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Gern A, Walter J, Xu S, Vakharia PP. A randomized controlled double-blinded split-face prospective clinical trial to assess the efficacy, safety, and tolerability of a novel 3-step routine compared to benzoyl peroxide for the treatment of mild to moderate acne vulgaris. Arch Dermatol Res 2024; 316:230. [PMID: 38787441 DOI: 10.1007/s00403-024-02874-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 02/20/2024] [Accepted: 04/07/2024] [Indexed: 05/25/2024]
Abstract
Adult acne vulgaris affects up to 43-51% of individuals. While there are numerous treatment options for acne including topical, oral, and energy-based approaches, benzoyl peroxide (BPO) is a popular over the counter (OTC) treatment. Although BPO monotherapy has a long history of efficacy and safety, it suffers from several disadvantages, most notably, skin irritation, particularly for treatment naïve patients. In this prospective, randomized, controlled, split-face study, we evaluated the comparative efficacy, safety, and tolerability of a novel 3-step azelaic acid, salicylic acid, and graduated retinol regimen versus a common OTC BPO-based regimen over 12 weeks. A total of 37 adult subjects with self-reported mild to moderate acne vulgaris were recruited. A total of 21 subjects underwent a 2-week washout period and completed the full study with 3 dropping out due to product irritation from the BPO routine, and 13 being lost to follow-up. Detailed tolerability surveys were conducted at Week 4. Additional surveys on tolerability and product preferences were collected monthly, at Week 4, Week 8, and Week 12. A blinded board-certified dermatologist objectively scored the presence and type of acne lesions (open or closed comedones, papules, pustules, nodules, and cysts) at baseline, Week 4, Week 8, and Week 12. Patients photographed themselves and uploaded the images using personal mobile phones. Detailed Week 4 survey results showed across 25 domains of user-assessed product performance, the novel routine outperformed the BPO routine in 19 (76%) which included domains in preference (e.g. "I would use this in the future) and performance ("my skin improved" and "helped my acne clear up faster"). Users of the novel routine reported less facial redness, itching, and burning, though differences did not reach statistical significance. In terms of efficacy, both products performed similarly, reducing total acne lesions by 36% (novel routine) and 40% (BPO routine) by Week 12. Overall, accounting for user preferences and tolerability the novel routine was more preferred than the BPO routine in 79% of domains (22/28). Differences in objective acne lesion reduction were not statistically significant (p = 0.97). In a randomized split-face study, a 3-step azelaic acid, salicylic acid, and graduated retinol regimen delivered similar acne lesion reduction, fewer user dropouts, greater user tolerability, and higher use preference compared to a 3-step BPO routine based in a cohort of participants with mild-to-moderate acne vulgaris.
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Affiliation(s)
- Alison Gern
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Jessica Walter
- Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Shuai Xu
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
- Department of Pediatrics (Dermatology), Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
- Sibel Health Inc., Chicago, IL, USA.
| | - Paras P Vakharia
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Kim HJ, Kim YH. Exploring Acne Treatments: From Pathophysiological Mechanisms to Emerging Therapies. Int J Mol Sci 2024; 25:5302. [PMID: 38791344 PMCID: PMC11121268 DOI: 10.3390/ijms25105302] [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: 03/22/2024] [Revised: 05/08/2024] [Accepted: 05/10/2024] [Indexed: 05/26/2024] Open
Abstract
Acne vulgaris is a common dermatological condition that can present across different ages but predominantly affects adolescents and young adults. Characterized by various lesion types, the pathogenesis of acne is complex, involving genetic, hormonal, microbial, and inflammatory factors. This review comprehensively addresses current and emerging acne management strategies, emphasizing both topical and systemic treatments, procedural therapies, and dietary modifications. Key topical agents include retinoids, benzoyl peroxide, antibiotics, and other specialized compounds. Systemic options like antibiotics, hormonal therapies, and retinoids offer significant therapeutic benefits, particularly for moderate to severe cases. Procedural treatments such as laser devices, photodynamic therapy, chemical peels, and intralesional injections present viable alternatives for reducing acne symptoms and scarring. Emerging therapies focus on novel biologics, bacteriophages, probiotics, and peptides, providing promising future options. This review underscores the importance of personalized approaches to treatment due to the multifaceted nature of acne, highlighting the potential of innovative therapies for improving patient outcomes.
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Affiliation(s)
- Hyun Jee Kim
- Department of Dermatology, International St. Mary’s Hospital, College of Medicine, Catholic Kwandong University, Incheon 22711, Republic of Korea;
| | - Yeong Ho Kim
- Department of Dermatology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
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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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Nascimento T, Gomes D, Simões R, da Graça Miguel M. Tea Tree Oil: Properties and the Therapeutic Approach to Acne-A Review. Antioxidants (Basel) 2023; 12:1264. [PMID: 37371994 DOI: 10.3390/antiox12061264] [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: 05/04/2023] [Revised: 06/05/2023] [Accepted: 06/06/2023] [Indexed: 06/29/2023] Open
Abstract
Acne vulgaris is an inflammatory dermatological pathology that affects mostly young people. However, it can also appear in adulthood, mainly in women. It has a high psychosocial impact, not only at the time of active lesions but also due to the consequences of lesions such as scarring and hyperpigmentation. Several factors are involved in the physiopathology of acne and the constant search for active ingredients is a reality, namely phytotherapeutic ingredients. Tea tree oil is an essential oil extracted from Melaleuca alternifolia (Maiden & Betch) Cheel with known antibacterial, anti-inflammatory, and antioxidant properties, making it a candidate for the treatment of acne. This review aims to describe the various properties of tea tree oil that make it a possible ingredient to use in the treatment of acne and to present several human studies that have evaluated the efficacy and safety of using tea tree oil in the treatment of acne. It can be concluded that tea tree oil has good antibacterial, anti-inflammatory, and antioxidant properties that result in a decrease in the number of inflammatory lesions, mainly papules, and pustules. However, given the diversity of study designs, it is not possible to draw concrete conclusions on the efficacy and safety of this oil in the treatment of acne.
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Affiliation(s)
- Tânia Nascimento
- Escola Superior de Saúde, Universidade do Algarve (ESSUAlg), Campus de Gambelas, Edifício 2, 8005-139 Faro, Portugal
- Algarve Biomedical Center Research Institute (ABC-RI), Universidade do Algarve, Campus de Gambelas, Edifício 2, 8005-139 Faro, Portugal
| | - Diana Gomes
- Faculdade de Ciências e Tecnologia, Universidade do Algarve, Campus de Gambelas, 8005-139 Faro, Portugal
| | - Ricardo Simões
- Faculdade de Ciências e Tecnologia, Universidade do Algarve, Campus de Gambelas, 8005-139 Faro, Portugal
| | - Maria da Graça Miguel
- Faculdade de Ciências e Tecnologia, Universidade do Algarve, Campus de Gambelas, 8005-139 Faro, Portugal
- Mediterranean Institute for Agriculture, Environment and Development, Mediterranean Institute for Agriculture, Environment and Development, Universidade do Algarve, Campus de Gambelas, 8005-139 Faro, Portugal
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Cañellas-Santos M, Rosell-Vives E, Montell L, Bilbao A, Goñi-de-Cerio F, Fernandez-Campos F. Anti-Inflammatory and Anti-Quorum Sensing Effect of Camellia sinensis Callus Lysate for Treatment of Acne. Curr Issues Mol Biol 2023; 45:3997-4016. [PMID: 37232724 DOI: 10.3390/cimb45050255] [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: 02/13/2023] [Revised: 04/26/2023] [Accepted: 04/30/2023] [Indexed: 05/27/2023] Open
Abstract
Cutibacterium acnes (C. acnes) is involved in the pathogenesis of acne by inducing inflammation and biofilm formation, along with other virulence factors. A Camellia sinensis (C. sinensis) callus lysate is proposed to reduce these effects. The aim of the present work is to study the anti-inflammatory properties of a callus extract from C. sinensis on C. acnes-stimulated human keratinocytes and the quorum-quenching activities. Keratinocytes were stimulated with thermo-inactivated pathogenic C. acnes and were treated with the herbal lysate (0.25% w/w) to evaluate its anti-inflammatory effect. C. acnes biofilm was developed in vitro and treated with 2.5 and 5% w/w of the lysate to evaluate quorum sensing and the lipase activity. The results showed that the lysate was able to reduce the production of interleukin-6 (IL-6), interleukin-8 (IL-8), tumor necrosis factor-α (TNF-α), and C-X-C motif chemokine ligand 1 (CXCL1), and decrease the nuclear translocation of nuclear factor kappa light chain enhancer of activated B cells (NF-κB). The lysate did not show bactericidal activity but showed diminished biofilm formation, the lipase activity, and the production of autoinducer 2 (AI-2), a member of a family of signaling molecules used in quorum sensing. Therefore, the proposed callus lysate could have the potential to reduce acne-related symptoms without the eradication of C. acnes, which is part of the natural skin microbiome.
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Affiliation(s)
| | | | - Laia Montell
- Laboratory Reig Jofre, Avda del Flors s/n, 08970 Sant Joan Despí, Barcelona, Spain
| | - Ainhoa Bilbao
- GAIKER Technology Centre, Basque Research and Technology Alliance (BRTA), Parque Tecnológico de Bizkaia, Edif. 202, 48170 Zamudio, Spain
| | - Felipe Goñi-de-Cerio
- GAIKER Technology Centre, Basque Research and Technology Alliance (BRTA), Parque Tecnológico de Bizkaia, Edif. 202, 48170 Zamudio, Spain
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Fan D, Ma J, Liu X, Zhang S, Sun J, Li Y, Jiang B, Zhang L. The safety and efficiency of benzoyl peroxide for reducing Cutibacterium acnes in the shoulder: An updated systematic review and meta-analysis. Front Surg 2023; 10:1015490. [PMID: 36969754 PMCID: PMC10036352 DOI: 10.3389/fsurg.2023.1015490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 02/20/2023] [Indexed: 03/12/2023] Open
Abstract
BackgroundCutibacterium acnes (C. acnes), a common pathogen, contributes significantly to infections in shoulder surgery. Prevention of shoulder infection is crucial to improve postoperative functional recovery and reduce costs. This study aimed to perform a systematic review and meta-analysis to assess the safety and efficacy of 5% benzoyl peroxide (BPO) application in the shoulder to decrease C. acnes.MethodsThree electronic databases were searched as follows: PubMed, Embase, and the Cochrane Library databases. Data extraction for this study was performed by two independent reviewers, and only level I and level II studies were included. The outcome data sources of individual studies were pooled. The fixed-effect model was used to determine the meta-analysis.ResultsThere were five level I studies and five level II studies. The results showed that the 5% BPO group had a lower risk of C. acnes positivity [OR, 0.21 (0.15, 0.30), I2 = 24, p < 0.00001]. The pooled analysis results showed that there was no significant difference in the ability of 5% BPO and 5% BPO + clindamycin to reduce C. acnes. However, the lower rate of adverse events was significantly in favour of the non-BPO group compared with the 5% BPO group.ConclusionBPO can decrease C. acnes in the shoulder to prevent infection. However, the combination of BPO and clindamycin does not enhance this effect further.Level of evidenceII, Systematic review and meta-analysis.
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Affiliation(s)
- DingYuan Fan
- Department of Joint Surgery and Sports Medicine, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Beijing University of Chinese Medicine, Beijing, China
| | - Jia Ma
- Department of Joint Surgery and Sports Medicine, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - XiaoHua Liu
- Department of Joint Surgery and Sports Medicine, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Sheng Zhang
- Department of Joint Surgery and Sports Medicine, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Jin Sun
- Department of Joint Surgery and Sports Medicine, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yan Li
- Department of Joint Surgery and Sports Medicine, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Bo Jiang
- Department of Joint Surgery and Sports Medicine, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Lei Zhang
- Department of Joint Surgery and Sports Medicine, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Correspondence: Lei Zhang
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Antibacterial and Anti-Acne Activity of Benzoyl Peroxide Nanoparticles Incorporated in Lemongrass Oil Nanoemulgel. Gels 2023; 9:gels9030186. [PMID: 36975635 PMCID: PMC10048723 DOI: 10.3390/gels9030186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 02/25/2023] [Accepted: 02/25/2023] [Indexed: 03/08/2023] Open
Abstract
Purpose: The goal of this study was to make Benzoyl Peroxide (BPO) nanoemulgel to improve its ability to kill bacteria. BPO has trouble getting into the skin, being absorbed by the skin, staying stable, and being spread out. Methods: A BPO nanoemulgel formulation was prepared by combining BPO nanoemulsion with Carbopol hydrogel. The drug was tested for solubility in various oils and surfactants in order to select the best oil and surfactant for the drug, and then the drug nanoemulsion formulation was prepared using a self-nano-emulsifying technique with Tween 80, Span 80, and lemongrass oil. The drug nanoemulgel was looked at in terms of its particle size, polydispersity index (PDI), rheological behavior, drug release, and antimicrobial activity. Results: Based on the solubility test results, lemongrass oil was the best solubilizing oil for drugs, while Tween 80 and Span 80 demonstrated the highest solubilizing ability for drugs among the surfactants. The optimum self-nano-emulsifying formulation had particle sizes of less than 200 nm and a PDI of close to zero. The results showed that incorporating the SNEDDS formulation of the drug with Carbopol at various concentrations did not cause a significant change in the particle size and PDI of the drug. The zeta potential results for drug nanoemulgel were negative, with more than 30 mV. All nanoemulgel formulations exhibited pseudo-plastic behavior, with 0.4% Carbopol exhibiting the highest release pattern. The drug nanoemulgel formulation worked better against bacteria and acne than the product on the market. Conclusion: Nanoemulgel is a promising way to deliver BPO because it makes the drug more stable and increases its ability to kill bacteria.
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Sagkrioti M, Glass S, Arealis G. Evaluation of the effectiveness of skin preparation methods for the reduction of Cutibacterium acnes (formerly Propionibacterium acnes) in shoulder surgery: a systematic review. Shoulder Elbow 2022; 14:583-597. [PMID: 36479010 PMCID: PMC9720868 DOI: 10.1177/17585732211032523] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 06/15/2021] [Indexed: 12/22/2022]
Abstract
Background Cutibacterium acnes (C. acnes) is the most common pathogen responsible for post-operative shoulder infections. The purpose of this study was to evaluate the effectiveness of skin preparation methods against C. acnes in shoulder surgery. Methods A systematic review was conducted evaluating the effectiveness of skin preparation methods in the reduction of C. acnes in patients undergoing shoulder surgery. Outcomes were assessed based on the effectiveness of the method used; side effects and cost were also analysed. Results Of the 19 included studies, 9 evaluated pre-surgical home treatments: 8 assessed benzoyl peroxide (BPO) and 6 concluded it is effective in reducing C. acnes. Nine studies assessed surgical skin preparation and concluded that Chlorhexidine gluconate (CHG) was not effective; in contrast hydrogen peroxide reduced C. acnes. Finally, one study evaluated an aseptic protocol using CHG and concluded that it was not effective. Conclusions It was demonstrated that BPO as home treatment is effective in reducing C. acnes load on skin; it rarely causes side effects and is also cost-effective. This study highlights non-effectiveness of CHG. There was some evidence that the addition of hydrogen peroxide could have a positive effect in the reduction of C. acnes skin load; however, more studies are required.
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Affiliation(s)
- Maria Sagkrioti
- Department of Infection Prevention and Control, East Kent Hospitals University NHS Foundation Trust, Canterbury, UK
| | - Stephen Glass
- Department of Microbiology, East Kent Hospitals University NHS Foundation Trust, Canterbury, UK
| | - Georgios Arealis
- Department of Trauma and Orthopaedics, East Kent Hospitals University NHS Foundation Trust, Canterbury, UK
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Treatment of Acne Vulgaris During Pregnancy and Lactation: A Narrative Review. Dermatol Ther (Heidelb) 2022; 13:115-130. [PMID: 36447117 PMCID: PMC9823189 DOI: 10.1007/s13555-022-00854-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 11/03/2022] [Indexed: 11/30/2022] Open
Abstract
Acne vulgaris frequently affects women during pregnancy and lactation. Hormonal and physiologic changes in pregnancy contribute to the pathogenesis of acne during the various phases of pregnancy. Several effective acne treatments commonly prescribed in the general population are contraindicated during pregnancy or lactation. There is a lack of guidelines and updated resources on acne management in these populations. In this narrative review, we summarize existing evidence on the safety and efficacy of acne treatments during pregnancy and breastfeeding. Acne management in pregnancy and lactation should follow a stepwise approach based on severity to minimize risk. Topical therapies, such as benzoyl peroxide, azelaic acid, or keratolytics, can be used to treat mild-to-moderate disease. Moderate-to-severe acne may require systemic treatments, including penicillin, amoxicillin, cephalexin, and erythromycin, with special consideration for trimester-specific teratogenicity of medications and relevant medical history of the mother and infant. For refractory cases, oral or intralesional corticosteroids as well as laser and light therapies may be considered. This review provides an updated reference to aid patient-physician decision-making on acne management in these special populations.
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10
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Novel topical drug delivery systems in acne management: Molecular mechanisms and role of targeted delivery systems for better therapeutic outcomes. J Drug Deliv Sci Technol 2022. [DOI: 10.1016/j.jddst.2022.103595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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11
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Mohsin N, Hernandez LE, Martin MR, Does AV, Nouri K. Acne Treatment Review and Future Perspectives. Dermatol Ther 2022; 35:e15719. [PMID: 35841269 DOI: 10.1111/dth.15719] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 06/25/2022] [Accepted: 07/13/2022] [Indexed: 11/30/2022]
Abstract
Acne affects approximately 9% of people worldwide and is the most common skin condition in the United States. There are abundant topical and oral treatment options available for patients with acne. First-line agents include topical retinoids, azelaic acid, benzoyl peroxide, and combinations of these agents. For recalcitrant or more severe acne, oral medications, including oral antibiotics, isotretinoin, or hormonal therapy, may be considered. This review will also discuss the many advances being made in the treatment of acne vulgaris, from the development of microencapsulated medications to targeted treatments. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Noreen Mohsin
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Loren E Hernandez
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | | | - Ashley Vander Does
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Keyvan Nouri
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
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Boonchaya P, Rojhirunsakool S, Kamanamool N, Khunkhet S, Yooyongsatit S, Udompataikul M, Taweechotipatr M. Minimum Contact Time of 1.25%, 2.5%, 5%, and 10% Benzoyl Peroxide for a Bactericidal Effect Against Cutibacterium acnes. CLINICAL, COSMETIC AND INVESTIGATIONAL DERMATOLOGY 2022; 15:403-409. [PMID: 35300432 PMCID: PMC8922035 DOI: 10.2147/ccid.s359055] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 03/01/2022] [Indexed: 11/24/2022]
Abstract
Purpose Benzoyl peroxide (BPO) is an effective acne treatment and has been used as a cleanser and short contact therapy. However, data on the minimum contact time of BPO needed to kill Cutibacterium acnes are lacking. Thus, the aim of this study was to determine the minimum contact time of commonly used BPO concentrations for bactericidal effects on C. acnes. Materials and Methods An in vitro experimental study of clinically isolated C. acnes was performed to determine the minimal inhibitory concentration (MIC) of BPO using the broth microdilution method. Subsequently, the minimum contact times of various concentrations of BPO were evaluated, and their bactericidal effects were assessed by the plate count method. Results The median MIC of BPO was 9375 µg/mL, which did not significantly differ between antibiotic-resistant and nonresistant C. acnes. The minimum contact time of BPO with C. acnes was significantly different among the BPO concentrations. For bactericidal activity against all isolates, 1.25%, 2.5%, 5%, and 10% BPO required 60 min, 15 min, 30 sec, and 30 sec, respectively. Conclusion BPO demonstrated bactericidal activity against both antibiotic-resistant and antibiotic-susceptible C. acnes. The in vitro contact time needed to kill C. acnes was almost immediate with 5% or more BPO, but ≤ 2.5% BPO required longer contact times for bactericidal effects.
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Affiliation(s)
- Punyanun Boonchaya
- Department of Dermatology, Faculty of Medicine, Srinakharinwirot University, Bangkok, Thailand
| | - Salinee Rojhirunsakool
- Department of Dermatology, Faculty of Medicine, Srinakharinwirot University, Bangkok, Thailand
| | - Nanticha Kamanamool
- Department of Preventive and Social Medicine, Srinakharinwirot University, Bangkok, Thailand
| | - Saranya Khunkhet
- Department of Dermatology, Faculty of Medicine, Srinakharinwirot University, Bangkok, Thailand
| | - Surasak Yooyongsatit
- Department of Microbiology, Faculty of Medicine, Srinakharinwirot University, Bangkok, Thailand
| | - Montree Udompataikul
- Department of Dermatology, Faculty of Medicine, Srinakharinwirot University, Bangkok, Thailand
| | - Malai Taweechotipatr
- Department of Microbiology, Faculty of Medicine, Srinakharinwirot University, Bangkok, Thailand
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13
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Polce EM, Cotter EJ, Polania-Gonzalez E, Grogan BF. Patient Compliance and Satisfaction with Topical Benzoyl Peroxide Gel Prior to Shoulder Surgery. JSES Int 2022; 6:686-689. [PMID: 35813137 PMCID: PMC9263990 DOI: 10.1016/j.jseint.2022.02.009] [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] [Indexed: 10/31/2022] Open
Abstract
Background Methods Results Conclusion
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14
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Otlewska A, Baran W, Batycka-Baran A. Adverse events related to topical drug treatments for acne vulgaris. Expert Opin Drug Saf 2021; 19:513-521. [PMID: 32347138 DOI: 10.1080/14740338.2020.1757646] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Introduction: Acne vulgaris is a widespread skin disease. Topical therapy is a standard treatment for mild to moderate acne. Given the complex pathophysiology of acne, various agents with complementary action are nowadays frequently combined to increase the efficacy of therapy.Area covered: This review focus on safety profile of topical agents used for the treatment of acne vulgaris, including topical retinoids, benzyl peroxide, azelaic acid, topical antibiotic, and combined agents. Data from clinical trials but also metanalyses, systematic reviews, and other secondary analyses are presented.Expert opinion: In general, topical agents used for acne vulgaris have a favorable safety profile. The most commonly reported AEs were associated with local skin irritation, usually mild to moderate in intensity, intermittent, and rarely led to the cessation of therapy. Irritative potential seems to be highest for BPO and topical retinoids. Due to the possibility of development of Cutibacterium acnes resistance, topical antibiotics should not be used in monotherapy but as a part of combination therapy. In female adolescent and adults of childbearing potential, topical retinoids should be used with caution, because they are contraindicated in pregnant females (FDA Pregnancy category) C (adapalene, tretinoin) and X (tazarotene).
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Affiliation(s)
- Agnieszka Otlewska
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland
| | - Wojciech Baran
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland
| | - Aleksandra Batycka-Baran
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland
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15
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Okamoto K, Kanayama S, Ikeda F, Fujikawa K, Fujiwara S, Nozawa N, Mori S, Matsumoto T, Hayashi N, Oda M. Broad spectrum in vitro microbicidal activity of benzoyl peroxide against microorganisms related to cutaneous diseases. J Dermatol 2020; 48:551-555. [PMID: 33369759 PMCID: PMC8048985 DOI: 10.1111/1346-8138.15739] [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: 05/18/2020] [Revised: 11/24/2020] [Accepted: 12/04/2020] [Indexed: 11/27/2022]
Abstract
The in vitro microbicidal activity of benzoyl peroxide against Cutibacterium acnes, Staphylococcus aureus, Staphylococcus epidermidis, Escherichia coli, Pseudomonas aeruginosa, Candida albicans, Malassezia furfur, Malassezia restricta, and Malassezia globosa was investigated. These strains were incubated for 1 h in the presence of 0.25, 0.5, 1, or 2 mmol/L benzoyl peroxide in phosphate buffered saline supplemented with 0.1% glycerol and 2% Tween 80. After exposure to benzoyl peroxide, counts of viable Gram-positive bacteria and fungi were markedly decreased, whereas counts of Gram-negative bacteria were unchanged. Transmission electron microscopy images showed a decrease in electron density and the destruction of C. acnes and M. restricta cell walls after exposure to 2 mmol/L benzoyl peroxide. In conclusion, this study showed that benzoyl peroxide has a potent and rapid microbicidal activity against Gram-positive bacteria and fungi that are associated with various cutaneous diseases. This suggests that the direct destruction of bacterial cell walls by benzoyl peroxide is an essential mechanism of its rapid and potent microbicidal activity against microorganisms.
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Affiliation(s)
- Kazuaki Okamoto
- Information Systems Department, Maruho Co., Ltd., Osaka, Japan.,Department of Microbiology and Infection Control Science, Kyoto Pharmaceutical University, Kyoto, Japan
| | - Shoji Kanayama
- Department of Microbiology and Infection Control Science, Kyoto Pharmaceutical University, Kyoto, Japan.,Drug Development Research Laboratories, Kyoto R&D Center, Maruho Co., Ltd., Kyoto, Japan
| | - Fumiaki Ikeda
- Drug Discovery Research Department, Kyoto R&D Center, Maruho Co., Ltd., Kyoto, Japan
| | - Koki Fujikawa
- Drug Development Research Laboratories, Kyoto R&D Center, Maruho Co., Ltd., Kyoto, Japan
| | - Shiori Fujiwara
- Drug Discovery Research Department, Kyoto R&D Center, Maruho Co., Ltd., Kyoto, Japan
| | - Naoki Nozawa
- Drug Discovery Research Department, Kyoto R&D Center, Maruho Co., Ltd., Kyoto, Japan
| | - Sachi Mori
- Drug Development Research Laboratories, Kyoto R&D Center, Maruho Co., Ltd., Kyoto, Japan
| | - Tatsumi Matsumoto
- Drug Discovery Research Department, Kyoto R&D Center, Maruho Co., Ltd., Kyoto, Japan
| | - Naoki Hayashi
- Department of Microbiology and Infection Control Science, Kyoto Pharmaceutical University, Kyoto, Japan.,Drug Development Research Laboratories, Kyoto R&D Center, Maruho Co., Ltd., Kyoto, Japan
| | - Masataka Oda
- Department of Microbiology and Infection Control Science, Kyoto Pharmaceutical University, Kyoto, Japan
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16
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Mancuso A, Cristiano MC, Fresta M, Paolino D. The Challenge of Nanovesicles for Selective Topical Delivery for Acne Treatment: Enhancing Absorption Whilst Avoiding Toxicity. Int J Nanomedicine 2020; 15:9197-9210. [PMID: 33239876 PMCID: PMC7682599 DOI: 10.2147/ijn.s237508] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 10/24/2020] [Indexed: 12/18/2022] Open
Abstract
Acne is a common skin disease that affect over 80% of adolescents. It is characterized by inflammation of the hair bulb and the attached sebaceous gland. To date, many strategies have been used to treat acne as a function of the disease severity. However, common treatments for acne seem to show several side effects, from local irritation to more serious collateral effects. The use of topical vesicular carriers able to deliver active compounds is currently considered as an excellent approach in the treatment of different skin diseases. Many results in the literature have proven that drug delivery systems are useful in overcoming the toxicity induced by common drug therapies, while maintaining their therapeutic efficacy. Starting from these assumptions, the authors reviewed drug delivery systems already realized for the topical treatment of acne, with a focus on their limitations and advantages over conventional treatment strategies. Although their exact mechanism of permeation is not often completely clear, deformable vesicles seem to be the best solution for obtaining a specific delivery of drugs into the deeper skin layers, with consequent increased local action and minimized collateral effects.
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Affiliation(s)
- Antonia Mancuso
- Department of Health Sciences, University “Magna Græcia” of Catanzaro, Catanzaro88100, Italy
| | - Maria Chiara Cristiano
- Department of Experimental and Clinical Medicine, University “Magna Græcia” of Catanzaro, Catanzaro88100, Italy
| | - Massimo Fresta
- Department of Health Sciences, University “Magna Græcia” of Catanzaro, Catanzaro88100, Italy
| | - Donatella Paolino
- Department of Experimental and Clinical Medicine, University “Magna Græcia” of Catanzaro, Catanzaro88100, Italy
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17
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Cha H, Kim SK, Kook M, Yi TH. Lactobacillus paraplantarum THG-G10 as a potential anti-acne agent with anti-bacterial and anti-inflammatory activities. Anaerobe 2020; 64:102243. [PMID: 32712375 DOI: 10.1016/j.anaerobe.2020.102243] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 06/11/2020] [Accepted: 07/14/2020] [Indexed: 02/01/2023]
Abstract
Cutibacterium acnes (formerly Propionibacterium acnes) is the main bacterium targeted for the prevention and medical treatment of acne vulgaris. Lactic acid bacteria (LAB) are a group of microorganisms classified by their ability to produce lactic acid through fermentation. Although the activities of LAB have been studied, their potential anti-acne effects are not well known. Here, Lactobacillus paraplantarum THG-G10, which has anti-bacterial activity against C. acnes, was isolated from traditional Kimchi in Republic of Korea. The anti-acne effects of dried cell-free supernatant of L. paraplantarum THG-G10 (DC-G10) were evaluated by determining its anti-microbial and anti-inflammatory activities. Anti-microbial activity was examined by a broth dilution assay: 25 mg/ml of DC-G10 inhibited the growth of C. acnes KCTC 5012 and KACC 1194; salicylic acid and benzoyl peroxide for acne treatment inhibited the growth of C. acnes KCTC 5012 and KACC 11946 at concentrations of 1.25 and 7.5 mg/ml, respectively; and tea tree oil inhibited the growth of C. acnes KCTC 5012 but not the growth of C. acnes KACC 11946 at 50 mg/ml. Anti-inflammatory activity was evaluated by a nitric oxide (NO) assay: only DC-G10 and ascorbic acid reduced LPS-induced NO production in RAW 264.7 cells in a dose-dependent manner. In addition, the toxicities of erythromycin, salicylic acid, benzoyl peroxide, tea tree oil, and DC-G10 were examined in HaCaT cells and normal human dermal fibroblasts (NHDFs). In these cells, the cytotoxic effects of DC-G10 were weaker than the effects of erythromycin, benzoyl peroxide, and ascorbic acid. Furthermore, scanning electron microscopy revealed that DC-G10 induces deleterious morphological changes in the bacterial cell membrane. These results demonstrate that DC-G10 may be an effective and safe treatment for acne vulgaris.
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Affiliation(s)
- HyeMin Cha
- Department of Oriental Medicinal Material and Processing, College of Life Science, Kyung Hee University Global Campus, 1732 Deokyoungdae-ro, Giheung-gu, Yongin-si, Gyeonggi-do, 446-701, Republic of Korea
| | - Su-Kyung Kim
- Department of Oriental Medicinal Material and Processing, College of Life Science, Kyung Hee University Global Campus, 1732 Deokyoungdae-ro, Giheung-gu, Yongin-si, Gyeonggi-do, 446-701, Republic of Korea
| | - MooChang Kook
- Department of Food and Nutrition, Baewha Women's University, Seoul, 03039, Republic of Korea.
| | - Tae-Hoo Yi
- Department of Oriental Medicinal Material and Processing, College of Life Science, Kyung Hee University Global Campus, 1732 Deokyoungdae-ro, Giheung-gu, Yongin-si, Gyeonggi-do, 446-701, Republic of Korea.
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18
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Hsiao KH, Huang CM, Lee YH. Novel Rifampicin and Indocyanine Green Co-Loaded Perfluorocarbon Nanodroplets Provide Effective In Vivo Photo-Chemo-Probiotic Antimicrobility against Pathogen of Acne Vulgaris Cutibacterium acnes. NANOMATERIALS 2020; 10:nano10061095. [PMID: 32492862 PMCID: PMC7353360 DOI: 10.3390/nano10061095] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 05/26/2020] [Accepted: 05/29/2020] [Indexed: 02/05/2023]
Abstract
Acne vulgaris is one of the most prevalent dermatological diseases among adolescents and is often associated with overgrowth of Cutibacterium acnes (C. acnes) in the pilosebaceous units. In this study, we aimed to develop novel rifampicin (RIF) and indocyanine green (ICG) co-loaded perfluorocarbon nanodroplets named RIPNDs which can simultaneously provide photo-, chemo-, and probiotic-antimicrobility, and explore their efficacy in treatment of C. acnes in vitro and in vivo. The RIPNDs were first characterized as being spherical in shape, with a size of 238.6 ± 7.51 nm and surface charge of -22.3 ± 3.5 mV. Then, the optimal dosages of Staphylococcus epidermidis-produced fermentation product medium (FPM) and RIPND were determined as 25% (v/v) and [RIF]/[ICG] = 3.8/20 μM, respectively, based on the analyses of inhibition zone and cytotoxicity in vitro. Through the in vivo study using C. acnes-inoculated mice, our data showed that the group treated with FPM followed by RIPNDs + near infrared (NIR) irradiation obtained the least granulocytes/macrophage-inflammatory protein 2 expression level in the epidermis, and showed a significantly lower microbial colony population compared to the groups treated with equal amount of RIF, FPM, RIPNDs, and/or combination of the above ± NIR. These results indicated that the RIPND-mediated photo-chemo-probiotic therapeutics was indeed able to rapidly suppress inflammatory response of the skin and provide a robust antibacterial effect against C. acnes with limited use of antibiotics. Taken altogether, we anticipate that the RIPND is highly potential for use in the clinical treatment of acne vulgaris.
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Affiliation(s)
- Kuang-Hung Hsiao
- Department of Biomedical Sciences and Engineering, National Central University. No. 300, Jhongda Rd., Taoyuan City 32001, Taiwan;
| | - Chun-Ming Huang
- Department of Biomedical Sciences and Engineering, National Central University. No. 300, Jhongda Rd., Taoyuan City 32001, Taiwan;
- Department of Dermatology, University of California, San Diego, CA 92093, USA
- Correspondence: (C.-M.H.); (Y.-H.L.); Tel.: +886-3-422-7151 (ext. 36101) (C.-M.H.); Tel.: +886-3-422-7151 (ext. 27755) (Y.-H.L.); Fax: +886-3-280-4627 (C.-M.H. & Y.-H.L.)
| | - Yu-Hsiang Lee
- Department of Biomedical Sciences and Engineering, National Central University. No. 300, Jhongda Rd., Taoyuan City 32001, Taiwan;
- Department of Chemical and Materials Engineering, National Central University, Taoyuan City 32001, Taiwan
- Correspondence: (C.-M.H.); (Y.-H.L.); Tel.: +886-3-422-7151 (ext. 36101) (C.-M.H.); Tel.: +886-3-422-7151 (ext. 27755) (Y.-H.L.); Fax: +886-3-280-4627 (C.-M.H. & Y.-H.L.)
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19
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The presence of Cutibacterium acnes on the skin of the shoulder after the use of benzoyl peroxide: a placebo-controlled, double-blinded, randomized trial. J Shoulder Elbow Surg 2020; 29:768-774. [PMID: 32197765 DOI: 10.1016/j.jse.2019.11.027] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 11/19/2019] [Accepted: 11/23/2019] [Indexed: 02/01/2023]
Abstract
HYPOTHESIS AND BACKGROUND We hypothesized that benzoyl peroxide (BPO) would reduce the presence of Cutibacterium acnes on the skin of the shoulder by 50% compared with placebo. Infections after shoulder surgery are most commonly caused by C acnes. Current prophylactic methods do not effectively reduce the bacterial load of this bacterium. However, it seems that BPO may reduce C acnes on the skin of the shoulder. Therefore, this study aimed to investigate the effect of BPO on the presence of C acnes on the shoulder skin. METHODS A double-blinded, randomized, placebo-controlled trial was performed including healthy participants aged between 40 and 80 years. Thirty participants with C acnes on the shoulder skin according to baseline skin swabs were randomized into the BPO or placebo group. After gel application 5 times, skin swabs were taken to determine the presence of C acnes. RESULTS Forty-two participants were screened for the presence of C acnes to include 30 participants with the bacterium. Participants with C acnes at baseline were 7.4 years younger than participants without C acnes (P = .015). One participant in the placebo group dropped out before application because of fear of adverse events. After application, C acnes remained present in 3 of 15 participants (20.0%) in the BPO group and in 10 of 14 participants (71.4%) in the placebo group, resulting in a 51.4% reduction in the presence of C acnes. CONCLUSION Applying BPO 5 times on the shoulder skin effectively reduces C acnes. Consequently, BPO may reduce the risk of postoperative infections.
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20
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Singh AM, Sethi PM, Romeo AA, Anakwenze OA, Abboud JA, Namdari S. Strategies to decolonize the shoulder of Cutibacterium acnes: a review of the literature. J Shoulder Elbow Surg 2020; 29:660-666. [PMID: 32197761 DOI: 10.1016/j.jse.2019.11.037] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Accepted: 11/27/2019] [Indexed: 02/07/2023]
Abstract
Cutibacterium acnes is the most prevalent cause of joint infection after shoulder surgery. Current methods for decolonizing this bacterium from the shoulder region have proved ineffective owing to its unique niche within dermal sebaceous glands and hair follicles. When we are making decisions to decolonize the skin of C acnes, the risks associated with decolonization must be balanced by the potential benefits of reduced deep tissue inoculation. The purpose of this review was to describe currently available methods of decolonization and their efficacy.
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Affiliation(s)
- Arjun M Singh
- Rothman Institute Department of Orthopaedic Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA
| | - Paul M Sethi
- Orthopaedic & Neurosurgery Specialists, Greenwich, CT, USA
| | - Anthony A Romeo
- Rothman Institute Department of Orthopaedic Surgery, New York, NY, USA
| | - Oke A Anakwenze
- Department of Orthopaedic Surgery, Duke University, Durham, NC, USA
| | - Joseph A Abboud
- Rothman Institute Department of Orthopaedic Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA
| | - Surena Namdari
- Rothman Institute Department of Orthopaedic Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
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21
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An update on formulation strategies of benzoyl peroxide in efficient acne therapy with special focus on minimizing undesired effects. Int J Pharm 2020; 578:119074. [PMID: 31982561 DOI: 10.1016/j.ijpharm.2020.119074] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Revised: 01/18/2020] [Accepted: 01/20/2020] [Indexed: 11/22/2022]
Abstract
Benzoyl peroxide (BPO) in the form of over the counter monotherapeutics or prescription-only combinations is a key component of topical acne therapy, but its unfavourable side effect profile reduces the therapeutic value of this compound. Various galenic approaches have been pursued to resolve this ambivalence, but only a few have managed to enter the market. This article aims to give a comprehensive overview of the published experimental vehicle systems and to identify the fundamental rationales. With regard to the formulation, an increase in the tolerability of BPO can essentially be achieved by combining BPO with re-fattening and moisturizing substances, by incorporating it and controlling its release, as well as by targeted deposition of the active ingredient at the site of action, i.e. drug targeting. Recently, novel particulate formulations have been proposed that combine several of these design principles and are expected to bring new developments in this dynamic field of research.
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22
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Abstract
BACKGROUND Acne is a common, economically burdensome condition that can cause psychological harm and, potentially, scarring. Topical benzoyl peroxide (BPO) is a widely used acne treatment; however, its efficacy and safety have not been clearly evaluated. OBJECTIVES To assess the effects of BPO for acne. SEARCH METHODS We searched the following databases up to February 2019: the Cochrane Skin Specialised Register, CENTRAL, MEDLINE, Embase, and LILACS. We also searched five trials registers and checked the reference lists of relevant randomised controlled trials (RCTs) and systematic reviews. SELECTION CRITERIA We included RCTs that compared topical BPO used alone (including different formulations and concentrations of BPO) or as part of combination treatment against placebo, no treatment, or other active topical medications for clinically diagnosed acne (used alone or in combination with other topical drugs not containing BPO) on the face or trunk. DATA COLLECTION AND ANALYSIS We used standard methodological procedures as expected by Cochrane. Primary outcome measures were 'participant global self-assessment of acne improvement' and 'withdrawal due to adverse events in the whole course of a trial'. 'Percentage of participants experiencing any adverse event in the whole course of a trial' was a key secondary outcome. MAIN RESULTS We included 120 trials (29,592 participants randomised in 116 trials; in four trials the number of randomised participants was unclear). Ninety-one studies included males and females. When reported, 72 trials included participants with mild to moderate acne, 26 included participants with severe acne, and the mean age of participants ranged from 18 to 30 years. Our included trials assessed BPO as monotherapy, as add-on treatment, or combined with other active treatments, as well as BPO of different concentrations and BPO delivered through different vehicles. Comparators included different concentrations or formulations of BPO, placebo, no treatment, or other active treatments given alone or combined. Treatment duration in 80 trials was longer than eight weeks and was only up to 12 weeks in 108 trials. Industry funded 50 trials; 63 trials did not report funding. We commonly found high or unclear risk of performance, detection, or attrition bias. Trial setting was under-reported but included hospitals, medical centres/departments, clinics, general practices, and student health centres. We reported on outcomes assessed at the end of treatment, and we classified treatment periods as short-term (two to four weeks), medium-term (five to eight weeks), or long-term (longer than eight weeks). For 'participant-reported acne improvement', BPO may be more effective than placebo or no treatment (risk ratio (RR) 1.27, 95% confidence interval (CI) 1.12 to 1.45; 3 RCTs; 2234 participants; treatment for 10 to 12 weeks; low-certainty evidence). Based on low-certainty evidence, there may be little to no difference between BPO and adapalene (RR 0.99, 95% CI 0.90 to 1.10; 5 RCTs; 1472 participants; treatment for 11 to 12 weeks) or between BPO and clindamycin (RR 0.95, 95% CI 0.68 to 1.34; 1 RCT; 240 participants; treatment for 10 weeks) (outcome not reported for BPO versus erythromycin or salicylic acid). For 'withdrawal due to adverse effects', risk of treatment discontinuation may be higher with BPO compared with placebo or no treatment (RR 2.13, 95% CI 1.55 to 2.93; 24 RCTs; 13,744 participants; treatment for 10 to 12 weeks; low-certainty evidence); the most common causes of withdrawal were erythema, pruritus, and skin burning. Only very low-certainty evidence was available for the following comparisons: BPO versus adapalene (RR 1.85, 95% CI 0.94 to 3.64; 11 RCTs; 3295 participants; treatment for 11 to 24 weeks; causes of withdrawal not clear), BPO versus clindamycin (RR 1.93, 95% CI 0.90 to 4.11; 8 RCTs; 3330 participants; treatment for 10 to 12 weeks; causes of withdrawal included local hypersensitivity, pruritus, erythema, face oedema, rash, and skin burning), erythromycin (RR 1.00, 95% CI 0.07 to 15.26; 1 RCT; 60 participants; treatment for 8 weeks; withdrawal due to dermatitis), and salicylic acid (no participants had adverse event-related withdrawal; 1 RCT; 59 participants; treatment for 12 weeks). There may be little to no difference between these groups in terms of withdrawal; however, we are unsure of the results because the evidence is of very low certainty. For 'proportion of participants experiencing any adverse event', very low-certainty evidence leaves us uncertain about whether BPO increased adverse events when compared with placebo or no treatment (RR 1.40, 95% CI 1.15 to 1.70; 21 RCTs; 11,028 participants; treatment for 10 to 12 weeks), with adapalene (RR 0.71, 95% CI 0.50 to 1.00; 7 RCTs; 2120 participants; treatment for 11 to 24 weeks), with erythromycin (no participants reported any adverse events; 1 RCT; 89 participants; treatment for 10 weeks), or with salicylic acid (RR 4.77, 95% CI 0.24 to 93.67; 1 RCT; 41 participants; treatment for 6 weeks). Moderate-certainty evidence shows that the risk of adverse events may be increased for BPO versus clindamycin (RR 1.24, 95% CI 0.97 to 1.58; 6 RCTs; 3018 participants; treatment for 10 to 12 weeks); however, the 95% CI indicates that BPO might make little to no difference. Most reported adverse events were mild to moderate, and local dryness, irritation, dermatitis, erythema, application site pain, and pruritus were the most common. AUTHORS' CONCLUSIONS Current evidence suggests that BPO as monotherapy or add-on treatment may be more effective than placebo or no treatment for improving acne, and there may be little to no difference between BPO and either adapalene or clindamycin. Our key efficacy evidence is based on participant self-assessment; trials of BPO versus erythromycin or salicylic acid did not report this outcome. For adverse effects, the evidence is very uncertain regarding BPO compared with adapalene, erythromycin, or salicylic acid. However, risk of treatment discontinuation may be higher with BPO compared with placebo or no treatment. Withdrawal may be linked to tolerability rather than to safety. Risk of mild to moderate adverse events may be higher with BPO compared with clindamycin. Further trials should assess the comparative effects of different preparations or concentrations of BPO and combination BPO versus monotherapy. These trials should fully assess and report adverse effects and patient-reported outcomes measured on a standardised scale.
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Affiliation(s)
- Zhirong Yang
- School of Clinical Medicine, University of CambridgePrimary Care Unit, Department of Public Health and Primary CareStrangeways Research Laboratory, 2 Worts’ CausewayCambridgeUKCB1 8RN
- School of Public Health, Peking UniversityCentre for Evidence Based Medicine and Clinical Research, Department of Epidemiology and BiostatisticsBeijingChina100191
| | - Yuan Zhang
- McMaster UniversityDepartment of Health Research Methods, Evidence, and Impact1280 Main Street WestHamiltonONCanadaL8S 4K1
| | - Elvira Lazic Mosler
- Catholic University of CroatiaDepartment of NursingIlica 242ZagrebCroatia10000
- General Hospital "Dr. Ivo Pedišić"Department for Dermatology and VenereologyJ.J. Strossmayera 59SisakCroatia44000
| | - Jing Hu
- School of Public Health, Peking UniversityCentre for Evidence Based Medicine and Clinical Research, Department of Epidemiology and BiostatisticsBeijingChina100191
| | - Hang Li
- Peking University First HospitalDepartment of Dermatology and Venereology8 Xishiku Main StreetBeijingXicheng DistrictChina100034
- Beijing Key Laboratory of Molecular Diagnosis on DermatosesBeijingChina
- National Clinical Research Center for Skin and Immune DiseasesBeijingChina
| | - Yanchang Zhang
- Yale School of Public HealthDepartment of Chronic Disease Epidemiology367 Cedar ST RM 704New HavenConnecticutUSA06510
| | - Jia Liu
- Xuanwu Hospital, Capital Medical UniversityDepartment of NeurologyChangchun Street 45BeijingChina100053
| | - Qian Zhang
- The University of Nottinghamc/o Cochrane Skin GroupA103, King's Meadow CampusLenton LaneNottinghamUKNG7 2NR
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23
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Blaskovich MAT, Elliott AG, Kavanagh AM, Ramu S, Cooper MA. In vitro Antimicrobial Activity of Acne Drugs Against Skin-Associated Bacteria. Sci Rep 2019; 9:14658. [PMID: 31601845 PMCID: PMC6787063 DOI: 10.1038/s41598-019-50746-4] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 09/12/2019] [Indexed: 01/07/2023] Open
Abstract
Acne is a common skin affliction that involves excess sebum production and modified lipid composition, duct blockage, colonization by bacteria, and inflammation. Acne drugs target one or more of these steps, with antibiotics commonly used to treat the microbial infection for moderate to severe cases. Whilst a number of other acne therapies are purported to possess antimicrobial activity, this has been poorly documented in many cases. We conducted a comparative analysis of the activity of common topical acne drugs against the principal etiological agent associated with acne: the aerotolerant anaerobic Gram-positive organism Propionibacterium acnes (recently renamed as Cutibacterium acnes). We also assessed their impact on other bacteria that could also be affected by topical treatments, including both antibiotic-sensitive and antibiotic-resistant strains, using broth microdilution assay conditions. Drugs designated specifically as antibiotics had the greatest potency, but lost activity against resistant strains. The non-antibiotic acne agents did possess widespread antimicrobial activity, including against resistant strains, but at substantially higher concentrations. Hence, the antimicrobial activity of non-antibiotic acne agents may provide protection against a background of increased drug-resistant bacteria.
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Affiliation(s)
- Mark A T Blaskovich
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland, 4072, Australia.
| | - Alysha G Elliott
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland, 4072, Australia
| | - Angela M Kavanagh
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland, 4072, Australia
| | - Soumya Ramu
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland, 4072, Australia
| | - Matthew A Cooper
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland, 4072, Australia
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24
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Chinese Guidelines for the Management of Acne Vulgaris: 2019 Update #. INTERNATIONAL JOURNAL OF DERMATOLOGY AND VENEROLOGY 2019. [DOI: 10.1097/jd9.0000000000000043] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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25
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Lubtikulthum P, Kamanamool N, Udompataikul M. A comparative study on the effectiveness of herbal extracts vs 2.5% benzoyl peroxide in the treatment of mild to moderate acne vulgaris. J Cosmet Dermatol 2019; 18:1767-1775. [PMID: 31012999 DOI: 10.1111/jocd.12962] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 02/23/2019] [Accepted: 03/22/2019] [Indexed: 11/30/2022]
Affiliation(s)
| | - Nanticha Kamanamool
- Department of Preventive and Social Medicine Srinakharinwirot University Bangkok Thailand
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26
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Edwards T, Cardwell LA, Patel N, Feldman SR. Benzoyl peroxide gel stains synthetic fabrics less than they stain cotton. J Am Acad Dermatol 2018; 85:481-482. [PMID: 29753055 DOI: 10.1016/j.jaad.2018.05.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 04/30/2018] [Accepted: 05/01/2018] [Indexed: 11/17/2022]
Affiliation(s)
- Taylor Edwards
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Leah A Cardwell
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, North Carolina.
| | - Nupur Patel
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Steven R Feldman
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, North Carolina; Department of Pathology, Wake Forest School of Medicine, Winston-Salem, North Carolina; Department of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina
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27
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Aarthi R, Ramalingam S, Periandy S, Senthil Kannan K. Molecular structure-associated pharmacodynamic investigation on benzoyl peroxide using spectroscopic and quantum computational tools. JOURNAL OF TAIBAH UNIVERSITY FOR SCIENCE 2018. [DOI: 10.1080/16583655.2018.1451116] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- R. Aarthi
- Department of Physics, A.V.C. College, Mayiladuthurai, India
| | - S. Ramalingam
- Department of Physics, A.V.C. College, Mayiladuthurai, India
| | - S. Periandy
- Department of Physics, Kanchi Mamunivar Centre for PG Studies, Puducherry, India
| | - K. Senthil Kannan
- Department of Physics, Dean R & D, EGS Pillay Arts and Science College, Nagapattinam, India
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Feetham HJ, Jeong HS, McKesey J, Wickless H, Jacobe H. Skin care and cosmeceuticals: Attitudes and trends among trainees and educators. J Cosmet Dermatol 2017; 17:220-226. [DOI: 10.1111/jocd.12460] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2017] [Indexed: 11/28/2022]
Affiliation(s)
- H Jill Feetham
- Department of Dermatology; UT Southwestern Medical Center; Dallas TX USA
| | - H Sam Jeong
- Department of Dermatology; UT Southwestern Medical Center; Dallas TX USA
| | - Jacqueline McKesey
- Department of Dermatology; UT Southwestern Medical Center; Dallas TX USA
- Department of Internal Medicine; University of California San Diego; San Diego CA USA
| | - Heather Wickless
- Department of Dermatology; UT Southwestern Medical Center; Dallas TX USA
| | - Heidi Jacobe
- Department of Dermatology; UT Southwestern Medical Center; Dallas TX USA
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Vil' VA, Yaremenko IA, Ilovaisky AI, Terent'ev AO. Peroxides with Anthelmintic, Antiprotozoal, Fungicidal and Antiviral Bioactivity: Properties, Synthesis and Reactions. Molecules 2017; 22:E1881. [PMID: 29099089 PMCID: PMC6150334 DOI: 10.3390/molecules22111881] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Accepted: 10/30/2017] [Indexed: 11/23/2022] Open
Abstract
The biological activity of organic peroxides is usually associated with the antimalarial properties of artemisinin and its derivatives. However, the analysis of published data indicates that organic peroxides exhibit a variety of biological activity, which is still being given insufficient attention. In the present review, we deal with natural, semi-synthetic and synthetic peroxides exhibiting anthelmintic, antiprotozoal, fungicidal, antiviral and other activities that have not been described in detail earlier. The review is mainly concerned with the development of methods for the synthesis of biologically active natural peroxides, as well as its isolation from natural sources and the modification of natural peroxides. In addition, much attention is paid to the substantially cheaper biologically active synthetic peroxides. The present review summarizes 217 publications mainly from 2000 onwards.
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Affiliation(s)
- Vera A Vil'
- N. D. Zelinsky Institute of Organic Chemistry, Russian Academy of Sciences, 47 Leninsky Prospekt, 119991 Moscow, Russia.
- Faculty of Chemical and Pharmaceutical Technology and Biomedical Products, D. I. Mendeleev University of Chemical Technology of Russia, 9 Miusskaya Square, 125047 Moscow, Russia.
- All-Russian Research Institute for Phytopathology, B. Vyazyomy, 143050 Moscow, Russia.
| | - Ivan A Yaremenko
- N. D. Zelinsky Institute of Organic Chemistry, Russian Academy of Sciences, 47 Leninsky Prospekt, 119991 Moscow, Russia.
- Faculty of Chemical and Pharmaceutical Technology and Biomedical Products, D. I. Mendeleev University of Chemical Technology of Russia, 9 Miusskaya Square, 125047 Moscow, Russia.
- All-Russian Research Institute for Phytopathology, B. Vyazyomy, 143050 Moscow, Russia.
| | - Alexey I Ilovaisky
- N. D. Zelinsky Institute of Organic Chemistry, Russian Academy of Sciences, 47 Leninsky Prospekt, 119991 Moscow, Russia.
| | - Alexander O Terent'ev
- N. D. Zelinsky Institute of Organic Chemistry, Russian Academy of Sciences, 47 Leninsky Prospekt, 119991 Moscow, Russia.
- Faculty of Chemical and Pharmaceutical Technology and Biomedical Products, D. I. Mendeleev University of Chemical Technology of Russia, 9 Miusskaya Square, 125047 Moscow, Russia.
- All-Russian Research Institute for Phytopathology, B. Vyazyomy, 143050 Moscow, Russia.
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Gold MH, Goldberg DJ, Nestor MS. Current treatments of acne: Medications, lights, lasers, and a novel 650-μs 1064-nm Nd: YAG laser. J Cosmet Dermatol 2017; 16:303-318. [PMID: 28703382 DOI: 10.1111/jocd.12367] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2017] [Indexed: 12/21/2022]
Abstract
The treatment of acne, especially severe acne, remains a challenge to dermatologists. Therapies include retinoids, antibiotics, hormones, lights, lasers, and various combinations of these modalities. Acne is currently considered a chronic rather than an adolescent condition. The appropriate treatment depends on the patient and the severity of disease. The purpose of this study was to review current therapies for acne of all severities and to introduce the 650-μs 1064-nm laser for the treatment of acne.
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Affiliation(s)
| | - David J Goldberg
- Skin Laser and Surgery Specialists of NY and NJ, Hackensack, NJ, USA
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31
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Cestone E, Michelotti A, Zanoletti V, Zanardi A, Mantegazza R, Dossena M. Acne RA-1,2, a novel UV-selective face cream for patients with acne: Efficacy and tolerability results of a randomized, placebo-controlled clinical study. J Cosmet Dermatol 2017; 16:265-270. [PMID: 28133878 DOI: 10.1111/jocd.12309] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/06/2016] [Indexed: 12/26/2022]
Abstract
BACKGROUND General skincare measures such as the use of moisturisers and products containing adequate photoprotection are important components of acne patients' management to complement the pharmacological regimen. Acne RA-1,2 is a novel dermato-cosmetic product which contains selective photofilters and active ingredients against the multifactorial pathophysiology of acne. OBJECTIVES To evaluate the tolerability of Acne RA-1,2 and its effect on the clinical signs of acne. METHODS This double-blind, placebo-controlled study randomized 40 adult patients with 10-25 comedones per half face to once-daily application of Acne RA-1,2 or placebo for 8 weeks. Evaluations after 4 and 8 weeks included the number of comedones, transepidermal water loss (TEWL), sebum production, and tolerability. RESULTS In the Acne RA-1,2 group, there was a significant 35% decrease in the mean number of comedones from 26 at baseline to 17 at Week 8 (P<.001), a 7% significant reduction in TEWL (9.32 to 8.66 g/h/m2 ; P<.001), and a 24% significant reduction in sebum production (154.8 to 117.6 μg/cm2 ; P<.001). The reductions in TEWL and sebum production were significantly greater than those in the placebo group at Weeks 4 and 8 (P<0.05). There were no adverse events. CONCLUSIONS Acne RA-1,2 was well tolerated and effective at reducing comedones and sebum production and improving epidermal barrier function. These results suggest that Acne RA-1,2 is useful against acne-prone facial skin, particularly as it targets sebum production, which topical pharmacological acne therapies do not address.
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Affiliation(s)
| | | | | | | | | | - Maurizia Dossena
- Department of Biology and Biotechnology, University of Pavia, Pavia, Italy
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32
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Khairutdinov VR, Statsenco AV, Samtsov AV. Topical formulations used in the treatment of acne. VESTNIK DERMATOLOGII I VENEROLOGII 2016. [DOI: 10.25208/0042-4609-2016-92-4-75-79] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
The article presents 2 clinical observations of patients with papules-pustular form of acne of moderate severity. In both cases the use of combined topical therapy - topical clindamycin and azelaic acid. The therapeutic effect of clindamycin is faster than other topical preparations. Azelaic acid strengthens the anti-bacterial action of clindamycin, prevents the development of resistance. The results indicate the feasibility of the combined use of these drugs in the treatment of acne.
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33
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Gollnick HP, Bettoli V, Lambert J, Araviiskaia E, Binic I, Dessinioti C, Galadari I, Ganceviciene R, Ilter N, Kaegi M, Kemeny L, López-Estebaranz JL, Massa A, Oprica C, Sinclair W, Szepietowski JC, Dréno B. A consensus-based practical and daily guide for the treatment of acne patients. J Eur Acad Dermatol Venereol 2016; 30:1480-90. [PMID: 27177989 DOI: 10.1111/jdv.13675] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Accepted: 02/11/2016] [Indexed: 01/01/2023]
Abstract
BACKGROUND Many current guidelines provide detailed evidence-based recommendations for acne treatment. OBJECTIVE To create consensus-based, simple, easy-to-use algorithms for clinical acne treatment in daily office-based practice and to provide checklists to assist in determining why a patient may not have responded to treatment and what action to take. METHODS Existing treatment guidelines and consensus papers were reviewed. The information in them was extracted and simplified according to daily clinical practice needs using a consensus-based approach and based on the authors' clinical expertise. RESULTS As outcomes, separate simple algorithms are presented for the treatment of predominant comedonal, predominant papulopustular and nodular/conglobate acne. Patients with predominant comedonal acne should initially be treated with a topical retinoid, azelaic acid or salicylic acid. Fixed combination topicals are recommended for patients with predominant papulopustular acne with treatment tailored according to the severity of disease. Treatment recommendations for nodular/conglobate acne include oral isotretinoin or fixed combinations plus oral antibiotics in men, and these options may be supplemented with oral anti-androgenic hormonal therapy in women. Further decisions regarding treatment responses should be evaluated 8 weeks after treatment initiation in patients with predominant comedonal or papulopustular acne and 12 weeks after in those with nodular/conglobate acne. Maintenance therapy with a topical retinoid or azelaic acid should be commenced once a patient is clear or almost clear of their acne to prevent the disease from recurring. The principal explanations for lack of treatment response fall into 5 main categories: disease progression, non-drug-related reasons, drug-related reasons, poor adherence, and adverse events. CONCLUSION This practical guide provides dermatologists with treatment algorithms adapted to different clinical features of acne which are simple and easy to use in daily clinical practice. The checklists to establish the causes for a lack of treatment response and subsequent action to take will facilitate successful acne management.
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Affiliation(s)
- H P Gollnick
- Department of Dermatology & Venereology, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - V Bettoli
- Department of Clinical and Experimental Medicine, O.U. of Dermatology, Azienda Ospedaliero-Universitaria, University of Ferrara, Ferrara, Italy
| | - J Lambert
- Department of Dermatology, University Hospital of Antwerp, University of Antwerp, Edegem, Belgium
| | - E Araviiskaia
- Department of Dermatology and Venereal Diseases, First I. P. Pavlov State Medical University of St. Petersburg, St. Petersburg, Russia
| | - I Binic
- Department of Dermatovenerology, Faculty of Medicine, University of Nis, Nis, Serbia
| | - C Dessinioti
- Department of Dermatology, A. Syggros Hospital, University of Athens, Athens, Greece
| | - I Galadari
- School of Medicine, United Arab Emirates University, Al-Ain, United Arab Emirates
| | - R Ganceviciene
- Clinic of Infectious, Chest Diseases, Dermatovenereology and Allergology, Vilnius University, Vilnius, Lithuania
| | - N Ilter
- Department of Dermatology, Gazi University Medical School, Ankara, Turkey
| | - M Kaegi
- Hautzentrum Zürich, Zürich, Switzerland
| | - L Kemeny
- Department of Dermatology and Allergology University of Szeged, Szeged, Hungary
| | | | - A Massa
- Clínica Dermatológica Dr António Massa, Porto, Portugal
| | - C Oprica
- Department of Laboratory Medicine, Karolinska Institutet Karolinska University Hospital Huddinge, Stockholm, Sweden.,Diagnostiskt Centrum Hud, Stockholm, Sweden
| | - W Sinclair
- Department of Dermatology, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa
| | - J C Szepietowski
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland
| | - B Dréno
- Department of Dermato-Cancerology, University of Nantes, Nantes, France
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Gollnick HPM. From new findings in acne pathogenesis to new approaches in treatment. J Eur Acad Dermatol Venereol 2016; 29 Suppl 5:1-7. [PMID: 26059819 DOI: 10.1111/jdv.13186] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Accepted: 04/14/2015] [Indexed: 01/01/2023]
Abstract
Acne is a chronic disease of the pilosebaceous unit which is most common during adolescence. Four factors are believed to play a key role in the development of acne lesions: excess sebum production, disturbed keratinization within the follicle, colonization of the pilosebaceous duct by Propionibacterium acnes, and the release of inflammatory mediators into the skin. Consequently, in order to effectively and rapidly reduce acne lesions, treatments need to address as many of these underlying factors as possible. Currently, about half of patients have poor adherence to acne treatments. To overcome this limitation, treatments need to be developed which are well tolerated by patients, and easy for them to use, handle and apply. Topical monotherapies for acne such as retinoids and antimicrobials by themselves have a restricted range of actions against the pathogenic factors of acne. Instead, the Global Alliance to Improve Outcomes in Acne Group recommends combination therapy with a topical retinoid and an antimicrobial agent as the preferred approach for almost all acne patients. The principal advantage of such combinations is that they target more of the underlying pathogenic factors of acne than individual monotherapies and this results in faster and more complete clearing of acne lesions. Fixed-dose combinations are also more convenient than applying two medications separately, which leads to improved adherence with the regimen. By normalizing desquamation, the retinoid component of these combinations allows entry of the antimicrobial agent into the pilosebaceous unit resulting in faster clearance of P. acnes. In conclusion, topical retinoid/antimicrobial fixed-dose combinations represent a rational approach for the treatment of acne. They should be considered as the cornerstone of acne management and should be used much more in the future.
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Affiliation(s)
- H P M Gollnick
- Department of Dermatology & Venereology, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
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Okamoto K, Ikeda F, Kanayama S, Nakajima A, Matsumoto T, Ishii R, Umehara M, Gotoh N, Hayashi N, Iyoda T, Matsuzaki K, Matsumoto S, Kawashima M. In vitro antimicrobial activity of benzoyl peroxide against Propionibacterium acnes assessed by a novel susceptibility testing method. J Infect Chemother 2016; 22:426-9. [PMID: 26806150 DOI: 10.1016/j.jiac.2015.12.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Revised: 11/17/2015] [Accepted: 12/09/2015] [Indexed: 11/28/2022]
Abstract
Benzoyl peroxide (BPO), a therapeutic agent for acne vulgaris, was assessed for in vitro antimicrobial activity against Propionibacterium acnes using a novel broth microdilution testing that improved BPO solubility. We searched for a suitable culture medium to measure the minimum inhibitory concentration (MIC) of BPO against P. acnes and finally found the Gifu anaerobic medium (GAM) broth supplemented with 0.1(v/v)% glycerol and 2(v/v)% Tween 80, in which BPO dissolved up to 1250 μg/mL and P. acnes grew well. The MICs and minimum bactericidal concentrations (MBCs) of BPO against 44 clinical isolates of P. acnes collected from Japanese patients with acne vulgaris were determined by our testing method using the supplemented GAM broth. The MICs of BPO were 128 or 256 μg/mL against all isolates of P. acnes regardless of susceptibility to nadifloxacin or clindamycin. The MBCs of BPO were also 128 or 256 μg/mL against the same isolates. Moreover, BPO at the MIC showed a rapid bactericidal activity against P. acnes ATCC11827 in time-kill assay. In conclusion, we could develop a novel assay for the MIC and MBC determinations of BPO against P. acnes, which is reliable and reproducible as a broth microdilution testing and the present results suggest that BPO has a potent bactericidal activity against P. acnes.
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Affiliation(s)
- Kazuaki Okamoto
- Drug Development Research Laboratories, Kyoto R&D Center, Maruho Co., Ltd., Japan; Department of Microbiology and Infection Control Science, Kyoto Pharmaceutical University, Japan.
| | - Fumiaki Ikeda
- Drug Development Research Laboratories, Kyoto R&D Center, Maruho Co., Ltd., Japan
| | - Shoji Kanayama
- Drug Development Research Laboratories, Kyoto R&D Center, Maruho Co., Ltd., Japan; Department of Microbiology and Infection Control Science, Kyoto Pharmaceutical University, Japan
| | - Akiko Nakajima
- Drug Development Research Laboratories, Kyoto R&D Center, Maruho Co., Ltd., Japan
| | - Tatsumi Matsumoto
- Drug Development Research Laboratories, Kyoto R&D Center, Maruho Co., Ltd., Japan
| | - Ritsuko Ishii
- Drug Development Research Laboratories, Kyoto R&D Center, Maruho Co., Ltd., Japan
| | - Masatoshi Umehara
- CMC Research Laboratories, Kyoto R&D Center, Maruho Co., Ltd., Japan
| | - Naomasa Gotoh
- Department of Microbiology and Infection Control Science, Kyoto Pharmaceutical University, Japan
| | - Naoki Hayashi
- Department of Microbiology and Infection Control Science, Kyoto Pharmaceutical University, Japan
| | - Takako Iyoda
- Clinical Trial Testing Department, LSI Medience Co., Japan
| | | | | | - Makoto Kawashima
- Department of Dermatology, Tokyo Women's Medical University, Japan
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Morimoto H, Kikukawa Y, Murakami N. [Pharmacological profiles and clinical effects of benzoyl peroxide gel as treatments for acne vulgaris]. Nihon Yakurigaku Zasshi 2015; 146:225-32. [PMID: 26656967 DOI: 10.1254/fpj.146.225] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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37
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Alkan S, Kayiran N, Zengin O, Kalem A, Kimyon G, Kilinc EO, Pehlivan Y, Kirtak N, Onat AM, Kisacik B. Isotretinoin-induced Spondyloarthropathy-related Symptoms: A Prospective Study. J Rheumatol 2015; 42:2106-9. [DOI: 10.3899/jrheum.150013] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2015] [Indexed: 12/16/2022]
Abstract
Objective.Acne vulgaris is a chronic inflammatory disease involving the pilosebaceous unit of the skin. Isotretinoin is a systemic retinoid that is often used as an effective treatment option for severe and treatment-resistant acne. Isotretinoin may also cause rheumatologic symptoms. The aim of this prospective observational study was to present followup results regarding the rheumatologic symptoms of patients who received systemic therapy for the treatment of acne (isotretinoin and tetracycline).Methods.For inclusion in the study, all consecutive patients with acne who were aged > 18 years were evaluated by the same dermatologist. The first 42 consecutive patients were included in the isotretinoin group, and after matching for age and sex, 32 consecutive patients were included in the tetracycline group. Isotretinoin treatment was planned as an average dose of 30 mg daily and a total dose of 120–150 mg/kg for 4–6 months. The patients were administered a dose of 1 g/day of tetracycline as 2 equal doses for 3 months.Results.Forty-two patients diagnosed with acne vulgaris were treated with isotretinoin 20.6 ± 4.4 (male/female: 17/22), and 32 patients were treated with tetracycline 20.6 ± 2.7 (male/female: 8/24). There was no significant difference between the 2 groups with respect to age and sex. Unilateral Achilles enthesopathy developed in 3 patients, whereas both Achilles enthesopathy and unilateral sacroiliitis developed in 1 patient. Inflammatory back pain developed in 6 patients in the isotretinoin group.Conclusion.To our knowledge, this was the first prospective observational study that assessed the rheumatologic symptoms of isotretinoin treatment. The spondyloarthropathy findings were identified in 23.1% of the patients who used isotretinoin.
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Ochsendorf F. Clindamycin phosphate 1.2% / tretinoin 0.025%: a novel fixed-dose combination treatment for acne vulgaris. J Eur Acad Dermatol Venereol 2015; 29 Suppl 5:8-13. [DOI: 10.1111/jdv.13185] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Accepted: 04/14/2015] [Indexed: 01/14/2023]
Affiliation(s)
- F. Ochsendorf
- Clinic for Dermatology, Venereology and Allergy; University Hospital; Frankfurt/Main Germany
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39
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Hsu P, Litman GI, Brodell RT. Overview of the Treatment of Acne Vulgaris with Topical Retinoids. Postgrad Med 2015; 123:153-61. [DOI: 10.3810/pgm.2011.05.2294] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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40
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Leccia MT, Auffret N, Poli F, Claudel JP, Corvec S, Dreno B. Topical acne treatments in Europe and the issue of antimicrobial resistance. J Eur Acad Dermatol Venereol 2015; 29:1485-92. [PMID: 25677763 DOI: 10.1111/jdv.12989] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2014] [Accepted: 01/06/2015] [Indexed: 12/31/2022]
Abstract
Acne vulgaris (acne) is a chronic inflammatory disease of the sebaceous gland, characterized by follicular hyperkeratinization, excessive colonization by Propionibacterium acnes (P. acnes) as well as immune reactions and inflammation. Despite an armamentarium of topical treatments available including benzoyl peroxide, retinoids and azelaic acid, topical antibiotics in monotherapies, especially erythromycin and clindamycin, are still used in Europe to treat acne. This intensive use led to antimicrobial-resistant P. acnes and staphylococci strains becoming one of the main health issues worldwide. This is an update on the current topical acne treatments available in Europe, their mechanism of action, their potential to induce antimicrobial resistance and their clinical efficacy and safety.
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Affiliation(s)
- M T Leccia
- Clinique de Dermatologie, Allergologie et Photobiologie, CHU A Michallon, Grenoble, France
| | - N Auffret
- Hôpital Européen Georges Pompidou, Paris, France
| | - F Poli
- Hôpital Européen Georges Pompidou, Paris, France
| | | | - S Corvec
- Institut de Biologie des Hôpitaux de Nantes, Service de Bactériologie-Hygiène, CHU de Nantes, Nantes, France
| | - B Dreno
- Clinique de Dermatologie, University Hospital, Nantes, France
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41
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Kawashima M, Hashimoto H, Alió Sáenz A, Ono M, Yamada M. Clindamycin phosphate 1·2%-benzoyl peroxide 3·0% fixed-dose combination gel has an effective and acceptable safety and tolerability profile for the treatment of acne vulgaris in Japanese patients: a phase III, multicentre, randomised, single-blinded, acti. Br J Dermatol 2015; 172:494-503. [DOI: 10.1111/bjd.13265] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/01/2014] [Indexed: 12/19/2022]
Affiliation(s)
- M. Kawashima
- Department of Dermatology; Tokyo Women's Medical University; Tokyo Japan
| | - H. Hashimoto
- Biomedical Data Science; Japan Development and Medical Affairs; GlaxoSmithKline K.K.; Tokyo Japan
| | - A.B. Alió Sáenz
- Medicines Development R&D; Stiefel, A GSK Company, Research Triangle Park; NC U.S.A
| | - M. Ono
- Business Innovation; GlaxoSmithKline K.K.; Tokyo Japan
| | - M. Yamada
- Medicines Development; Japan Development and Medical Affairs; GlaxoSmithKline K.K.; Tokyo Japan
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Ino H, Takahashi N, Saenz AA, Wakamatsu A, Hashimoto H, Nakahara N, Hasegawa S. Systemic exposure to benzoic acid and hippuric acid following topical application of clindamycin 1%/benzoyl peroxide 3% fixed-dose combination gel in Japanese patients with acne vulgaris. Clin Pharmacol Drug Dev 2015; 4:18-24. [PMID: 27128000 DOI: 10.1002/cpdd.125] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2013] [Accepted: 03/28/2014] [Indexed: 11/10/2022]
Abstract
Clindamycin 1%/benzoyl peroxide 3% fixed-dose combination gel (CLDM/BPO3%) is a topical product for the treatment of acne vulgaris. In this study, plasma and urine concentrations of benzoic acid (BA) and hippuric acid (HA) were analyzed to estimate the pharmacokinetics (PK) of BPO after application of CLDM/BPO3% twice-daily for 7 days in Japanese patients with acne vulgaris. Seven-day repeated application of CLDM/BPO3% appears to be safe in this patient population. Concentrations of plasma and urine BA were below the limit of quantification before and after repeated application in most of the 12 adult male patients. Mean difference in Cmax and AUC0-last for plasma HA indicated increased exposures after repeated application, but with wide 90% confidence intervals. Mean Ae0-12 for urine HA was similar before and after repeated application. Repeated application of CLDM/BPO3% is thus unlikely to result in accumulation of BA and HA. The study suggests negligible systemic exposure to BPO metabolites from CLDM/BPO3% after 7-day repeated application in male patients with acne vulgaris.
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Fabbrocini G, Saint Aroman M. Cosmeceuticals based on Rhealba®
Oat plantlet extract for the treatment of acne vulgaris. J Eur Acad Dermatol Venereol 2014; 28 Suppl 6:1-6. [DOI: 10.1111/jdv.12791] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2014] [Accepted: 09/19/2014] [Indexed: 12/26/2022]
Affiliation(s)
- G. Fabbrocini
- Department of Dermatology and Venerology; University of Naples Federico II; Naples Italy
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44
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Kawashima M, Hashimoto H, Alio Sáenz AB, Ono M, Yamada M. Is benzoyl peroxide 3% topical gel effective and safe in the treatment of acne vulgaris in Japanese patients? A multicenter, randomized, double-blind, vehicle-controlled, parallel-group study. J Dermatol 2014; 41:795-801. [DOI: 10.1111/1346-8138.12580] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Accepted: 06/16/2014] [Indexed: 01/24/2023]
Affiliation(s)
- Makoto Kawashima
- Department of Dermatology; Tokyo Women's Medical University; Tokyo Japan
| | - Hirofumi Hashimoto
- Biomedical Data Science; Japan Development and Medical Affairs; GlaxoSmithKline K.K.; Tokyo Japan
| | | | - Makoto Ono
- Business Innovation; GlaxoSmithKline K.K.; Tokyo Japan
| | - Masahiro Yamada
- Medicines Development; Japan Development and Medical Affairs; GlaxoSmithKline K.K.; Tokyo Japan
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Lynde C, Tan J, Andriessen A, Barankin B, Dutil M, Gilbert M, Hong CH, Humphrey S, Rochette L, Toole J, Thomas R, Vender R, Wiseman M, Zip C. A Consensus on Acne Management Focused on Specific Patient Features. J Cutan Med Surg 2014; 18:243-55. [DOI: 10.2310/7750.2013.13154] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Background: Most treatment guidelines for acne are based on clinical severity. Our objective was to expand that approach to one that also comprised individualized patient features: a case-based approach. Methods: An expert panel of Canadian dermatologists was established to develop demographic and clinical features considered to be particularly important in acne treatment selection. A nominal group consensus process was used for inclusion of features and corresponding appropriate treatments. Results: Consensus was achieved on the following statements: follicular epithelial dysfunction contributes to acne pathogenesis; inflammation from underlying disease(s) or prior treatment may impact further patient management; management focusing on specific patient features and on addressing psychosocial factors, including impact on quality of life, may improve treatment adherence and outcomes; and case-based scenarios are a practical approach to illustrate the effect of these factors. To address the latter, eight case profiles were developed. Conclusions: Management of acne should be based on multifactorial considerations beyond clinically determined acne severity and should include patient-reported impact, gender, skin sensitivity (including preexisting dermatoses), and phototype.
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Affiliation(s)
- Charles Lynde
- From University of Toronto, Toronto, ON; University of Western Ontario, Windsor, ON; Andriessen Consultants Malden and UMC St Radboud Nijmegen, The Netherlands; Toronto Dermatology Center, Toronto, ON; University of British Columbia, Vancouver, BC; Centre Dermatologique du Québec, QC; University of Manitoba, Winnipeg, MB; Department of Medicine, McMaster University, Hamilton, ON; University of Calgary Calgary, AB
| | - Jerry Tan
- From University of Toronto, Toronto, ON; University of Western Ontario, Windsor, ON; Andriessen Consultants Malden and UMC St Radboud Nijmegen, The Netherlands; Toronto Dermatology Center, Toronto, ON; University of British Columbia, Vancouver, BC; Centre Dermatologique du Québec, QC; University of Manitoba, Winnipeg, MB; Department of Medicine, McMaster University, Hamilton, ON; University of Calgary Calgary, AB
| | - Anneke Andriessen
- From University of Toronto, Toronto, ON; University of Western Ontario, Windsor, ON; Andriessen Consultants Malden and UMC St Radboud Nijmegen, The Netherlands; Toronto Dermatology Center, Toronto, ON; University of British Columbia, Vancouver, BC; Centre Dermatologique du Québec, QC; University of Manitoba, Winnipeg, MB; Department of Medicine, McMaster University, Hamilton, ON; University of Calgary Calgary, AB
| | - Benjamin Barankin
- From University of Toronto, Toronto, ON; University of Western Ontario, Windsor, ON; Andriessen Consultants Malden and UMC St Radboud Nijmegen, The Netherlands; Toronto Dermatology Center, Toronto, ON; University of British Columbia, Vancouver, BC; Centre Dermatologique du Québec, QC; University of Manitoba, Winnipeg, MB; Department of Medicine, McMaster University, Hamilton, ON; University of Calgary Calgary, AB
| | - Maha Dutil
- From University of Toronto, Toronto, ON; University of Western Ontario, Windsor, ON; Andriessen Consultants Malden and UMC St Radboud Nijmegen, The Netherlands; Toronto Dermatology Center, Toronto, ON; University of British Columbia, Vancouver, BC; Centre Dermatologique du Québec, QC; University of Manitoba, Winnipeg, MB; Department of Medicine, McMaster University, Hamilton, ON; University of Calgary Calgary, AB
| | - Martin Gilbert
- From University of Toronto, Toronto, ON; University of Western Ontario, Windsor, ON; Andriessen Consultants Malden and UMC St Radboud Nijmegen, The Netherlands; Toronto Dermatology Center, Toronto, ON; University of British Columbia, Vancouver, BC; Centre Dermatologique du Québec, QC; University of Manitoba, Winnipeg, MB; Department of Medicine, McMaster University, Hamilton, ON; University of Calgary Calgary, AB
| | - Chih-ho Hong
- From University of Toronto, Toronto, ON; University of Western Ontario, Windsor, ON; Andriessen Consultants Malden and UMC St Radboud Nijmegen, The Netherlands; Toronto Dermatology Center, Toronto, ON; University of British Columbia, Vancouver, BC; Centre Dermatologique du Québec, QC; University of Manitoba, Winnipeg, MB; Department of Medicine, McMaster University, Hamilton, ON; University of Calgary Calgary, AB
| | - Shannon Humphrey
- From University of Toronto, Toronto, ON; University of Western Ontario, Windsor, ON; Andriessen Consultants Malden and UMC St Radboud Nijmegen, The Netherlands; Toronto Dermatology Center, Toronto, ON; University of British Columbia, Vancouver, BC; Centre Dermatologique du Québec, QC; University of Manitoba, Winnipeg, MB; Department of Medicine, McMaster University, Hamilton, ON; University of Calgary Calgary, AB
| | - Linda Rochette
- From University of Toronto, Toronto, ON; University of Western Ontario, Windsor, ON; Andriessen Consultants Malden and UMC St Radboud Nijmegen, The Netherlands; Toronto Dermatology Center, Toronto, ON; University of British Columbia, Vancouver, BC; Centre Dermatologique du Québec, QC; University of Manitoba, Winnipeg, MB; Department of Medicine, McMaster University, Hamilton, ON; University of Calgary Calgary, AB
| | - Jack Toole
- From University of Toronto, Toronto, ON; University of Western Ontario, Windsor, ON; Andriessen Consultants Malden and UMC St Radboud Nijmegen, The Netherlands; Toronto Dermatology Center, Toronto, ON; University of British Columbia, Vancouver, BC; Centre Dermatologique du Québec, QC; University of Manitoba, Winnipeg, MB; Department of Medicine, McMaster University, Hamilton, ON; University of Calgary Calgary, AB
| | - Richard Thomas
- From University of Toronto, Toronto, ON; University of Western Ontario, Windsor, ON; Andriessen Consultants Malden and UMC St Radboud Nijmegen, The Netherlands; Toronto Dermatology Center, Toronto, ON; University of British Columbia, Vancouver, BC; Centre Dermatologique du Québec, QC; University of Manitoba, Winnipeg, MB; Department of Medicine, McMaster University, Hamilton, ON; University of Calgary Calgary, AB
| | - Ronald Vender
- From University of Toronto, Toronto, ON; University of Western Ontario, Windsor, ON; Andriessen Consultants Malden and UMC St Radboud Nijmegen, The Netherlands; Toronto Dermatology Center, Toronto, ON; University of British Columbia, Vancouver, BC; Centre Dermatologique du Québec, QC; University of Manitoba, Winnipeg, MB; Department of Medicine, McMaster University, Hamilton, ON; University of Calgary Calgary, AB
| | - Marni Wiseman
- From University of Toronto, Toronto, ON; University of Western Ontario, Windsor, ON; Andriessen Consultants Malden and UMC St Radboud Nijmegen, The Netherlands; Toronto Dermatology Center, Toronto, ON; University of British Columbia, Vancouver, BC; Centre Dermatologique du Québec, QC; University of Manitoba, Winnipeg, MB; Department of Medicine, McMaster University, Hamilton, ON; University of Calgary Calgary, AB
| | - Catherine Zip
- From University of Toronto, Toronto, ON; University of Western Ontario, Windsor, ON; Andriessen Consultants Malden and UMC St Radboud Nijmegen, The Netherlands; Toronto Dermatology Center, Toronto, ON; University of British Columbia, Vancouver, BC; Centre Dermatologique du Québec, QC; University of Manitoba, Winnipeg, MB; Department of Medicine, McMaster University, Hamilton, ON; University of Calgary Calgary, AB
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Abstract
Acne is a common skin condition in adolescents. It is not uncommon in childhood and it persists into adulthood. A broad range of acne treatments are available and have been shown to be safe and effective in adolescents and adults. However, there is limited literature regarding acne treatment in childhood and its available therapeutic options. It seems reasonable to extrapolate findings of the various studies reported on treatment of acne in the adolescent and adult age group, with the exclusion of the use of tetracycline derivatives. As clinicians, we must be more familiar with the clinical presentation of acne and available treatment options in our younger patients. Early recognition of acne with prompt and appropriate initiation of therapy in childhood will help prevent severe scarring in children.
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Pariser D. Adapalene 0.1% and benzoyl peroxide 2.5% combination gel for the treatment of acne vulgaris. ACTA ACUST UNITED AC 2014. [DOI: 10.1586/edm.10.32] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Intense pulsed light versus benzoyl peroxide 5 % gel in treatment of acne vulgaris. Lasers Med Sci 2013; 29:1009-15. [PMID: 24114421 DOI: 10.1007/s10103-013-1440-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2013] [Accepted: 09/16/2013] [Indexed: 10/26/2022]
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