Concepts in ImmunoTherapy (INCIT), Nantes, France
| | - Lucia Tomas-Aragones
- Department of Psychology, University of Zaragoza, Aragon Health Sciences Institute (IACS), Zaragoza, Spain
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Akuffo-Addo E, Ramsay K, Mohsen S, Boisvert J, Mukovozov I. Visible Light in the Treatment of Acne Vulgaris. J Cutan Med Surg 2024:12034754241265697. [PMID: 39056372 DOI: 10.1177/12034754241265697] [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: 07/28/2024]
Abstract
Acne vulgaris, a prevalent dermatological disorder, frequently affects individuals' self-perception and general psychosocial functioning. The growing demand for home-based light therapy devices prompted a systematic review to assess the efficacy of visible light in acne treatment. Overall, 35 studies were included, representing 1185 cases of acne vulgaris (mean age: 23.7 years; sex: 63% female). A total of 69% of the included studies were level 2 evidence. Overall, 92% of patients achieved partial remission of their acne lesions using visible light therapy. Among the patients who experienced a partial remission of their acne, 46% experienced a reduction of 0% to 50% in their acne lesions, while 33% and 12% experienced reductions of 51% to 74% and 75% to 99%, respectively. Notably, blue light emerged as the predominant treatment modality in this context, used in around 64% of the cases. A total of 95% of the patients who were treated with blue light experienced a partial clearance of acne lesions; 44% experienced a reduction of 0% to 50% in their acne lesions, while 42% and 9% experienced reductions of 51% to 74% and 75% to 99%, respectively. Overall, the average total lesion count improved by 43% at week 4 compared to the baseline. The average number of treatment sessions was 22 (range 1-112 sessions). On average, treated patients responded within a period of 4 weeks. Commonly reported side effects included skin irritation and erythema. This review highlights the potential of visible light therapy in acne treatment. Head-to-head studies are needed to compare the efficacy of visible light compared to existing therapies for the treatment of acne.
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Affiliation(s)
- Edgar Akuffo-Addo
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Kaitlyn Ramsay
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Samiha Mohsen
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Jeannie Boisvert
- Faculty of Arts and Science, University of Toronto, Toronto, ON, Canada
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Kazeminejad A, Hajheydari Z, Taghian SS, Gholizadeh N. Serum zinc, selenium, and vitamin D levels in patients with acne vulgaris: A case-control study. J Cosmet Dermatol 2024. [PMID: 39051440 DOI: 10.1111/jocd.16494] [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: 04/24/2024] [Revised: 07/15/2024] [Accepted: 07/17/2024] [Indexed: 07/27/2024]
Abstract
BACKGROUND Acne vulgaris is a very common inflammatory skin disease that significantly impacts the quality of life of affected individuals. Previous studies have indicated that individuals with acne vulgaris often have low levels of zinc, selenium, and vitamin D. However, these three nutrients have rarely been collectively examined in a single study. The objective of this study was to compare serum levels of zinc, selenium, and vitamin D in patients with acne vulgaris in comparison to a control group. METHODS This case-control study included 100 adult patients with acne vulgaris attending a dermatology clinic, in 2020. A group of 100 patients without acne vulgaris attending the same clinics were evaluated as controls. Participants' sociodemographic characteristics, including age, sex, occupation, alcohol consumption, and tobacco smoking were recorded. In addition, anthropometric indices, such as weight and height, were measured and the body mass index (BMI) was calculated accordingly. Acne severity was determined using Tutakne and Chari's grading system. Serum zinc, selenium, and vitamin D levels were evaluated in peripheral blood samples of all the participants. RESULTS Acne patients and controls were comparable regarding age, sex, weight, height, BMI, occupation, alcohol consumption, and tobacco smoking (p > 0.05). Serum zinc, selenium, and vitamin D levels were all significantly lower in acne patients than in controls (p < 0.001). Furthermore, the frequency of abnormal zinc and vitamin D levels was significantly higher in acne patients (p = 0.002 and p = 0.001, respectively), but there was no significant difference between the two groups regarding abnormal serum selenium levels (p = 0.228). Also, serum zinc, selenium, and vitamin D levels lower levels in patients with grade 4 acne compared to other disease severity grades (p < 0.001). CONCLUSIONS Patients with acne vulgaris have lower levels of serum zinc, selenium, and vitamin D compared to the control group. Additionally, there is a correlation between the severity of the disease and lower levels of these nutrients.
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Affiliation(s)
- Armaghan Kazeminejad
- Department of Dermatology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Zohreh Hajheydari
- Department of Dermatology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Seyed Shokoufe Taghian
- Student Research Committee, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Nasim Gholizadeh
- Department of Dermatology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
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Yoshida M, Hayashi S, Haraguchi T, Ito M, Hatanaka Y, Yoshii M, Tatsuoka H, Tanaka S, Nagao T. Antimicrobial Activity of Positively Charged Oligopeptides with Theoretical High α-Helix Content against Cutibacterium acnes. Int J Mol Sci 2024; 25:7445. [PMID: 39000551 PMCID: PMC11242407 DOI: 10.3390/ijms25137445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2024] [Revised: 07/01/2024] [Accepted: 07/04/2024] [Indexed: 07/16/2024] Open
Abstract
Cutibacterium acnes is abundant and commonly exists as a superficial bacteria on human skin. Recently, the resistance of C. acnes to antimicrobial agents has become a serious concern, necessitating the development of alternative pharmaceutical products with antimicrobial activity against C. acnes. To address this need, we evaluated the antimicrobial activity of CKR-13-a mutant oligopeptide of FK-13 with increased net charge and theoretical α-helical content-against C. acnes in modified Gifu Anaerobic Medium broth by determining the minimum inhibitory concentration (MIC). CKR-13 exerted greater antimicrobial activity against C. acnes than FK-13 in the broth at pH 7.0. The antimicrobial activity of CKR-13 with RXM against C. albicans was pH-dependent. The ionization of CKR-13 and pH-dependent growth delay of C. albicans was suggested to be associated with the increase in CKR-13 antimicrobial activity.
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Affiliation(s)
- Miyako Yoshida
- Department of Clinical Pharmaceutics, Faculty of Pharmaceutical Sciences, Mukogawa Women’s University, 11-68 Koshien 9-Bancho, Nishinomiya City 663-8179, Hyogo, Japan; (S.H.); (T.H.); (M.I.)
| | - Saki Hayashi
- Department of Clinical Pharmaceutics, Faculty of Pharmaceutical Sciences, Mukogawa Women’s University, 11-68 Koshien 9-Bancho, Nishinomiya City 663-8179, Hyogo, Japan; (S.H.); (T.H.); (M.I.)
| | - Tamami Haraguchi
- Department of Clinical Pharmaceutics, Faculty of Pharmaceutical Sciences, Mukogawa Women’s University, 11-68 Koshien 9-Bancho, Nishinomiya City 663-8179, Hyogo, Japan; (S.H.); (T.H.); (M.I.)
| | - Momoka Ito
- Department of Clinical Pharmaceutics, Faculty of Pharmaceutical Sciences, Mukogawa Women’s University, 11-68 Koshien 9-Bancho, Nishinomiya City 663-8179, Hyogo, Japan; (S.H.); (T.H.); (M.I.)
| | - Yoshiro Hatanaka
- Osaka Research Institute of Industrial Science and Technology, 1-6-50 Morinomiya, Joto-ku, Osaka City 536-8553, Osaka, Japan; (Y.H.); (M.Y.); (H.T.); (S.T.); (T.N.)
| | - Miki Yoshii
- Osaka Research Institute of Industrial Science and Technology, 1-6-50 Morinomiya, Joto-ku, Osaka City 536-8553, Osaka, Japan; (Y.H.); (M.Y.); (H.T.); (S.T.); (T.N.)
| | - Hiroaki Tatsuoka
- Osaka Research Institute of Industrial Science and Technology, 1-6-50 Morinomiya, Joto-ku, Osaka City 536-8553, Osaka, Japan; (Y.H.); (M.Y.); (H.T.); (S.T.); (T.N.)
| | - Shigemitsu Tanaka
- Osaka Research Institute of Industrial Science and Technology, 1-6-50 Morinomiya, Joto-ku, Osaka City 536-8553, Osaka, Japan; (Y.H.); (M.Y.); (H.T.); (S.T.); (T.N.)
| | - Toshihiro Nagao
- Osaka Research Institute of Industrial Science and Technology, 1-6-50 Morinomiya, Joto-ku, Osaka City 536-8553, Osaka, Japan; (Y.H.); (M.Y.); (H.T.); (S.T.); (T.N.)
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Boos MD, Ryan ME, Milliren C, Golub S, Maslyanskaya S, Escovedo M, DiVasta A, Pitts S. Relationship between long-acting reversible contraception and acne in a cohort of adolescents and young adults. Pediatr Dermatol 2024; 41:628-634. [PMID: 38444121 DOI: 10.1111/pde.15578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 02/17/2024] [Indexed: 03/07/2024]
Abstract
BACKGROUND The use of progestin-only long-acting reversible contraception (LARC) may be a risk factor for acne. Few studies have focused primarily on the effects of hormonal LARC on the development or exacerbation of acne in adolescents and young adults. We sought to understand the incidence and management of acne following hormonal LARC insertion in this adolescent/young adult population. METHODS A secondary data analysis was conducted of prospectively collected quality improvement (QI) data from the Adolescent Medicine LARC Collaborative. Subjects were evaluated by clinicians in adolescent medicine clinics at participating study sites, and acne severity was documented using a standardized recording instrument and scale. Descriptive statistics were reported as frequencies and percentages for categorical variables or mean and standard deviation (SD) for continuous variables. We compared demographic and clinical characteristics by those who had worsening acne, accounting for site inter-correlation using Cochran-Mantel-Haenszel chi-square tests for categorical variables and linear generalized estimating equation (GEE) regression for continuous variables. RESULTS Of 1319 subjects who completed LARC insertion, 28.5% (376/1319) experienced worsening acne following use of progestin-only LARC. Acne was a contributing factor to LARC removal in only 3% (40/1319), and the sole reason for removal in 0.4% (5/1319) of all subjects. As this was a secondary analysis of prospectively collected QI data, limitations of this study include incomplete or inaccurate documentation of acne severity. Moreover, LARC insertions without follow-up/removal visits or with only follow-up/removal within 8 weeks of insertion were excluded from our study, which may also bias results. CONCLUSIONS Adolescents and young adults seeking progestin-only LARC should be counseled about the potential for developing acne or experiencing a worsening of existing acne during LARC use. However, acne was not a common reason for LARC discontinuation.
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Affiliation(s)
- Markus D Boos
- Division of Dermatology, Department of Pediatrics, University of Washington School of Medicine and Seattle Children's Hospital, Seattle, Washington, USA
| | - Morgan E Ryan
- Institutional Centers for Clinical and Translational Research, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Carly Milliren
- Institutional Centers for Clinical and Translational Research, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Sarah Golub
- Division of Adolescent Medicine, Department of Pediatrics, University of Washington School of Medicine and Seattle Children's Hospital, Seattle, Washington, USA
| | - Sofya Maslyanskaya
- Division of Adolescent Medicine, Children's Hospital of Montefiore, New York, New York, USA
| | - Michelle Escovedo
- Division of Adolescent/Young Adult Medicine, Children's Hospital Los Angeles, Los Angeles, California, USA
| | - Amy DiVasta
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Sarah Pitts
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
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Kakpovbia EE, Young T, Milam EC, Qian Y, Yassin S, Nicholson J, Hu J, Troxel AB, Nagler AR. Efficacy of topical treatments for mild-to-moderate acne: A systematic review and meta-analysis of randomized control trials. J Eur Acad Dermatol Venereol 2024. [PMID: 38943431 DOI: 10.1111/jdv.20154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 03/26/2024] [Indexed: 07/01/2024]
Abstract
Acne is a common skin condition, but little data exist on the comparative efficacy of topical acne therapies. We conducted a systematic review and network meta-analysis to evaluate the efficacy of topical therapies for mild-to-moderate acne. Searches in PubMed/MEDLINE, Cochrane CENTRAL via Ovid, Embase via Ovid and Web of Science were conducted on 29 November 2021. Randomized controlled trials examining ≥12 weeks of topical treatments for acne vulgaris in subjects aged 12 and older were included. Main outcomes were absolute or percent change in acne lesion count and treatment success on the Investigator's Global Assessment scale. Thirty-five randomized clinical trials with 33,472 participants comparing nine different topical agents were included. Adapalene-benzoyl peroxide (BPO), clindamycin-BPO and clindamycin-tretinoin demonstrated the greatest reduction in non-inflammatory (ratio of means [RoM] 1.76; 95% CI [1.46; 2.12], RoM 1.70; 95% CI [1.44; 2.02] and RoM 1.87; 95% CI [1.53; 2.30], respectively), inflammatory (RoM 1.56; 95% CI [1.44; 1.70], RoM 1.49; 95% CI [1.39; 1.60] and RoM 1.48; 95% CI [1.36; 1.61], respectively) and total lesion count (ROM 1.67; 95% CI [1.47; 1.90], RoM 1.59; 95% CI [1.42; 1.79] and RoM 1.64; 95% CI [1.42; 1.89], respectively) compared to placebo. All single agents outperformed placebo except tazarotene, which did not significantly outperform placebo for inflammatory and non-inflammatory lesion count reduction. Most combination agents significantly outperformed their individual components in lesion count reduction and global assessment scores, except for clindamycin-tretinoin and clindamycin-BPO, which did not significantly outperform tretinoin (RoM 1.13; 95% CI [0.94; 1.36]) and BPO (RoM = 1.15, 95% CI [0.98; 1.36]), respectively, for non-inflammatory lesion reduction. There was no significant difference amongst most single agents when evaluating lesion count reduction. Combination agents are generally most effective for mild-to-moderate acne; however for non-inflammatory acne, the addition of clindamycin in topical regimens is unnecessary and should be avoided.
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Affiliation(s)
- Efe E Kakpovbia
- The Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, New York, USA
| | - Trevor Young
- Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Emily C Milam
- The Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, New York, USA
| | - Yingzhi Qian
- Department of Population Health, New York University Grossman School of Medicine, New York, New York, USA
| | - Sallie Yassin
- Department of Population Health, New York University Grossman School of Medicine, New York, New York, USA
| | - Joey Nicholson
- NYU Health Sciences Library, NYU Grossman School of Medicine, New York, New York, USA
| | - Jiyuan Hu
- Department of Population Health, New York University Grossman School of Medicine, New York, New York, USA
| | - Andrea B Troxel
- Department of Population Health, New York University Grossman School of Medicine, New York, New York, USA
| | - Arielle R Nagler
- The Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, New York, USA
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Kazan D, Inci BB, Ilchan S, Ozkoca D. Evaluation of Depression, Self-esteem, Anxiety, and Dermatological Quality of Life Index in Adolescent Acne Patients: A Case-Control Study. SISLI ETFAL HASTANESI TIP BULTENI 2024; 58:210-215. [PMID: 39021686 PMCID: PMC11249996 DOI: 10.14744/semb.2024.38268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 02/25/2024] [Accepted: 03/24/2024] [Indexed: 07/20/2024]
Abstract
Objectives Acne vulgaris is a common skin condition that affects adolescents and can have a significant impact on their mental health. In this study, we aimed to evaluate the depression and anxiety symptoms, self-esteem and dermatological quality of life indexes of adolescent patients with acne vulgaris. Methods A total of 160 patients aged between 10 and 19 years with acne vulgaris and 100 healthy controls were included in the study. All participants completed the Reynolds Adolescent Depression Scale (RADS), Beck Adolescent Anxiety Scale (BAAS), and Coopersmith Self-Esteem Survey Scale (CSES), alone and independently. The dermatologists evaluated the acne disease severity of the study group using the Global Acne Grading System, while the Children's Dermatological Quality of Life Index (CDLQI) was evaluated in the same group. Age, gender, and scale results of all participants were recorded on case report forms for further analysis. Results The study group had significantly higher RADS (27.5% vs 12.5%, p=0.003) and BAAS scores (80% vs 64%, p=0.001) than the control group. The percentage of patients with CSES scores below 20 in the study group was significantly higher than the control group (p=0.001). Higher RADS and BAAS scores were associated with higher CDLQI scores (p=0.001, p=0.001, respectively), while higher CSES scores were associated with lower CDLQI scores (p=0.001). Conclusion The study shows that acne vulgaris has a significant impact on the depression, anxiety, and self-esteem levels of adolescent patients. Dermatologists should pay attention to the psychological well-being of patients and provide psychiatric evaluation if necessary.
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Affiliation(s)
- Didem Kazan
- Department of Dermatology and Venerology, Kutahya Health Science University, Evliya Celebi Training and Research Hospital, Kutahya, Türkiye; Department of Dermatology and Venerology, Istanbul Arel University, Istanbul, Türkiye
| | - Burcu Bahar Inci
- Department of Dermatology and Venerology, Kutahya Health Science University, Evliya Celebi Training and Research Hospital, Kutahya, Türkiye
| | - Selin Ilchan
- Department of Dermatology and Venerology, Kocaeli University, Kocaeli, Türkiye
| | - Defne Ozkoca
- Department of Dermatology and Venerology, Zonguldak Ataturk State Hospital, Zonguldak, Türkiye
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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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Ji Y, Li H, Li J, Yang G, Zhang W, Shen Y, Xu B, Liu J, Wen J, Song W. Hair Follicle-Targeted Delivery of Azelaic Acid Micro/Nanocrystals Promote the Treatment of Acne Vulgaris. Int J Nanomedicine 2024; 19:5173-5191. [PMID: 38855733 PMCID: PMC11162231 DOI: 10.2147/ijn.s459788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 05/28/2024] [Indexed: 06/11/2024] Open
Abstract
Purpose Acne vulgaris is a chronic inflammatory skin disorder centered on hair follicles, making hair follicle-targeted delivery of anti-acne drugs a promising option for acne treatment. However, current researches have only focused on the delivering to healthy hair follicles, which are intrinsically different from pathologically clogged hair follicles in acne vulgaris. Patients and Methods Azelaic acid (AZA) micro/nanocrystals with different particle sizes were prepared by wet media milling or high-pressure homogenization. An experiment on AZA micro/nanocrystals delivering to healthy hair follicles was carried out, with and without the use of physical enhancement techniques. More importantly, it innovatively designed an experiment, which could reveal the ability of AZA micro/nanocrystals to penetrate the constructed clogged hair follicles. The anti-inflammatory and antibacterial effects of AZA micro/nanocrystals were evaluated in vitro using a RAW264.7 cell model stimulated by lipopolysaccharide and a Cutibacterium acnes model. Finally, both the anti-acne effects and skin safety of AZA micro/nanocrystals and commercial products were compared in vivo. Results In comparison to commercial products, 200 nm and 500 nm AZA micro/nanocrystals exhibited an increased capacity to target hair follicles. In the combination group of AZA micro/nanocrystals and ultrasound, the ability to penetrate hair follicles was further remarkably enhanced (ER value up to 9.6). However, toward the clogged hair follicles, AZA micro/nanocrystals cannot easily penetrate into by themselves. Only with the help of 1% salicylic acid, AZA micro/nanocrystals had a great potential to penetrate clogged hair follicle. It was also shown that AZA micro/nanocrystals had anti-inflammatory and antibacterial effects by inhibiting pro-inflammatory factors and Cutibacterium acnes. Compared with commercial products, the combination of AZA micro/nanocrystals and ultrasound exhibited an obvious advantage in both skin safety and in vivo anti-acne therapeutic efficacy. Conclusion Hair follicle-targeted delivery of AZA micro/nanocrystals provided a satisfactory alternative in promoting the treatment of acne vulgaris.
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Affiliation(s)
- Yan Ji
- Department of Pharmaceutics, School of Pharmacy, China Pharmaceutical University, Nanjing, People’s Republic of China
| | - Haorong Li
- Department of Pharmaceutics, School of Pharmacy, China Pharmaceutical University, Nanjing, People’s Republic of China
| | - Jiguo Li
- Nanjing Miaobang Meiye Enterprise Management Co, LTD, Nanjing, People’s Republic of China
| | - Guangqiang Yang
- Department of Pharmaceutics, School of Pharmacy, China Pharmaceutical University, Nanjing, People’s Republic of China
| | - Wenli Zhang
- Department of Pharmaceutics, School of Pharmacy, China Pharmaceutical University, Nanjing, People’s Republic of China
| | - Yan Shen
- Department of Pharmaceutics, School of Pharmacy, China Pharmaceutical University, Nanjing, People’s Republic of China
| | - Bohui Xu
- School of Pharmacy, Nantong University, Nantong, 226001, People’s Republic of China
| | - Jianping Liu
- Department of Pharmaceutics, School of Pharmacy, China Pharmaceutical University, Nanjing, People’s Republic of China
| | - Jingyuan Wen
- School of Pharmacy, Faculty of Medical and Health Sciences, the University of Auckland, Auckland, New Zealand
| | - Wenting Song
- Department of Pharmaceutics, School of Pharmacy, China Pharmaceutical University, Nanjing, People’s Republic of China
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Orenay OM, Temel B, Capci AK, Bal ZI, Karaosmanoglu N. Evaluation of isotretinoin effects on depression, sleep apnea and sleep quality. Cutan Ocul Toxicol 2024; 43:129-133. [PMID: 38608451 DOI: 10.1080/15569527.2024.2340435] [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: 02/16/2024] [Accepted: 04/03/2024] [Indexed: 04/14/2024]
Abstract
BACKGROUND Isotretinoin is used to treat severe acne, treatment-resistant moderate acne, and acne that leads to scarring or psychological distress. It has many side effects and is also associated with depression, sleep apnea, and sleep disturbances. OBJECTIVES In this study, we aimed to evaluate the effects of isotretinoin on depression, sleep apnea, and sleep quality. METHODS A total of 42 patients diagnosed with acne and started isotretinoin treatment were included in the study. In order to compare the effects of isotretinoin, patients were asked to fill out a questionnaire containing the Beck Depression Inventory (BDI), the Berlin Questionnaire (BQ), and the Pittsburg Sleep Quality Index (PSQI) at baseline and third months of treatment. RESULTS There was no statistically significant difference in BDI, BQ, and PSQI scores between the 1st and 3rd months of treatment (p = .53, p = .5, p = .35). CONCLUSION This study showed that isotretinoin had no significant effects on depression and sleep quality.
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Affiliation(s)
- Ozge Mine Orenay
- Department of Dermatology, Ministry of Health, Ankara Training and Research Hospital, Ankara, Turkey
| | - Berkay Temel
- Department of Dermatology, Ministry of Health, Ankara Training and Research Hospital, Ankara, Turkey
| | - Arcan Kivanc Capci
- Department of Dermatology, Ministry of Health, Ankara Training and Research Hospital, Ankara, Turkey
| | - Zulal Inci Bal
- Department of Dermatology, Ministry of Health, Ankara Training and Research Hospital, Ankara, Turkey
| | - Nermin Karaosmanoglu
- Department of Dermatology, Ministry of Health, Ankara Training and Research Hospital, Ankara, Turkey
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11
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Gantz HY, Zameza PA, Zaino M, Parraga SP, Duong JQ, Taylor SL, Feldman SR. Validity of facial skin analysis pore detection: A comparative analysis. J Cosmet Dermatol 2024. [PMID: 38822560 DOI: 10.1111/jocd.16412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 05/02/2024] [Accepted: 05/21/2024] [Indexed: 06/03/2024]
Abstract
BACKGROUND Reliable, objective measures to assess facial characteristics would aid in the assessment of many dermatological treatments. Previous work utilized an iOS application-based artificial intelligence (AI) tool compared to the "gold standard" computer-based and a physician assessment on five skin metrics (British Journal of Dermatology, 2013, 169, 474). The AI tool had superior agreement for all skin metrics except pores and subsequently underwent an algorithm update for its pore detection system. AIMS This comparative analysis assessed the performance of the updated AI tool's pore scores across all Fitzpatrick skin phototypes to determine whether the AI tool more accurately represents a dermatologist's assessment of pores. PATIENTS/METHODS Frontal facing photographs in uniform lighting conditions were taken of each participant. Percentile scores were generated by each of the four self-learning models of the updated AI tool. The pore percentile scores generated by the original and updated AI tool were used to rate "worse" pores among participant pairs. These ratings were compared to pore assessments performed by a "gold-standard" device and a board-certified dermatologist. RESULTS Compared to the original pore detection tool and the computer-based program, models A and D had the highest concordance with the physician's pore assessments for Fitzpatrick skin phototypes III-IV and V-VI, respectively. CONCLUSIONS The AI tool's pores detection update was successful in its ability to accurately detect pores on all Fitzpatrick skin types, improving on the performance of the AI prior to the update. Responsibly developed AI tools that can accurately and reliably detect skin metrics across diverse Fitzpatrick skin types can facilitate dermatologic evaluation, individualize treatment, and determine treatment response.
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Affiliation(s)
- Hannah Y Gantz
- Center for Dermatology Research, Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Priscila Arellano Zameza
- Center for Dermatology Research, Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Mallory Zaino
- Center for Dermatology Research, Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Shirley P Parraga
- Center for Dermatology Research, Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Jessica Q Duong
- Center for Dermatology Research, Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Sarah L Taylor
- Center for Dermatology Research, Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Steven R Feldman
- Center for Dermatology Research, Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
- Department of Pathology, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
- Department of Social Sciences & Health Policy, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
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12
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Basendwh MA, Alharbi AA, Bukhamsin SA, Abdulwahab RA, Alaboud SA. The efficacy of Topical Clascoterone versus systematic spironolactone for treatment of acne vulgaris: A systematic review and network meta-analysis. PLoS One 2024; 19:e0298155. [PMID: 38814916 PMCID: PMC11139337 DOI: 10.1371/journal.pone.0298155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 01/18/2024] [Indexed: 06/01/2024] Open
Abstract
OBJECTIVES This study aimed to evaluate the effectiveness of topical clascoterone (TC) compared to oral spironolactone for acne vulgaris treatment. METHODS A computerized search through PubMed/MEDLINE, SCOPUS, and the Cochrane Library was conducted to find relevant papers. We used the "netmeta" and "meta" packages for network meta-analysis (NMA) in RStudio 1.2.5019 (2009-2019 RStudio, Inc.) to conduct all of our statistical tests. RESULTS Seven articles (n = 2,006 patients) were included. The fixed-effect size showed that TC 1% bis in die (BID) showed potential effectiveness in reducing the inflammatory and non-inflammatory lesion count compared to placebo (Standardized mean difference, SMD = -0.27, 95% CI: -0.36 to -0.17) and (SMD = -0.31, 95% CI: -0.41 to -0.22), respectively. The random-effect size showed that TC 1% BID was significantly associated with a 12-week treatment success compared to placebo (Odds ratio, OR = 2.44, 95% CI: 1.12 to 5.30). Spironolactone 200 mg was associated with a significant reduction in total lesion count (SMD = -4.46, 95% CI: -5.60 to -3.32). CONCLUSION TC appears to reduce both inflammatory and non-inflammatory lesion count and may lead to treatment success. Spironolactone at 200 mg showed potential effectiveness in terms of total lesion count reduction. These results suggest that both TC and Spironolactone could be beneficial in treating patients with acne vulgaris.
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13
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Dagenet CB, Gawey L, Davoudi S, Slepian R, Park SE, Tran KA, Hsiao JL, Shi VY. Allergenicity and marketing characteristics of 100 popular over-the-counter acne treatments. Arch Dermatol Res 2024; 316:276. [PMID: 38796573 DOI: 10.1007/s00403-024-03099-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 04/15/2024] [Accepted: 04/26/2024] [Indexed: 05/28/2024]
Affiliation(s)
| | - Lauren Gawey
- University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Sahar Davoudi
- University of Arizona College of Medicine, Tucson, AZ, USA
| | | | - Sarah E Park
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Khiem A Tran
- Department of Dermatology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Jennifer L Hsiao
- Department of Dermatology, University of Southern California, Los Angeles, CA, USA
| | - Vivian Y Shi
- Department of Dermatology, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
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14
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Eguren C, Navarro-Blasco A, Corral-Forteza M, Reolid-Pérez A, Setó-Torrent N, García-Navarro A, Prieto-Merino D, Núñez-Delegido E, Sánchez-Pellicer P, Navarro-López V. A Randomized Clinical Trial to Evaluate the Efficacy of an Oral Probiotic in Acne Vulgaris. Acta Derm Venereol 2024; 104:adv33206. [PMID: 38751177 PMCID: PMC11110809 DOI: 10.2340/actadv.v104.33206] [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: 12/01/2023] [Accepted: 04/11/2024] [Indexed: 05/24/2024] Open
Abstract
The relevance of the gut microbiota in some skin inflammatory diseases, including acne vulgaris, has been emphasized. Probiotics could play a role in the modulation of the microbiota, improving the clinical course of this disease. A 12-week randomized, double-blind, placebo-controlled, clinical trial with patients aged 12 to 30 years with acne vulgaris was conducted. The study product was a capsule composed of the probiotic Lacticaseibacillus rhamnosus (CECT 30031) and the cyanobacterium Arthrospira platensis (BEA_IDA_0074B). Patients with improvement in the Acne Global Severity Scale were 10/34 (29.41%) in the placebo group compared with 20/40 (50%) in the probiotic group (p = 0.03). A significant reduction (p = 0.03) in the number of non-inflammatory acne lesions was observed in the probiotic group (-18.60 [-24.38 to -12.82]) vs the placebo group (-10.54 [-17.43 to -3.66]). Regarding the number of total lesions, a reduction almost reaching statistical significance (p = 0.06) was observed in the probiotic group (-27.94 [-36.35 to -19.53]) compared with the placebo group (-18.31 [-28.21 to -8.41]). In addition, patients with improvement attending the Global Acne Grading System were 7/34 (20.58%) in the placebo group vs 17/40 (42.50%) in the probiotic group (p = 0.02). The number of adverse events was similar in both groups. The probiotic used in this study was effective and well tolerated, and it should be considered for acne vulgaris patients.
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Affiliation(s)
- Cristina Eguren
- Department of Dermatology, Eguren Dermatology and Aesthetics Clinic, Madrid, Spain
| | | | | | | | - Núria Setó-Torrent
- Department of Dermatology, University Hospital Sagrat Cor, Barcelona, Spain
| | | | | | - Eva Núñez-Delegido
- Faculty of Medicine, Catholic University of Murcia (UCAM), Murcia, Spain
| | | | - Vicente Navarro-López
- Faculty of Medicine, Catholic University of Murcia (UCAM), Murcia, Spain; Department of Internal Medicine, University Hospital Vinalopó-Fisabio, Elche, Spain.
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15
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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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16
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Kim HJ, Lee YS, Lee BS, Han CH, Kim SG, Kim CH. NLRP3 inflammasome activation and NETosis positively regulate each other and exacerbate proinflammatory responses: implications of NETosis inhibition for acne skin inflammation treatment. Cell Mol Immunol 2024; 21:466-478. [PMID: 38409251 PMCID: PMC11061142 DOI: 10.1038/s41423-024-01137-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 01/18/2024] [Indexed: 02/28/2024] Open
Abstract
Inflammasomes are multiprotein complexes involved in the host immune response to pathogen infections. Thus, inflammasomes participate in many conditions, such as acne. Recently, it was shown that NETosis, a type of neutrophil cell death, is induced by bacterial infection and is involved in inflammatory diseases such as delayed wound healing in patients with diabetes. However, the relationship between inflammasomes and NETosis in the pathogenesis of inflammatory diseases has not been well studied. In this study, we determined whether NETosis is induced in P. acnes-induced skin inflammation and whether activation of the nucleotide-binding domain, leucine-rich family, and pyrin domain-containing-3 (NLRP3) inflammasome is one of the key factors involved in NETosis induction in a mouse model of acne skin inflammation. We found that NETosis was induced in P. acnes-induced skin inflammation in mice and that inhibition of NETosis ameliorated P. acnes-induced skin inflammation. In addition, our results demonstrated that inhibiting inflammasome activation could suppress NETosis induction in mouse skin. These results indicate that inflammasomes and NETosis can interact with each other to induce P. acnes-induced skin inflammation and suggest that targeting NETosis could be a potential treatment for inflammasome-mediated diseases as well as NETosis-related diseases.
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Affiliation(s)
- Hyo Jeong Kim
- Department of Otolaryngology, School of Medicine, Ajou University, Suwon, Republic of Korea
| | - Yun Sang Lee
- Department of Otolaryngology, School of Medicine, Ajou University, Suwon, Republic of Korea
| | - Bok-Soon Lee
- Department of Otolaryngology, School of Medicine, Ajou University, Suwon, Republic of Korea
| | - Chang-Hak Han
- Department of Otolaryngology, School of Medicine, Ajou University, Suwon, Republic of Korea
- Department of Molecular Science and Technology, Ajou University, Suwon, Republic of Korea
| | - Sang Gyu Kim
- Department of Otolaryngology, School of Medicine, Ajou University, Suwon, Republic of Korea
- Department of Molecular Science and Technology, Ajou University, Suwon, Republic of Korea
| | - Chul-Ho Kim
- Department of Otolaryngology, School of Medicine, Ajou University, Suwon, Republic of Korea.
- Department of Molecular Science and Technology, Ajou University, Suwon, Republic of Korea.
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17
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Reynolds RV, Yeung H, Cheng CE, Cook-Bolden F, Desai SR, Druby KM, Freeman EE, Keri JE, Stein Gold LF, Tan JKL, Tollefson MM, Weiss JS, Wu PA, Zaenglein AL, Han JM, Barbieri JS. Guidelines of care for the management of acne vulgaris. J Am Acad Dermatol 2024; 90:1006.e1-1006.e30. [PMID: 38300170 DOI: 10.1016/j.jaad.2023.12.017] [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: 11/16/2023] [Accepted: 12/05/2023] [Indexed: 02/02/2024]
Abstract
BACKGROUND Acne vulgaris commonly affects adults, adolescents, and preadolescents aged 9 years or older. OBJECTIVE The objective of this study was to provide evidence-based recommendations for the management of acne. METHODS A work group conducted a systematic review and applied the Grading of Recommendations, Assessment, Development, and Evaluation approach for assessing the certainty of evidence and formulating and grading recommendations. RESULTS This guideline presents 18 evidence-based recommendations and 5 good practice statements. Strong recommendations are made for benzoyl peroxide, topical retinoids, topical antibiotics, and oral doxycycline. Oral isotretinoin is strongly recommended for acne that is severe, causing psychosocial burden or scarring, or failing standard oral or topical therapy. Conditional recommendations are made for topical clascoterone, salicylic acid, and azelaic acid, as well as for oral minocycline, sarecycline, combined oral contraceptive pills, and spironolactone. Combining topical therapies with multiple mechanisms of action, limiting systemic antibiotic use, combining systemic antibiotics with topical therapies, and adding intralesional corticosteroid injections for larger acne lesions are recommended as good practice statements. LIMITATIONS Analysis is based on the best available evidence at the time of the systematic review. CONCLUSIONS These guidelines provide evidence-based recommendations for the management of acne vulgaris.
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Affiliation(s)
- Rachel V Reynolds
- Department of Dermatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Howa Yeung
- Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia
| | - Carol E Cheng
- Division of Dermatology, Department of Medicine, University of California Los Angeles, Los Angeles, California
| | - Fran Cook-Bolden
- Department of Dermatology, Weill Cornell Medicine, New York, New York
| | - Seemal R Desai
- Innovative Dermatology, Plano, Texas; Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Kelly M Druby
- Penn State Health Hampden Medical Center, Enola, Pennsylvania
| | - Esther E Freeman
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts
| | - Jonette E Keri
- University of Miami, Miller School of Medicine, Miami, Florida; Miami VA Medical Center, Miami, Florida
| | | | - Jerry K L Tan
- Western University, London, Ontario, Canada; Windsor Clinical Research Inc., Windsor, Ontario, Canada
| | - Megha M Tollefson
- Departments of Dermatology and Pediatrics, Mayo Clinic, Rochester, Minnesota
| | - Jonathan S Weiss
- Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia; Georgia Dermatology Partners, Snellville, Georgia
| | - Peggy A Wu
- Department of Dermatology, University of California Davis, Sacramento, California
| | - Andrea L Zaenglein
- Departments of Dermatology and Pediatrics, Penn State/Hershey Medical Center, Hershey, Pennsylvania
| | - Jung Min Han
- American Academy of Dermatology, Rosemont, Illinois.
| | - John S Barbieri
- Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts
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18
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Shucheng H, Zhou X, Du D, Li J, Yu C, Jiang X. Effects of 15% Azelaic Acid Gel in the Management of Post-Inflammatory Erythema and Post-Inflammatory Hyperpigmentation in Acne Vulgaris. Dermatol Ther (Heidelb) 2024; 14:1293-1314. [PMID: 38734843 PMCID: PMC11116308 DOI: 10.1007/s13555-024-01176-2] [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: 03/16/2024] [Accepted: 04/22/2024] [Indexed: 05/13/2024] Open
Abstract
INTRODUCTION The aim of this study was to assess the efficacy and safety of 15% azelaic acid (AzA) gel in treating acne-induced post-inflammatory erythema (PIE) and post-inflammatory hyperpigmentation (PIH). The effects of 15% AzA gel on acne, skin barrier function, and quality of life were also evaluated. METHODS A total of 72 patients with mild to moderate acne were enrolled in a randomized, double-blind, placebo-controlled trial. Patients were divided into two groups: patients in the AzA group applied 15% AzA gel twice daily for 12 weeks, and those in the placebo group applied AzA-free gel. Clinical evaluations using non-invasive skin detection technologies, including VISIA skin analysis, dermoscopy, and skin physiological function tests, were performed at 0, 4, 8, and 12 weeks. Main outcome measures included the post-acne hyperpigmentation index (PAHPI), melanin, hemoglobin, individual typology angle, water content, transepidermal water loss, and sebum. Investigator Global Assessment) and Dermatology Life Quality Index (DLQI) assessments were conducted at weeks 0 and 12. Adverse reactions were recorded. RESULTS Of the 72 patients at study initiation, 60 completed the trial. At 8 and 12 weeks, patients in the AzA group showed significantly reduced PAHPI for PIE lesions compared to baseline and patients receiving placebo (P < 0.05). Patients in both groups exhibited reduced PIH lesions at weeks 8 and 12 that differed significantly from baseline (P < 0.05). Hemoglobin content decreased significantly in AzA-treated PIE lesions compared to those treated with placebo at week 12 (P < 0.05). Melanin content decreased significantly in AzA-treated PIH lesions at week 12 (P < 0.05). The AzA group showed higher improvement in DLQI (P < 0.05), and greater overall satisfaction (P < 0.05) compared to placebo. CONCLUSION The results indicate that 15% AzA gel effectively improved acne-induced PIE and PIH with minimal adverse reactions, making it a viable clinical application. In the study population, it had no adverse effects on skin barrier function and contributed positively to acne improvement and patient quality of life. TRIAL REGISTRATION This study was registered with the Chinese Clinical Trial Registry (ChiCTR.org.cn) under the identifier ChiCTR2300076959. The registration date was 25 October 2023, retrospectively registered.
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Affiliation(s)
- Huidi Shucheng
- Department of Dermatology and Venereology, West China Hospital, Sichuan University, Chengdu, 610041, China
- Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Xinyu Zhou
- Department of Dermatology and Venereology, West China Hospital, Sichuan University, Chengdu, 610041, China
- Department of Dermatology, Nanbu People's Hospital, Nanchong, 637399, China
| | - Dan Du
- Department of Dermatology and Venereology, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Jiaqi Li
- Department of Dermatology and Venereology, West China Hospital, Sichuan University, Chengdu, 610041, China
- Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Chenyang Yu
- Department of Dermatology and Venereology, West China Hospital, Sichuan University, Chengdu, 610041, China
- Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Xian Jiang
- Department of Dermatology and Venereology, West China Hospital, Sichuan University, Chengdu, 610041, China.
- Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, 610041, China.
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19
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Wang Q, Gan Z, Wang X, Li X, Zhao L, Li D, Xu Z, Mu C, Ge L, Li D. Dissolving Hyaluronic Acid-Based Microneedles to Transdermally Deliver Eugenol Combined with Photothermal Therapy for Acne Vulgaris Treatment. ACS APPLIED MATERIALS & INTERFACES 2024; 16:21595-21609. [PMID: 38635857 DOI: 10.1021/acsami.4c01790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/20/2024]
Abstract
A microneedle transdermal drug delivery system simultaneously avoids systemic toxicity of oral administration and low efficiency of traditional transdermal administration, which is of great significance for acne vulgaris therapy. Herein, eugenol-loaded hyaluronic acid-based dissolving microneedles (E@P-EO-HA MNs) with antibacterial and anti-inflammatory activities are developed for acne vulgaris therapy via eugenol transdermal delivery integrated with photothermal therapy. E@P-EO-HA MNs are pyramid-shaped with a sharp tip and a hollow cavity structure, which possess sufficient mechanical strength to penetrate the stratum corneum of the skin and achieve transdermal delivery, in addition to excellent in vivo biocompatibility. Significantly, E@P-EO-HA MNs show effective photothermal therapy to destroy sebaceous glands and achieve antibacterial activity against deep-seated Propionibacterium acnes (P. acnes) under near-infrared-light irradiation. Moreover, cavity-loaded eugenol is released from rapidly dissolved microneedle bodies to play a sustained antibacterial and anti-inflammatory therapy on the P. acnes infectious wound. E@P-EO-HA MNs based on a synergistic therapeutic strategy combining photothermal therapy and eugenol transdermal administration can significantly alleviate inflammatory response and ultimately facilitate the repair of acne vulgaris. Overall, E@P-EO-HA MNs are expected to be clinically applied as a functional minimally invasive transdermal delivery strategy for superficial skin diseases therapy in skin tissue engineering.
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Affiliation(s)
- Qi Wang
- Department of Pharmaceutics and Bioengineering, School of Chemical Engineering, Sichuan University, Chengdu 610065, P. R. China
| | - Zhiyang Gan
- Department of Pharmaceutics and Bioengineering, School of Chemical Engineering, Sichuan University, Chengdu 610065, P. R. China
| | - Xinxin Wang
- Department of Pharmaceutics and Bioengineering, School of Chemical Engineering, Sichuan University, Chengdu 610065, P. R. China
| | - Xinying Li
- Key Laboratory of General Chemistry of the National Ethnic Affairs Commission, School of Chemistry and Environment, Southwest Minzu University, Chengdu 610041, P. R. China
| | - Lei Zhao
- Department of Periodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, P. R. China
| | - Derong Li
- People's Hospital of Lanshan District, Linyi 27600, P. R. China
| | - Zhilang Xu
- Department of Pharmaceutics and Bioengineering, School of Chemical Engineering, Sichuan University, Chengdu 610065, P. R. China
| | - Changdao Mu
- Department of Pharmaceutics and Bioengineering, School of Chemical Engineering, Sichuan University, Chengdu 610065, P. R. China
| | - Liming Ge
- Department of Pharmaceutics and Bioengineering, School of Chemical Engineering, Sichuan University, Chengdu 610065, P. R. China
| | - Defu Li
- Department of Pharmaceutics and Bioengineering, School of Chemical Engineering, Sichuan University, Chengdu 610065, P. R. China
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20
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Piazza S, Martinelli G, Maranta N, Pozzoli C, Fumagalli M, Nicolaci V, Sonzogni E, Colombo L, Sangiovanni E, Dell’Agli M. Investigation into the Anti-Acne Effects of Castanea sativa Mill Leaf and Its Pure Ellagitannin Castalagin in HaCaT Cells Infected with Cutibacterium acnes. Int J Mol Sci 2024; 25:4764. [PMID: 38731983 PMCID: PMC11084787 DOI: 10.3390/ijms25094764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 04/24/2024] [Accepted: 04/25/2024] [Indexed: 05/13/2024] Open
Abstract
Acne vulgaris is a prevalent skin disorder affecting many young individuals, marked by keratinization, inflammation, seborrhea, and colonization by Cutibacterium acnes (C. acnes). Ellagitannins, known for their antibacterial and anti-inflammatory properties, have not been widely studied for their anti-acne effects. Chestnut (Castanea sativa Mill., C. sativa), a rich ellagitannin source, including castalagin whose acne-related bioactivity was previously unexplored, was investigated in this study. The research assessed the effect of C. sativa leaf extract and castalagin on human keratinocytes (HaCaT) infected with C. acnes, finding that both inhibited IL-8 and IL-6 release at concentrations below 25 μg/mL. The action mechanism was linked to NF-κB inhibition, without AP-1 involvement. Furthermore, the extract displayed anti-biofilm properties and reduced CK-10 expression, indicating a potential role in mitigating inflammation, bacterial colonization, and keratosis. Castalagin's bioactivity mirrored the extract's effects, notably in IL-8 inhibition, NF-κB inhibition, and biofilm formation at low μM levels. Other polyphenols, such as flavonol glycosides identified via LC-MS, might also contribute to the extract's biological activities. This study is the first to explore ellagitannins' potential in treating acne, offering insights for developing chestnut-based anti-acne treatments pending future in vivo studies.
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Affiliation(s)
- Stefano Piazza
- Department of Pharmacological and Biomolecular Sciences “Rodolfo Paoletti”, University of Milan, 20133 Milan, Italy; (S.P.); (G.M.); (N.M.); (C.P.); (M.F.); (V.N.); (E.S.); (M.D.)
| | - Giulia Martinelli
- Department of Pharmacological and Biomolecular Sciences “Rodolfo Paoletti”, University of Milan, 20133 Milan, Italy; (S.P.); (G.M.); (N.M.); (C.P.); (M.F.); (V.N.); (E.S.); (M.D.)
| | - Nicole Maranta
- Department of Pharmacological and Biomolecular Sciences “Rodolfo Paoletti”, University of Milan, 20133 Milan, Italy; (S.P.); (G.M.); (N.M.); (C.P.); (M.F.); (V.N.); (E.S.); (M.D.)
| | - Carola Pozzoli
- Department of Pharmacological and Biomolecular Sciences “Rodolfo Paoletti”, University of Milan, 20133 Milan, Italy; (S.P.); (G.M.); (N.M.); (C.P.); (M.F.); (V.N.); (E.S.); (M.D.)
| | - Marco Fumagalli
- Department of Pharmacological and Biomolecular Sciences “Rodolfo Paoletti”, University of Milan, 20133 Milan, Italy; (S.P.); (G.M.); (N.M.); (C.P.); (M.F.); (V.N.); (E.S.); (M.D.)
| | - Vincenzo Nicolaci
- Department of Pharmacological and Biomolecular Sciences “Rodolfo Paoletti”, University of Milan, 20133 Milan, Italy; (S.P.); (G.M.); (N.M.); (C.P.); (M.F.); (V.N.); (E.S.); (M.D.)
| | - Elisa Sonzogni
- Department of Pharmacological and Biomolecular Sciences “Rodolfo Paoletti”, University of Milan, 20133 Milan, Italy; (S.P.); (G.M.); (N.M.); (C.P.); (M.F.); (V.N.); (E.S.); (M.D.)
| | - Luca Colombo
- Consorzio Castanicoltori di Brinzio, Orino e Castello Cabiaglio, Società Cooperativa Agricola-Varese, 21100 Varese, Italy;
| | - Enrico Sangiovanni
- Department of Pharmacological and Biomolecular Sciences “Rodolfo Paoletti”, University of Milan, 20133 Milan, Italy; (S.P.); (G.M.); (N.M.); (C.P.); (M.F.); (V.N.); (E.S.); (M.D.)
| | - Mario Dell’Agli
- Department of Pharmacological and Biomolecular Sciences “Rodolfo Paoletti”, University of Milan, 20133 Milan, Italy; (S.P.); (G.M.); (N.M.); (C.P.); (M.F.); (V.N.); (E.S.); (M.D.)
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Dias da Rocha MA, Saint Aroman M, Mengeaud V, Carballido F, Doat G, Coutinho A, Bagatin E. Unveiling the Nuances of Adult Female Acne: A Comprehensive Exploration of Epidemiology, Treatment Modalities, Dermocosmetics, and the Menopausal Influence. Int J Womens Health 2024; 16:663-678. [PMID: 38650835 PMCID: PMC11034510 DOI: 10.2147/ijwh.s431523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 04/15/2024] [Indexed: 04/25/2024] Open
Abstract
Previously considered a skin disease exclusively affecting adolescents, characterized by inflammatory and non-inflammatory skin lesions, acne vulgaris is now increasingly observed in adult life, including post-menopause. Today, adult female acne (AFA) is a common chronic inflammatory disease of the pilosebaceous unit, with polymorphic lesions presenting as open or closed comedones, papules, pustules, and even nodules or cysts, often with the presence of sequelae. AFA may persist from adolescence or manifest de novo in adulthood. Its etiology is multifactorial, involving genetic, hormonal, dietary, and environmental factors, yet still incompletely understood. Increased sebum production, keratinocyte hyper-proliferation, inflammation, and reduced diversity of Cutibacterium acnes strains are the underlying disease mechanisms. During menopausal transition, a relative increase in androgen levels occurs, just as estrogens begin to decline, which can manifest itself as acne. Whereas most AFA exhibit few acne lesions with normo-androgenic serum levels, baseline investigations including androgen testing panel enable associated comorbidities to be eliminated, such as polycystic ovarian syndrome, congenital adrenal hyperplasia, or tumors. Another interesting feature is AFA's impact on quality of life, which is greater than in adolescents, being similar to other chronic diseases like asthma. The therapeutic approach to AFA depends on its severity and associated features. This review investigates the intricate facets of AFA, with a specific focus on incidence rates, treatment modalities, and the curious impact of menopause. Utilizing insights from contemporary literature and scientific discussions, this article seeks to advance our understanding of AFA, offering new perspectives to shape clinical practices and improve patient outcomes.
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Affiliation(s)
| | - Markéta Saint Aroman
- Corporate Medical Direction Dermocosmetics Care & Personal Care, Pierre Fabre, Toulouse, France
| | - Valérie Mengeaud
- Laboratoires Dermatologiques Ducray, Pierre Fabre Dermo-Cosmétique, Lavaur, France
| | - Fabienne Carballido
- Laboratoires Dermatologiques A-Derma, Pierre Fabre Dermo-Cosmétique, Lavaur, France
| | - Gautier Doat
- Laboratoires Dermatologiques Avène, Pierre Fabre Dermo-Cosmétique, Lavaur, France
| | - Ana Coutinho
- Laboratorios Pierre Fabre do Brasil LTDA, Rio de Janeiro, Brazil
| | - Edileia Bagatin
- Department of Dermatology, Universidade Federal de São Paulo, São Paulo, Brazil
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22
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Al-Sheyab RF, Alshiyab D, Al-Shagarin RA, Murshidi R, ALSalamat HA, Abu-Rayyan H, Abu-Arja Y, Ghunaim S, Altamimi S. Prescribing Patterns of Isotretinoin for Acne Among Dermatologists in Central Jordan. Cureus 2024; 16:e58840. [PMID: 38784345 PMCID: PMC11114621 DOI: 10.7759/cureus.58840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/23/2024] [Indexed: 05/25/2024] Open
Abstract
INTRODUCTION Prescribing practices among dermatologists play a crucial role in managing acne, particularly concerning medications like isotretinoin. In Jordan's central region, encompassing the Governorates of Amman, Balqa, Zarqa, and Madaba, dermatologists in both public and private sectors encounter diverse cases of acne. Understanding their prescription patterns and awareness regarding isotretinoin usage is essential for optimizing acne treatment outcomes and minimizing potential risks. METHODS This study aimed to evaluate dermatologists' practices in prescribing isotretinoin for acne. It relied on the descriptive analytical approach, with the study population including all dermatologists working in the public and private sectors in the central region of Jordan. Simple random sampling was used to include 147 male and female doctors. An online questionnaire was adopted to collect data from the study sample, which was distributed through social media platforms and messaging platforms such as Facebook, WhatsApp, and Instagram to dermatologists working in the central region. RESULTS In this study of 147 dermatologists, 58 (39.45%) prescribed isotretinoin primarily for severe acne, and 53 (36.06%) prescribed isotretinoin to about 50-100 patients per year, with the initial dosage based on guidelines (n=102, 69.39%). The majority (n=115; 78.23%) refrained from prescribing if liver enzymes were elevated. Pregnancy tests were required by 42 (28.57%) in the first session, while 78 (53.07%) deemed it the patient's responsibility. Common precautions included sunscreen (n=77; 52.38%) and moisturizing cream (n=31, 21.09%). Only six of the dermatologists (4.08%) advised their patients not to use contact lenses, and only 17 (11.57%) prescribed moisturizing eye drops. CONCLUSION This study's findings emphasize how crucial physicians' experience is when it comes to prescribing isotretinoin for severe acne. Continued educational initiatives are imperative to address gaps in patient information and safeguards in order to optimize treatment outcomes and ensure patient safety.
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Affiliation(s)
- Ruba F Al-Sheyab
- Division of Dermatology, Department of Internal Medicine, Faculty of Medicine, Al-Balqa Applied University, Al-Salt, JOR
| | - Diala Alshiyab
- Department of Dermatology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, JOR
| | - Rawan A Al-Shagarin
- Department of Dermatology, Al-Hussein New Salt Hospital, Ministry of Health, Al-Salt, JOR
| | - Rand Murshidi
- Department of Dermatology, School of Medicine, University of Jordan, Amman, JOR
| | - Husam A ALSalamat
- Division of Dermatology, Department of Internal Medicine, Faculty of Medicine, Al-Balqa Applied University, Al-Salt, JOR
- Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, University of Jordan, Amman, JOR
| | - Haya Abu-Rayyan
- Division of Dermatology, Department of Internal Medicine, Faculty of Medicine, Al-Balqa Applied University, Al-Salt, JOR
| | - Yasmine Abu-Arja
- Division of Dermatology, Department of Internal Medicine, Faculty of Medicine, Al-Balqa Applied University, Al-Salt, JOR
| | - Sumaia Ghunaim
- Division of Dermatology, Department of Internal Medicine, Faculty of Medicine, Al-Balqa Applied University, Al-Salt, JOR
| | - Shawkat Altamimi
- Department of Special Surgery, Faculty of Medicine, Al-Balqa Applied University, Al-Salt, JOR
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Marzola E, Bettoli V. Isotretinoin-unresponsive acne as a sign of a congenital disorder: a case of 21-hydroxylase deficiency. Dermatol Reports 2024; 16:9717. [PMID: 38623375 PMCID: PMC11017713 DOI: 10.4081/dr.2023.9717] [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: 03/24/2023] [Accepted: 04/03/2023] [Indexed: 04/17/2024] Open
Abstract
Acne is a multifactorial and common disorder among young people and a frequent reason for dermatology consultation. When moderate-to-severe acne is not responsive to conventional treatments, oral isotretinoin is a very effective solution. However, there are cases in which this treatment fails to produce the expected results. In this case, an 18-year-old male patient with acne, unresponsive to traditional acne therapies, experienced only a partial benefit from oral isotretinoin. Endocrinology consultation and hormonal work-up revealed androgen metabolism anomalies suggestive of a non-classical form of congenital adrenal hyperplasia due to 21-hydroxylase deficiency. In this case report, the authors discuss when to suspect, how to diagnose, and how to manage similar cases.
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Affiliation(s)
| | - Vincenzo Bettoli
- Department of Medical Sciences, Section of Dermatology and Infectious Diseases, University of Ferrara, Italy
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24
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Witkam WCAM, Dal Belo SE, Pourhamidi S, Raynaud E, Moreau M, Aguilar L, Jansen PW, Nijsten TEC, Pardo LM. The epidemiology of acne vulgaris in a multiethnic adolescent population from Rotterdam, the Netherlands: A cross-sectional study. J Am Acad Dermatol 2024; 90:552-560. [PMID: 37967670 DOI: 10.1016/j.jaad.2023.10.062] [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: 06/23/2023] [Revised: 10/09/2023] [Accepted: 10/27/2023] [Indexed: 11/17/2023]
Abstract
BACKGROUND Although acne is a prevalent multifactorial inflammatory skin condition, few studies were performed in multiethnic populations. OBJECTIVES To study the prevalence and determinants of acne in a multiethnic study at the start of puberty. METHODS This cross-sectional study is embedded in Generation R, a population-based prospective study from Rotterdam, the Netherlands. Three-dimensional facial photos at the center visit in 2016-2019 (of ∼13-year-olds) were used to grade acne severity using the Global Evaluation of the Acne Severity (GEA). Analyses were stratified by biological sex and explored through chi-square tests and multivariable ordinal logistic regression. RESULTS A total of 4561 children (51% girls) with a median age of 13.5 (IQR 13.3-13.6) were included. The visible acne prevalence (GEA 2-5) for girls vs boys was 62% vs 45% and moderate-to-severe acne (GEA 3-5) 14% vs 9%. Higher puberty stages (adjusted odds ratios: 1.38 [1.20-1.59] and 2.16 [1.86-2.51] for girls and boys, respectively) and darker skin colors V and VI (adjusted odds ratios: 1.90 [1.17-3.08] and 2.43 [1.67-3.56]) were associated with more severe acne in both sexes, and being overweight in boys (adjusted odds ratio: 1.58 [1.15-2.17]). LIMITATIONS Cross-sectional design. CONCLUSIONS Acne prevalence was high at the age of 13 years and was associated with advanced puberty, darker skin color, and weight status.
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Affiliation(s)
- Willemijn C A M Witkam
- Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands; Department of Dermatology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands. https://twitter.com/WitkamWillemijn
| | | | | | | | - Magali Moreau
- L'Oréal Research and Innovation, Aulnay-sous-Bois, France
| | - Luc Aguilar
- L'Oréal Research and Innovation, Aulnay-sous-Bois, France
| | - Pauline W Jansen
- Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands; Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Center Rotterdam, the Netherlands; Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, the Netherlands
| | - Tamar E C Nijsten
- Department of Dermatology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Luba M Pardo
- Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands; Department of Dermatology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.
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25
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Marino JA, Davis EP, Glynn LM, Sandman CA, Hahn-Holbrook J. Temporal relation between pubertal development and peer victimization in a prospective sample of US adolescents. Aggress Behav 2024; 50:e22139. [PMID: 38348515 PMCID: PMC10983834 DOI: 10.1002/ab.22139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 10/26/2023] [Accepted: 01/21/2024] [Indexed: 02/15/2024]
Abstract
Peer victimization typically peaks in early adolescence, leading researchers to hypothesize that pubertal timing is a meaningful predictor of peer victimization. However, previous methodological approaches have limited our ability to parse out which puberty cues are associated with peer victimization because gonadal and adrenal puberty, two independent processes, have either been conflated or adrenal puberty timing has been ignored. In addition, previous research has overlooked the possibility of reverse causality-that peer victimization might drive pubertal timing, as it has been shown to do in non-human primates. To fill these gaps, we followed 265 adolescents (47% female) prospectively across three-time points (Mage : T1 = 9.6, T2 = 12.0, T3 = 14.4) and measured self-report peer victimization and self- and maternal-report of gonadal and adrenal pubertal development on the Pubertal Development Scale. Multilevel modeling revealed that females who were further along in adrenal puberty at age 9 were more likely to report peer victimization at age 12 (Cohen's d = 0.25, p = .005). The relation between gonadal puberty status and peer victimization was not significant for either sex. In terms of the reverse direction, the relation between early peer victimization and later pubertal development was not significant in either sex. Overall, our findings suggest that adrenal puberty status, but not gonadal puberty status, predicted peer victimization in females, highlighting the need to separate gonadal and adrenal pubertal processes in future studies.
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Affiliation(s)
- Jessica A. Marino
- Department of Psychology, University of California, Merced, California, USA
| | - Elysia Poggi Davis
- Department of Psychology, University of Denver, Denver, Colorado, USA
- Department of Pediatrics, University of California, Irvine, California, USA
| | - Laura M. Glynn
- Department of Psychology, Chapman University, Orange, California, USA
| | - Curt A. Sandman
- Department of Psychiatry and Human Behavior, University of California, Irvine, California, USA
| | - Jennifer Hahn-Holbrook
- Department of Psychology, University of California, Merced, California, USA
- Health Sciences Research Institute, University of California, Merced, California, USA
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Farhan M. The Promising Role of Polyphenols in Skin Disorders. Molecules 2024; 29:865. [PMID: 38398617 PMCID: PMC10893284 DOI: 10.3390/molecules29040865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 02/05/2024] [Accepted: 02/08/2024] [Indexed: 02/25/2024] Open
Abstract
The biochemical characteristics of polyphenols contribute to their numerous advantageous impacts on human health. The existing research suggests that plant phenolics, whether consumed orally or applied directly to the skin, can be beneficial in alleviating symptoms and avoiding the development of many skin disorders. Phenolic compounds, which are both harmless and naturally present, exhibit significant potential in terms of counteracting the effects of skin damage, aging, diseases, wounds, and burns. Moreover, polyphenols play a preventive role and possess the ability to delay the progression of several skin disorders, ranging from small and discomforting to severe and potentially life-threatening ones. This article provides a concise overview of recent research on the potential therapeutic application of polyphenols for skin conditions. It specifically highlights studies that have investigated clinical trials and the use of polyphenol-based nanoformulations for the treatment of different skin ailments.
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Affiliation(s)
- Mohd Farhan
- Department of Chemistry, College of Science, King Faisal University, Al Ahsa 31982, Saudi Arabia;
- Department of Basic Sciences, Preparatory Year, King Faisal University, Al Ahsa 31982, Saudi Arabia
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27
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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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28
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Hosseinpour P, Gholamabbas G, Pezeshkian F, Erfani A, Shahriarirad R, Parhizkar AR. Practice and attitude of general practitioners towards initiating isotretinoin for acne vulgaris in Fars province, Iran: cross-sectional study. BMC PRIMARY CARE 2024; 25:27. [PMID: 38216903 PMCID: PMC10787458 DOI: 10.1186/s12875-023-02260-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 12/26/2023] [Indexed: 01/14/2024]
Abstract
BACKGROUND Since general practitioners manage acne-related referrals, there needs to be more information in Iran about how drugs such as Isotretinoin are prescribed and the treatment plan. Thus, this study aimed to evaluate general practitioners s' practices and attitudes in prescribing Isotretinoin for acne vulgaris in primary care. METHODS This web-based cross-sectional descriptive study was conducted using two questionnaires designed with the target population of GPs working in Fars province in 2021 regarding the prescription of Isotretinoin. Moreover, demographic information, questions about interest in dermatology, and participation in dermatology workshops were gathered. RESULTS A total of 308 complete questionnaires were obtained. According to our results, 85 (27.6%) GPs prescribed Isotretinoin in primary care. Based on our results, higher age (OR: 1.042; CI95%: 1.013-1.072; P-value:0.004) and attending dermatological courses (OR: 3.280; CI95%: 1.592-6.755; P-value:0.001) were significantly correlated with more frequent Isotretinoin administration. Among GPs who do not prescribe Isotretinoin, the most common causes are concerns about liver dysfunction (54.7%), teratogenic concerns (37.2%), and lack of familiarity with the drug (31.4%) respectively. CONCLUSION The results of this study depicted the reluctance of most physicians to prescribe Isotretinoin and factors such as taking part in supplementary courses under the supervision of dermatologists and following national guidelines that could encourage them to prescribe Isotretinoin.
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Affiliation(s)
- Parisa Hosseinpour
- School of Medicine, Islamic Azad University, Kazeroun branch, Kazeroun, Iran.
| | - Ghazal Gholamabbas
- School of Medicine, Islamic Azad University, Kazeroun branch, Kazeroun, Iran
| | | | - Amirhossein Erfani
- Thoracic and Vascular Surgery Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Reza Shahriarirad
- Thoracic and Vascular Surgery Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Osman KM, Gerard P, Hale EW. Co-occurring ASD Mediates Impact of ADHD on Atopic Dermatitis and Acne: A Retrospective Cohort Study. J Atten Disord 2024; 28:109-116. [PMID: 37740474 DOI: 10.1177/10870547231197236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/24/2023]
Abstract
BACKGROUND ADHD and ASD are associated with dermatologic manifestations, yet little research investigates co-occurring ADHD/ASD and common dermatologic conditions. OBJECTIVE To investigate associations between ADHD, ASD, acne vulgaris, and atopic dermatitis. METHODS Using de-identified patient records from the TriNetX database, we created four cohorts on ADHD diagnosis, ASD diagnosis, both, neither. Cohorts were separated into males and females. We balanced each cohort based on age, sex, race, and ethnicity to the baseline cohort with neither ASD or ADHD. Finally, we examined prevalence of acne and eczema. RESULTS The cohort sizes varied from 19,764 to 345,626. Compared to matched peers, males with ADHD or ADHD/ASD had increased prevalence of acne, and all neurodivergent males had increased prevalence of eczema. Females with ADHD had an increase in both. Females with ADHD/ASD had no significant differences, and females with ASD had a decreased risk of eczema. LIMITATIONS Due to database limitations, we are unable to: analyze symptom severity, skincare routine, or treatment adherence. CONCLUSIONS The decreased risk of eczema in females with ASD and lack of significant difference in incidence of acne or eczema in females with ADHD/ASD compared to matched peers suggests research into approaches to skincare in males versus females with ASD may provide clinically relevant insights.
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30
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Lee SH, Kim DH, Jo SJ, Lim Y, Lee JW, Lee JH, Kim TM, Kim SR, Kang J, Yoon JY, Suh DH. The efficacy and safety of low- versus high-fluence fractional picosecond Nd:YAG 1064-nm laser in the treatment of acne scars: A randomized split-face comparison study. PHOTODERMATOLOGY, PHOTOIMMUNOLOGY & PHOTOMEDICINE 2024; 40:e12922. [PMID: 37898983 DOI: 10.1111/phpp.12922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 10/19/2023] [Accepted: 10/24/2023] [Indexed: 10/31/2023]
Abstract
BACKGROUND Differences in clinical efficacy based on the fluence of fractional picosecond laser treatment for acne scars are unknown. OBJECTIVE To compare the efficacy and safety of low-fluence versus high-fluence fractional picosecond Nd:YAG 1064-nm laser treatment in acne scar patients. METHODS In this 12-week, investigator-blinded, randomized, split-face study, 25 patients with moderate-to-severe acne scars received three sessions of high-fluence laser treatment (1.0 J/cm2 ) on one side of their face and low-fluence (0.3 J/cm2 ) on the other side every 4 weeks. Patients were assessed using acne scar counts, the scar global assessment (SGA), and the ECCA scar grading scale every 4 weeks. The histological analysis compared the acne scars obtained before and 4 weeks after treatment. RESULTS At their last visit, 88.00% and 92.00% of the subjects achieved >30% reduction in scar counts on the low- and high-fluence sides, respectively, without a significant difference between the two sides. On both sides, the scar counts, SGA, and ECCA score significantly improved 4 weeks after the last treatment. Although the high-fluence side showed a greater reduction in scar counts (-66.73%) than the low-fluence side (-62.13%), the two sides had no significant difference in the grading scores. The high-fluence side showed significantly more severe pain and higher side-effect scores immediately and 4 weeks after treatment. Histological analysis revealed a significantly increased collagen, elastin, and vimentin expression after treatment on the low-fluence side. CONCLUSIONS The low-fluence setting demonstrated comparable efficacy and superior safety in treating acne scars compared with the high-fluence setting.
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Affiliation(s)
- Si-Hyung Lee
- Department of Dermatology, Seoul National University College of Medicine, Seoul, Korea
| | - Dong Hyo Kim
- Department of Dermatology, Seoul National University College of Medicine, Seoul, Korea
- Acne, Rosacea, Seborrheic Dermatitis and Hidradenitis Suppurativa Research Laboratory, Seoul National University Hospital, Seoul, Korea
| | - Seong Jin Jo
- Department of Dermatology, Seoul National University College of Medicine, Seoul, Korea
| | - Youngkyoung Lim
- Department of Dermatology, Seoul National University College of Medicine, Seoul, Korea
| | - Ji Won Lee
- Department of Dermatology, Seoul National University College of Medicine, Seoul, Korea
| | - Jun Hyo Lee
- Department of Dermatology, Seoul National University College of Medicine, Seoul, Korea
- Acne, Rosacea, Seborrheic Dermatitis and Hidradenitis Suppurativa Research Laboratory, Seoul National University Hospital, Seoul, Korea
| | - Tae Min Kim
- Department of Dermatology, Seoul National University College of Medicine, Seoul, Korea
| | - Seong Rae Kim
- Department of Dermatology, Seoul National University College of Medicine, Seoul, Korea
| | - Jeewoo Kang
- Department of Dermatology, Seoul National University College of Medicine, Seoul, Korea
| | - Ji Young Yoon
- Acne, Rosacea, Seborrheic Dermatitis and Hidradenitis Suppurativa Research Laboratory, Seoul National University Hospital, Seoul, Korea
| | - Dae Hun Suh
- Department of Dermatology, Seoul National University College of Medicine, Seoul, Korea
- Acne, Rosacea, Seborrheic Dermatitis and Hidradenitis Suppurativa Research Laboratory, Seoul National University Hospital, Seoul, Korea
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Atallah DAA, Badran AY, Makhlouf AG, Mekkawy MM. Topical Silymarin Cream as a Novel Therapy Versus Salicylic Acid Peels in Acne Vulgaris: A Split-Face Clinical Trial. J Cutan Med Surg 2024; 28:22-28. [PMID: 37942562 DOI: 10.1177/12034754231211568] [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] [Indexed: 11/10/2023]
Abstract
BACKGROUND Acne vulgaris is a common dermatological condition that greatly impacts patients' self-confidence. Ongoing research is conducted to explore new treatment modalities. Silymarin owns special characteristics that qualify it as a possible treatment for acne vulgaris. OBJECTIVE We evaluated the efficacy and safety of silymarin cream as a new therapeutic option against salicylic acid peels in the treatment of mild to moderate acne vulgaris. METHODS A split-face, comparative, Quasi-experimental clinical trial included 30 patients with acne vulgaris. Salicylic acid 30% peels were applied as an office procedure to one half of the face every 2 weeks for 3 months. Topical silymarin 1.4% cream was prescribed as a home treatment, twice daily, to the other half of the face for 3 months. The results were evaluated using the Global Acne Grading System (GAGS), photographic evaluation, and patient self-assessment scale. The adverse effects during treatment were recorded. The sample size was calculated by Stata/IC 16.1. RESULTS After treatment, a significant reduction of GAGS was noted on both sides of the face, with an insignificant difference between both treatments. The comparative photographic evaluation and patient self-assessment scale were also insignificant. Hyperpigmentation was recorded in 2 cases on the salicylic acid-treated side. No side effects for silymarin cream were observed. CONCLUSION Topical silymarin cream 1.4% showed comparable results to Salicylic acid 30% peels. It can be considered a promising safe treatment modality for mild to moderate acne vulgaris.
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Affiliation(s)
- Dalia Abdel-Aziz Atallah
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Aya Yousef Badran
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Alaa Gamal Makhlouf
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Marwa Mohammad Mekkawy
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Assiut University, Assiut, Egypt
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Santer M, Burden-Teh E, Ravenscroft J. Managing acne vulgaris: an update. Drug Ther Bull 2023; 62:6-10. [PMID: 38154809 PMCID: PMC10803966 DOI: 10.1136/dtb.2023.000051] [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] [Indexed: 12/30/2023]
Abstract
Acne vulgaris is very common and can have significant negative impact on people. While sometimes a transient problem, acne may persist for many years and often leads to permanent scars or pigment changes. Guidelines unanimously advise topical treatments as first-line, although differ in recommending either topical benzoyl peroxide or topical retinoid (mainly adapalene) alone or in combination. Guidance published by the National Institute for Health and Care Excellence advises counselling patients regarding avoidance of skin irritation when starting topical treatments and promoting adherence (treatments take 6-8 weeks to work). Oral antibiotics are currently overprescribed for acne but have a role when coprescribed with a non-antibiotic topical treatment. Hormonal treatments, such as the combined contraceptive pill, are also effective and there is growing evidence for the use of spironolactone for women with persistent acne. Recent guidance from the Medicines and Healthcare products Regulatory Agency regarding isotretinoin has implications for specialist prescribing and monitoring, and increasing public awareness of potential risks of mental health problems and sexual dysfunction. Although acne is associated with psychiatric disorder, the mental health effects of isotretinoin remain controversial.
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Affiliation(s)
- Miriam Santer
- Primary Care Research Centre, University of Southampton, Southampton, UK
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Demir EY, Köse ÖK. Effects of oral isotretinoin treatment for acne vulgaris patients on anger responses and the relationship with temperament. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2023; 70:e20230592. [PMID: 38126449 PMCID: PMC10729670 DOI: 10.1590/1806-9282.20230592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 08/22/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVE Isotretinoin is the only medication against all the factors involved in acne vulgaris pathogenesis. The aim of our study was to verify whether patients with acne vulgaris receiving isotretinoin therapy exhibit elevated anger levels and to observe the correlation between age, temperament traits, and anger. METHODS The study group comprised a sum of 100 cases, involving 50 individuals with acne vulgaris-required high-dose retinol therapy and 50 controls who did not start any medication. RESULTS Our study showed that anger levels increased with drug use. A positive correlation between cyclothymic temperament, the anxiety-related behavior subdimension, and the introvert and passive-aggressive subdimension of interpersonal anger reactions has been recognized. In addition, a positive one was observed between hyperthymic temperament and the introvert subdimension, which is one of the anger-related thoughts and interpersonal anger reactions. CONCLUSION This study elucidates anger dimensions such as anger-related thoughts, behaviors, and reactions in individuals who received retinol treatment for acne vulgaris. In addition to anger and its dimensions, temperament was also investigated. Although several studies have investigated the relationship between acne vulgaris and psychiatric symptoms, to the best of our knowledge, no research has been reported in the English-language literature regarding the relationship between anger dimensions and temperament after retinol treatment that might make our study an original and valuable contribution to the literature.
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Jin Z, Song Y, He L. A review of skin immune processes in acne. Front Immunol 2023; 14:1324930. [PMID: 38193084 PMCID: PMC10773853 DOI: 10.3389/fimmu.2023.1324930] [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: 10/20/2023] [Accepted: 11/30/2023] [Indexed: 01/10/2024] Open
Abstract
Acne vulgaris is one of the most prevalent skin conditions, affecting almost all teenagers worldwide. Multiple factors, including the excessive production of sebum, dysbiosis of the skin microbiome, disruption of keratinization within hair follicles, and local inflammation, are believed to trigger or aggravate acne. Immune activity plays a crucial role in the pathogenesis of acne. Recent research has improved our understanding of the immunostimulatory functions of microorganisms, lipid mediators, and neuropeptides. Additionally, significant advances have been made in elucidating the intricate mechanisms through which cutaneous innate and adaptive immune cells perceive and transmit stimulatory signals and initiate immune responses. However, our understanding of precise temporal and spatial patterns of immune activity throughout various stages of acne development remains limited. This review provides a comprehensive overview of the current knowledge concerning the immune processes involved in the initiation and progression of acne. Furthermore, we highlight the significance of detailed spatiotemporal analyses, including analyses of temporal dynamics of immune cell populations as well as single-cell and spatial RNA sequencing, for the development of targeted therapeutic and prevention strategies.
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Affiliation(s)
| | | | - Li He
- Skin Health Research Center, Yunnan Characteristic Plant Extraction Laboratory, Kunming, Yunnan, China
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Alfouzan YA, Al-Hammad RA, Alkhuzayem FA, Alkhudair RF, Alotaibi MA, Alajaji AN, Al-Muhaylib AA. Isotretinoin-Related Eye Dryness in Acne Patients in Qassim, Saudi Arabia. Cureus 2023; 15:e49904. [PMID: 38174184 PMCID: PMC10763593 DOI: 10.7759/cureus.49904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/04/2023] [Indexed: 01/05/2024] Open
Abstract
Background Isotretinoin is a commonly prescribed agent mainly used to treat acne vulgaris. Since its Food and Drug Administration (FDA) approval, the subject of its associations with various medical conditions has become a growing interest in many investigational studies. Methodology A retrospective study was conducted using the validated Standardized Patient Evaluation of Eye Dryness (SPEED) questionnaire. All statistical calculations were performed using the Statistical Package for the Social Sciences (SPSS) version 27.0.1 (IBM SPSS Statistics, Armonk, NY). Results The research study involved 107 participants, predominantly Saudi nationals (98.1%), with an average age of 22 years. Regarding the total cumulative dose (TCD), 40.2% had less than 50 mg/kg, 33.6% had between 50 and 100 mg/kg, and 15.9% had more than 100 mg/kg. The majority (73.8%) did not stop using isotretinoin. The average Ocular Surface Disease Index (OSDI) score, indicating ocular surface disease symptoms, was 26.78. There was no significant association between gender, dose/duration of isotretinoin, TCD, and age, and OSDI scores. However, participants with severe OSDI scores were more likely to have worsened pre-existing eye symptoms compared to those with non-severe OSDI scores (35.1% versus 11.4%, p = 0.011). Conclusions This study contributes to the understanding of the impact of isotretinoin usage on ocular surface health. While no significant associations were found between gender, dose, duration, TCD, and age, and OSDI scores, participants with pre-existing eye symptoms were more likely to experience worsened symptoms during isotretinoin treatment.
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Affiliation(s)
| | | | | | | | | | - Abdullah N Alajaji
- Department of Dermatology, Qassim University Medical City (QUMC), Buraydah, SAU
| | - Ahmed A Al-Muhaylib
- Department of Ophthalmology, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, SAU
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Dai R, Cao Y, Su Y, Cai S. Comparison of 1064-nm Nd:YAG picosecond laser using fractional micro-lens array vs. ablative fractional 2940-nm Er:YAG laser for the treatment of atrophic acne scar in Asians: a 20-week prospective, randomized, split-face, controlled pilot study. Front Med (Lausanne) 2023; 10:1248831. [PMID: 38034535 PMCID: PMC10687437 DOI: 10.3389/fmed.2023.1248831] [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: 06/27/2023] [Accepted: 10/30/2023] [Indexed: 12/02/2023] Open
Abstract
Background The 1064-nm Nd:YAG picosecond lasers using fractional micro-lens array (P-MLA) was a promising therapy for skin resurfacing. However, no studies have compared P-MLA with ablative fractional 2940-nm Er:YAG lasers (AF-Er) in the treatment of atrophic acne scars. Objectives To evaluate the efficacy and safety of P-MLA and AF-Er for the treatment of atrophic acne scars. Methods We performed a prospective, randomized, split-face, controlled pilot study. Thirty-one Asian patients with mild to moderate atrophic acne scars underwent four consecutive sessions of randomized split-face treatment with P-MLA and AF-Fr at 4-week intervals. The efficacy of the two devices were evaluated by Echelle d'Evaluation Clinique des Cicatrices d'acne (ECCA) grading scale, Investigator's Global Assessment (IGA) score and patient's satisfaction. VISIA analysis was also performed to evaluate the pore and skin texture. Adverse events were recorded at each follow-up. Results The P-MLA afforded comparable clinical responses in scar appearance as AF-Er based on the investigator's assessments (ECCA percent reduction: 39.11% vs. 43.73%; IGA score: 2.97 ± 0.65 vs. 3.16 ± 0.68; P > 0.05 for both). However, the result of patient satisfaction indicated the AF-Er-treated side achieved a slightly greater improvement in scar appearance (3.97 ± 0.78 vs. 3.55 ± 0.71; P < 0.05). Overall, the two devices did not differ largely in terms of efficacy. VISIA analysis revealed similar changing patterns of the pore and skin texture between two devices. For safety profiles, no serious side effects were reported on both sides. The P-MLA showed lower pain level, shortened duration of crust shed and edema, and less occurrence of PIH (P < 0.05 for all). Conclusion Compared with AF-Er, P-MLA afforded comparable effect and more safety profiles in treating atrophic acne scars in Asian patients. Clinical trial registration ClinicalTrials.gov, identifier NCT05686603.
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Affiliation(s)
- Ru Dai
- Department of Dermatology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Yiyu Cao
- Research Department of Industrial Development, Zhejiang Development & Planning Institute, Hangzhou, China
| | - Yiping Su
- Department of Dermatology, The First People Hospital of Hangzhou Linan District, Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Suiqing Cai
- Department of Dermatology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
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Schachner LA, Alexis AF, Andriessen A, Berson D, Gold M, Goldberg DJ, Hu S, Keri J, Kircik L, Woolery-Lloyd H. Insights into acne and the skin barrier: Optimizing treatment regimens with ceramide-containing skincare. J Cosmet Dermatol 2023; 22:2902-2909. [PMID: 37605504 DOI: 10.1111/jocd.15946] [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: 04/24/2023] [Revised: 06/27/2023] [Accepted: 07/22/2023] [Indexed: 08/23/2023]
Abstract
INTRODUCTION Acne is a common, complex, multifactorial inflammatory skin disease associated with epidermal barrier dysfunction. Beginning in childhood, acne affects many adolescents and adults. Acne is associated with lower self-esteem, anxiety, and depression and may cause scars and pigmentary sequelae. The review explores the relationships between acne and the skin barrier function and discusses nuances in the prevention, treatment, and maintenance of acne and its impact on the skin barrier. METHODS The advisors' previous publications addressed prescription and nonprescription pediatric acne treatment and skincare using cleansers, moisturizers, and a practical algorithm for treatment and maintenance, including skincare recommendations for pediatric acne patients and an algorithm for skin of color patients with acne. Before the meeting, literature was culled on the relationship between the skin barrier and acne and current best practices in acne, addressing prescription and nonprescription acne products and skincare as monotherapy, adjunctive, and maintenance treatment. RESULTS After discussing 13 draft statements, the advisors applied the selected literature and drew from their clinical knowledge and experience, and agreed on five statements. The follicular epithelial barrier is directly involved with changes that occur during both comedogenesis and in stages of inflammation, especially with follicular rupture compromising the barrier's integrity. In acne-affected skin, sebaceous glands are larger, sebum excretion and filaggrin expression higher, and stratum corneum lipids are reduced. Educating patients and clinicians about inflammation's central role in acne and measures to reduce inflammation is essential. Skin irritation and xerosis from acne and treatments lead to poor treatment adherence. A skincare regimen should be included in the acne prevention, treatment, and maintenance care regimen and should be ongoing. Maintenance treatment with topical agents and skincare using gentle ceramide-containing cleansers and moisturizers is a recommended strategy after successfully controlling the disease. CONCLUSIONS Epidermal barrier dysfunction contributes to acne exacerbation. Using the appropriate treatment and skincare helps to minimize irritation and inflammation, enhance treatment adherence, and improve patient outcomes.
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Affiliation(s)
- Lawrence A Schachner
- Division of Pediatric Dermatology, Department of Dermatology and Cutaneous Surgery, Department of Pediatrics, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida, USA
| | | | - Anneke Andriessen
- Radboud UMC, Nijmegen and Andriessen Consultants, Malden, the Netherlands
| | - Diane Berson
- Weill Cornell Medical College, New York, New York, USA
- New York-Presbyterian Hospital, New York, New York, USA
| | - Michael Gold
- Gold Skin Care Center, Nashville, Tennessee, USA
- Vanderbilt University School of Medicine and Nursing, Nashville, Tennessee, USA
| | - David J Goldberg
- Schweiger Dermatology Group, Hackensack, New Jersey, USA
- Icahn School of Medicine at Mt. Sinai, New York, New York, USA
| | - Shasa Hu
- Division of Pediatric Dermatology, Department of Dermatology and Cutaneous Surgery, Department of Pediatrics, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Jonette Keri
- Division of Pediatric Dermatology, Department of Dermatology and Cutaneous Surgery, Department of Pediatrics, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Leon Kircik
- Icahn School of Medicine at Mt. Sinai, New York, New York, USA
- Dermatology, Indiana University Medical Center, Indianapolis, Indiana, USA
- Physicians Skin Care, PLLC, Louisville, Kentucky, USA
- DermResearch, PLLC, Louisville, Kentucky, USA
| | - Heather Woolery-Lloyd
- Skin of Color Division, Dr Phillip Frost Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, University of Miami, Miami, Florida, USA
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Alshehri AA, Althobaiti BA, Khawagi WY, Murphy KD. Awareness of isotretinoin use and safety in Saudi Arabia: A nationwide cross-sectional study. Saudi Pharm J 2023; 31:101796. [PMID: 37822697 PMCID: PMC10562744 DOI: 10.1016/j.jsps.2023.101796] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 09/17/2023] [Indexed: 10/13/2023] Open
Abstract
Introduction Acne is a prevalent skin condition that affects numerous adolescents and adults worldwide. The most effective treatment for acne is isotretinoin, but its usage is associated with a wide range of adverse effects, and regular monitoring is necessary. Hence, appropriate usage with awareness of potential side effects is crucial. This study aimed to assess the knowledge and awareness of isotretinoin use and safety among individuals with acne in Saudi Arabia. Methods A national cross-sectional survey was conducted through an online self-administered questionnaire distributed via social media platforms. The questionnaire consisted of 27 questions in multiple-choice and Likert scale formats, covering demographics, patient awareness of isotretinoin use and side effects, satisfaction with clinical consultation and information provided. Descriptive statistics were used to summarize data. Results 1315 participants completed the survey, of which most were female (74.1%), single (67.5%), and aged 18-25 years (48.9%). Dryness and teratogenicity were the most commonly known side effects of isotretinoin use (85.5% and 64.9% respectively). However, most participants were unaware of other side effects, such as psychiatric disorders (62.9%), altered liver enzyme concentrations (65.2%), hyperlipidemia (68.1%), anemia (92.4%), and decreased platelet count (96%). Moreover, 36% of sexually active females initiated isotretinoin without contraception. Regarding satisfaction with the information provided during clinical consultation, 63.2% of participants were very satisfied or satisfied. Doctors were the primary source of information (86.8%), followed by the internet (17.8%). Only 45% were informed to avoid blood donation during and after treatment for at least two months. Conclusion The study highlights the significance of providing patients with comprehensive information about the potential side effects of isotretinoin, including the need to use contraception and avoid blood donation during and after treatment. Effective communication between physicians and patients is critical in ensuring the safe and effective use of isotretinoin.
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Affiliation(s)
- Abdullah A Alshehri
- Department of Clinical Pharmacy, College of Pharmacy, Taif University, Al Huwaya, Taif 26571, Saudi Arabia
| | - Bander A Althobaiti
- Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, Cork, Ireland
- King Abduaziz Specialised Hospital, Ministry of Health, Taif, Saudi Arabia
| | - Wael Y Khawagi
- Department of Clinical Pharmacy, College of Pharmacy, Taif University, Al Huwaya, Taif 26571, Saudi Arabia
| | - Kevin D Murphy
- Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, Cork, Ireland
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Goldberg DJ, Andriessen A, Bhatia AC, Gold MH, Lewis AB, Lolis MS, Miller JH, Ros A. Treatment of mild to severe acne with 1726 nm laser: A safe alternative to traditional acne therapies. J Cosmet Dermatol 2023; 22:3026-3032. [PMID: 37596781 DOI: 10.1111/jocd.15964] [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: 07/04/2023] [Revised: 08/01/2023] [Accepted: 08/07/2023] [Indexed: 08/20/2023]
Abstract
INTRODUCTION Acne is the most common reason for dermatology consultation in adolescents and young adults. Consultation is often delayed despite unsuccessful self-treatment. Postponing effective treatment places acne sufferers at higher risk for permanent acne scars and post-inflammatory pigment changes. AIM This review discusses clinical challenges with present therapeutic options for acne treatment and the role of a 1726 nm laser for acne. METHODS Current acne treatment guidelines were reviewed. A literature review was conducted for trials of light-based acne therapy. The selectivity of previous light-based therapies was reviewed. RESULTS Available acne therapy is effective, but treatment-related side effects are common. Acne treatment guidelines do not include recommendations for light-based treatments. Different types of light-based treatments have been tried but until now no wavelength specifically targeted sebaceous glands. CONCLUSION The 1726 nm laser is safe and effective for treating mild to severe acne in all Fitzpatrick skin types. Acne resolution is apparent within the first month and improves for up to 2 years beyond treatment.
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Affiliation(s)
- David J Goldberg
- Cosmetic Dermatology and Clinical Research, Schweiger Dermatology Group, Clinical Professor of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Anneke Andriessen
- Radboud UMC Nijmegen, Andriessen Consultants, Malden, The Netherlands
| | - Ashish C Bhatia
- Department of Dermatology, Northwestern University - Feinberg School of Medicine, Chicago, Illinois, USA
- Dermatologic, Laser & Cosmetic Surgery, Oak Dermatology, Naperville, Illinois, USA
- Dermatologic Research, Oak Dermatology, Naperville, Illinois, USA
| | - Michael H Gold
- Founder of Gold Skin Care Center, Nashville, Tennessee, USA
- Vanderbilt University School of Medicine and Nursing, Nashville, Tennessee, USA
| | - Amy B Lewis
- Schweiger Dermatology Group, New York, New York, USA
| | | | | | - Adriana Ros
- Medical and cosmetic dermatology, North Bergen, New Jersey, USA
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Chen YT, Lin YJ, Chang CC, Liu PH, Huang YH, Shen JW, Lu ME, Chiang HM, Lin BS. The quantitative analysis of low-concentration (2%) ALA-PDT assisted with Q-switch 1064-nm Nd:YAG laser for acne vulgaris treatment. Lasers Med Sci 2023; 38:236. [PMID: 37843672 DOI: 10.1007/s10103-023-03896-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 09/25/2023] [Indexed: 10/17/2023]
Abstract
Conventional 5-aminolevulinic acid-photodynamic (ALA-PDT) therapy (10-20%) has been widely applied for moderate-to-severe acne. The aim of this study is to investigate the effects of non-ablative Q-switched 1064-nm Nd:YAG laser-assisted ALA-PDT with low concentration (2%) on the treatment of acne vulgaris. Enrolled patients were randomly assigned to 2 groups. One group received combined therapy of 2% ALA-PDT and non-ablative Q-switched 1064-nm Nd:YAG laser, and the other received only 2% ALA-PDT. Patients in each group had received 3-session treatments with 4-week intervals (week 0, 4, and 8). Sebum secretion, melanin index, erythema index, and transepidermal water loss (TEWL) were assessed at week 2, 8, 12, and 24. VISIA® skin image system score and global esthetic improvement scale (GAIS) were also evaluated. Twenty-four participants were enrolled and evenly randomized to two groups. Significant improvement in sebum secretion was noted in combined therapy group compared to the monotherapy group at week 12 (37.5% versus 16.3%), and the improvement would still be noted until week 24 (18.3% versus 17.4%). Combined group also showed more severe melanin index and erythema index after treatment. For VISIA® skin analysis, patients in combined group had better percentile ranking in porphyrins and red-light images. There were no significant differences in GAIS at the end of the follow-up between each group, whereas higher proportion of satisfaction was noted in combined group at week 2. With the assistance of laser, low concentrations (2%) of 5-ALA can provide effective phototoxic reactions in treating acne vulgaris. The satisfaction of patients is high with acceptable adverse effects.
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Affiliation(s)
- Yu-Tsung Chen
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan
- Department of Dermatology, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
| | - Yun-Jhen Lin
- School of Medicine, College of Medicine, China Medical University, China Medical University Hospital, Taichung, Taiwan
| | - Chang-Cheng Chang
- School of Medicine, College of Medicine, China Medical University, China Medical University Hospital, Taichung, Taiwan.
- Institute of Imaging and Biomedical Photonics, National Yang Ming Chiao Tung University, Tainan, Taiwan.
- Department of Cosmeceutics, China Medical University, Taichung, Taiwan.
- Aesthetic Medical Center, China Medical University Hospital, Taichung, Taiwan.
| | | | | | - Jia-Wei Shen
- Department of Cosmeceutics, China Medical University, Taichung, Taiwan
| | - Meng-En Lu
- Department of Cosmeceutics, China Medical University, Taichung, Taiwan
| | - Hsiu-Mei Chiang
- Department of Cosmeceutics, China Medical University, Taichung, Taiwan
| | - Bor-Shyh Lin
- Institute of Imaging and Biomedical Photonics, National Yang Ming Chiao Tung University, Tainan, Taiwan
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Liu L, Xue Y, Chen J, Li Y, Chen T, Pan X, Zhong J, Shao X, Chen Y, Chen J. DNA methylation profiling and integrative multi-omics analysis of skin samples reveal important contribution of epigenetics and immune response in the pathogenesis of acne vulgaris. Clin Immunol 2023; 255:109773. [PMID: 37717673 DOI: 10.1016/j.clim.2023.109773] [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: 03/21/2023] [Revised: 07/25/2023] [Accepted: 09/11/2023] [Indexed: 09/19/2023]
Abstract
The regulatory effect of DNA methylation on the pathogenesis of acne vulgaris is completely unknown. Herein we analyzed the DNA methylation profile in skin samples of acne vulgaris and further integrated it with gene expression profiles and single-cell RNA-sequencing data. Finally, 31,134 differentially methylated sites and 770 differentially methylated and expressed genes (DMEGs) were identified. The multi-omics analysis suggested the importance of DNA methylation in inflammation and immunity in acne. And DMEGs were verified in an external dataset and were closely related to early inflammatory acne. Additionally, we conducted experiments to verify the mRNA expression and DNA methylation level of DMEGs. This study supports the significant contribution of epigenetics to the pathogenesis of acne vulgaris and may provide new ideas for the molecular mechanisms of and potential therapeutic strategies for acne vulgaris.
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Affiliation(s)
- Lin Liu
- Department of Dermatology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yuzhou Xue
- Department of Cardiology and Institute of Vascular Medicine, Peking University Third Hospital, Beijing, China
| | - Jiayi Chen
- Department of Dermatology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yuxin Li
- Department of Dermatology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Tingqiao Chen
- Department of Dermatology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xingyu Pan
- Department of Dermatology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Judan Zhong
- Department of Dermatology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xinyi Shao
- Department of Dermatology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yangmei Chen
- Department of Dermatology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
| | - Jin Chen
- Department of Dermatology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
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Alexiades M, Kothare A, Goldberg D, Dover JS. Novel 1726 nm laser demonstrates durable therapeutic outcomes and tolerability for moderate-to-severe acne across skin types. J Am Acad Dermatol 2023; 89:703-710. [PMID: 37328000 DOI: 10.1016/j.jaad.2023.05.085] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 05/13/2023] [Accepted: 05/18/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Traditional acne management with topical therapy, systemic antibiotics, hormonal agents, or oral isotretinoin requires compliance and may produce significant side effects. However, alternative treatments with lasers had failed to demonstrate durable clearance. OBJECTIVE To assess the tolerability and therapeutic outcomes of a novel 1726 nm laser treatment of moderate-to-severe acne across skin types. METHODS A prospective, open-label, single-arm, Investigational Device Exemption-approved, institutional review board-approved study of 104 subjects with moderate-to-severe facial acne and Fitzpatrick Skin Types ranging from II-to-VI was conducted. Subjects received 3 laser treatments at 3 (-1/+2)-week intervals. RESULTS Following final treatment, ≥50% reduction in active acne inflammatory lesions was 32.6% at 4-weeks follow-up, increasing further to 79.8% and 87.3% at 12 and 26-weeks, respectively. The percentage of subjects clear or almost clear increased from 0% at baseline to 9%, 36.0%, and 41.8% at 4-, 12-, and 26-weeks follow-up. No serious adverse events were observed related to device or protocol; treatments were well tolerated, requiring no anesthetic. Therapeutic outcomes and discomfort were similar across all skin types. LIMITATIONS Lack of control group. CONCLUSIONS The study findings demonstrate the novel 1726 nm laser is well tolerated with durable progressive posttreatment improvement to at least 26 weeks for moderate-to-severe acne across skin types.
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Affiliation(s)
- Macrene Alexiades
- Founder & Director, Dermatology & Laser Surgery Center of New York, New York, New York; Associate Clinical Professor, Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut; Adjunct Professor of Dermatology, Syggros Hospital, Athens, Greece.
| | | | - David Goldberg
- Skin Laser & Surgery Specialists, Division of Schweiger Dermatology Group, New York, New York; Department of Dermatology, Icahn School of Medicine at Mt. Sinai, New York, New York
| | - Jeffrey S Dover
- Associate Clinical Professor, Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut; Director, SkinCare Physicians, Chestnut Hill, Massachusetts; Adjunct Professor, Department of Dermatology, Brown University, Providence, Rhode Island
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Harper JC, Armstrong A, Fried RG, Rieder EA, Alexis AF, Salem RJ, Kasujee I, Grada A. Patient-reported outcomes with sarecycline treatment for acne vulgaris: Pooled analysis of phase 3 clinical studies. J Am Acad Dermatol 2023; 89:832-834. [PMID: 37321481 DOI: 10.1016/j.jaad.2023.04.075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 03/27/2023] [Accepted: 04/26/2023] [Indexed: 06/17/2023]
Affiliation(s)
- Julie C Harper
- Dermatology and Skin Care Center of Birmingham, Birmingham, Alabama
| | | | | | | | | | | | | | - Ayman Grada
- Department of Dermatology, Case Western Reserve University School of Medicine, Health Education Campus, Cleveland, Ohio
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Zolotarev O, Khakimova A, Rahim F, Senel E, Zatsman I, Gu D. Scientometric analysis of trends in global research on acne treatment. Int J Womens Dermatol 2023; 9:e082. [PMID: 37521754 PMCID: PMC10378739 DOI: 10.1097/jw9.0000000000000082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 03/12/2023] [Indexed: 08/01/2023] Open
Abstract
Acne or acne vulgaris is the most common chronic inflammatory disease of the sebaceous follicles. Objectives The present study aims to identify the main lines of research in the field of acne treatment using reproducible scientometric methods. In this article, we reviewed the following research trends: facial acne, different antibiotics, retinoids, anti-inflammatory drugs, epidermal growth factor receptor inhibitors therapy, and associated diseases. Methods The analysis of publications from the PubMed collection was carried out from 1871 to 2022. All data were analyzed using Microsoft Excel. The evolution of the terminological portrait of the disease is shown. Results Trends in the use of various groups of antibiotics, retinoids, anti-inflammatory drugs, and photodynamic therapy for acne treatment have been found. There is a growing interest in clindamycin and doxycycline (polynomial and exponential growth, respectively). The effects of isotretinoin are also being studied more frequently (active linear growth). The publication of studies on spironolactone is increasing (linear growth). There is also a steady interest in the use of epidermal growth factor receptor inhibitors in the recent years. There is active research on acne and polycystic ovary syndrome (exponential growth). Limitations Only articles in English were selected. The most frequent terms were considered. Conclusions The dynamics of publication activity in the field of acne was considered. The aim of the current scientometric study was to analyze the global trends in acne treatments. The trend analysis made it possible to identify the most explored areas of research, as well as indicate those areas in dermatology in which interest is declining.
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Affiliation(s)
- Oleg Zolotarev
- Institute of Information Systems and Engineering Computer Technologies, Russian New University, Moscow, Russia
| | - Aida Khakimova
- Institute of Information Systems and Engineering Computer Technologies, Russian New University, Moscow, Russia
| | - Fakher Rahim
- Department of Anesthesia, Cihan University - Sulaimaniya, Kurdistan Region, Iraq
| | - Engin Senel
- Department of Dermatology and Venereology, Hitit University Faculty of Medicine, Corum, Turkey
| | - Igor Zatsman
- Research Department, Institute of Informatics Problems FRC CSC RAS, Moscow, Russia
| | - Dongxiao Gu
- MIS School of Management, Hefei University of Technology, Hefei, Anhui, China
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Kontzias C, Zaino M, Feldman SR. Tretinoin 0.1% and Benzoyl Peroxide 3% Cream for the Treatment of Facial Acne Vulgaris. Ann Pharmacother 2023; 57:1088-1093. [PMID: 36639853 DOI: 10.1177/10600280221147338] [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] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVE To assess the efficacy, safety, and clinical application of tretinoin 0.1%-benzoyl peroxide 3% cream for the topical treatment of acne vulgaris. DATA SOURCES A systematic review of the literature was performed using the terms Twyneo OR tretinoin and benzoyl peroxide OR S6G5T-3 in MEDLINE (PubMed) and EMBASE. ClinicalTrials.gov was searched to obtain completed clinical trial results not published elsewhere. STUDY SELECTION AND DATA EXTRACTION All human studies published in English prior to November 2022 related to pharmacology, clinical trials, safety, and efficacy were evaluated for inclusion. DATA SYNTHESIS In two 12-week, phase 3, randomized, vehicle-controlled clinical trials, tretinoin 0.1%-benzoyl peroxide 3% cream significantly reduced inflammatory and noninflammatory facial acne lesions and significantly improved Investigator Global Assessment (IGA) rating to clear or almost clear. The cream has a suitable safety profile, with application site pain and dryness as the most common adverse events. RELEVANCE TO PATIENT CARE AND CLINICAL PRACTICE IN COMPARISON TO EXISTING AGENTS Tretinoin-BPO had similar IGA success compared to other topical retinoid and retinoid-BPO treatments for acne vulgaris. Compared to individual tretinoin and benzoyl peroxide therapy, the combination product streamlines application, which will improve medication adherence; however, the cost of tretinoin-BPO cream may be prohibitive. CONCLUSIONS Tretinoin 0.1%-benzoyl peroxide 3% cream is safe and effective for the treatment of moderate-to-severe acne. Long-term trial data on efficacy and tolerability are not yet available.
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Affiliation(s)
- Christina Kontzias
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Mallory Zaino
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Steven R Feldman
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA
- Department of Pathology, Wake Forest School of Medicine, Winston-Salem, NC, USA
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA
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Hu X, Tang M, Dong K, Zhou J, Wang D, Song L. Changes in the skin microbiome during male maturation from 0 to 25 years of age. Skin Res Technol 2023; 29:e13432. [PMID: 37753696 PMCID: PMC10493343 DOI: 10.1111/srt.13432] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 07/22/2023] [Indexed: 09/28/2023]
Abstract
BACKGROUND Skin microorganisms co-develop with the human body and age influences the skin microenvironment and thus the skin bacterial community. OBJECTIVES To investigate the changes in the skin microbiota during male development. METHODS High-throughput 16S ribosomal RNA pyrosequencing was utilized to analyze the differences in bacterial composition of the skin in healthy males aged 0-25 years. RESULTS There were significant differences in facial skin bacterial diversity (Shannon index) and richness (Chao index) among the 4 groups of subjects (p < 0.05). Streptococcus, Staphylococcus, Cutibacterium are dominant in males during growth, and regular changes occur with age after birth. Further analysis of skin bacteria between the 4 groups showed that the bacterial abundance of Cutibacterium acnes and Staphylococcus epidermidis tended to increase with age, and the bacterial abundance of Streptococcus, Rothia mucilaginosa, and Staphylococcus hominis tended to decrease with age. CONCLUSIONS There are some changes in cheek skin bacterial diversity during male development, and there is a relationship between skin bacterial changes and skin development processes.
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Affiliation(s)
- Xinyue Hu
- Beijing Key Laboratory of Plant Resources Research and Development, College of Chemistry and Materials EngineeringBeijing Technology and Business UniversityBeijingChina
- Key Laboratory of Cosmetic of China National Light Industry, College of Chemistry and Materials EngineeringBeijing Technology and Business UniversityBeijingChina
| | - Meng Tang
- Beijing Key Laboratory of Plant Resources Research and Development, College of Chemistry and Materials EngineeringBeijing Technology and Business UniversityBeijingChina
- Key Laboratory of Cosmetic of China National Light Industry, College of Chemistry and Materials EngineeringBeijing Technology and Business UniversityBeijingChina
| | - Kun Dong
- Beijing Key Laboratory of Plant Resources Research and Development, College of Chemistry and Materials EngineeringBeijing Technology and Business UniversityBeijingChina
- Key Laboratory of Cosmetic of China National Light Industry, College of Chemistry and Materials EngineeringBeijing Technology and Business UniversityBeijingChina
| | - Jin Zhou
- Beijing Key Laboratory of Plant Resources Research and Development, College of Chemistry and Materials EngineeringBeijing Technology and Business UniversityBeijingChina
- Key Laboratory of Cosmetic of China National Light Industry, College of Chemistry and Materials EngineeringBeijing Technology and Business UniversityBeijingChina
| | - Dexian Wang
- Beijing Key Laboratory of Plant Resources Research and Development, College of Chemistry and Materials EngineeringBeijing Technology and Business UniversityBeijingChina
- Key Laboratory of Cosmetic of China National Light Industry, College of Chemistry and Materials EngineeringBeijing Technology and Business UniversityBeijingChina
| | - Liya Song
- Beijing Key Laboratory of Plant Resources Research and Development, College of Chemistry and Materials EngineeringBeijing Technology and Business UniversityBeijingChina
- Key Laboratory of Cosmetic of China National Light Industry, College of Chemistry and Materials EngineeringBeijing Technology and Business UniversityBeijingChina
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Cruz S, Vecerek N, Elbuluk N. Targeting Inflammation in Acne: Current Treatments and Future Prospects. Am J Clin Dermatol 2023; 24:681-694. [PMID: 37328614 PMCID: PMC10460329 DOI: 10.1007/s40257-023-00789-1] [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] [Accepted: 04/30/2023] [Indexed: 06/18/2023]
Abstract
Acne is a common, chronic inflammatory condition affecting millions of people worldwide, with significant negative impact on quality of life and mental health. Acne is characterized by comedones, inflammatory papules, pustules, and nodulocystic lesions, with long-lasting sequelae including scarring and dyspigmentation, the latter of which is more common in skin of color. The four main pillars of acne pathophysiology include alteration of sebum production and concentration, hyperkeratinization of the follicular unit, Cutibacterium acnes strains, and an inflammatory immune response. Newer research has provided greater insight into these pathophysiologic categories. This greater understanding of acne pathogenesis has led to numerous new and emerging treatment modalities. These modalities include combinations of existing treatments, repurposing of existing agents historically used for other conditions, new topical treatments, novel antibiotics, topical and oral probiotics, and various procedural devices. This article will provide an overview of emerging treatments of acne and their link to our current and improved understanding of acne pathogenesis.
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Affiliation(s)
- Sebastian Cruz
- Department of Dermatology, Keck School of Medicine, University of Southern California, 830 S Flower St Ste 100, Los Angeles, CA, 90017, USA
| | - Natalia Vecerek
- Department of Dermatology, Keck School of Medicine, University of Southern California, 830 S Flower St Ste 100, Los Angeles, CA, 90017, USA
| | - Nada Elbuluk
- Department of Dermatology, Keck School of Medicine, University of Southern California, 830 S Flower St Ste 100, Los Angeles, CA, 90017, USA.
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Peng Z, He M, Yang X, Zhang J. Discovery and Characterization of a Novel Bacteriocin HA2-5 that Strongly Inhibits Propionibacterium acnes. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2023; 71:12741-12748. [PMID: 37587448 DOI: 10.1021/acs.jafc.3c04617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/18/2023]
Abstract
Increased drug resistance has significantly reduced the effectiveness of antibiotics used in the treatment of Propionibacterium acnes. Therefore, there has been a trend toward the development of new antimicrobial agents to circumvent drug resistance. In this study, we isolated and purified a novel bacteriocin, HA2-5, from Bacillus haynesii HA2, which effectively killed P. acnes through membrane disruption at a minimum inhibitory concentration (MIC) of 8 μg/mL. HA2-5 with 2× MIC was able to kill 99.9% of P. acnes within 24 h. HA2-5 shows excellent stability and tolerance to temperature, pH, proteases, chemical reagents, UV radiation, and metal ions, with almost no loss of inhibitory activity after treatment. In addition, the very low hemolytic activity and cytotoxicity suggest that HA2-5 is biosafe. Notably, HA2-5 exhibits preferred antibacterial activity against gram-positive pathogens with an MIC of 16-32 μg/mL. In conclusion, this study shows that bacteriocin HA2-5 has the potential to be used as an alternative to antibiotics for acne treatment.
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Affiliation(s)
- Zheng Peng
- Key Laboratory of Industrial Biotechnology, Ministry of Education, School of Biotechnology, Jiangnan University, 1800 Lihu Road, Wuxi 214122, China
- Science Center for Future Foods, Jiangnan University, 1800 Lihu Road, Wuxi 214122, China
- Engineering Research Center of Ministry of Education on Food Synthetic Biotechnology, Jiangnan University, 1800 Lihu Road, Wuxi 214122, China
- Jiangsu Province Engineering Research Center of Food Synthetic Biotechnology, Jiangnan University, 1800 Lihu Road, Wuxi 214122, China
| | - Mengni He
- Key Laboratory of Industrial Biotechnology, Ministry of Education, School of Biotechnology, Jiangnan University, 1800 Lihu Road, Wuxi 214122, China
- Science Center for Future Foods, Jiangnan University, 1800 Lihu Road, Wuxi 214122, China
- Engineering Research Center of Ministry of Education on Food Synthetic Biotechnology, Jiangnan University, 1800 Lihu Road, Wuxi 214122, China
- Jiangsu Province Engineering Research Center of Food Synthetic Biotechnology, Jiangnan University, 1800 Lihu Road, Wuxi 214122, China
| | - Xinyu Yang
- Key Laboratory of Industrial Biotechnology, Ministry of Education, School of Biotechnology, Jiangnan University, 1800 Lihu Road, Wuxi 214122, China
- Science Center for Future Foods, Jiangnan University, 1800 Lihu Road, Wuxi 214122, China
- Engineering Research Center of Ministry of Education on Food Synthetic Biotechnology, Jiangnan University, 1800 Lihu Road, Wuxi 214122, China
- Jiangsu Province Engineering Research Center of Food Synthetic Biotechnology, Jiangnan University, 1800 Lihu Road, Wuxi 214122, China
| | - Juan Zhang
- Key Laboratory of Industrial Biotechnology, Ministry of Education, School of Biotechnology, Jiangnan University, 1800 Lihu Road, Wuxi 214122, China
- Science Center for Future Foods, Jiangnan University, 1800 Lihu Road, Wuxi 214122, China
- Engineering Research Center of Ministry of Education on Food Synthetic Biotechnology, Jiangnan University, 1800 Lihu Road, Wuxi 214122, China
- Jiangsu Province Engineering Research Center of Food Synthetic Biotechnology, Jiangnan University, 1800 Lihu Road, Wuxi 214122, China
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Pénzes Z, Alimohammadi S, Horváth D, Oláh A, Tóth BI, Bácsi A, Szöllősi AG. The dual role of cannabidiol on monocyte-derived dendritic cell differentiation and maturation. Front Immunol 2023; 14:1240800. [PMID: 37680639 PMCID: PMC10482398 DOI: 10.3389/fimmu.2023.1240800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 08/03/2023] [Indexed: 09/09/2023] Open
Abstract
Introduction Extracts and compounds isolated from hemp (Cannabis sativa) are increasingly gaining popularity in the treatment of a number of diseases, with topical formulations for dermatological conditions leading the way. Phytocannabinoids such as ( )-cannabidiol, ( )-cannabinol and ( )-Δ9-tetrahydrocannabivarin (CBD, CBN, and THCV, respectively), are present in variable amounts in the plant, and have been shown to have mostly anti-inflammatory effects both in vitro and in vivo, albeit dominantly in murine models. The role of phytocannabinoids in regulating responses of dendritic cells (DCs) remains unclear. Methods Our research aimed to investigate the effects of CBD, CBN, and THCV on human DCs differentiated from monocytes (moDCs). moDCs were treated with up to 10 μM of each phytocannabinoid, and their effects on viability, differentiation, and maturation were assessed both alone, and in conjunction with TLR agonists. The effects of CBD on cytokine production, T cell activation and polarization as well as the transcriptome of moDCs was also determined. Results Phytocannabinoids did not influence the viability of moDCs up to 10 μM, and only CBD had effects on maturational markers of moDCs, and neither compound influenced LPS-induced activation at 10 μM. Since only CBD had measurable effects on moDCs, in our subsequent experiments we tested the effect only of that pCB. On moDCs differentiated in the presence of CBD subsequent activation by LPS induced a markedly different, much more tolerogenic response. CBD-treated moDCs also produced significantly more interleukin (IL)-6, TNFα and, importantly, IL-10 in response to LPS, which shows a shift toward anti-inflammatory signaling, as well as a more robust secretory response in general. To rule out the possibility that these effects of CBD are specific to TLR4 signaling, we determined the effect of CBD on TLR7/8-induced maturation as well, and saw similar, although less marked responses. CBD-treated moDCs were also less efficient at activating naïve T cells after LPS stimulation, further supporting the tolerogenic effect of this phytocannabinoid on moDCs. Reactome pathway analysis showed an inflammatory response to LPS in moDCs, and to a lesser extent to CBD as well. In contrast CBD-treated moDCs responded to LPS with a shift towards a more tolerogenic phenotype, as IL-10 signaling was the most prominently induced pathway in this group. Discussion Our results show that CBD achieves an anti-inflammatory effect on adaptive immune responses only in the presence of an activating stimuli on moDCs by reprogramming cells during long-term treatment, and not through acute, short-term effects.
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Affiliation(s)
- Zsófia Pénzes
- Department of Immunology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
- Doctoral School of Molecular Medicine, University of Debrecen, Debrecen, Hungary
| | - Shahrzad Alimohammadi
- Doctoral School of Molecular Medicine, University of Debrecen, Debrecen, Hungary
- Department of Dermatology, School of Medicine, University of California, San Diego, La Jolla, CA, United States
| | - Dorottya Horváth
- Department of Immunology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
- Doctoral School of Molecular Medicine, University of Debrecen, Debrecen, Hungary
| | - Attila Oláh
- Doctoral School of Molecular Medicine, University of Debrecen, Debrecen, Hungary
- Department of Physiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Balázs István Tóth
- Doctoral School of Molecular Medicine, University of Debrecen, Debrecen, Hungary
- Department of Physiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Attila Bácsi
- Department of Immunology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
- ELKH-DE Allergology Research Group, Debrecen, Hungary
| | - Attila Gábor Szöllősi
- Department of Immunology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
- Doctoral School of Molecular Medicine, University of Debrecen, Debrecen, Hungary
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Hammoda TM, Ahmed NA, Hamdino M. Fractional CO 2 laser versus 1064-nm long-pulsed Nd:YAG laser for inflammatory acne vulgaris treatment: a randomized clinical trial. Lasers Med Sci 2023; 38:187. [PMID: 37592125 PMCID: PMC10435603 DOI: 10.1007/s10103-023-03855-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 08/08/2023] [Indexed: 08/19/2023]
Abstract
Acne vulgaris is challenging to treat for several individuals. Laser therapy may be a desirable alternative to traditional therapies with limited success. This study aimed to assess efficacy of fractional CO2 laser versus Nd:YAG laser for acne vulgaris therapy. Thirty cases with acne vulgaris underwent both fractional CO2 laser and Nd: YAG laser treatments in a randomized split face design at a 14-day interval for four sessions. The clinical efficacy was evaluated by counting acne lesions and utilizing the Global Acne Severity Scale (GEA Scale). GEAs decreased significantly after both fractional CO2 and Nd:YAG modalities after treatment and at a 3-month follow-up; fractional CO2 demonstrated significant more decrease in GEAs with (P = 0.006, 0.00 (respectively. Moreover, fractional CO2 showed a significantly higher satisfaction level (P = 0.004) and a better clinical improvement percentage regarding inflammatory and noninflammatory acne lesions (P = 0.007 and 0.000, respectively) after 3 months of follow-up. Apart from transient erythema, there were insignificant adverse effects concerning both treated sides. Fractional CO2 and Nd:YAG lasers are efficient physical modalities of acne treatment. However, fractional CO2 laser was more effective and more satisfying to the patients.
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Affiliation(s)
- Tasneem Muhammad Hammoda
- Dermatology and Venereology Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | - Naglaa Abdallah Ahmed
- Dermatology and Venereology Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | - Mervat Hamdino
- Dermatology and Venereology Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt.
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