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Binsaleh AY, Ali LS, Bahaa MM, Elmasry TA, Negm WA, Hamouda AO, Salahuddin MM, Wahsh E, El-Samongy MA, Alsubaie N, El-Khateeb E, Yasser M, Eltantawy N. Correlation between depression scores and serum NF-ĸB/NLRP3 axis, biotinidase, and HMGB1 after treatment with isotretinoin in patients with acne vulgaris. J Cosmet Dermatol 2024; 23:3409-3417. [PMID: 38923374 DOI: 10.1111/jocd.16433] [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: 03/23/2024] [Revised: 05/11/2024] [Accepted: 06/08/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND Acne vulgaris (AV) is an inflammatory skin disorder leading to scars and discomfort, its intensity has major psychological consequences such as depression. AIM To investigate the effect of isotretinoin (ISO) on NF-κB/NLRP3, biotinidase, and HMGB and correlation with depression. PATIENTS AND METHODS This was a case-control study that involved two groups. Group 1 is 20 healthy control, and group 2 is 20 patients diagnosed with AV according to Global Acne Grading System (GAGS) and received 20 mg ISO for 2 months. Before and after therapy, the Hamilton Depression Rating Scale (HDRS) was applied to assess each participant's level of depression. Nuclear factor kappa B (NF-ĸB), biotinidase, high mobility group box protein (HMGB1), nucleotide-binding domain, leucine-rich-containing family, and pyrin domain-containing-3 (NLRP-3) were measured in serum samples. RESULTS There was no significant difference in all measured markers of healthy group before and after 2 months. Regarding group 2, there was a statistically significant decrease in all measured markers after 2 months of treatment and significant correlations between GAGS, NF-ĸB, HMGB1, NLRP3, biotinidase, and depression score. CONCLUSION Increased GAGS, HMGB1, NLRP3, and biotinidase were associated with depression severity in AV patients and ISO treatment significantly reduced these parameters and reduced depressive symptoms.
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Affiliation(s)
- Ammena Y Binsaleh
- Department of Pharmacy Practice, College of Pharmacy, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia
| | - Lahin Saad Ali
- Department of Basic Medical Science, Faculty of Dentistry, Al-Ahliyya Amman University, Amman, Jordan
- Physiology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Mostafa M Bahaa
- Pharmacy Practice Department, Faculty of Pharmacy, Horus University, New Damietta, Egypt
| | - Thanaa A Elmasry
- Pharmacology and Toxicology Department, Faculty of Pharmacy, Tanta University, Tanta, Al-Gharbia, Egypt
| | - Walaa A Negm
- Pharmacognosy Department, Faculty of Pharmacy, Tanta University, Tanta, Al-Gharbia, Egypt
| | - Amir O Hamouda
- Department of Biochemistry and Pharmacology, Faculty of Pharmacy, Horus University, New Damietta, Egypt
| | - Muhammed M Salahuddin
- Department of Biochemistry and Pharmacology, Faculty of Pharmacy, Horus University, New Damietta, Egypt
| | - Eman Wahsh
- Pharmacology and Toxicology Department, Faculty of Pharmacy, Sinai University, Arish, Egypt
| | | | - Nawal Alsubaie
- Department of Pharmacy Practice, College of Pharmacy, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia
| | - Eman El-Khateeb
- Clinical Pharmacy Department, Faculty of Pharmacy, Tanta University, Tanta, Al-Gharbia, Egypt
| | - Mohamed Yasser
- Department of Pharmaceutics, Faculty of Pharmacy, Port Said University, Port Said, Egypt
- Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Horus University, New Damietta, Egypt
| | - Nashwa Eltantawy
- Pharmacy Practice Department, Faculty of Pharmacy, Heliopolis University, Cairo 11757, Egypt
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Su L, Wang F, Wang Y, Qin C, Yang X, Ye J. Circulating biomarkers of oxidative stress in people with acne vulgaris: a systematic review and meta-analysis. Arch Dermatol Res 2024; 316:105. [PMID: 38489064 DOI: 10.1007/s00403-024-02840-5] [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: 11/14/2023] [Revised: 01/15/2024] [Accepted: 02/06/2024] [Indexed: 03/17/2024]
Abstract
The relationship between acne vulgaris and oxidative stress biomarkers lacks a clear consensus. This study aimed to explore the potential correlation between acne vulgaris and circulating oxidative stress biomarkers (superoxide dismutase [SOD], malondialdehyde [MDA], and total antioxidant capacity [TAC]). We searched the PubMed, Embase, and Cochrane Library databases for articles published before June 26, 2023. The literature search combined free words and the medical subject headings terms related to acne vulgaris, SOD, MDA, and TAC. Data were analyzed using Stata 15 software. Additionally, we conducted a subgroup analysis stratified by the severity of acne vulgaris. A total of 14 trials involving 1191 participants were included. Overall results revealed that acne vulgaris was associated with MDA concentrations (SMD = 1.73; 95% CI 1.05, 2.4; P < 0.001). Subgroup analyses indicated that the severity of acne vulgaris was correlated with levels of circulating biomarkers of oxidative stress. TAC concentrations were significantly lower in patients with moderate acne vulgaris compared to controls (SMD = - 1.37; 95% CI = - 2.15, - 0.58, P = 0.001). SOD concentrations were significantly lower (SMD = - 2.92; 95% CI = - 5.39, - 0.46, P = 0.02) and MDA concentrations were significantly higher (SMD = 2.26; 95% CI = 0.95, 3.57, P = 0.001) in patients with severe acne vulgaris compared to controls. Our results implied that oxidative stress may exist in acne vulgaris. Furthermore, the severity of acne vulgaris was also correlated with oxidative stress.
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Affiliation(s)
- Liang Su
- Department of Dermatology, The First Affiliated Hospital of Yunnan University of Chinese Medicine, Kunming, China
- Department of Dermatology, Yunnan Provincial Hospital of Traditional Chinese Medicine, No 120, Guanghua Street, Kunming, 650021, China
| | - Fang Wang
- The First Clinical School of Yunnan University of Chinese Medicine, Kunming, China
| | - Yuan Wang
- Department of Dermatology, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Cheng Qin
- The First Clinical School of Yunnan University of Chinese Medicine, Kunming, China
| | - Xuesong Yang
- Department of Dermatology, The First Affiliated Hospital of Yunnan University of Chinese Medicine, Kunming, China.
- Department of Dermatology, Yunnan Provincial Hospital of Traditional Chinese Medicine, No 120, Guanghua Street, Kunming, 650021, China.
| | - Jianzhou Ye
- Department of Dermatology, The First Affiliated Hospital of Yunnan University of Chinese Medicine, Kunming, China.
- Department of Dermatology, Yunnan Provincial Hospital of Traditional Chinese Medicine, No 120, Guanghua Street, Kunming, 650021, China.
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Dabash D, Salahat H, Awawdeh S, Hamadani F, Khraim H, Koni AA, Zyoud SH. Prevalence of acne and its impact on quality of life and practices regarding self-treatment among medical students. Sci Rep 2024; 14:4351. [PMID: 38388743 PMCID: PMC10883973 DOI: 10.1038/s41598-024-55094-6] [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: 02/10/2023] [Accepted: 02/20/2024] [Indexed: 02/24/2024] Open
Abstract
Acne vulgaris is one of the most common skin diseases worldwide and causes great distress to patients. In addition, most acne patients suffer from low self-esteem and social withdrawal. This study aimed to assess the prevalence of acne and its impact on quality of life among medical students. It also evaluates the patterns of self-treatment use. The study population consisted of all medical students from An-Najah National University (ANU) and the hospital. The questionnaire consists of three parts, and the first part consists of questions regarding demographic information. The second part consisted of questions to measure the severity of acne using the acne severity scale as well as the Cardiff Disability Index, which assesses the quality of life concerning acne in medical students. Finally, the third part consisted of questions exploring and assessing acne self-treatment. The mean age of our study sample was 21.3 ± 1.9 years, with a female predominance of 72.3%. The prevalence of acne among medical students was 80.9%, and 36.6% practiced self-medication. Acne was strongly associated with female sex (p < 0.001) and skin type (p = 0.024). Regarding diet, dairy consumption (p = 0.007), sweets (p < 0.001), chocolate (p < 0.001), and oily food (p = 0.006) were all significantly associated with acne. Skin type was strongly associated with the severity of acne (p < 0.001) and the Cardiff acne disability index (p = 0.016). Gender (p = 0.039) was also associated with Cardiff acne disability. A significant correlation was found between the severity of acne and impaired quality of life. The most commonly used topical agent for self-treatment remedies was antibiotics (70.3%). The most commonly used oral agent was isotretinoin (9.4%). A total of 22.7% of the students used herbal products, while 47.7% used home remedies. Acne is prevalent among medical students, with a high percentage of students having different degrees of impairment in their daily lives. As a result, self-medication among acne sufferers is highly common. Awareness of the appropriate use of self-medication should increase among medical students.
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Affiliation(s)
- Duaa Dabash
- Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine
| | - Haya Salahat
- Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine
| | - Sally Awawdeh
- Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine
| | - Fadi Hamadani
- Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine
| | - Husam Khraim
- Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine
| | - Amer A Koni
- Division of Clinical Pharmacy, Department of Hematology and Oncology, An-Najah National University Hospital, Nablus, 44839, Palestine
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine
| | - Sa'ed H Zyoud
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine.
- Poison Control and Drug Information Center (PCDIC), College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine.
- Clinical Research Center, An-Najah National University Hospital, Nablus, 44839, Palestine.
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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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Hughes O, Bewley A. Is it really ever 'just acne'? Considering the psychodermatology of acne. Br J Dermatol 2023; 189:i11-i16. [PMID: 37903071 DOI: 10.1093/bjd/ljad251] [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: 07/08/2023] [Indexed: 11/01/2023]
Abstract
Acne can create a significant burden for people of all ages. However, the psychological consequences might often be overlooked. This review comments on recent evidence in the field of psychodermatology, to highlight the importance of considering a person's mental health in the treatment of acne. A range of presenting issues are discussed, and cases of underserved patients needing additional considerations are highlighted. This article considers how the psychological sequelae can contribute to the pathogenesis of acne, and discusses how psychotherapeutic approaches can be of benefit to people experiencing appearance-related distress. Importantly, attention is paid to the need for clinicians to assess a patient's wellbeing alongside their physical symptoms. In doing this, early intervention can be facilitated if psychological comorbidities are present, with referral to appropriate specialist services, where available. To improve treatment outcomes, the skin and the mind must be addressed together in a multidisciplinary approach to dermatology care.
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Affiliation(s)
- Olivia Hughes
- School of Psychology, Cardiff University, Cardiff, UK
| | - Anthony Bewley
- Barts Health NHS Trust and Queen Mary University of London Medical School, London, UK
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Layton AM, Alexis A, Baldwin H, Bettoli V, Del Rosso J, Dirschka T, Dréno B, Gold LS, Harper J, Ko JY, Al Nuaimi K, Oon HH, Rajagopalan M, Rocha M, See JA, Weiss J, Tan J. The Personalized Acne Treatment Tool - Recommendations to facilitate a patient-centered approach to acne management from the Personalizing Acne: Consensus of Experts. JAAD Int 2023; 12:60-69. [PMID: 37274381 PMCID: PMC10236180 DOI: 10.1016/j.jdin.2023.03.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/20/2023] [Indexed: 06/06/2023] Open
Abstract
Background Acne, a commonly treated skin disease, requires patient-centered management due to its varying presentations, chronicity, and impact on health-related quality of life. Despite this, evidence-based clinical guidelines focus primarily on clinical severity of facial acne, omitting important patient- and disease-related factors, including ongoing management. Objectives To generate recommendations to support patient-centered acne management, which incorporate priority and prognostic factors beyond conventional clinical severity, traditionally defined by grading the appearance and extent of visible lesions. Methods The Personalizing Acne: Consensus of Experts consisted of 17 dermatologists who used a modified Delphi approach to reach consensus on statements regarding patient- and treatment-related factors pertaining to patient-centered acne management. Consensus was defined as ≥75% voting "agree" or "strongly agree." Results Recommendations based on factors such as acne sequelae, location of acne, high burden of disease, and individual patient features were generated and incorporated into the Personalized Acne Treatment Tool. Limitations Recommendations are based on expert opinion, which may differ from patients' perspectives. Regional variations in healthcare systems may not be represented. Conclusions The Personalizing Acne: Consensus of Experts panel provided practical recommendations to facilitate individualized management of acne, based on patient features, which can be implemented to improve treatment outcomes, adherence, and patient satisfaction.
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Affiliation(s)
- Alison M. Layton
- Skin Research Centre, York University, York, UK
- Harrogate and District NHS Foundation Trust, Harrogate, UK
| | | | - Hilary Baldwin
- Robert Wood Johnson Medical Center, New Brunswick, New Jersey
- The Acne Treatment and Research Center, Brooklyn, New York
| | - Vincenzo Bettoli
- Dermatology Unit – Teaching Hospital, Azienda Ospedaliera, University of Ferrara, Ferrara, Italy
| | - James Del Rosso
- Advanced Dermatology and Cosmetic Surgery, Maitland, Florida
- JDR Dermatology Research, Las Vegas, Nevada
| | | | | | | | - Julie Harper
- Dermatology and Skin Care Center of Birmingham, Birmingham, Alabama
| | - Joo Yeon Ko
- Department of Dermatology, Hanyang University College of Medicine, Seoul, Republic of Korea
| | - Khaled Al Nuaimi
- Faculty of Medicine, Sharjah University, Sharjah, United Arab Emirates
| | - Hazel H. Oon
- Division of Dermatology, National Skin Centre, Singapore
| | | | - Marco Rocha
- Federal University of São Paulo, São Paulo, Brazil
| | - Jo-Ann See
- Central Sydney Dermatology, Sydney, New South Wales, Australia
| | | | - Jerry Tan
- Windsor Clinical Research Inc, Windsor, Ontario, Canada
- Department of Medicine, University of Western Ontario, Windsor, Ontario, Canada
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Campos-Muñoz L, Belmar Madrid C, Conde-Taboada A, Iglesias Puzas A, Gonzalez Guerra E, López-Bran E. Quality of life in children with skin disease: A Spanish sample. An Pediatr (Barc) 2023; 99:170-175. [PMID: 37658021 DOI: 10.1016/j.anpede.2023.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 06/18/2023] [Indexed: 09/03/2023] Open
Abstract
INTRODUCTION The impact of skin diseases on quality of life varies widely, and some can have an impact similar to that of asthma or cystic fibrosis. MATERIAL AND METHODS We conducted a cross-sectional, observational and descriptive study with the aim of describing the degree to which quality of life was affected in paediatric patients managed in a dermatology clinic by means of the Children's Dermatology Life Quality Index (CDLQI). RESULTS In our study, the skin disease with the greatest impact on quality of life was atopic dermatitis, chiefly on account of symptoms like pruritus and insomnia. It was followed by acne, mainly due to the associated negative feelings (shame, sadness, etc.). Quality of life in patients with viral warts and molluscum contagiosum was mostly affected by the treatment, chiefly based on cryotherapy. Most patients with nevi or café-au-lait spots did not have a decreased quality of life, although up to one third of them had negative feelings in relation to their skin disease. DISCUSSION Atopic dermatitis was the common skin disease that caused the greatest impairment in quality of life in our sample, although other diseases also had an impact on different dimensions of quality of life. We ought to underscore the recommendation to use less painful treatments than cryotherapy for viral warts and molluscum contagiosum, as the impairment in quality of life in paediatric patients with these conditions was mainly due to the treatment.
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Pala E, Bayraktar M. Relationships Between Disease Severity and the C-reactive Protein/Albumin Ratio and Various Hematological Parameters in Patients With Acne Vulgaris. Cureus 2023; 15:e44089. [PMID: 37750127 PMCID: PMC10518065 DOI: 10.7759/cureus.44089] [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: 08/24/2023] [Indexed: 09/27/2023] Open
Abstract
OBJECTIVE Acne vulgaris, an inflammatory disease, was investigated in this study with the claim that the C-reactive protein (CRP)/albumin ratio and some hematological parameter ratios have the potential to be used as inflammatory markers to monitor disease severity and prognosis. METHODS A descriptive cross-sectional study was conducted with two groups of patients aged 18-65 years, 61 patients diagnosed with acne vulgaris and 35 healthy control patients, and routine hemogram and biochemical parameters were compared. The Global Acne Severity Index was used to determine the severity of acne vulgaris. RESULTS The median age of acne patients was 22.0 (IQR=5.0) and the median age of healthy volunteers was 30.0 (IQR=14.0). There were 75.4% (n=46) women in the acne group and 77.1% (n=27) women in the control group. Among the acne patients, 42.6% (n=26) had mild acne, and 41% (n=25) had moderate acne severity. A significant difference was found between the study groups in terms of CRP/albumin ratio, CRP, monocyte/lymphocyte ratio (MLR), lymphocyte/albumin ratio (LAR), and monocyte/CRP ratio (MCR) according to laboratory test results and calculated test ratios (p<0.05). The area under the curve (AUC) value of the CRP/albumin ratio in the receiver operating characteristic (ROC) analysis between the acne and control groups was 0.660, and its cut-off value was found to be 0.236 with 68.6% sensitivity and 68.9% specificity. CONCLUSION This study is the first to compare the CRP/albumin ratio with the severity of acne vulgaris in the literature. CRP/albumin ratio and MCR may serve as inflammatory markers that can be used to monitor the severity of acne vulgaris.
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Affiliation(s)
- Erdal Pala
- Department of Dermatology and Venerology, Faculty of Medicine, Ataturk University, Erzurum, TUR
| | - Mustafa Bayraktar
- Department of Family Medicine, Faculty of Medicine, Ataturk University, Erzurum, TUR
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Nong Y, Gahoonia N, Rizzo J, Burney W, Sivamani RK, Maloh J. Prospective Evaluation of a Topical Botanical Skin Care Regimen on Mild to Moderate Facial and Truncal Acne and Mood. J Clin Med 2023; 12:jcm12041484. [PMID: 36836020 PMCID: PMC9966061 DOI: 10.3390/jcm12041484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 02/03/2023] [Accepted: 02/07/2023] [Indexed: 02/16/2023] Open
Abstract
Acne vulgaris is a common inflammatory condition that can be associated with profound psychosocial impacts. Conventional treatment includes topical retinoids, benzoyl peroxide, and antimicrobials, and some may cause irritation and skin dryness. In this 8-week open-label study, we examined the effects of a botanical skin care regimen (Codex Labs Shaant Balancing regimen) on mild to moderate facial and truncal acne. Twenty-four male and female subjects between the ages of 12 and 45 years were assessed for eligibility, 20 were enrolled, and 15 completed all study visits. Facial and truncal acne lesion counts, skin hydration, sebum excretion rate, and mood were assessed at baseline, week 4, and week 8. Total facial lesion counts (inflammatory and non-inflammatory lesions) decreased by 20.5% at week 4 (p = 0.06) and by 25.2% at week 8 (p < 0.05). Inflammatory lesion counts on the trunk were found to decrease at week 8 relative to baseline by 48% (p < 0.05). Forehead sebum excretion rate decreased by 40% at week 4 (p = 0.07) and 22% at week 8 (p = 0.08), and cheek skin hydration increased by 27.6% at week 4 (p = 0.14) and 65% at week 8 (p = 0.10). Participants also experienced significant improvement in components of a positive effect, such as feeling "strong" and "inspired", and a decrease in negative effects, such as feeling "irritable." Overall, the botanical skin care regimen was found to be well-tolerated. Our study suggests that a botanical skin care regimen may reduce facial and truncal acne lesion counts, increase skin hydration, reduce sebum production, and augment positive effects and moods in those with mild to moderate facial and truncal acne.
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Affiliation(s)
- Yvonne Nong
- Integrative Skin Science and Research, Sacramento, CA 95815, USA
- College of Human Medicine, Michigan State University, East Lansing, MI 48824, USA
| | - Nimrit Gahoonia
- Integrative Skin Science and Research, Sacramento, CA 95815, USA
- College of Osteopathic Medicine, Touro University, Vallejo, CA 94592, USA
| | - Julianne Rizzo
- Integrative Skin Science and Research, Sacramento, CA 95815, USA
- School of Medicine, University of California Davis, Sacramento, CA 95817, USA
| | - Waqas Burney
- Integrative Skin Science and Research, Sacramento, CA 95815, USA
| | - Raja K. Sivamani
- Integrative Skin Science and Research, Sacramento, CA 95815, USA
- Pacific Skin Institute, Sacramento, CA 95815, USA
- Department of Dermatology, University of California Davis, Davis, CA 95816, USA
- Correspondence: (R.K.S.); (J.M.)
| | - Jessica Maloh
- Integrative Skin Science and Research, Sacramento, CA 95815, USA
- Correspondence: (R.K.S.); (J.M.)
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10
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Chen T, Chen Y, Shao X, Chen J, Liu L, Li Y, Pu Y, Chen J. Hematological parameters in patients with acnes. J Cosmet Dermatol 2023. [PMID: 36757679 DOI: 10.1111/jocd.15676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 01/20/2023] [Accepted: 01/30/2023] [Indexed: 02/10/2023]
Abstract
OBJECTIVE To compare complete blood count (CBC) parameters and inflammatory factors in the patients with different grade of acne vulgaris and healthy controls. METHODS A total of 20 patients were enrolled in this study. Patients were divided into mild group and moderate-to-severe group based on the acne severity, and compared to controls. Inflammatory factors (TNF-α, IL-6, IL-8, and IL1-α) detected by ELISA and complete blood count parameters (MPV, NLR, dNLR, PLR, LMR, and SII) obtained by routine blood tests were compared among the three group. RESULTS All CBC parameters were not significantly elevated in patients with acne compared to healthy controls. However, the present studies have found that the inflammatory factors in acne patients were significantly elevated relative to healthy controls, and increase with the acne grade. CONCLUSIONS Inflammatory factors are convenient parameters to show inflammatory response to acne vulgaris, and may be a new clinical method for judging the acne grades of objectively. Considering the use of antibiotic, we believe that this metric worth further study.
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Affiliation(s)
- Tingqiao Chen
- 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
| | - Xinyi Shao
- Department of Dermatology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jiayi Chen
- Department of Dermatology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Lin Liu
- 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
| | - Yihuan Pu
- 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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11
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Ozcan Y, Sungur MA, Ozcan BY, Eyup Y, Ozlu E. The Psychosocial Impact of Chronic Facial Dermatoses in Adults. Dermatol Pract Concept 2023; 13:dpc.1301a29. [PMID: 36892338 PMCID: PMC9946076 DOI: 10.5826/dpc.1301a29] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/16/2022] [Indexed: 02/04/2023] Open
Abstract
INTRODUCTION Skin diseases have negative psychological and social consequences, especially when they are chronic and affect a visible area of the body, such as the face. OBJECTIVES The purpose of this study is to investigate and compare the psychosocial impact of three common chronic dermatoses of the face: acne, rosacea, and seborrheic dermatitis. METHODS The Dermatology Life Quality Index (DLQI), Hospital Anxiety and Depression Scale (HADS), and Social Appearance Anxiety Scale (SAAS) were used to compare acne, rosacea, and seborrheic dermatitis patients and healthy controls. The relationships between DLQI, HADS, and SAAS results were investigated, as well as their associations with disease duration and severity. RESULTS The study included 166 acne patients, 134 rosacea patients, 120 seborrheic dermatitis patients, and 124 controls. The patient groups had significantly higher DLQI, HADS, and SAAS scores than the control group. Rosacea patients had the highest DLQI and SAAS scores, as well as the highest anxiety prevalence. Patients with seborrheic dermatitis had the highest rate of depression. The DLQI, HADS, and SAAS results were moderately correlated with each other, but their relationship with disease duration and severity was insignificant or weak at best. CONCLUSIONS Chronic facial dermatoses have a detrimental impact on mood and quality of life. Although patients with acne, rosacea, and seborrheic dermatitis have distinct lesions, the outcomes in terms of quality of life, anxiety, and depression are largely similar. Furthermore, these patients report similar levels of social anxiety as a result of their overall appearance.
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Affiliation(s)
- Yunus Ozcan
- Department of Dermatology, Duzce Ataturk State Hospital, Duzce, Turkey
| | - Mehmet Ali Sungur
- Department of Biostatistics, Duzce University Faculty of Medicine, Duzce, Turkey
| | - Begum Yaman Ozcan
- Department of Psychiatry, Duzce University Faculty of Medicine, Duzce, Turkey
| | - Yavuz Eyup
- Department of Dermatology, Unye State Hospital, Unye/Ordu, Turkey
| | - Emin Ozlu
- Associate Professor of Dermatology, Private Practice, Duzce, Turkey
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Muacevic A, Adler JR, Akkoyun A. The Relationship of Acne With Somatosensory Amplification, Health Anxiety, and Depression Levels. Cureus 2022; 14:e32314. [PMID: 36628010 PMCID: PMC9825042 DOI: 10.7759/cureus.32314] [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: 11/14/2022] [Indexed: 12/13/2022] Open
Abstract
Objective The objective of this study is to evaluate the somatosensory amplification, as well as anxiety and depression levels in acne vulgaris (AV) patients, and to examine their relationship with disease severity. Methods Sociodemographic form, Global Acne Grading System (GAGS), Somatosensory Amplification Scale (SSAS), Health Anxiety Inventory (HAI), Beck Anxiety Inventory (BAI), and Beck Depression Inventory (BDI) were applied to the patient group. All scales, except GAGS, were also applied to the healthy controls. Results All psychiatric scale scores of acne patients were higher than those of the control group. Moreover, the patient group had significantly higher SSAS, BDI scores, HAI total scores, and subscales of hypersensitivity to somatic symptoms and anxiety compared to the healthy controls. A positive but weak correlation was found between all scale scores. In patients with AV, no correlation was found between acne severity, age, disease duration, and all scale scores. Conclusion A significant relationship was found between somatosensory amplification, depression, and health anxiety in acne patients, independent of global acne severity, age, and disease duration. More successful acne treatment and patient management will be possible with an interdisciplinary approach that includes both psychiatry and dermatology.
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13
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Huang Y, Liu L, Hao Z, Chen L, Yang Q, Xiong X, Deng Y. Potential roles of gut microbial tryptophan metabolites in the complex pathogenesis of acne vulgaris. Front Microbiol 2022; 13:942027. [PMID: 35966699 PMCID: PMC9363916 DOI: 10.3389/fmicb.2022.942027] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 07/04/2022] [Indexed: 11/23/2022] Open
Abstract
Acne vulgaris is a chronic inflammatory skin disease in which the influence of gut microbiota has been implicated but without clarification of mechanisms. Gut microbiota may exert such an influence via metabolites, particularly those of tryptophan. End metabolites of tryptophan activate receptors, including aryl hydrocarbon, G protein-coupled, and pregnane X receptors to stabilize the immune microenvironment and intestinal mucosal homeostasis. Any impact on the pathogenesis of acne vulgaris remains unclear. The current review collates recent advances concerning potential roles of tryptophan metabolism in mediating skin inflammation, follicular sebaceous gland function and intestinal permeability, all of which influence the pathogenesis of acne vulgaris. The aim was to improve understanding of the pathogenesis of acne vulgaris and to expose therapeutic opportunities.
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Affiliation(s)
- Yukun Huang
- Department of Dermatology and STD, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Lu Liu
- Department of Dermatology and STD, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Zhenyu Hao
- Department of Dermatology and STD, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Lingna Chen
- Department of Dermatology and STD, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Qian Yang
- School of Nursing, Chengdu Medical College, Chengdu, China
- *Correspondence: Qian Yang,
| | - Xia Xiong
- Department of Dermatology and STD, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Xia Xiong,
| | - Yongqiong Deng
- Department of Dermatology and STD, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Yongqiong Deng,
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14
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Sex Differences in Comorbidity Combinations in the Swedish Population. Biomolecules 2022; 12:biom12070949. [PMID: 35883505 PMCID: PMC9313065 DOI: 10.3390/biom12070949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 06/23/2022] [Accepted: 06/30/2022] [Indexed: 11/16/2022] Open
Abstract
High comorbidity rates, especially mental–physical comorbidity, constitute an increasing health care burden, with women and men being differentially affected. To gain an overview of comorbidity rates stratified by sex across a range of different conditions, this study examines comorbidity patterns within and between cardiovascular, pulmonary, skin, endocrine, digestive, urogenital, musculoskeletal, neurological diseases, and psychiatric conditions. Self-report data from the LifeGene cohort of 31,825 participants from the general Swedish population (62.5% female, 18–84 years) were analyzed. Pairwise comorbidity rates of 54 self-reported conditions in women and men and adjusted odds ratios (ORs) for their comparison were calculated. Overall, the rate of pairwise disease combinations with significant comorbidity was higher in women than men (14.36% vs. 9.40%). Among psychiatric conditions, this rate was considerably high, with 41.76% in women and 39.01% in men. The highest percentages of elevated mental–physical comorbidity in women were found for musculoskeletal diseases (21.43%), digestive diseases (20.71%), and skin diseases (13.39%); in men, for musculoskeletal diseases (14.29%), neurological diseases (11.22%), and digestive diseases (10%). Implications include the need for integrating mental and physical health care services and a shift from a disease-centered to an individualized, patient-centered focus in clinical care.
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Nickles MA, Lake E. Topical dapsone in the treatment of acne: a systematic review. Int J Dermatol 2022; 61:1412-1421. [PMID: 35132625 DOI: 10.1111/ijd.16074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Revised: 11/12/2021] [Accepted: 12/31/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Acne is one of the most common dermatological disorders. Initial therapies for acne include topical retinoids, benzoyl peroxide, and topical clindamycin. However, patients who fail initial therapies may benefit from alternative topicals, including dapsone gel. OBJECTIVE To analyze the current literature studying the efficacy of topical dapsone in the treatment of acne. METHODS PubMed, Embase, and Cochrane Library were systematically searched for clinical trials examining the efficacy of topical dapsone in the treatment of acne. RESULTS Fourteen studies were included in the analysis. Dapsone monotherapy showed a treatment success rate of 40.1-69.4% for dapsone gel 5% and 29.8-47.0% for dapsone gel 7.5% when used for 12-16 weeks. In all studies, inflammatory lesions decreased by a larger percentage than noninflammatory or total lesions. Dapsone gel was also studied in combination with various other acne treatments, including doxycycline, oral isotretinoin, benzoyl peroxide, and topical retinoids. While mild treatment-related adverse effects, most commonly consisting of skin irritation, occurred in 2.0-75.0% of participants, no major treatment-related adverse effects were reported. LIMITATIONS Limitations of the study include variable treatment regimens making it difficult to compare results across studies. Additionally, adverse effects and skin irritation were reported differently, and potential selection biases exist in the randomized trials. CONCLUSION Dapsone gel offers a safe and promising alternative therapy for patients with difficult to treat acne or those who experience adverse effects to first-line therapies.
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Affiliation(s)
- Melissa A Nickles
- University of Illinois at Chicago College of Medicine, Chicago, IL, USA
| | - Eden Lake
- Division of Dermatology, Loyola University Medical Center, Maywood, IL, USA
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16
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Tan J, Alexis A, Baldwin H, Beissert S, Bettoli V, Del Rosso J, Dréno B, Gold LS, Harper J, Lynde C, Thiboutot D, Weiss J, Layton AM. Gaps and recommendations for clinical management of truncal acne from the Personalising Acne: Consensus of Experts panel. JAAD Int 2021; 5:33-40. [PMID: 34816132 PMCID: PMC8593751 DOI: 10.1016/j.jdin.2021.06.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/25/2021] [Indexed: 11/30/2022] Open
Abstract
Background Truncal acne is common and burdensome for patients; however, there is paucity of evidence and guidance for the management of truncal acne. Currently, clinical practice guidelines provide very little guidance on the assessment or management of truncal acne. Objectives To identify unmet needs in truncal acne and make recommendations to address clinical and management gaps using an international consensus. Methods The Personalising Acne: Consensus of Experts panel consisted of 13 dermatologists, who used a modified Delphi approach to reach a consensus on statements related to clinically relevant aspects of truncal acne evaluation and management. A consensus was defined as ≥75% of the panelists voting “agree” or “strongly agree.” The voting was electronic and blinded. Results The panel identified gaps and made recommendations related to truncal acne identification, assessment, and grading; the evaluation of the impact on patients; and treatment goals and factors to be considered for its management. Limitations The recommendations are based on expert opinion, in the absence of high-quality evidence. Conclusions We highlighted addressing not just facial acne but also truncal acne during patient consultations. The recommendations made herein may help facilitate the care of patients who present with truncal acne, with or without facial acne.
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Affiliation(s)
- Jerry Tan
- Windsor Clinical Research Inc, Windsor, Ontario, Canada
- Department of Medicine, University of Western Ontario, Windsor Campus, Windsor, Ontario, Canada
- Correspondence to: Jerry Tan, MD, Windsor Clinical Research Inc, 2224 Walker Rd, Suite 300, Windsor, Ontario, N8W 5L7, Canada.
| | | | - Hilary Baldwin
- Robert Wood Johnson Medical Center, New Brunswick, New Jersey
- The Acne Treatment and Research Center, Brooklyn, New York
| | - Stefan Beissert
- Department of Dermatology, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Vincenzo Bettoli
- Dermatology Unit – Teaching Hospital, Azienda Ospedaliera, University of Ferrara, Ferrara, Italy
| | - James Del Rosso
- Thomas Dermatology, Las Vegas, Nevada
- JDR Dermatology Research, Las Vegas, Nevada
| | - Brigitte Dréno
- Dermato-cancérology Department, CHU Nantes, University of Nantes, Nantes, France
| | | | - Julie Harper
- Dermatology and Skin Care Center of Birmingham, Birmingham, Alabama
| | - Charles Lynde
- Department of Medicine, University of Toronto, Markham, Ontario, Canada
- Lynderm Research Inc, Markham, Ontario, Canada
| | - Diane Thiboutot
- Department of Dermatology, Pennsylvania State University College of Medicine, Hershey, Philadelphia
| | | | - Alison M. Layton
- Hull York Medical School, University of York, York, United Kingdom
- Harrogate and District NHS Foundation Trust, United Kingdom
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Alghofaili A, Alolayan S, Alhowail A, Mobark MA, Alderaibi S, Almogbel Y. The Effect of Depression on Treatment Adherence Among a Sample of Saudi Patients Diagnosed with Acne Vulgaris. Clin Cosmet Investig Dermatol 2021; 14:1497-1506. [PMID: 34675585 PMCID: PMC8523313 DOI: 10.2147/ccid.s335007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 10/01/2021] [Indexed: 11/23/2022]
Abstract
Purpose Acne vulgaris is an inflammatory disorder of the skin and is the most common dermatological disease, affecting all ages and races. Acne is known to be associated with depression. This study aimed to assess the impact of depression on patient adherence to acne vulgaris treatment using The Expectation Confirmation Theory (ECT). Patients and Methods This cross-sectional study was conducted with 204 patients with acne using four scales (depression, satisfaction, intention to adhere to acne medication, and control for confirmation). ECT scales were used to assess patient satisfaction and intention to adhere to medication. Demographic data were also collected, and descriptive and analytical statistical analyses were performed. Results A total of 204 questionnaires were completed. The mean age of the respondents was 25 ± 7.2. The majority were female; 167 (83.50%). Multiple linear regression analysis indicated a negative association between depression (β= −0.121, p = 0.033; 95% CI, −0.232 to −0.009) and satisfaction, when holding other variables constant, and the expected medication effect (confirmation) had a positive association with satisfaction (β= 0.334, p< 0.001; 95% CI, 0.202 to 0.466), keeping all other factors constant. Male sex was negatively associated with satisfaction (β= −2.388, p= 0.015; 95% CI −4.303 to −0.473), while keeping all other covariate sconstant. Residence in central provinces was a significant predictor of satisfaction (β= 2.562, p= 0.004; 95% CI, 0.832 to 4.292), when holding other factors constant. After conducting a simple linear regression, a positive significant association was found between adherence and satisfaction (β = 0.1713; 95% CI, 0.068 to 0.274). Conclusion Adherence is the cornerstone for a successful treatment plan and prevention of relapse or treatment failure, and satisfaction is an essential indicator for improving health policies and implementing social service provisions.
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Affiliation(s)
- Alanoud Alghofaili
- Department of Pharmacy Practice, College of Pharmacy, Qassim University, Buraidah, Qassim, 51452, Kingdom of Saudi Arabia
| | - Salma Alolayan
- Department of Pharmacy Practice, College of Pharmacy, Qassim University, Buraidah, Qassim, 51452, Kingdom of Saudi Arabia
| | - Ahmad Alhowail
- Department of Pharmacology and Toxicology, College of Pharmacy, Qassim University, Buraidah, Qassim, 51452, Kingdom of Saudi Arabia
| | - Mugahid A Mobark
- Department of Pharmacy Practice, College of Pharmacy, Qassim University, Buraidah, Qassim, 51452, Kingdom of Saudi Arabia
| | - Sulaiman Alderaibi
- Qassim Armed Forces Hospital, Buraidah, Qassim, 51442, Kingdom of Saudi Arabia
| | - Yasser Almogbel
- Department of Pharmacy Practice, College of Pharmacy, Qassim University, Buraidah, Qassim, 51452, Kingdom of Saudi Arabia
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Gold M. Clascoterone cream (1%) topical androgen receptor inhibitor for the treatment of acne in patients 12 years and older. Expert Rev Clin Immunol 2021; 17:301-308. [PMID: 33616473 DOI: 10.1080/1744666x.2021.1894131] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
INTRODUCTION The efficacy of clascoterone cream was demonstrated in two phase three vehicle-controlled clinical trials that enrolled over 1,400 subjects. Its safety profile allowed it to be approved for treating patients as young as 12 years old. During clinical trials, the occurrence of local skin reactions (edema, erythema, pruritus, dryness) was similar to treatment with vehicle alone. AREAS COVERED All publications describing the clinical development of clascoterone cream (cortexolone 17α-propionate) are reviewed and discussed in relation to with existing topical and systemic therapies for acne vulgaris. EXPERT OPINION Clascoterone 1% cream is a novel first-in-class topical androgen receptor inhibitor for the treatment of acne vulgaris. Topical clascoterone 1% cream represents the first new type of therapy for acne treatment in almost 40 years and may become first-line therapy.
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