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Furth G, Marroquin NA, Kirk J, Ajmal H, Szeto MD, Zueger M, Quinn AP, Carboni A, Dellavalle RP. Cutaneous Manifestations of Anabolic-Androgenic Steroid Use in Bodybuilders and the Dermatologist's Role in Patient Care. JMIR DERMATOLOGY 2023; 6:e43020. [PMID: 37632935 PMCID: PMC10436113 DOI: 10.2196/43020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 03/05/2023] [Accepted: 06/21/2023] [Indexed: 08/28/2023] Open
Abstract
Young adults have been increasingly facing pressure to achieve an appealing athletic physique, often influenced by social media influencers on platforms like Instagram. This viewpoint highlights the association between image-centric social media, dissatisfied body image, the use of anabolic-androgenic steroids (AAS) to achieve desired results, and the overlooked dermatological side effects of AAS, including acne and acne fulminans. We underscore the importance of recognizing acne fulminans as an indicator of possible AAS abuse and encourage dermatologists to actively identify and address AAS use to improve their patients' well-being.
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Affiliation(s)
- Garrett Furth
- College of Osteopathic Medicine, Rocky Vista University, Greenwood Village, CO, United States
| | - Nathaniel A Marroquin
- College of Osteopathic Medicine, Rocky Vista University, Greenwood Village, CO, United States
| | - Jessica Kirk
- College of Osteopathic Medicine, Rocky Vista University, Greenwood Village, CO, United States
| | - Hamza Ajmal
- College of Osteopathic Medicine, Rocky Vista University, Greenwood Village, CO, United States
| | - Mindy D Szeto
- Department of Dermatology, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Morgan Zueger
- College of Osteopathic Medicine, Rocky Vista University, Greenwood Village, CO, United States
| | - Alyssa P Quinn
- College of Osteopathic Medicine, Rocky Vista University, Greenwood Village, CO, United States
| | - Alexa Carboni
- College of Osteopathic Medicine, Rocky Vista University, Greenwood Village, CO, United States
| | - Robert P Dellavalle
- Department of Dermatology, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
- Dermatology Service, Rocky Mountain Regional VA Medical Center, Aurora, CO, United States
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Cabral MD, Patel DR, Greydanus DE, Deleon J, Hudson E, Darweesh S. Medical perspectives on pediatric sports medicine–Selective topics. Dis Mon 2022; 68:101327. [DOI: 10.1016/j.disamonth.2022.101327] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Lee G, Ferri-Huerta R, Greenberg KB, Somers KE. Acne fulminans in a transgender boy after an increase in testosterone dosage. JAAD Case Rep 2022; 21:32-34. [PMID: 35141385 PMCID: PMC8816645 DOI: 10.1016/j.jdcr.2021.11.029] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- Gayin Lee
- University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - Rita Ferri-Huerta
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, Minnesota
| | - Katherine B. Greenberg
- Department of Pediatrics, University of Rochester Medical Center, Rochester, New York
- Correspondence to: Kathryn E. Somers, MD, Department of Dermatology, University of Rochester, 601 Elmwood Avenue, Box 697, Rochester, NY 14642.
| | - Kathryn E. Somers
- Department of Dermatology, University of Rochester Medical Center, Rochester, New York
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Abstract
Acne fulminans (AF) is a rare and severe form of inflammatory acne presenting clinically with an abrupt outburst of painful, hemorrhagic pustules and ulceration, that may or may not be associated with systemic symptoms, such as fever, polyarthritis, and laboratory abnormalities. It typically affects male teenagers with a pre-existing acne. Although the pathogenetic mechanism has not been established yet, a role of genetic, abnormal immunologic response, drugs intake, hormonal imbalance and viral infection, as causal factors, has been identified. AF may occur as a single disease or may be associated with other disorders. Traditionally, AF has been classified, on the basis of the presence of systemic involvement, in "acne fulminans" and acne fulminans "sine fulminans," when no systemic involvement is present. Recently, four clinical variants have been proposed: acne fulminans with systemic symptoms (AF-SS), acne fulminans without systemic symptoms (AF-WOSS), isotretinoin-induced acne fulminans with systemic symptoms (IIAF-SS), isotretinoin-induced acne fulminans without systemic symptoms (IIAF-WOSS). The diagnosis of AF is usually based on clinical history and physical examination. No specific laboratory abnormalities are generally found. In selected cases, biopsy and/or radiologic imaging are helpful for a correct diagnosis. The treatment significantly differs from severe acne according to severity of clinical presentation and possible systemic involvement. Currently, systemic corticosteroids (prednisolone) and retinoids (isotretinoin) represent the first choice of treatment. Dapsone, cyclosporine A, methotrexate, azathioprine, levamisole, and biological agents such as anakinra, infliximab, adalimumab may be considered as alternative therapies in selected cases. Adjunctive topical and physical therapies may also be considered.
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Affiliation(s)
| | | | - Maria R Nasca
- Dermatology Clinic, University of Catania, Catania, Italy
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Claudel JP, Auffret N, Leccia MT, Poli F, Dréno B. Acne and nutrition: hypotheses, myths and facts. J Eur Acad Dermatol Venereol 2018; 32:1631-1637. [PMID: 29633388 DOI: 10.1111/jdv.14998] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 03/15/2018] [Indexed: 12/28/2022]
Abstract
Acne is an inflammatory and multifactorial skin disease. Different external and internal factors, including air pollution, aggressive skincare products, medication, mechanical, hormonal and familial factors and, more recently, lifestyle and stress, have been suggested as having an impact on acne. Moreover, for many years nutrition was believed to cause or worsen acne. Over the last decades, however, it has become a dermatological doctrine that there is no direct association between diet and acne. Even if recent research has allowed to identify certain nutritional elements and behaviour that may impact on acne, including the excessive intake of dairy products and hyperglycaemic food, modern lifestyle nutrition, obesity and eating disorders, knowledge about the role of nutrition in the physiopathology of acne still remains sparse and hypotheses and myths continue to dominate the debate. Thus, further clinical and translational research is necessary to investigate and confirm the association between nutrition and acne.
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Affiliation(s)
| | | | - M T Leccia
- Department of Dermatology, Allergology and Photobiology, CHU A Michallon, Grenoble, France
| | - F Poli
- Private Practice, Paris, France
| | - B Dréno
- Department of Dermatology, CIC 1413, CRCINA Inserm 1232, Nantes University Hospital, Nantes, France
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Dréno B, Bettoli V, Araviiskaia E, Sanchez Viera M, Bouloc A. The influence of exposome on acne. J Eur Acad Dermatol Venereol 2018; 32:812-819. [PMID: 29377341 PMCID: PMC5947266 DOI: 10.1111/jdv.14820] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Accepted: 01/10/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND Acne vulgaris is one of the main reasons for dermatological consultations. Severity and response to treatment may be impacted by various external factors or exposome. AIM To assess the impact of environmental factors on acne and to provide a comprehensive overview of the acne exposome. METHODS Two consensus meetings of five European dermatologists and a comprehensive literature search on exposome factors triggering acne served as a basis for this review. RESULTS Acne exposome was defined as the sum of all environmental factors influencing the occurrence, duration and severity of acne. Exposome factors impact on the response and the frequency of relapse to treatments by interacting with the skin barrier, sebaceous gland, innate immunity and cutaneous microbiota. They may be classified into the following six main categories: nutrition, psychological and lifestyle factors, occupational factors including cosmetics, as well as pollutants, medication and climatic factors. Moreover, practical considerations for the dermatologist's clinical practice are proposed. CONCLUSION Exposome factors including nutrition, medication, occupational factors, pollutants, climatic factors, and psychosocial and lifestyle factors may impact on the course and severity of acne and on treatment efficacy. Identifying and reducing the impact of exposome is important for an adequate acne disease management.
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Affiliation(s)
- B Dréno
- Service de Dermatologie, CIC 1413, CRCINA Inserm 1232, University Hospital Nantes, Nantes, France
| | - V Bettoli
- Department of Clinical and Experimental Medicine, Azienda Ospedaliero-Universitaria di Ferrara, Ferrara, Italy
| | - E Araviiskaia
- Department of Dermatology, First Pavlov State Medical University of St. Petersburg, St. Petersburg, Russia
| | - M Sanchez Viera
- Skin Health, Aging and Cancer, Institute for Dermatology, Madrid, Spain
| | - A Bouloc
- Laboratoires Vichy, Levallois Perret, France
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