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Salari N, Heidarian P, Hosseinian-Far A, Babajani F, Mohammadi M. Global Prevalence of Anxiety, Depression, and Stress Among Patients with Skin Diseases: A Systematic Review and Meta-analysis. JOURNAL OF PREVENTION (2022) 2024:10.1007/s10935-024-00784-0. [PMID: 38822990 DOI: 10.1007/s10935-024-00784-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/13/2024] [Indexed: 06/03/2024]
Abstract
The changes in human lifestyle over the past few decades have impacted the prevalence of skin diseases within different societies. Skin diseases may result in various physical and mental disorders. The most common mental disorders observed among the patients are stress, anxiety, and depression. This study aims to investigate the global prevalence of anxiety, depression, and stress in patients with skin diseases. In this Systematic Review and Meta-Analysis study, the PubMed, Scopus, Science Direct, Embase, Web of science, and Google Scholar repositories were searched without a lower time limit. Heterogeneity among the identified studies was examined using the I2 index, and accordingly random effects model was adopted for analysis. Data analysis was conducted within the Comprehensive Meta-Analysis software (v. 2). In total, 113 studies were included for the final analysis. The overall pooled prevalence of stress, depression, and anxiety in skin disease patients was found to be 39.4%, 27.2% and 28.8%, respectively. Among patients with psoriasis, acne, vitiligo or atopic dermatitis diseases, the highest number of patients suffering from stress was related to patients with acne (75.7%). The highest prevalence of depression, and anxiety was reported in patients with vitiligo (38.3%) and acne (36.5%), respectively. Considering the high prevalence of mental disorders among patients with skin diseases and recognising the impacts of mental health challenges on patients' well-being, the findings of this study provide valuable insights for identifying specific populations that require targeted interventions for the diagnosis, treatment, and prevention of mental illnesses. Accordingly, healthcare policymakers should incorporate psychological treatment and support measures as integral components of comprehensive care strategies for patients with skin diseases.
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Affiliation(s)
- Nader Salari
- Department of Biostatistics, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Pegah Heidarian
- Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Amin Hosseinian-Far
- Department of Business Analytics & Systems, University of Hertfordshire, Hatfield, AL10 9EU, UK
| | - Fateme Babajani
- Department of Clinical Psychology, Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Masoud Mohammadi
- Research Center for Non-Communicable Diseases, Jahrom University of Medical Sciences, Jahrom, Iran.
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Dabash D, Salahat H, Awawdeh S, Hamadani F, Khraim H, Koni AA, Zyoud SH. Prevalence of acne and its impact on quality of life and practices regarding self-treatment among medical students. Sci Rep 2024; 14:4351. [PMID: 38388743 PMCID: PMC10883973 DOI: 10.1038/s41598-024-55094-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 02/20/2024] [Indexed: 02/24/2024] Open
Abstract
Acne vulgaris is one of the most common skin diseases worldwide and causes great distress to patients. In addition, most acne patients suffer from low self-esteem and social withdrawal. This study aimed to assess the prevalence of acne and its impact on quality of life among medical students. It also evaluates the patterns of self-treatment use. The study population consisted of all medical students from An-Najah National University (ANU) and the hospital. The questionnaire consists of three parts, and the first part consists of questions regarding demographic information. The second part consisted of questions to measure the severity of acne using the acne severity scale as well as the Cardiff Disability Index, which assesses the quality of life concerning acne in medical students. Finally, the third part consisted of questions exploring and assessing acne self-treatment. The mean age of our study sample was 21.3 ± 1.9 years, with a female predominance of 72.3%. The prevalence of acne among medical students was 80.9%, and 36.6% practiced self-medication. Acne was strongly associated with female sex (p < 0.001) and skin type (p = 0.024). Regarding diet, dairy consumption (p = 0.007), sweets (p < 0.001), chocolate (p < 0.001), and oily food (p = 0.006) were all significantly associated with acne. Skin type was strongly associated with the severity of acne (p < 0.001) and the Cardiff acne disability index (p = 0.016). Gender (p = 0.039) was also associated with Cardiff acne disability. A significant correlation was found between the severity of acne and impaired quality of life. The most commonly used topical agent for self-treatment remedies was antibiotics (70.3%). The most commonly used oral agent was isotretinoin (9.4%). A total of 22.7% of the students used herbal products, while 47.7% used home remedies. Acne is prevalent among medical students, with a high percentage of students having different degrees of impairment in their daily lives. As a result, self-medication among acne sufferers is highly common. Awareness of the appropriate use of self-medication should increase among medical students.
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Affiliation(s)
- Duaa Dabash
- Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine
| | - Haya Salahat
- Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine
| | - Sally Awawdeh
- Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine
| | - Fadi Hamadani
- Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine
| | - Husam Khraim
- Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine
| | - Amer A Koni
- Division of Clinical Pharmacy, Department of Hematology and Oncology, An-Najah National University Hospital, Nablus, 44839, Palestine
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine
| | - Sa'ed H Zyoud
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine.
- Poison Control and Drug Information Center (PCDIC), College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine.
- Clinical Research Center, An-Najah National University Hospital, Nablus, 44839, Palestine.
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Jankowski M, Goroncy A. Anatomical variants of acne differ in their impact on social perception. J Eur Acad Dermatol Venereol 2024. [PMID: 38379351 DOI: 10.1111/jdv.19798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 12/11/2023] [Indexed: 02/22/2024]
Abstract
BACKGROUND Acne negatively affects quality of life, however quality-of-life scores poorly correlate with disease severity scores. Previous research demonstrated existence of facial areas in which skin lesions have greater impact on gaze patterns. Therefore, we hypothesized that anatomical variants of acne may be perceived differently. OBJECTIVES The aim was to investigate effect of anatomical variants of acne on natural gaze patterns and resulting impact on social perception of acne patients. METHODS We tracked eye movements of participants viewing neutral and emotional faces with acne. Images were rated for acne-related visual disturbance, and emotional faces were rated for valence intensity. Respondents of an online survey were asked to rate their perception of pictured individuals' personality traits. RESULTS All faces with acne were perceived as less attractive and received poorer personality judgements with mid-facial acne presenting smallest deviation from healthy faces. T-zone and mixed acne exhibited the least significant difference in respondents gaze behaviour pattern from each other. In addition, there was no significant difference in respondents' grading of acne visual disturbance or ratings for attractiveness, success and trustworthiness. U-zone adult female acne was rated as the most visually disturbing and received the lowest scores for attractiveness. Happy faces with adult female acne were rated as less happy compared to other acne variants and clear-skin faces. CONCLUSIONS Anatomic variants of acne have a distinct impact on gaze patterns and social perception. Adult female acne has the strongest negative effect on recognition of positive emotions in affected individuals, attractiveness ratings and forming social impressions. If perioral acne lesions are absent, frontal lesions determine impact of acne on social perception irrespective of the presence of mid-facial lesions. This perceptive hierarchy should be taken into consideration while deciding treatment goals in acne patients, prioritizing achieving remission in perioral and frontal area.
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Affiliation(s)
- Marek Jankowski
- Department of Dermatology and Venereology, Faculty of Medicine in Bydgoszcz, Nicolaus Copernicus University, Bydgoszcz, Poland
| | - Agnieszka Goroncy
- Department of Mathematical Statistics and Data Mining, Faculty of Mathematics and Computer Science, Nicolaus Copernicus University in Torun, Torun, Poland
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Hartman N, Loyal J, Borsack S, Goldman M. Alternating Treatment With Nonablative Fractional Laser and Radiofrequency Microneedling for the Treatment of Acne Scars: A Prospective, Randomized, Split-Face Study. Dermatol Surg 2024; 50:81-85. [PMID: 37962952 DOI: 10.1097/dss.0000000000003994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2023]
Abstract
BACKGROUND Acne scarring is an unfortunate sequela affecting up to 95% of patients with acne and carries profound psychosocial impact. Both nonablative fractional lasers (NAFL) and microneedling with radiofrequency (MNRF) have demonstrated comparable efficacy in the treatment of atrophic acne scars. OBJECTIVE To determine whether alternating NAFL and MNRF is superior to NAFL alone in the treatment of atrophic acne scars. METHODS AND MATERIALS This was a prospective, single-center, double-blinded, split-face clinical trial. Twenty patients with atrophic acne scars who had their facial halves randomized to receive either NAFL alone or NAFL alternating with MNRF. Patients received 4 total treatments at 4-week intervals. RESULTS Ninety days after the final treatment, both facial halves demonstrated a significant improvement in the mean global échelle d'évaluation clinique des cicatrices d'acné (ECCA) score from baseline ( p < .001 for both halves). The average percentage improvement at the final end point was 20% to 30% from baseline. No significant difference was noted between facial halves for mean global ECCA score or percentage improvement at any time point. CONCLUSION Although both NAFL and MNRF are safe and effective in the treatment of atrophic acne scars, alternating NAFL and MNRF does not seem to be superior to NAFL alone.
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Affiliation(s)
- Nina Hartman
- Lupo Center for Aesthetic and General Dermatology, New Orleans, Louisiana
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Alfahl SO, Almehmadi LA, Alamri RS, Almalki DS, Alnakhli F. Impact of Acne Vulgaris and Vitiligo on Quality of Life and Self-Esteem in the Patient Population of Madinah, Saudi Arabia. Cureus 2024; 16:e52586. [PMID: 38371097 PMCID: PMC10874647 DOI: 10.7759/cureus.52586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2024] [Indexed: 02/20/2024] Open
Abstract
BACKGROUND Acne vulgaris and vitiligo are skin disorders that can have a negative impact on a person's self-esteem and quality of life (QoL). The purpose of this study is to look into the impact of acne and vitiligo on the self-esteem and QoL of the patient population in Madinah, Saudi Arabia. METHODS A cross-sectional survey of 171 Saudi adults (141 individuals with acne vulgaris (9.4%) and 30 with vitiligo (1.5%) between the ages of 16 and 35 was conducted in Madinah. A self-reported questionnaire with four domains was used: socio-demographic data, lifestyle and coexisting pathologic factors or diseases, Rosenberg's self-esteem scale, and the dermatology life quality index (DLQI). RESULTS Acne patients had a mean total score of 20.3 on the self-esteem scale, with 5% (n = 7) having low self-esteem, 48.2% (n = 68) having medium self-esteem, and 46.8% (n = 66) having high self-esteem. Females had higher self-esteem (75.29) than males (56.95). The mean DLQI score for acne patients was 5.4, with 30.5% (n = 47) unaffected, 29.1% (n = 45) mildly affected, 23.4% (n = 35) moderately affected, 5.6% (n = 10) severely affected, and 1.4% (n = 4) severely affected. Vitiligo patients had a mean self-esteem scale score of 13.7, with 63.3% (n = 19) having low self-esteem, 30% (n = 9) having medium self-esteem, and 6.7% (n = 2) having high self-esteem. The mean DLQI was 15.2, with 6.7% (n = 2) reporting that vitiligo had no effect on their lives, 10% (n = 3) reporting a moderate effect, 66.7% (n = 20) reporting a severe effect, and 16.7% (n = 5) reporting a very severe effect. CONCLUSIONS Our research confirms that acne vulgaris and vitiligo have a negative impact on self-esteem and quality of life. Along with medical treatment, effective treatment and psychological improvement of the patient should be prioritized.
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Affiliation(s)
- Samah O Alfahl
- Family Medicine, College of Medicine, Taibah University, Madinah, SAU
| | | | - Ranad S Alamri
- Medicine, College of Medicine, Taibah University, Madinah, SAU
| | - Dalia S Almalki
- Medicine, College of Medicine, Taibah University, Jeddah, SAU
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Wu J, Zou J, Yang Q, Wang H, Tian H, Chen L, Ji Z, Zheng D, Li Z, Xie Y. The effects of scar in psychological disorder: A bibliometric analysis from 2003 to 2022. Int Wound J 2024; 21:e14373. [PMID: 37675814 PMCID: PMC10784201 DOI: 10.1111/iwj.14373] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 08/23/2023] [Indexed: 09/08/2023] Open
Abstract
Scars are fibrous tissues that replace normal tissue during the wound healing process. Scarring can lead to low self-esteem, social impairment, depression, anxiety, and other psychiatric and psychological distress, necessitating a comprehensive understanding of the latest perspectives, topical research, and directions in scarring-mental health. This is a biblioshiny and VOSviewer based bibliometric analysis study. All data were obtained from the Web of Science, and a total of 664 articles from 2003 to 2022 met the criteria. The last 7 years have been a period of rapid growth in the field, with 2022 having the highest number of articles. The United States is the core country with the highest production and citation rate. The most cited literature was written in 2003 by Van Loey NE et al. Van Loey NE is the most prolific and influential author in this field. The top five popular keywords include "quality of life", "depression", "management", "anxiety", and "prevalence". The paper concludes that the current focus of scholars in the field is on the treatment of scars and that multidisciplinary treatment of such patients is worth exploring. These findings provide relevant researchers with the current state of research and possible future directions in this field.
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Affiliation(s)
- Jinyao Wu
- Department of Respiratory and Critical Care MedicineThe First Affiliated Hospital of Shantou University Medical CollegeShantouChina
- Department of Thyroid, Breast and Hernia Surgery, General SurgeryThe Second Affiliated Hospital of Shantou University Medical CollegeShantouChina
| | - Juan Zou
- Department of Thyroid, Breast and Hernia Surgery, General SurgeryThe Second Affiliated Hospital of Shantou University Medical CollegeShantouChina
| | - Qiuping Yang
- Department of Thyroid, Breast and Hernia Surgery, General SurgeryThe Second Affiliated Hospital of Shantou University Medical CollegeShantouChina
| | - Haiting Wang
- Department of Thyroid, Breast and Hernia Surgery, General SurgeryThe Second Affiliated Hospital of Shantou University Medical CollegeShantouChina
| | - Huiting Tian
- Department of Thyroid, Breast and Hernia Surgery, General SurgeryThe Second Affiliated Hospital of Shantou University Medical CollegeShantouChina
| | - Lingzhi Chen
- Department of Thyroid, Breast and Hernia Surgery, General SurgeryThe Second Affiliated Hospital of Shantou University Medical CollegeShantouChina
| | - Zeqi Ji
- Department of Thyroid, Breast and Hernia Surgery, General SurgeryThe Second Affiliated Hospital of Shantou University Medical CollegeShantouChina
| | - Daitian Zheng
- Department of Thyroid, Breast and Hernia Surgery, General SurgeryThe Second Affiliated Hospital of Shantou University Medical CollegeShantouChina
| | - Zhiyang Li
- Department of Thyroid, Breast and Hernia Surgery, General SurgeryThe Second Affiliated Hospital of Shantou University Medical CollegeShantouChina
| | - Yanna Xie
- Department of Respiratory and Critical Care MedicineThe First Affiliated Hospital of Shantou University Medical CollegeShantouChina
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Taleb E, Gallo ES, Salameh F, Koren A, Shehadeh W, Artzi O. Fractional ablative CO 2 laser and oral isotretinoin-A prospective randomized controlled split-face trial comparing concurrent versus delayed laser treatment for acne scars. Lasers Surg Med 2024; 56:54-61. [PMID: 37555247 DOI: 10.1002/lsm.23713] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 07/17/2023] [Accepted: 07/17/2023] [Indexed: 08/10/2023]
Abstract
BACKGROUND Therapeutic dogma has been to treat acne scars with ablative fractional laser no less than 6 months after isotretinoin (ITN) cessation. OBJECTIVE To evaluate the safety and efficacy of fractional ablative CO2 laser (FACL) in patients treated concurrently with ITN. METHODS We conducted a prospective split-face randomized control trial in patients treated with FACL concurrently with ITN versus patients treated with FACL 6 months post-ITN treatment. Patients received 3 monthly sessions of FACL with concurrent ITN treatment on half of the face; the other side of the face received the same FACL treatment regimen 6 months post-ITN cessation. Patients were followed for adverse effects up to 6 months post-FACL treatment. Final cosmesis was scored using the Quantitative Global Acne Scarring Grading System (GASGS) by three independent dermatologists. RESULTS The GASGS of the concurrent ITN-FACL treated side of the face was significantly lower than the side treated with delayed laser therapy (4.7 ± 2.5 vs. 7.7 ± 2.9, respectively, p < 0.001). LIMITATIONS The laser's settings were standardized, and not adjusted per patient skin type. CONCLUSION Per our prospective trial, concurrent treatment of FACL -ITN is superior to delayed FACL treatment 6 months post-ITN cessation. Fractional ablative laser treatment is effective in improving acne scars, which persist despite isotretinoin therapy.
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Affiliation(s)
- Eyal Taleb
- Division of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Elisa S Gallo
- Division of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Fares Salameh
- Division of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Amir Koren
- Division of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Waseem Shehadeh
- Division of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Ofir Artzi
- Division of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Lekskul M, Thaiwat S, Lekvijittada J. Evaluation of recovery time of tear film function and ocular surface after discontinuing oral isotretinoin treatment for acne vulgaris : Correlation between oral isotretinoin and tear film function. Int Ophthalmol 2023; 43:4683-4688. [PMID: 37688653 DOI: 10.1007/s10792-023-02868-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Accepted: 08/20/2023] [Indexed: 09/11/2023]
Abstract
PURPOSE This study aimed to evaluate the recovery time of tear film function and ocular surface after discontinuing systemic isotretinoin treatment. METHODS This was a prospective, cross-sectional study. 34 eyes of 17 patients treated with low- dose oral isotretinoin (< 0.5 mg/kg/day) were enrolled. The modified OSDI score, tear break-up time, Schirmer test, and corneal staining were performed in all patients at baseline, during the course of treatment and after withdrawing treatment every two weeks until the result returned to baseline. RESULTS Tear breakup time appeared to be the most sensitive and changed significantly at 2 weeks after starting treatment (p < 0.001) and returned to baseline at 4 weeks after withdrawal from treatment (p < 0.001). The Schirmer test results significantly decreased at 6 weeks and returned to baseline at 4 weeks after withdrawal from treatment (p < 0.001). OSDI scores were significantly changed at 6 weeks after treatment (81.8%) and returned to baseline at 2 weeks (54.5%) after withdrawal from treatment. No significant change was found in the MGD. Corneal staining was significantly positive 90.9% 6 weeks after starting treatment and returned to baseline 6 weeks after withdrawal from treatment (p < 0.001). CONCLUSION Dry eye disease can return to baseline levels after treatment withdrawal. At least 6 weeks later, they could wear contact lenses again, and it was useful to prepare all patients requiring further ocular surgery.
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Affiliation(s)
- Manapon Lekskul
- Cornea External Disease and Refractive Surgery, Cornea Consultants, Boston, USA
- Cornea External Disease and Refractive Surgery, Wills Eye Hospital, Philadelphia, USA
- Department of Ophthalmology, Phramongkutklao Hospital, 315 Ratchawithi Road, Thung Phayathai Subdistict, Ratchathewi, Bangkok, 10400, Thailand
| | - Supitchaya Thaiwat
- St John's Institute of Dermatology, London, UK
- Department of Dermatology, Phramongkutklao Hospital, 315 Ratchawithi Road, Thung Phayathai Subdistict, Ratchathewi, Bangkok, 10400, Thailand
| | - Jiraporn Lekvijittada
- Department of Ophthalmology, Phramongkutklao Hospital, 315 Ratchawithi Road, Thung Phayathai Subdistict, Ratchathewi, Bangkok, 10400, Thailand.
- Thai Board in Ophthalmology, Phramongkutklao Hospital, Bangkok, Thailand.
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Morshed ASM, Noor T, Uddin Ahmed MA, Mili FS, Ikram S, Rahman M, Ahmed S, Uddin MB. Understanding the impact of acne vulgaris and associated psychological distress on self-esteem and quality of life via regression modeling with CADI, DLQI, and WHOQoL. Sci Rep 2023; 13:21084. [PMID: 38030667 PMCID: PMC10687248 DOI: 10.1038/s41598-023-48182-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 11/23/2023] [Indexed: 12/01/2023] Open
Abstract
Acne vulgaris (AV) is a psychosomatic disorder and can negatively affect individuals, especially in terms of psychological well-being, self-esteem, and quality of life (QoL). The current study aimed to investigate the association between AV and psychological health, as well as the influence of acne and psychological distress in predicting patients' self-esteem and QoL. This cross-sectional study included 150 patients clinically diagnosed with AV. The severity of acne was measured using GAGS, and following that, patients were instructed to complete the following forms: DASS-21, RSES, CADI, DLQI, and WHOQoL. Female AV patients had significantly higher depression (p = 0.003, t = 3.025) and anxiety (p < 0.001, t = 3.683). Pearson's correlation analysis indicated a strong, positive, and significant correlation between having acne and experiencing depression (r = 0.630), anxiety (r = 0.661), and stress (r = 0.758) (p < 0.001). Multiple regression analysis suggested acne and associated psychological distress had a significant and negative impact on the patient's self-esteem and quality of life. This study highlights the multifaceted consequences of AV and the need to manage its psychological distress. It emphasizes the need for holistic patient care that addresses acne's physical and emotional aspects, with the ultimate goal of enhancing well-being and QoL.
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Affiliation(s)
- A S M Morshed
- Department of Psychiatry, Dr. Sirajul Islam Medical College, Dhaka, Bangladesh
- Department of Psychiatry, Bangladesh Psychiatric Care Limited, Dhanmondi, Dhaka, Bangladesh
| | - Towhida Noor
- Department of Dermatology and Venereology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
- Department of Dermatology and Venereology, Matador Diagnostic and Wellness Center, Dhaka, Bangladesh
| | | | - Fahmida Sultana Mili
- Department of Obstetrics and Gynecology, Munshiganj General Hospital, Munshiganj, Dhaka, Bangladesh
| | - Shuma Ikram
- Department of Pediatrics, East West Medical College and Hospital, Dhaka, Bangladesh
| | - Mashiqur Rahman
- Department of Pharmaceutical Sciences, North South University, Bashundhara, Dhaka, 1229, Bangladesh
| | - Shamim Ahmed
- Department of Psychiatry, Bangladesh Psychiatric Care Limited, Dhanmondi, Dhaka, Bangladesh
- Department of Pharmaceutical Sciences, North South University, Bashundhara, Dhaka, 1229, Bangladesh
| | - Mohammad Borhan Uddin
- Department of Pharmaceutical Sciences, North South University, Bashundhara, Dhaka, 1229, Bangladesh.
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Güler HA, Koç Yıldırım S, Güler D. The Relationship Between Adolescents' Perception of Family Emotional Atmosphere and Acne Severity, Self-Esteem, and Quality of Life in Adolescents Diagnosed with Acne Vulgaris. Turk Arch Pediatr 2023; 58:646-652. [PMID: 37915273 PMCID: PMC10724803 DOI: 10.5152/turkarchpediatr.2023.23111] [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: 07/11/2023] [Accepted: 08/31/2023] [Indexed: 11/03/2023]
Abstract
OBJECTIVE Acne vulgaris, a prevalent chronic condition among adolescents, significantly impacts patients' quality of life and self-esteem. Our aim was to investigate whether how adolescents perceive their family emotional atmosphere has an impact on their acne severity, quality of life, and self-esteem. MATERIALS AND METHODS This study included 118 patients with acne vulgaris who completed various assessments, including a sociodemographic data form, the Acne Quality of Life Scale, the Hospital Anxiety and Depression Scale, the Shortened Level of Expressed Emotion Scale (SLEES) and, the Rosenberg Self-Esteem Scale. The Global Acne Grading System is performed by an experienced dermatologist to determine the severity of acne. RESULTS Out of 118 patients, 78 (66.1%) were female and 40 (33.9%) were male. The mean age of patients was 15.2 ± 1.3 years. There was a positive correlation between the severity of acne and the levels of perceived intrusiveness subscores of SLEES (P = .021, r = 0.212). Significant correlations were also observed among quality of life scores, anxiety and depression levels, lack of emotional support (LES) scores, and self-esteem levels. The initial linear regression analysis demonstrated that the level of LES subscores of SLEES and levels of anxiety and depression were predictors of self-esteem. In the second regression analysis, anxiety and depression levels were identified as significant predictors of quality of life. CONCLUSION The perceived family emotional atmosphere may be an important factor in evaluating the severity of acne as well as the self-esteem and quality of life of adolescent patients with acne vulgaris.
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Affiliation(s)
- Hasan Ali Güler
- Department of Child and Adolescent Psychiatry, Selçuk University Faculty of Medicine, Konya, Turkey
| | - Sema Koç Yıldırım
- Department of Dermatology, Uşak University Faculty of Medicine, Uşak, Turkey
| | - Dilara Güler
- Department of Dermatology, Meram State Hospital, Konya, Turkey
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11
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Zhu J, Peng K, Zhang Y, Bai X, Zhong C, Ye J, Lu M. Sleep quality, circadian preferences, and mood among patients with acne vulgaris: a case-control study. Sleep Breath 2023; 27:1997-2003. [PMID: 36650359 DOI: 10.1007/s11325-023-02777-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 12/21/2022] [Accepted: 01/10/2023] [Indexed: 01/19/2023]
Abstract
PURPOSE Poor sleep and mood may be predisposing factors for acne. We aimed to investigate the associations between acne and sleep quality, circadian preferences, and mood. METHODS This case-control study recruited patients with acne and age- and sex-matched healthy controls. We used the Investigator's Global Assessment to evaluate acne severity and various validated questionnaires to measure sleep quality, daytime sleepiness, sleep apnea, circadian preference, and mood symptoms. RESULTS A total of 81 patients with acne (age: 21.6 ± 5.0 years, 52% female) and 76 controls were recruited. Compared to controls, patients had a higher score on the Pittsburgh Sleep Quality Index (5.2 ± 2.6 vs. 4.1 ± 2.3, p = 0.008) and State-Trait Anxiety Inventory (State: 44.6 ± 9.7 vs. 40.6 ± 6.6, p = 0.003; Trait: 47.9 ± 8.2 vs. 45.3 ± 6.2, p = 0.03), and a lower score on a reduced version of the Morningness and Eveningness Questionnaire (13.9 ± 2.6 vs. 14.7 ± 2.3, p = 0.05) and Epworth Sleepiness Scale (7.4 ± 3.4 vs. 8.6 ± 3.6, p = 0.04). Acne severity was associated with sleep quality (β = 0.33), eveningness (β = 0.34), depression (β = 0.66), and anxiety (State: β = 1.73; Trait: β = 1.21), even when adjusted for education level and family history of acne. CONCLUSION Acne is highly associated with poor sleep and mood. Dermatologists are advised to attend closely to the psychological impact of acne. Improvements in sleep and mood may benefit the treatment of acne.
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Affiliation(s)
- Jiangting Zhu
- Department of Dermatology, the First Affiliated Hospital of Chengdu Medical College, Xindu District, No.278, Middle Baoguang Avenue, Chengdu, Sichuan Province, China
| | - Ke Peng
- Department of Dermatology, the First Affiliated Hospital of Chengdu Medical College, Xindu District, No.278, Middle Baoguang Avenue, Chengdu, Sichuan Province, China
| | - Yunjie Zhang
- Department of Dermatology, the First Affiliated Hospital of Chengdu Medical College, Xindu District, No.278, Middle Baoguang Avenue, Chengdu, Sichuan Province, China
| | - Xiaohong Bai
- Department of Dermatology, the First Affiliated Hospital of Chengdu Medical College, Xindu District, No.278, Middle Baoguang Avenue, Chengdu, Sichuan Province, China
| | - Chuanhui Zhong
- Department of Dermatology, the First Affiliated Hospital of Chengdu Medical College, Xindu District, No.278, Middle Baoguang Avenue, Chengdu, Sichuan Province, China
| | - Junru Ye
- Department of Dermatology, the First Affiliated Hospital of Chengdu Medical College, Xindu District, No.278, Middle Baoguang Avenue, Chengdu, Sichuan Province, China
| | - Mao Lu
- Department of Dermatology, the First Affiliated Hospital of Chengdu Medical College, Xindu District, No.278, Middle Baoguang Avenue, Chengdu, Sichuan Province, China.
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12
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Mahajan S, Sawant NS, Mahajan S. Depression, body image and quality of life in acne scars. Ind Psychiatry J 2023; 32:282-287. [PMID: 38161457 PMCID: PMC10756596 DOI: 10.4103/ipj.ipj_201_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 01/27/2023] [Accepted: 01/30/2023] [Indexed: 01/03/2024] Open
Abstract
Background Acne scars commonly occur in almost 95% of adolescents having acne. Depression and the psychosocial impact of acne have been studied by previous researchers but there are few studies on acne scar patients. Objectives To study the prevalence of depression, body image, and quality of life in patients with acne scars and the correlation of depression with body image and quality of life. Material and Methods Around 81 patients above 18 years of age clinically diagnosed as having different grades of acne by a dermatologist were assessed for depression using Becks Depression Inventory, Body image concern inventory, and Dermatology Life Quality Index and included in the study after being informed consent. Results The mean duration of acne was 6.03 ± 2.9 years, and acne scar was 2.88 ± 1.2 years. Nearly 93% of our sample had an equal preponderance of Grade 1 and Grade 2 acne scars. 31 (38.27%) patients had clinical depression with a total mean BDI score of 16.8 ± 9.7. 15 (18.5%) and 7 (8.6%) patients had moderate and severe depression respectively. Only 5 (6.17%) patients reported significant body image disturbances. All patients reported a very large effect on the quality of life due to flaws in facial appearance leading to feelings of embarrassment and impairment in sexual activities. Depression was significantly associated with grade 1 and 2 scars, body image disturbances, and quality of life. Conclusions There is a high prevalence of depression in patients with acne scarring which needs to be detected and treated. Liaison with a psychiatrist would improve the outcome.
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Affiliation(s)
- Sachin Mahajan
- Department of Psychiatry, Seth GSMC and KEM Hospital, Parel, Mumbai, Maharashtra, India
| | - Neena S. Sawant
- Department of Psychiatry, Seth GSMC and KEM Hospital, Parel, Mumbai, Maharashtra, India
| | - Sunanda Mahajan
- Department of Dermatology, Seth GSMC and KEM Hospital, Parel, Mumbai, Maharashtra, India
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13
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Tuğrul B, Demirdağ HG, Aslan C, Muştu Koryürek Ö. An overlooked burden of acne in adolescents: the psychosocial well-being of their families. An Pediatr (Barc) 2023:S2341-2879(23)00130-8. [PMID: 37316404 DOI: 10.1016/j.anpede.2023.06.009] [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: 01/25/2023] [Accepted: 04/14/2023] [Indexed: 06/16/2023] Open
Abstract
INTRODUCTION Acne vulgaris is significantly associated with an increased burden of care and has an important impact on the quality of life (QoL) and self-esteem of affected individuals. We aimed to assess the QoL of adolescents with acne and their families as well as the association of QoL with acne severity, treatment response, duration of acne and localization of lesions. MATERIAL AND METHODS The sample included a total of 100 adolescents with acne vulgaris, 100 healthy controls and their parents. We collected data on sociodemographic characteristics, presentation of acne, duration of acne, treatment history, treatment response, and parental sex. We used the Global Acne Severity scale, Children's Dermatology Life Quality Index (CDLQI), and the Family Dermatology Life Quality Index (FDLQI). RESULTS In the group of patients with acne, the mean CDLQI score in the patients was 7.89 (SD, 5.43) and the mean FDLQI score in the parents was 6.01 (SD, 6.11). In the control group, the mean CDLQI score in healthy controls was 3.92 (SD, 3.88) and the mean FDLQI score in their family members was 2.12 (SD, 2.91). We found a statistically significant difference between the acne and control groups in CDLQI and FDLQI scores (P < .001). There were also statistically significant differences in the CDLQI score based on the duration of acne and the response to treatment. CONCLUSIONS Patients with acne and their parents had a decreased QoL compared with healthy controls. Acne was associated with impaired QoL in family members. Assessing QoL in the family in addition to that of the patient may allow an improved management of acne vulgaris.
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Affiliation(s)
- Burcu Tuğrul
- Servicio de Dermatología, Ankara Şehir Hastanesi, Ankara, Turkey
| | | | - Cihan Aslan
- Departamento de Psiquiatría Infantil y de la Adolescencia, Facultad de Medicina, Hacettepe Üniversitesi, Ankara, Turkey
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14
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Hendel K, Karmisholt K, Hedelund L, Haedersdal M. Fractional CO 2 -laser versus microneedle radiofrequency for acne scars: A randomized, single treatment, split-face trial. Lasers Surg Med 2023; 55:335-343. [PMID: 36934435 DOI: 10.1002/lsm.23655] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 03/07/2023] [Accepted: 03/09/2023] [Indexed: 03/20/2023]
Abstract
BACKGROUND Ablative fractional CO2 laser (AFL) is an established first-line energy-based treatment for acne scars. Microneedle radiofrequency (MNRF) is an emerging treatment, also targeting the skin in fractions. No studies have so far compared AFL with MNRF for acne scars in a direct controlled, side-by-side comparison. In this study, we compared AFL and MNRF treatments for acne scars in a randomized split-face trial with blinded response evaluation, objective measures, and patient-reported outcomes. STUDY DESIGN/MATERIALS AND METHOD Fifteen patients with moderate to severe acne scars were included. At baseline each patient had two similar test areas identified, these were randomized to receive a single treatment with either AFL or MNRF. Standardized multilayer techniques were applied with AFL and MNRF, first targeting the scar base, thereafter the entire scar area. Outcome measures included blinded evaluation of clinical improvement of scar texture (0-10 scale) at 1- and 3-months follow-up, local skin reactions (LSR), pain according to Visual Analogue Scale (VAS), skin integrity quantified by transepidermal water loss, and patient satisfaction. RESULTS Fifteen patients completed the study with a median test area size of 24.6 cm2 (interquartile range [IQR] 14.9-40.6). A single treatment with AFL or MNRF equally resulted in a median 1-point texture improvement after 3 months follow-up (p < 0.001). Best responders achieved up to a 3-point improvement (n = 3 test areas, 10% of treatment areas). Erythema and loss of skin integrity was more intense after AFL compared with MNRF after 2-4 days (p < 0.001). Patients reported MNRF (VAS 7.0) to be significantly more painful than AFL (5.5) (p = 0.009). Patients were generally satisfied with the overall outcome on a 10-point scale at median 6 for both treatments (IQR 5-7). CONCLUSION AFL and MNRF treatments are equally effective at improving texture in skin with acne scars. AFL resulted in more pronounced LSRs whereas MNRF was more painful. Patients were generally satisfied with the overall outcome.
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Affiliation(s)
- Kristoffer Hendel
- Department of Dermatology, Copenhagen University Hospital Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Katrine Karmisholt
- Department of Dermatology, Copenhagen University Hospital Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Lene Hedelund
- Department of Dermatology, Aaarhus University Hospital, Aarhus, Denmark
| | - Merete Haedersdal
- Department of Dermatology, Copenhagen University Hospital Bispebjerg and Frederiksberg, Copenhagen, Denmark
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15
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Asnaashari S, Kazemnezhad M, Masoud F, Javadzadeh Y. An overview on the anti-acne properties of herbal essential oils. J Herb Med 2023. [DOI: 10.1016/j.hermed.2023.100642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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16
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Anczyk S, Stępień M, Raczyński M, Anczyk A, Woźniakowska M, Miziołek B, Polak K, Bergler‐Czop B. The impact of face masks on acne-prone skin in Polish young adults during COVID-19 pandemic. Dermatol Ther 2022; 35:e15922. [PMID: 36218217 PMCID: PMC9874778 DOI: 10.1111/dth.15922] [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: 05/15/2022] [Revised: 09/10/2022] [Accepted: 10/08/2022] [Indexed: 01/27/2023]
Abstract
COVID-19 pandemic raised many problems for patients with acne-prone skin: a limited access to health care services, the necessity of developing telemedical consultations also in dermatology, and the usage of face masks. The aim of the study was to investigate the influence of respiratory protective measures (type of masks, wearing time during the day) on declared skin condition in patients already diagnosed with acne or reporting acne for the first time. The study was conducted in Poland among 1420 responders using the original authors' questionnaire, of which 1274 responders were included in the final sample. Acne exacerbations were reported as being more frequent and more severe in women than in men. Changing cosmetic products, facial skin decontamination before or after applying masks, the number of days per week that a mask was worn were related to acne exacerbation. The type of mask had no significant impact on the occurrence of acne lesions. Respondents noted that masks contribute significantly to skin condition worsening by exacerbating existing and causing new acne lesions. This phenomenon was particularly observable in women, in whom, according to the research results, new lesions appeared much more frequently. Therefore, there is a need to develop new ways of limiting acne exacerbation during COVID-19 pandemic.
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Affiliation(s)
- Stanisław Anczyk
- Student Scientific Club of the Department of DermatologyMedical University of SilesiaKatowicePoland
| | - Maciej Stępień
- Student Scientific Club of the Department of DermatologyMedical University of WarsawWarsawPoland
| | - Michał Raczyński
- Student Scientific Club of the Department of DermatologyMedical University of SilesiaKatowicePoland
| | - Adam Anczyk
- Institute of PsychologyJesuit University Ignatianum in KrakówKrakówPoland
| | - Maja Woźniakowska
- Ludwik Rydygier Collegium Medicum in BydgoszczNicolaus Copernicus University in ToruńToruńPoland
| | - Bartosz Miziołek
- Chair and Department of DermatologyMedical University of SilesiaKatowicePoland
| | - Karina Polak
- Doctoral SchoolMedical University of SilesiaKatowicePoland
| | - Beata Bergler‐Czop
- Chair and Department of DermatologyMedical University of SilesiaKatowicePoland
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17
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Khan AS, Almulhim AF, Alqattan MH, Almakhaitah NF, Alomair FI, Alkhateeb AA. Psychological Impact of Acne Vulgaris Among Young Females in the Eastern Province, Saudi Arabia. Cureus 2022; 14:e29378. [PMID: 36304354 PMCID: PMC9584798 DOI: 10.7759/cureus.29378] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2022] [Indexed: 11/24/2022] Open
Abstract
Introduction Acne vulgaris is considered one of the most common dermatological issues that affect approximately 9.4% of the world’s population, and the most affected group is adolescents. Acne can vary among adolescents and adults of different ethnicities and countries. Aim This study aimed to assess the psychological impact of acne vulgaris among female adults in the Eastern province of Saudi Arabia. Subjects and methods This is a cross-sectional study conducted among young females aged 15 to 25 years old. A self-administered validated questionnaire translated into Arabic was distributed among the female respondents with acne vulgaris using an online survey. The questionnaire includes basic demographic data and the Dermatology Life Quality Index (DLQI) questionnaire to assess the psychological impact of acne vulgaris. Results Four hundred seventy-six female participants aged 15-25 years took part. The majority were single (86.3%) and of Saudi nationality (92.4%). The prevalence of psychological impact affecting acne patients was 85.5% (ranging from low effect to severe effect). A significant relationship was observed between psychological impact according to marital status (p=0.034) and educational level (p=0.023). In a multivariate regression model, patients who had never been married and were more educated were the independent significant factors associated with increased rates of psychological impairment. Conclusion The quality of life of young females has been greatly affected by acne vulgaris. The severity of psychological impairment associated with acne vulgaris can be significantly predicted among educated and single females. Psychological counseling is necessary to decrease the burden caused by the dermatologic condition affecting young females in the region.
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18
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Rudzińska J, Głąbska D. Influence of Selected Food Product Groups Consumption Frequency on Acne-Related Quality of Life in a National Sample of Polish Female Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11670. [PMID: 36141942 PMCID: PMC9517132 DOI: 10.3390/ijerph191811670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 09/10/2022] [Accepted: 09/14/2022] [Indexed: 06/16/2023]
Abstract
Acne vulgaris affects over 80% of adolescents, mainly female ones, and may reduce their general quality of life, so its prevention and treatment are becoming necessary, while among the options for acne management, the potential influence of diet is indicated. The aim of the study was to assess the influence of selected food product groups consumption frequency on acne-related quality of life in a national sample of Polish female adolescents. The studied population of 1370 Polish female adolescents was gathered using random quota sampling of secondary schools representative of the whole country. The acne-related quality of life was assessed using the Acne Quality of Life (AQoL) Scale with the calculated Social Quality of Life (SOCQOL) Score, as well as the Acne Disability Questionnaire (ADQ) with the calculated Cardiff Acne Disability Index (CADI). The acne-related food product groups' consumption frequency was assessed using the Acne-specific Food Frequency Questionnaire (Acne-FFQ). There were no differences in food product consumption between subgroups stratified by the acne-related quality of life (p > 0.05), and there was no correlation between food product consumption and the results of the SOCQOL Score (p > 0.05). For the CADI, positive correlations were indicated for fast foods (p = 0.0450; R = 0.0688), salty snacks (p = 0.0342; R = 0.0727), and chocolate confectionary (p = 0.0147; R = 0.0837), while a negative correlation was indicated for dairy beverages other than milk (p = 0.0414; R = -0.0701). In the studied group of Polish female adolescents, fast foods, salty snacks, and chocolate confectionary were indicated as potential acne-promoting factors, while dairy beverages other than milk were indicated as a potential acne-protective factor.
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19
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The Synergy between Pharmacological Regimens and Dermocosmetics and Its Impact on Adherence in Acne Treatment. Dermatol Res Pract 2022; 2022:3644720. [PMID: 35982914 PMCID: PMC9381271 DOI: 10.1155/2022/3644720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 07/04/2022] [Accepted: 07/07/2022] [Indexed: 11/17/2022] Open
Abstract
Background Acne is the most common inflammatory skin disease in adolescence. It is also prevalent in adults, especially females. The disease has a considerable impact on health-related quality of life. Many studies have reported the negative impact of acne on patients due to skin disfigurement, ineffective treatment, and adverse effects of the treatment. Numerous factors contribute towards nonadherence to therapy. Summary. This review discusses the various factors that are related to treatment nonadherence such as ineffective therapy, adverse effects with topical pharmacotherapy such as skin irritation and erythema as well as patient-related factors such as lack of knowledge of disease and a poor patient-physician relationship. Various methods are being adopted to increase adherence to treatments. Increased adherence to acne therapy has been associated with the use of dermocosmetics, such as moisturizers and cleansers. Encouraging the use of dermocosmetics in synergy with pharmacological regimens could support improved treatment adherence resulting in better clinical outcomes for acne patients. Conclusion Dermocosmetics as an adjunct to pharmacological regimens has the potential to improve clinical outcomes by increasing treatment adherence in patients with acne.
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Tan J, Beissert S, Cook-Bolden F, Chavda R, Harper J, Hebert A, Lain E, Layton A, Rocha M, Weiss J, Dréno B. Evaluation of Psychological Wellbeing and Social Impact of Combined Facial and Truncal Acne: a Multi-national, Mixed-Methods Study. Dermatol Ther (Heidelb) 2022; 12:1847-1858. [PMID: 35904707 PMCID: PMC9357600 DOI: 10.1007/s13555-022-00768-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 06/27/2022] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION Half of the individuals with facial acne develop truncal acne, but the impact of combined facial and truncal acne (CA) on patients' quality of life is poorly researched. METHODS A 60-min interview of 30 participants with CA was conducted that formed the basis for a cross-sectional survey of 694 adolescents and adults with CA. RESULTS The main themes identified from the qualitative interviews among CA subjects included acceptability to self and others, social functioning and emotional wellbeing. Feelings of embarrassment, self-consciousness and low confidence were experienced often or all the time by over 50% of participants, and were more frequent in those who perceived their acne to be out of control (P = 0.003). Half of patients reported feeling stigmatised because of their CA, and 65.4% believed that others associated their truncal acne with unhealthy or unhygienic habits. Perceived stigma was associated with more feelings of embarrassment (P = 0.005), self-consciousness (P = 0.034) and low self-confidence (P = 0.017). Overall, 64% participants reported that CA interfered with daily life, 46.4% often or always avoided social interaction, 48.6% were often concerned about talking to unfamiliar people and 47.4% were uncomfortable showing affection. Further, 32% and 24.4% participants ≥ 16 years old avoided dating or having romantic/intimate relationships because of their facial and truncal acne, respectively. Social and leisure activities were more frequently negatively impacted among those with perceived uncontrolled CA than among those with controlled CA. Avoiding undressing in front of spouse/partner/friends/relatives was more commonly reported by participants with perceived uncontrolled truncal acne than by those with controlled truncal acne (90.5% versus 80.6%, P = 0.031). CONCLUSION CA is associated with considerable psychological morbidity, with several exacerbating (e.g. perceived stigma) and attenuating factors (e.g. acne being perceived as being under control) that should be accounted for in CA management.
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Affiliation(s)
- Jerry Tan
- Schulich School of Medicine and Dentistry, Western University Canada, 2224 Walker Rd, Suite 300, Windsor, ON, N8W 5L7, Canada.
| | - Stefan Beissert
- Department of Dermatology, University Hospital Carl Gustav Carus, TU Dresden, Fetscherstrasse 74, 01307, Dresden, Germany
| | - Fran Cook-Bolden
- Mount Sinai Department of Dermatology, New York, 5 East 98th Street, New York, NY, 10029, USA
| | | | - Julie Harper
- The Dermatology and Skin Care Center of Birmingham, 2470 Rocky Ridge Rd # 100, Vestavia Hills, AL, 35243, USA
| | - Adelaide Hebert
- The University of Texas Medical School-Houston, 6655 Travis, Suite 980, Houston, TX, 77030, USA
| | - Edward Lain
- Austin Institute for Clinical Research, 1601 E Pflugerville Pkwy Suite 1101, Pflugerville, TX, USA
| | - Alison Layton
- Hull York Medical School, University Rd, Heslington, YO10 5DD, York, UK
| | - Marco Rocha
- Federal University of São Paulo, R. Sena Madureira, 1500-Vila Clementino, São Paulo, SP, 04021-001, Brazil
| | - Jonathan Weiss
- Georgia Dermatology Partners, (Formerly, Gwinnett Dermatology, PC), 2383 Pate St., N, Snellville, GA, 30078, USA
| | - Brigitte Dréno
- Unité Thérapie Cellulaire et Génique, Faculté de Médecine de Nantes, CHU Nantes-Place Alexis Ricordeau, 44093, Cedex 01, France
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21
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Do TH, Ma F, Andrade PR, Teles R, de Andrade Silva BJ, Hu C, Espinoza A, Hsu JE, Cho CS, Kim M, Xi J, Xing X, Plazyo O, Tsoi LC, Cheng C, Kim J, Bryson BD, O'Neill AM, Colonna M, Gudjonsson JE, Klechevsky E, Lee JH, Gallo RL, Bloom BR, Pellegrini M, Modlin RL. TREM2 macrophages induced by human lipids drive inflammation in acne lesions. Sci Immunol 2022; 7:eabo2787. [PMID: 35867799 PMCID: PMC9400695 DOI: 10.1126/sciimmunol.abo2787] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Acne affects 1 in 10 people globally, often resulting in disfigurement. The disease involves excess production of lipids, particularly squalene, increased growth of Cutibacterium acnes, and a host inflammatory response with foamy macrophages. By combining single-cell and spatial RNA sequencing as well as ultrahigh-resolution Seq-Scope analyses of early acne lesions on back skin, we identified TREM2 macrophages expressing lipid metabolism and proinflammatory gene programs in proximity to hair follicle epithelium expressing squalene epoxidase. We established that the addition of squalene induced differentiation of TREM2 macrophages in vitro, which were unable to kill C. acnes. The addition of squalene to macrophages inhibited induction of oxidative enzymes and scavenged oxygen free radicals, providing an explanation for the efficacy of topical benzoyl peroxide in the clinical treatment of acne. The present work has elucidated the mechanisms by which TREM2 macrophages and unsaturated lipids, similar to their involvement in atherosclerosis, may contribute to the pathogenesis of acne.
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Affiliation(s)
- Tran H Do
- Molecular Biology Institute, University of California, Los Angeles, Los Angeles, CA 90095, USA.,Division of Dermatology, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles,, Los Angeles, CA 90095, USA
| | - Feiyang Ma
- Molecular Biology Institute, University of California, Los Angeles, Los Angeles, CA 90095, USA.,Institute for Quantitative and Computational Biosciences-The Collaboratory, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Priscila R Andrade
- Division of Dermatology, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles,, Los Angeles, CA 90095, USA
| | - Rosane Teles
- Division of Dermatology, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles,, Los Angeles, CA 90095, USA
| | - Bruno J de Andrade Silva
- Division of Dermatology, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles,, Los Angeles, CA 90095, USA
| | - Chanyue Hu
- Institute for Quantitative and Computational Biosciences-The Collaboratory, University of California, Los Angeles, Los Angeles, CA 90095, USA.,Department of Molecular Cell and Developmental Biology, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Alejandro Espinoza
- Institute for Quantitative and Computational Biosciences-The Collaboratory, University of California, Los Angeles, Los Angeles, CA 90095, USA.,Department of Molecular Cell and Developmental Biology, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Jer-En Hsu
- Department of Molecular and Integrative Physiology, University of Michigan Medical School, Ann Arbor, MI 48109, USA
| | - Chun-Seok Cho
- Department of Molecular and Integrative Physiology, University of Michigan Medical School, Ann Arbor, MI 48109, USA
| | - Myungjin Kim
- Department of Molecular and Integrative Physiology, University of Michigan Medical School, Ann Arbor, MI 48109, USA
| | - Jingyue Xi
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA
| | - Xianying Xing
- Department of Dermatology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Olesya Plazyo
- Department of Dermatology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Lam C Tsoi
- Department of Dermatology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Carol Cheng
- Division of Dermatology, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles,, Los Angeles, CA 90095, USA
| | - Jenny Kim
- Division of Dermatology, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles,, Los Angeles, CA 90095, USA
| | - Bryan D Bryson
- Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Alan M O'Neill
- Department of Dermatology, University of California San Diego, La Jolla, CA 92093, USA
| | - Marco Colonna
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO 63110, USA
| | | | - Eynav Klechevsky
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Jun Hee Lee
- Department of Molecular and Integrative Physiology, University of Michigan Medical School, Ann Arbor, MI 48109, USA
| | - Richard L Gallo
- Department of Dermatology, University of California San Diego, La Jolla, CA 92093, USA
| | - Barry R Bloom
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Matteo Pellegrini
- Institute for Quantitative and Computational Biosciences-The Collaboratory, University of California, Los Angeles, Los Angeles, CA 90095, USA.,Department of Molecular Cell and Developmental Biology, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Robert L Modlin
- Division of Dermatology, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles,, Los Angeles, CA 90095, USA.,Department of Microbiology, Immunology and Molecular Genetics, University of California, Los Angeles, Los Angeles, CA 90095, USA
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22
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Tan J, Chavda R, Leclerc M, Dréno B. Projective Personification Approach to the Experience of People With Acne and Acne Scarring-Expressing the Unspoken. JAMA Dermatol 2022; 158:1005-1012. [PMID: 35857307 PMCID: PMC9301587 DOI: 10.1001/jamadermatol.2022.2742] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance The association of acne with emotional and social well-being is not limited to active acne because acne scarring can extend long after cessation of active lesions. Objective To explore the psychosocial burden of facial and truncal acne (FTA) and acne scars (AS) in a spontaneous manner using qualitative research. Design, Setting, and Participants This qualitative study recruited participants via local panels. A personification exercise, "Letter to my Disease," was developed for participants of 2 independent arms, FTA and AS, of an international qualitative study in the form of letter completion. Main Outcomes and Measures Study outcomes comprised perceptions, psychosocial effects of FTA and AS, and coping behaviors. Results A total of 60 participants were recruited for the FTA and AS study. Among participants with FTA, 17 were women (57%), 21 (70%) were aged 13 to 25 years, and 9 (30%) were aged 26 to 40 years. Twenty-six (87%) participants had severe active acne and 4 (13%) had moderate active acne. Among participants with AS, 18 were women (60%), 9 (30%) were aged 18 to 24 years, and 21 (70%) were aged between 25 and 45 years. Of these 60 participants, 56 (FTA, 28 and AS, 28) completed the projective exercise, "Letter to my Disease," the analysis of which is presented in the current study. During completion of the letter exercise, participants spontaneously expressed emotional and physical burden as well as the social stigma associated with their skin condition. Three major themes emerged, namely, (1) burden of the condition, (2) attitudes and beliefs, and (3) relationship to the personified condition. Conclusions and Relevance Consistent with their skin condition, participants associated acne, through personification, with the character of an intruder and unwanted companion responsible for their poor self-esteem and emotional impairment. The findings of the joint analyses of letters (FTA and AS), as a catalytic process and free-expression space, outline the continuous burden of active acne starting from adolescence and then continuing into adulthood and beyond active lesions with AS, and highlight the struggle for self-acceptance.
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Affiliation(s)
- Jerry Tan
- Western University Canada, Schulich School of Medicine and Dentistry, Windsor, Ontario, Canada
| | - Rajeev Chavda
- Galderma SA Rue d'Entre-deux-Villes 10, La Tour-de-Peilz, Switzerland
| | | | - Brigitte Dréno
- Nantes Université, Univ Angers, INSERM, Immunology and New Concepts in ImmunoTherapy, INCIT, UMR 1302, Nantes, France
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23
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Hopkins ZH, Thiboutot D, Homsi HA, Perez-Chada LM, Barbieri JS. Patient-Reported Outcome Measures for Health-Related Quality of Life in Patients With Acne Vulgaris: A Systematic Review of Measure Development and Measurement Properties. JAMA Dermatol 2022; 158:900-911. [PMID: 35731537 PMCID: PMC9218927 DOI: 10.1001/jamadermatol.2022.2260] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Importance Multiple patient-reported outcome measures (PROMs) for health-related quality of life (HRQoL) exist for patients with acne. However, little is known about the content validity and other measurement properties of these PROMs. Objective To systematically review PROMs for HRQoL in adults or adolescents with acne. Data Sources Eligible studies were extracted from PubMed and Embase (OVID). Study Selection Full-text articles published in English or Spanish on development, pilot, or validation studies for acne-specific, dermatology-specific, or generic HRQoL PROMs were included. Development studies included original development studies, even if not studied in acne patients per Consensus-Based Standards for the Selection of Health Measurement Instruments (COSMIN) recommendations. If a study included several diagnoses, the majority (ie, over 50%) of patients must have acne or acne-specific subgroup analyses must be available. Abstract and full-text screening was performed by 2 independent reviewers. Data Extraction and Synthesis Two independent reviewers assessed study quality applying the COSMIN checklist and extracted and analyzed the data. For each distinctive PROM, quality of evidence was graded by measurement property. Main Outcomes and Measures PROM properties (target population, domains, recall period, development language), PROM development and pilot studies, content validity (relevance, comprehensiveness, comprehensibility), and remaining measurement properties (structural validity, internal consistency, cross-cultural validity, reliability, measurement error, criterion validity, construct validity, and responsiveness). Quality of evidence was assigned for each measurement property of included PROMs. An overall recommendation level was assigned based on content validity and quality of the evidence of measurement properties. Results We identified 54 acne PROM development or validation studies for 10 acne-specific PROMs, 6 dermatology-specific PROMs, and 5 generic PROMs. Few PROMs had studies for responsiveness. The only acne-specific PROMs with sufficient evidence for content validity were the CompAQ and Acne-Q. Based on available evidence, the Acne-Q and CompAQ can be recommended for use in acne clinical studies. Conclusions and Relevance Two PROMs can currently be recommended for use in acne clinical studies: the Acne-Q and CompAQ. Evidence on content validity and other measurement properties were lacking for all PROMs; further research investigating the quality of remaining acne-specific, dermatology-specific, and generic HRQoL PROMs is required to recommend their use.
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Affiliation(s)
| | - Diane Thiboutot
- Department of Dermatology, Pennsylvania State University College of Medicine, Hershey
| | - Haya A Homsi
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | | | - John S Barbieri
- Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts
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24
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Rai S, Gupta GN, Singh S, Michael J, Misra P, Gupta B, Singh S, Prakash A, Tomar M, Sadhukhan S, Koley M, Saha S. Efficacy of Individualized Homeopathic Medicines in Treatment of Acne Vulgaris: A Double-Blind, Randomized, Placebo-Controlled Trial. HOMEOPATHY 2022; 111:240-251. [PMID: 35299272 DOI: 10.1055/s-0041-1739397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Acne is estimated to affect 9.4% of the global population, making it the 8th most prevalent disease worldwide. Acne vulgaris (AV) is among the diseases that directly affect quality of life. This trial evaluated the efficacy of individualized homeopathic medicines (IHM) against placebo in AV. METHODS In this double-blind, randomized, placebo-controlled trial conducted at the National Institute of Homoeopathy, India, 126 patients suffering from AV were randomized in a 1:1 ratio to receive either IHM (verum) in centesimal potencies or identical-looking placebo (control). The primary outcome measure was the Global Acne Grading System score; secondary outcomes were the Cardiff Acne Disability Index and Dermatology Life Quality Index questionnaires - all measured at baseline and 3 months after the intervention. Group differences and effect sizes (Cohen's d) were calculated on the intention-to-treat sample. RESULTS Overall, improvements were greater in the IHM group than placebo, with small to medium effect sizes after 3 months of intervention; however, the inter-group differences were statistically non-significant. Sulphur (17.5%), Natrum muriaticum (15.1%), Calcarea phosphorica (14.3%), Pulsatilla nigricans (10.3%), and Antimonium crudum (7.1%) were the most frequently prescribed medicines; Pulsatilla nigricans, Tuberculinum bovinum and Natrum muriaticum were the most effective of those used. No harms, unintended effects, homeopathic aggravations or any serious adverse events were reported from either group. CONCLUSION There was non-significant direction of effect favoring homeopathy against placebo in the treatment of AV. TRIAL REGISTRATION CTRI/2018/11/016248; UTN: U1111-1221-8164.
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Affiliation(s)
- Shruti Rai
- Department of Organon of Medicine and Homoeopathic Philosophy, National Institute of Homoeopathy, Salt Lake, Kolkata, West Bengal, India
| | - Gobind Narayan Gupta
- Department of Organon of Medicine and Homoeopathic Philosophy, National Institute of Homoeopathy, Salt Lake, Kolkata, West Bengal, India
| | - Subhas Singh
- Department of Organon of Medicine and Homoeopathic Philosophy, National Institute of Homoeopathy, Salt Lake, Kolkata, West Bengal, India
| | - James Michael
- Department of Organon of Medicine and Homoeopathic Philosophy, National Institute of Homoeopathy, Salt Lake, Kolkata, West Bengal, India
| | - Pankhuri Misra
- Department of Materia Medica, National Institute of Homoeopathy, Salt Lake, Kolkata, West Bengal, India
| | - Bharti Gupta
- Department of Paediatrics, National Institute of Homoeopathy, Salt Lake, Kolkata, West Bengal, India
| | - Suman Singh
- Department of Organon of Medicine and Homoeopathic Philosophy, National Institute of Homoeopathy, Salt Lake, Kolkata, West Bengal, India
| | - Akshaya Prakash
- Department of Organon of Medicine and Homoeopathic Philosophy, National Institute of Homoeopathy, Salt Lake, Kolkata, West Bengal, India
| | - Maneela Tomar
- Department of Organon of Medicine and Homoeopathic Philosophy, National Institute of Homoeopathy, Salt Lake, Kolkata, West Bengal, India
| | - Satarupa Sadhukhan
- Department of Organon of Medicine and Homoeopathic Philosophy, National Institute of Homoeopathy, Salt Lake, Kolkata, West Bengal, India
| | - Munmun Koley
- East Bishnupur State Homoeopathic Dispensary, Chandi Daulatabad Block Primary Health Centre, South 24 Parganas, West Bengal, under Department of Health & Family Welfare, Govt. of West Bengal, India
| | - Subhranil Saha
- Department of Repertory, D.N. De Homoeopathic Medical College and Hospital, Govt. of West Bengal, Tangra, Kolkata, West Bengal, India
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25
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Tan J, Beissert S, Cook-Bolden F, Chavda R, Harper J, Hebert A, Lain E, Layton A, Rocha M, Weiss J, Dréno B. Evaluation of psychological well-being and social impact of atrophic acne scarring: A multinational, mixed-methods study. JAAD Int 2022; 6:43-50. [PMID: 35005652 PMCID: PMC8719008 DOI: 10.1016/j.jdin.2021.11.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2021] [Indexed: 11/16/2022] Open
Abstract
Background Most people with acne are at risk of developing acne scars, but the impact of these scars on patients' quality of life is poorly researched. Objective To assess the perspective of patients with acne scars and the impact of these scars on their emotional well-being and social functioning. Methods A 60-minute interview of 30 adults with acne scars informed and contextualized the development of a cross-sectional survey of 723 adults with atrophic acne scars. Results The main themes identified in the qualitative interviews included acceptability to self and others, social functioning, and emotional well-being. In the cross-sectional survey, 31.6%, 49.6%, and 18.8% of the participants had mild, moderate, and severe/very severe acne scarring. The survey revealed that 25.7% of the participants felt less attractive, 27.5% were embarrassed or self-conscious because of their scars, 8.3% reported being verbally and/or physically abused because of their scars on a regular basis, and 15.9% felt that they were unfairly dismissed from work. In addition, 37.5% of the participants believed that their scars affected people's perceptions about them, and 19.7% of the participants were very bothered about hiding their scars daily. Moreover, 35.5% of the participants avoided public appearances, and 43.2% felt that their scars had negatively impacted their relationships. Limitations The temporal evaluation of the impact was not estimated. Conclusion Even mild atrophic acne scarring can evoke substantial emotional, social, and functional concerns.
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Affiliation(s)
- Jerry Tan
- Western University Canada, Schulich School of Medicine and Dentistry, Ontario, Canada
| | - Stefan Beissert
- Department of Dermatology, University Hospital Carl Gustav Carus, Dresden, Germany
| | | | | | - Julie Harper
- The Dermatology and Skin Care Center of Birmingham, Birmingham, Alabama
| | | | - Edward Lain
- Austin Institute for Clinical Research, Pflugerville, Texas
| | - Alison Layton
- Hull York Medical School, York University, York, United Kingdom
| | - Marco Rocha
- Federal University of São Paulo, São Paulo, Brazil
| | - Jonathan Weiss
- Georgia Dermatology Partners (formerly, Gwinnett Dermatology, PC), Snellville, Georgia
| | - Brigitte Dréno
- Unité Thérapie Cellulaire et Génique, Faculté de Médecine de Nantes, Centre Hospitalier Universitaire de Nantes, Nantes, France
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26
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Alenezy DA, Alshammari MRM, Alanazi ANF, Alshammari NNZ, Alrawaili SDK. Acne Vulgaris among Adolescent Females in Arar City, Northern Saudi Arabia. PHARMACOPHORE 2022. [DOI: 10.51847/w3h5yx3kdq] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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27
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Skin Disease in Children: Effects on Quality of Life, Stigmatization, Bullying, and Suicide Risk in Pediatric Acne, Atopic Dermatitis, and Psoriasis Patients. CHILDREN (BASEL, SWITZERLAND) 2021; 8:children8111057. [PMID: 34828770 PMCID: PMC8619705 DOI: 10.3390/children8111057] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 11/09/2021] [Accepted: 11/10/2021] [Indexed: 12/23/2022]
Abstract
Acne, atopic dermatitis (AD), and psoriasis are all chronic dermatologic conditions that greatly impact the lives of pediatric patients and their caregivers. The visible nature of these diseases negatively affects the self-image of children early in life as well as their relationships with their families and peers. Physicians recognize the importance of addressing both the physical and mental symptoms of their patients but are currently not equipped with clear guidelines to manage long-term psychosocial comorbidities in pediatric dermatologic patients. A PubMed and Google Scholar search of key words was conducted to explore self-image in pediatric patients with acne, AD, and psoriasis. Chronic skin diseases put pediatric patients at risk for strained family relationships, poor self-image, psychiatric comorbidities, stigmatization, and eventual suicidal behavior. A limitation of this study is a lack of a validated measure of quality of life in the pediatric population that fulfills enough criteria to evaluate long term quality of life in children and adults. Possible management options, including connecting patients with the same diagnosis and allocating resources to parents and teachers to better understand these chronic skin conditions, may provide pediatric patients with the support they need to develop resilience in the face of these challenges.
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28
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Grayson C, Heath C. Tips for addressing common conditions affecting pediatric and adolescent patients with skin of color. Pediatr Dermatol 2021; 38 Suppl 2:155-157. [PMID: 33650150 DOI: 10.1111/pde.14525] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Pediatric and adolesent patients with skin of color are seen by dermatologists for common complaints such as acne, atopic dermatitis, and traction alopecia. Combining the understanding of cultural practices, empathetic patient communication, and social implications is useful in counseling and treating pediatric and adolescent patients with skin of color.
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Affiliation(s)
- Ciara Grayson
- Florida State University College of Medicine, Tallahassee, Florida, USA
| | - Candrice Heath
- Lewis Katz School of Medicine, Department of Dermatology, Temple University, Philadelphia, PA, USA
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29
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Salameh F, Shumaker PR, Goodman GJ, Spring LK, Seago M, Alam M, Al-Niaimi F, Cassuto D, Chan HH, Dierickx C, Donelan M, Gauglitz GG, Haedersdal M, Krakowski AC, Manuskiatti W, Norbury WB, Ogawa R, Ozog DM, Paasch U, Victor Ross E, Clementoni MT, Waibel J, Bayat A, Goo BL, Artzi O. Energy-based devices for the treatment of acne scars: 2021 international consensus recommendations. Lasers Surg Med 2021; 54:10-26. [PMID: 34719045 DOI: 10.1002/lsm.23484] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 10/03/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND OBJECTIVES Acne scars are one of the most distressing and long-term consequences of acne vulgaris, with damaging effect on a person's physical, mental, and social well-being. Numerous treatment options are available including surgical and nonsurgical techniques, depending on the clinical presentation. Although considerable advances in the development of new treatment technologies and applications have been made in the last decade, international treatment guidelines and reimbursement schemes have not yet caught up with current knowledge and practice in many centers. The authors intend to highlight the potential utility of energy-based devices (EBDs) for acne scarring, offer recommendations for safe and efficacious treatment, and provide consensus-based EBD treatment options based on varying presentations demonstrated in a series of real-life clinical photographs. STUDY DESIGN/MATERIALS AND METHODS An international panel of 24 dermatologists and plastic surgeons from 12 different countries and a variety of practice backgrounds was self-assembled to develop updated consensus recommendations for the treatment of acne scars. A two-step modified Delphi method took place between March 2020 and February 2021 consisting of two rounds of emailed questionnaires. The panel members approved the final manuscript via email correspondence. RESULTS The manuscript includes a comprehensive discussion and panel recommendations regarding the following topics: 1. the role of EBD in mitigating and treating acne scars in a patient with active acne, 2. the use of various EBDs for the treatment of different acne scar types with special focus on commonly used laser platform such as vascular lasers, ablative fractional lasers (AFLs) and non-AFLs (NAFLs), 3. treatment combinations, and 4. acne scar treatments in skin of color. The last part comprised of 10 photos of real-life clinical cases with the panel recommendation treatment plan to achieve best aesthetic outcome. CONCLUSION Panel members were unanimous in their view that EBDs have a role in the management of acne scars, with AFLs, NAFLs, vascular lasers, and RF devices preferentially selected by most of the panel experts. EBDs are considered a first-line treatment for a variety of acne scar types and patients without access to these treatments may not be receiving the best available care for optimal cosmetic results. Future high-quality research and updated international treatment guidelines and reimbursement schemes should reflect this status.
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Affiliation(s)
- Fares Salameh
- Department of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Peter R Shumaker
- VA San Diego Healthcare System and University of California, San Diego, California, USA
| | - Greg J Goodman
- Department of General Practice, Monash University, Clayton, Victoria, Australia
| | - Leah K Spring
- Micrographic Surgery and Surgical Oncology, SkinCare Physicians, Chestnut Hill, Massachusetts, USA
| | - Meghan Seago
- VA San Diego Healthcare System and University of California, San Diego, California, USA.,Micrographic Surgery and Surgical Oncology, Scripps Clinic, La Jolla, California, USA
| | - Murad Alam
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | | | | | - Henry Hl Chan
- Private Practice and Department of Medicine (Dermatology), University of Hong Kong, People's Republic of China
| | | | - Matthias Donelan
- Department of Surgery, Massachusetts General Hospital, Shriners Hospitals for Children-Boston, Harvard Medical School, Boston, Massachusetts, USA
| | - Gerd G Gauglitz
- Department of Dermatology and Allergy, Ludwig Maximillian University, Munich, Germany
| | - Merete Haedersdal
- Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Andrew C Krakowski
- Department of Dermatology, St. Luke's University Health Network, Easton, Pennsylvania, USA
| | | | - William B Norbury
- Department of Surgery, University of Texas Medical Branch, Shriners Hospital for Children-Galveston, Galveston, Texas, USA
| | - Rei Ogawa
- Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School, Tokyo, Japan
| | - David M Ozog
- Department of Dermatology, Henry Ford Hospital, Detroit, Michigan, USA
| | - Uwe Paasch
- Department of Dermatology, Venereology, and Allergy, University of Leipzig, Leipzig, Germany
| | | | | | - Jill Waibel
- Miami Dermatology and Laser Institute, Miami, Florida, USA
| | - Ardeshir Bayat
- Plastic & Reconstructive Surgery Research, Centre for Dermatology Research, NIHR Manchester Biomedical Research Centre, University of Manchester, England, UK.,MRC-SA Wound Healing Unit, Hair & Skin Research Laboratory, Division of Dermatology, University of Cape Town, Cape Town, South Africa
| | - Boncheol Leo Goo
- Naeum Dermatology and Aesthetic Clinic/Skin Rehabilitation Center, Seoul, Korea
| | - Ofir Artzi
- Department of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
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30
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Double-blind, randomized controlled trial comparing the use of microneedling alone versus chemical peeling alone versus a combination of microneedling and chemical peeling in the treatment of atrophic post-acne scars. An assessment of clinical effectiveness and patients' quality-of-life. Postepy Dermatol Alergol 2021; 38:629-635. [PMID: 34658706 PMCID: PMC8501429 DOI: 10.5114/ada.2021.108913] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 03/23/2020] [Indexed: 11/17/2022] Open
Abstract
Introduction Acne vulgaris is a common, chronic disease. One of the most commonly encountered complications of acne is permanent atrophic scarring. Treatment of atrophic scars includes fillers, dermabrasion, laser resurfacing, microneedling and peelings and it is often difficult to treat. In our double-blind randomized controlled trial (RCT), we investigated the synergistic effect of microneedling with the application of trichloroacetic acid, kojic acid and hydrogen peroxide in the treatment of atrophic acne scars. Aim To assess the clinical effectiveness and patients' quality-of-life (HRQoL) after three types of atrophic post-acne scar treatment, namely microneedling alone (MN) vs chemical peeling alone (CP) vs. a combination of microneedling and chemical peeling (MN + CP). Material and methods A total of 120 patients were enrolled into the study following strict inclusion/exclusion criteria and randomized into the three treatment groups - MN, CP (a combination of trichloroacetic acid, kojic acid and hydrogen peroxide), and MN + CP. According to a preapproved protocol, each patient underwent four treatment sessions, each spread 20 days apart. Both pre- and post-treatment clinical status (using the Goodman-Baron scale; two expert raters blinded to the treatment used) and patients' HRQoL (using the Dermatology Life Quality Index) were assessed. Results During the 5-month recruitment period, a total of 120 patients were approached and agreed to take part in the study (94 females - 78.3% and 26 males) (mean age of 30.14 ±3.64 years; range: 18-45 years). Only in the MN + CP group there was a statistically significant improvement according to the G-B scale post-treatment (2.87 ±0.83 vs. 2.03 ±1.16 respectively; p = 0.0005). Patients in all three treatment groups experienced a statistically significant improvement in their HRQoL post-treatment (all p's < 0.05). Conclusions A combination of microneedling and chemical peeling produces the best, objectively measured effects in the treatment of atrophic post-acne scars. All examined treatments, even if not producing a clinically significant treatment outcome, improve patients' HRQoL.
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31
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Cortés H, Rojas-Márquez M, Del Prado-Audelo ML, Reyes-Hernández OD, González-Del Carmen M, Leyva-Gómez G. Alterations in mental health and quality of life in patients with skin disorders: a narrative review. Int J Dermatol 2021; 61:783-791. [PMID: 34403497 DOI: 10.1111/ijd.15852] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 07/13/2021] [Accepted: 07/26/2021] [Indexed: 12/29/2022]
Abstract
The presence of lesions in visible areas of skin may cause emotional troubles in patients, including low self-worth, embarrassment, sorrow, and social isolation. Those alterations may predispose to psychiatric disorders such as anxiety, depression, and even suicidal ideation, severely affecting patients' health state and quality of life (QoL). In this article, we focus on dermatologic patients that present with secondary mental health alterations. Thus, we offer a detailed description of mental disorders observed in patients with acne vulgaris, atopic dermatitis, psoriasis, ichthyosis, vitiligo, and hidradenitis suppurativa. Moreover, we point out the relationship between the severity of the cutaneous symptoms with mental illnesses and QoL decline. Our objective was to highlight the importance of mental health care for patients with skin diseases. The impact of skin alterations on the mental health of dermatological patients should be a central concern. Likewise, the timely identification and treatment of mental disorders are essential for the comprehensive management of these skin diseases.
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Affiliation(s)
- Hernán Cortés
- Laboratorio de Medicina Genómica, Departamento de Genómica, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Mexico City, Mexico
| | - Martín Rojas-Márquez
- Hospital Psiquiátrico Infantil Dr. Juan N. Navarro, Secretaría de Salud, Mexico City, Mexico
| | - María L Del Prado-Audelo
- Departamento de Farmacia, Facultad de Química, Universidad Nacional Autónoma de México, Mexico City, Mexico.,Departamento de Bioingeniería, Escuela de Ingeniería y Ciencias, Tecnológico de Monterrey Campus Ciudad de México, Mexico City, Mexico
| | - Octavio D Reyes-Hernández
- Laboratorio de Biología Molecular del Cáncer, UMIEZ, Facultad de Estudios Superiores Zaragoza, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | | | - Gerardo Leyva-Gómez
- Departamento de Farmacia, Facultad de Química, Universidad Nacional Autónoma de México, Mexico City, Mexico
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32
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Barbieri JS, Fulton R, Neergaard R, Nelson MN, Barg FK, Margolis DJ. Patient Perspectives on the Lived Experience of Acne and Its Treatment Among Adult Women With Acne: A Qualitative Study. JAMA Dermatol 2021; 157:1040-1046. [PMID: 34319378 DOI: 10.1001/jamadermatol.2021.2185] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Introduction Acne often persists into adulthood in women. However, few studies have specifically explored the lived experience of acne in adult populations. Objective To examine the lived experience of acne and its treatment among a cohort of adult women. Design, Setting, and Participants A qualitative analysis was conducted from free listing and open-ended, semistructured interviews of patients at a large academic health care system (University of Pennsylvania Health System) and a private practice (Dermatologists of Southwest Ohio). Fifty women 18 to 40 years of age with moderate to severe acne participated in interviews conducted between August 30, 2019, and December 31, 2020. Main Outcomes and Measures Free-listing data from interviews were used to calculate the Smith S, a measure of saliency for each list item. Semistructured interviews were examined to detect themes about patient perspectives regarding their acne and its treatment. Results Fifty participants (mean [SD] age, 28 [5.38] years; 24 [48%] White) described acne-related concerns about their appearance that affected their social, professional, and personal lives, with many altering their behavior because of their acne. Depression, anxiety, and social isolation were commonly reported. Participants described successful treatment as having completely clear skin over time or a manageable number of blemishes. Many participants described frustration with finding a dermatologist with whom they were comfortable and with identifying effective treatments for their acne. Conclusions and Relevance The results of this qualitative study suggest that women with acne have strong concerns about appearance and experience mental and emotional health consequences and disruption of their personal and professional lives. In addition, many patients describe challenges finding effective treatments and accessing care. Future trials to understand the optimal treatment approaches for women with acne are needed to improve outcomes in this population.
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Affiliation(s)
- John S Barbieri
- Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Rachel Fulton
- Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia.,Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania
| | - Rebecca Neergaard
- Mixed Methods Research Lab, University of Pennsylvania Perelman School of Medicine, Philadelphia.,Department of Family Medicine and Community Health, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Maria N Nelson
- Mixed Methods Research Lab, University of Pennsylvania Perelman School of Medicine, Philadelphia.,Department of Family Medicine and Community Health, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Frances K Barg
- Mixed Methods Research Lab, University of Pennsylvania Perelman School of Medicine, Philadelphia.,Department of Family Medicine and Community Health, University of Pennsylvania Perelman School of Medicine, Philadelphia.,Center for Clinical Epidemiology and Biostatistics, Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - David J Margolis
- Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia.,Center for Clinical Epidemiology and Biostatistics, Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia
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Salameh F, Shehadeh W, Sprecher E, Artzi O. A stereoscopic optical system for objective quantification of the change in cumulative acne scar depth following various treatment interventions. J Cosmet Dermatol 2021; 21:2099-2105. [PMID: 34228895 DOI: 10.1111/jocd.14334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 06/08/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Current approaches for assessment of acne scars are subjective, including counting scar subtypes, subjective self-assessment, or scoring global acne scar severity. AIMS We aimed to validate accuracy and present initial data of a new, simple, non-contact, high-resolution 3D stereoscopic optical imaging system in the setting of acne scarring. PATIENTS/METHODS Ten patients treated for acne scars in the dermo-esthetic outpatient clinics in our institution from July to December 2019 were recruited from medical files and completed by telephone interview. Each patient was assessed by the 3D imaging system, the Qualitative Scarring Grading Score (QSGS), and the patient's questionnaire for Self-assessment of Clinical Acne-Related Scars (SCARS) before and 4 weeks after a single intervention. RESULTS Scar depth measured by the imaging system correlated significantly with the actual depth of printed surface depressions and the 3D optical imaging assessments. The changes in SCARS and 3D optical imaging assessments correlated significantly, but there were no correlations between changes in QSGS and 3D optical assessment measures, or between the QSGS and SCARS results. CONCLUSION The new stereoscopic optical system is a reliable and practical objective method for assessing the cumulative depth of atrophic acne scars and monitoring treatment response. It is more sensitive, accurate, and informative than subjective scales.
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Affiliation(s)
- Fares Salameh
- Division of Dermatology, Tel Aviv Sourasky Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Waseem Shehadeh
- Division of Dermatology, Tel Aviv Sourasky Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Eli Sprecher
- Division of Dermatology, Tel Aviv Sourasky Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Human Molecular Genetics & Biochemistry, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ofir Artzi
- Division of Dermatology, Tel Aviv Sourasky Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Provini LE, Omandac VT, Bahrani E, Aghdasi C, Cordoro KM. Cutaneous body image: A window into the adolescent experience of dermatologic disease. Pediatr Dermatol 2021; 38:851-858. [PMID: 34152034 DOI: 10.1111/pde.14618] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 03/22/2021] [Accepted: 04/13/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND/OBJECTIVES Cutaneous body image (CBI) is a self-reported measure of an individual's satisfaction with their hair, skin, and nails using a psychometric survey described and validated in adult dermatology patient populations. As the CBI's clinical utility for pediatric dermatology patients has not yet been examined, we assessed the relationship between CBI scores, demographic, and clinical parameters among adolescents. METHODS Retrospective cohort of 293 patients ages 13-18 seen at the UCSF pediatric dermatology clinic from June 2017 to February 2019. An 11-question CBI survey was administered as part of routine clinical care, querying patient satisfaction with their skin, hair, and nails on a 10-point Likert-type scale, and experience with embarrassment, bullying, and mental health care. RESULTS Satisfaction with overall skin, skin of face, and hair significantly varied by patient age (P < .05), decreasing among subjects ages 13-16, and comparatively higher among patients ages 17-18. Mean total CBI scores did not significantly vary by sex, ethnicity, diagnosis, or new versus established patients. Mean total CBI scores were significantly higher among patients who did not report embarrassment (27.5) than among those who did (20.5) (P < .01), and among patients who had not experienced bullying (25.7) than among those who had (22.0) (P < .01). CONCLUSIONS Objective CBI scores among adolescents correlate with reported negative experiences of skin disease (embarrassment and bullying) and with age. The CBI provides insight into the psychosocial impact of skin disease among adolescents, validates the patient's subjective perspective of their disease, and informs patient-centered discussions and management in the pediatric dermatology clinic setting.
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Affiliation(s)
- Lauren E Provini
- Department of Dermatology, University of California San Francisco, San Francisco, CA, USA
| | - Venea T Omandac
- University of Nevada, Reno School of Medicine, Reno, NV, USA
| | - Eman Bahrani
- Department of Dermatology, University of California San Francisco, San Francisco, CA, USA
| | - Carmel Aghdasi
- University of California, San Francisco School of Medicine, San Francisco, CA, USA
| | - Kelly M Cordoro
- Department of Dermatology and Pediatrics, University of California San Francisco, Benioff Children's Hospital, San Francisco, CA, USA
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Social Support and Appearance Satisfaction Can Predict Changes in the Psychopathology Levels of Patients with Acne, Psoriasis and Eczema, before Dermatological Treatment and in a Six-Month Follow-up Phase. PSYCH 2021. [DOI: 10.3390/psych3030020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This was a cross-sectional study which assessed the factors that predicted changes in the levels of psychopathological symptomatology of patients with acne, psoriasis and eczema both before dermatological treatment and in a six-month follow-up phase. One hundred and eight dermatological patients (18–35 years) participated in the study; 54 with visible facial cystic acne (Group A), and 54 with non-visible psoriasis/eczema (Group B). A battery of self-report questionnaires were administered to all patients before their dermatological treatment and in a six-month follow-up phase and included: the Symptom Checklist-90 Revised (SCL-90-R), the Interpersonal Support Evaluation List (ISEL-40), the Multidimensional Body–Self Relations Questionnaire (MBSRQ–AS) and the Rosenberg Self-Esteem Scale. Multiple regression analyses revealed that patients’ overall perceived social support and overall appearance satisfaction appeared to be strong predictors of the maintenance of patients’ psychopathology levels, even six months after they began their dermatological treatment. Psychosocial factors such as patients’ social support and appearance satisfaction could influence their psychopathology levels and the way they experienced their skin condition, before treatment and after a six-month period of time. The psychological assessment of the aforementioned factors could detect patients who would benefit from psychotherapeutic interventions in order to help them adapt to the extra burden which accompanies dermatological disorders.
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Ramadhanty RP, Hamid AYS. Body image perception is related to self-esteem of the adolescents with acne vulgaris. ENFERMERIA CLINICA 2021. [PMID: 33849191 DOI: 10.1016/j.enfcli.2020.09.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Having acne vulgaris may affect the way adolescents perceive themselves. The objective of this study was to examine the relationship between the body image perception and self-esteem of adolescents with acne vulgaris. A cross-sectional descriptive-correlative study was conducted in 173 high school students in a subdistrict in Indonesia. The relationship between body image and self-esteem was analyzed using Chi-square test. The results of this study showed there was a significant relationship between body image perception and self-esteem of adolescents with acne vulgaris in this study (p=0.000). Body image perception of adolescents with acne vulgaris is associated with their self-esteem. Nurses should deliver health education containing the major concerns of adolescents, such as acne vulgaris, to promote positive body image and self-esteem among adolescents.
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Tan J, Beissert S, Cook-Bolden F, Chavda R, Harper J, Hebert A, Lain E, Layton A, Rocha M, Weiss J, Dréno B. Impact of facial and truncal acne on quality of life: A multi-country population-based survey. JAAD Int 2021; 3:102-110. [PMID: 34409378 PMCID: PMC8362284 DOI: 10.1016/j.jdin.2021.03.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/05/2021] [Indexed: 11/26/2022] Open
Abstract
Background Acne confers an increased risk of physical, psychiatric, and psychosocial sequelae, potentially affecting multiple dimensions of health-related quality of life (HRQoL). Morbidity associated with truncal acne is poorly understood. Objective To determine how severity and location of acne lesions impact the HRQoL of those who suffer from it. Methods A total of 694 subjects with combined facial and truncal acne (F+T) and 615 with facial acne only (F) participated in an online, international survey. Participants self-graded the severity of their acne at different anatomical locations and completed the dermatology life quality index (DLQI). Results The F+T participants were twice as likely to report “very large” to “extremely large” impact on HRQoL (ie, DLQI > 10 and children's DLQI [CDLQI] > 12) as compared with the F participants (DLQI: odds ratio [OR] 1.61 [95% confidence interval {CI} 1.02-2.54]; CDLQI: OR 1.86 [95% CI 1.10-3.14]). The impact of acne on HRQoL increased with increasing acne severity on the face (DLQI and CDLQI P values = .001 and .017, respectively), chest (P = .003; P = .008), and back (P = .001; P = .028). Limitations Temporal evaluation of acne impact was not estimated. Conclusions Facial and truncal acne was associated with a greater impact on HRQoL than facial acne alone. Increasing severity of truncal acne increases the adverse impact on HRQoL irrespective of the severity of facial acne.
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Affiliation(s)
- Jerry Tan
- Schulich School of Medicine and Dentistry, Western University Canada, Windsor, Ontario, Canada
| | - Stefan Beissert
- Department of Dermatology, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
| | | | | | - Julie Harper
- The Dermatology and Skin Care Center of Birmingham, Birmingham, Alabama
| | - Adelaide Hebert
- The University of Texas Medical School - Houston, Houston, Texas
| | - Edward Lain
- Austin Institute for Clinical Research, Pflugerville, Texas
| | - Alison Layton
- Hull York Medical School, York University, Heslington, York, United Kingdom
| | - Marco Rocha
- Federal University of São Paulo, São Paulo, Brazil
| | - Jonathan Weiss
- Georgia Dermatology Partners (Formerly, Gwinnett Dermatology, PC), Snellville, Georgia
| | - Brigitte Dréno
- Unité Thérapie Cellulaire et Génique, Faculté de Médecine de Nantes, CHU Nantes - Place Alexis Ricordeau, Nantes, France
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Đurović MR, Đurović M, Janković J, Janković S. Quality of life in Montenegrin pupils with acne. PLoS One 2021; 16:e0250155. [PMID: 33857237 PMCID: PMC8049225 DOI: 10.1371/journal.pone.0250155] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 03/31/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Acne is a common skin disease that can affect a person's quality of life (QoL), self-esteem, and mood in an adverse manner. The aim of the current study was to assess QoL among Montenegrin pupils with acne. METHODS This cross-sectional survey was conducted over October and November 2020 in four randomly selected secondary schools in Podgorica, Montenegro. All 500 pupils were asked to fill in a short questionnaire which included questions on age, sex, presence of acne, and for those with acne their duration and location, visits to doctors, presence of any other coexisting skin disease, and family history of acne. Only pupils who self-reported acne were asked to complete the Children's Dermatology Life Quality Index (CDLQI) and the Cardiff Acne Disability Index (CADI). RESULTS Self reported acne were presented in 49.8% (249/500) of all pupils. The mean CDLQI score of the total sample was 4.27 ± 5.13. Overall, the CDLQI domains that were most affected by acne were symptoms and feelings (mean score 1.49 ± 1.43), leisure (mean score 0.94 ± 1.72), and treatment (0.66 ± 0.79). The mean total CADI score was 3.53 ± 3.11 which was higher in girls (4.07 ± 3.11) than in boys (2.90 ± 3.00). There was good correlation between the two questionnaires (Rho = 0.76; P < 0.01). According to multiple linear regressions, higher overall CDLQI score was found in pupils with acne who reported other skin diseases, while girls, pupils who reported both acne on face and back, and who had any concomitant skin disease had higher CADI total score. CONCLUSIONS Acne affects QoL of young adolescents in Montenegro with greater impact in girls. Our findings should point out the importance of timely diagnosis, treatment, and education of adolescents with acne.
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Affiliation(s)
- Milena Ražnatović Đurović
- Clinic of Dermatology and Venereology, Clinical Center of Montenegro, Podgorica, Montenegro
- Faculty of Medicine, University of Montenegro, Podgorica, Montenegro
| | - Milica Đurović
- Clinic of Dermatology and Venereology, Clinical Center of Montenegro, Podgorica, Montenegro
| | - Janko Janković
- Institute of Social Medicine, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Slavenka Janković
- Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
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Özkesici Kurt B. Comparison of the psychosocial impact of acne in adolescents and adults; body satisfaction, self-esteem, and quality of life. J Cosmet Dermatol 2021; 21:836-843. [PMID: 33844401 DOI: 10.1111/jocd.14151] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 03/31/2021] [Accepted: 04/06/2021] [Indexed: 01/28/2023]
Abstract
BACKGROUND Dermatological diseases, including acne vulgaris, have significant psychosocial effects on patients. AIMS To compare body satisfaction, self-esteem, and quality of life (QoL) in adolescents and adults with acne. METHODS A total of 192 acne patients (132 female, 60 male; aged 19.42 ± 3.50 years) were included in the study. Global Acne Grading System, Rosenberg Self-Esteem Scale (RSES), Turkish Acne Quality of Life Index (TAQoLI), and Body Cathexis Scale (BCS) were used. The patients were divided into two groups: under 20 years old (adolescents) and 20 years and above (adults). RESULTS The mean RSES score was found as 19.49 ± 5.11, the mean BCS score was 143.95 ± 20.92 and the mean TAQoLI score was 23.44 ± 10.02. There was no difference between adolescents and adults in terms of the mean value of the RSES score, TAQoLI score, and BCS score (p > 0.05). But, the proportion of those whose RSES score is below 15 is higher in patients under 20 years of age (28%) than patients aged 20 and over (14%) (p < 0.05). Linear regression analysis revealed that the most important determinant of body satisfaction was self-esteem (β = 0.287, p < 0.05), the most important determinants of self-esteem were body satisfaction (β = 0.208, p < 0.05), QoL (β = -0.398, p < 0.001), and education level (β = 0.245, p = 0.007) and, one of the most important determinant of QoL was self-esteem (β = -0.403, p < 0.001). CONCLUSIONS This study demonstrates that acne vulgaris negatively affects an individual's body satisfaction, self-esteem, and QoL. The psychosocial burden of acne is as significant for adults as for adolescents. Body satisfaction, self-esteem, and QoL are in interaction with each other.
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Affiliation(s)
- Birgül Özkesici Kurt
- Clinic of Dermatology, Adıyaman Training and Research Hospital, Adıyaman, Turkey
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40
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Dréno B, Khammari A, Seité S, Legrand C, Halioua B, Misery L, Ezzedine K, Shourick J, Taieb C. Impact of acne on the daily life of adult patients: building a self-administered patient questionnaire. J Eur Acad Dermatol Venereol 2021; 35:1212-1218. [PMID: 33506539 DOI: 10.1111/jdv.17134] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 12/10/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Acne is a long-lasting disease in adolescents and adults impacting the patient's daily life. Currently, there is no specific questionnaire that assesses its impact in adult patients. AIM To build a self-administered questionnaire assessing the impact of acne on the daily life in adult patients. METHOD A multidisciplinary working group was created, including 3 experts in healthcare questionnaires and dermatologists specialized in acne. A questionnaire using a standardized methodology for designing self-administered patient questionnaires according to conceptual, development and validation phases was developed. A cultural and linguistic validation into US English was conducted, based on the original French version. RESULTS A 14-item questionnaire demonstrating consistency, reproducibility and high reliability was build. The questionnaire significantly correlated with the SF-12 mental and SF-12 physical scores and CADI, indicating good external validity. CONCLUSION The present acne burden questionnaire AI-ADL allows the practioner to assess quickly and easily the burden of acne in patients during his daily clinical practice. Moreover, its short format allows patients to express easily and quickly their feelings and to initiate a conversation between the practioner and his patient. Thus, AI-ADL may help to better understand the multidimensional nature of acne, as well as the individual impact on the acne patient's daily life and moreover, it may play a key role in the decision-making process of treatment initiation and involvement of the patient in the management of his acne.
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Affiliation(s)
- B Dréno
- Department of Oncodermatology, CHU Nantes, CRCINA, Inserm 1232, CIC 1413, University of Nantes, Nantes, France
| | - A Khammari
- Department of Oncodermatology, CHU Nantes, CRCINA, Inserm 1232, CIC 1413, University of Nantes, Nantes, France
| | - S Seité
- La Roche Posay Dermatological Laboratories, Levallois Perret, France
| | - C Legrand
- France Acné- Adolescents- Adultes, France3A, Association française de Patients, Vincennes, France
| | | | - L Misery
- Dermatology and Venerology Department, University Hospital, Brest, France
| | | | - J Shourick
- Department of Epidemiology, Hôpital de Toulouse, Toulouse, France
| | - C Taieb
- Patient-Priority, European Market Maintenance Assessment, Fontenay sous Bois, France
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Goyal S, Sajid N, K. Nayak S, Husain S. CDLQI-based assessment of skin disorders among children: A study from Northern India. Indian J Dermatol 2021; 66:704. [PMID: 35283507 PMCID: PMC8906316 DOI: 10.4103/ijd.ijd_807_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Background: Skin is the largest organ of the human body, and one of the most sensitive indicators of a child's general health. Skin disorders, especially among children, may cause an additional emotional and psychological stress to the patients and their family. Aim: We aim to compare the extent to which various skin diseases affect the quality of life among the pediatric age group (5–12 years) based on Children's Dermatology Life Quality Index (CDLQI) scores. Materials and Methods: A cross-sectional study of 453 patients who attended skin clinic at a regional hospital in Northern India between November 2015 and May 2017. The study consists of questions regarding dermatoses. Patients were evaluated using a standardized pro forma and a CDLQI questionnaire. The diseases with abnormal high proportions were evaluated by the control chart technique. Results: Out of a total of 453 pediatric patients identified for dermatoses, the average quality of life based on the CDLQI score did not show significant variation across different seasons (P < 0.522). Although the type of skin disorders (P < 0.001) had a significant effect on the quality of life of the children. Based on the CDLQI scores, following diseases have a significant adverse effect on quality of life of the patients – miliaria, atopic dermatitis, scabies, impetigo, and pediculosis capitis. Conclusion: Our study has shown that skin diseases, irrespective of the type, adversely impair the quality of life of the child and in turn the family, therefore, calls for an enhanced level of compassion and care.
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Amer A, Elhariry S, Al-Balat W. Combined autologous platelet-rich plasma with microneedling versus microneedling with non-cross-linked hyaluronic acid in the treatment of atrophic acne scars: Split-face study. Dermatol Ther 2020; 34:e14457. [PMID: 33107665 DOI: 10.1111/dth.14457] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 09/12/2020] [Accepted: 09/18/2020] [Indexed: 11/28/2022]
Abstract
Acne scarring causes cosmetic discomfort, depression, low self-esteem and reduced quality of life. Microneedling is an established treatment for scars. A multimodality approach to scar treatment is usually necessary to achieve the best cosmetic results. The objective of this study was to evaluate the efficacy and safety of platelet rich plasma (PRP) combined with microneedling in comparison with microneedling with non-cross-linked hyaluronic acid for the treatment of atrophic acne scars. Forty-one patients of 20-40 years of age with atrophic acne scars were included. Microneedling was performed on both halves of the face. Topical application of PRP was given on right half of the face, while the left half of the face was treated with topical application of non-cross-linked hyaluronic acid. Four treatment sessions were given at an interval of 1 month consecutively. Goodman's Qualitative scale and the quartile grading scale are used for the final evaluation of results. There was a statistically significant improvement in acne scars after treatment among the studied group. Right and left halves showed 85.4% and 82.9% improvement, So the difference of the improvement between the two modalities is statistically insignificant P > 0.05 We conclude that microneedling has efficacy in the management of atrophic acne scars. It can be combined with either PRP or noncross-linked hyaluronic acid to enhance the final clinical outcomes in comparison with microneedling alone. The difference between the two modalities is insignificant.
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Affiliation(s)
- Amin Amer
- Department of Dermatology, Medical School, Zagazig University, Zagazig, Egypt
| | - Seham Elhariry
- Department of Dermatology, Medical School, Zagazig University, Zagazig, Egypt
| | - Waleed Al-Balat
- Department of Dermatology, Medical School, Zagazig University, Zagazig, Egypt
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Association between Satisfaction with Life and Personality Types A and D in Young Women with Acne Vulgaris. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17228524. [PMID: 33212977 PMCID: PMC7698541 DOI: 10.3390/ijerph17228524] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 11/14/2020] [Accepted: 11/16/2020] [Indexed: 12/25/2022]
Abstract
People with acne vulgaris report a lower level of satisfaction with life and are more frequently classified as having Type D personalities than those without acne. This research examined, for the first time, the moderating and mediating role of personality type in the relationship between acne severity and satisfaction with life. Among 300 female nursing and cosmetology students ranging in age from 19 to 24 years (M = 21.28, SD = 1.39), 150 individuals (50%) presented with symptoms of acne vulgaris (AV group), while the other 150 (50%) were categorized as controls without acne vulgaris (WAV sample). A cross-sectional study was conducted using three self-report questionnaires: The Satisfaction with Life Scale (SWLS), the Framingham Type A Scale (FTAS), and the Type D Scale (DS14). Acne vulgaris was clinically diagnosed using the Hellgren–Vincent Scale (HVS). The AV group scored significantly higher on the FTAS and DS14 and lower on the SWLS than the WAV sample. Life satisfaction correlated negatively with both the negative affectivity (NA) and social inhibition (SI) subscales of the DS14. The moderating role of the Type A behavioral pattern (TABP) and the mediating role of both NA and SI subscales of the DS14 were observed in the relationship between acne severity and satisfaction with life. The type of personality may explain the mechanism of the relationship between acne disease and subjective well-being. Therefore, psychological interventions and strategies focused on managing stress and mood may effectively improve satisfaction with life in people with acne.
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Paschou SA, Vryonidou A, Melissourgou M, Kosteria I, Goulis D, Chrousos GP, Kanaka-Gantenbein C. Menstrual Disorders and Androgen-Related Traits in Young Women with Type 1 Diabetes Mellitus: a Clinical Study. Endocr Pract 2020; 26:1269-1276. [PMID: 33471656 DOI: 10.4158/ep-2020-0153] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 05/28/2020] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To investigate possible causes of menstrual disorders and androgen-related traits in young women with type 1 diabetes mellitus (T1DM). METHODS Fifty-three women with T1DM (duration 8.0±5.6 years), 41 women with (polycystic ovary syndrome) PCOS, and 51 controls matched for age (19.4±4.3 years vs. 21.2±2.7 years vs. 20.8±3.1 years; P>.05) and body mass index (BMI) (22.2±2.7 kg/m2 vs. 21.9±2.0 kg/m2 vs. 21.4±1.9 kg/m2; P>.05) were prospectively recruited. RESULTS Two women (3.8%) in the T1DM group had not experienced menarche (at 15.5 and 16.6 years); of the rest, 23.5% had oligomenorrhea, 32.1% hirsutism, and 45.3% had acne. The age at menarche was delayed in the T1DM group compared to controls (12.7±1.3 vs. 12.0±1.0 years; P = .004), while no difference was observed with the polycystic ovary syndrome (PCOS) group (12.4±1.2 years). There were no differences in total testosterone (0.43±0.14 ng/mL vs. 0.39±0.14 ng/mL; P>.05), dehydroepiandrosterone sulfate (DHEA-S) (269 ± 112 μg/dL vs. 238 ± 106 μg/dL; P>.05) or Δ4-androstenedione (2.4±1.3 ng/mL vs. 1.9±0.5 ng/mL; P>.05) concentrations between T1DM and controls. However, patients with T1DM had lower sex hormone binding globulin (SHBG) concentrations than controls (61 ± 17 nmol/L vs. 83 ± 18.1 nmol/L; P = .001), which were even lower in the PCOS group (39.5±12.9 nmol/L; P = .001 compared with T1DM). The free androgen index (FAI) was higher in the PCOS group compared with both other groups (T1DM vs. PCOS vs. controls: 2.53±0.54 vs. 7.88±1.21 vs. 1.6 ± 0.68; P<.001). FAI was higher in patients with T1DM compared to controls as well (P = .038). There was no difference in DHEA-S concentrations between T1DM and PCOS patients (269 ± 112 μg/dL vs. 297 ± 100 μg/dL; P>.05). CONCLUSION Menstrual disorders and androgen-related traits in young women with T1DM may be attributed to an increase in androgen bioavailability due to decreased SHBG concentrations.
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Affiliation(s)
- Stavroula A Paschou
- Division of Endocrinology, Diabetes and Metabolism, First Department of Pediatrics and University Research Institute on Maternal and Child Health and Precision Medicine, Aghia Sophia Children's Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Andromachi Vryonidou
- Department of Diabetes and Endocrinology, Hellenic Red Cross Hospital, Athens, Greece
| | - Marina Melissourgou
- Department of Diabetes and Endocrinology, Hellenic Red Cross Hospital, Athens, Greece
| | - Ioanna Kosteria
- Division of Endocrinology, Diabetes and Metabolism, First Department of Pediatrics and University Research Institute on Maternal and Child Health and Precision Medicine, Aghia Sophia Children's Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - DimitriosG Goulis
- Unit of Reproductive Endocrinology, First Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - George P Chrousos
- Division of Endocrinology, Diabetes and Metabolism, First Department of Pediatrics and University Research Institute on Maternal and Child Health and Precision Medicine, Aghia Sophia Children's Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Christina Kanaka-Gantenbein
- Division of Endocrinology, Diabetes and Metabolism, First Department of Pediatrics and University Research Institute on Maternal and Child Health and Precision Medicine, Aghia Sophia Children's Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
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Stamu-O'Brien C, Jafferany M, Carniciu S, Abdelmaksoud A. Psychodermatology of acne: Psychological aspects and effects of acne vulgaris. J Cosmet Dermatol 2020; 20:1080-1083. [PMID: 33031607 DOI: 10.1111/jocd.13765] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 09/21/2020] [Accepted: 09/28/2020] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Acne is a chronic inflammatory skin condition seen commonly in adolescence and young adulthood. Despite being a frequent and nonthreatening life condition, acne has a significant psychological impact and comorbidity. AIMS This review will describe prevalence, common clinical features, different clinical presentations, differential diagnoses, and treatment recommendation. Special focus has been put on psychological aspects. METHODS We conducted a literature search on PubMed from January 2001 to June 2020 with the search terms of Acne vulgaris, psychological, adolescents, anxiety, suicide, mood disorders. Reference lists of identified articles were examined for further relevant studies. The search was limited to English language articles. No specified quality criteria were used for study inclusion. RESULTS The clinical manifestations of acne are very important in the differential diagnosis and its psychological implications. CONCLUSION Through this article, we conclude that despite being a frequent and nonthreatening life condition, acne has a significant psychological impact which requires effective treatment to improve the patient's skin and self-esteem.
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Affiliation(s)
- Caroline Stamu-O'Brien
- Department of Psychiatry, NYU School of Medicine, Woodhull Medical and Mental Health Center, Brooklyn, NY, USA
| | | | - Simona Carniciu
- Center of Research, Diagnosis and Treatment in Diabetes and Nutrition Diseases Corposana, Bucharest, Romania
| | - Ayman Abdelmaksoud
- Mansoura Dermatology, Venerology and Leprology Hospital, Mansoura, Egypt
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Fang F, Xie Z, Quan J, Wei X, Wang L, Yang L. Baicalin suppresses Propionibacterium acnes-induced skin inflammation by downregulating the NF-κB/MAPK signaling pathway and inhibiting activation of NLRP3 inflammasome. ACTA ACUST UNITED AC 2020; 53:e9949. [PMID: 33111746 PMCID: PMC7584154 DOI: 10.1590/1414-431x20209949] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 08/14/2020] [Indexed: 01/08/2023]
Abstract
Acne is a kind of common, chronic skin condition caused by the inflammation of the sebaceous glands in hair follicles. Recent studies have demonstrated that baicalin (BA) possesses potential anti-inflammatory properties. In this study, we evaluated the anti-inflammatory activity of BA in vitro and in vivo. Heat-killed Propionibacterium acnes-induced THP-1 cells and live P. acnes-injected male Sprague Dawley rats were used for establishing the acne model. The rate of ear swelling was calculated, and the severity was determined by hematoxylin and eosin staining. The production of cytokines [interleukin (IL)-1β, IL-6, IL-8, and tumor necrosis factor (TNF-α)] in the cell supernatant and ear tissue homogenates was measured by ELISA. Protein levels of JNK, ERK, P38, IκBα, P65, Nod-like receptor pyrin domain-containing 3 (NLRP3), pro-caspase-1, and IL-1β in THP-1 cells and ear tissues were detected by western blotting. NLRP3 and IL-1β were detected by immunohistochemistry, and the NLRP3, IL-1β and pro-caspase-1 mRNAs were detected by quantitative real-time polymerase chain reaction (qRT-PCR). The results showed that BA decreased the expression of pro-inflammatory cytokines in vitro and in vivo. Moreover, BA down-regulated the phosphorylation of JNK, ERK1/2, and κBα and inhibited the nuclear translocation of p65. Furthermore, BA inhibited the activation of NLRP3 inflammasome, at both the gene and protein levels. Taken together, the results demonstrated that BA might exert its anti-inflammatory activity by inhibiting NF-κB/MAPK signaling pathways and consequently suppressing the activation of the NLRP3 inflammasome both in vivo and in vitro.
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Affiliation(s)
- Fang Fang
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China
| | - Zeping Xie
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China
| | - Jingyu Quan
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China
| | - Xiaohan Wei
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China
| | - Linlin Wang
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China
| | - Liu Yang
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China
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Öztekin C, Öztekin A. The association of depression, loneliness and internet addiction levels in patients with acne vulgaris. Biopsychosoc Med 2020; 14:17. [PMID: 32774449 PMCID: PMC7405352 DOI: 10.1186/s13030-020-00190-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 07/29/2020] [Indexed: 12/14/2022] Open
Abstract
Background Acne vulgaris is a very common skin disorder that has negative effects on the mood, self image and social relations of the patients. We want to evaluate the effects of acne vulgaris and its severity on depression, loneliness, internet addiction levels, and the quality of life of young adult females. Methods Two hundred three female acne vulgaris patients and 202 healthy controls who admitted to the dermatology clinic of a university hospital formed the study sample. Global Acne Grading System (GAGS) was used to assess the severity of acne. The Young Internet Addiction Scale-Short Form (YIAS-SF), The Acne Quality of Life Scale (AQLS), The University of California Los Angeles-Loneliness Scale (UCLA-LS), and The Beck Depression Inventory (BDI) were used to collect information about the patients. Results The median BDI and the mean UCLA-LS and YIAS-SF scores were higher in the Acne group than those in the control group. The correlations between acne severity and the 3 scales were not significant but the correlations between AQLS and BDI, UCLA-LS, and YIAS-SF were highly significant. In multiple regression analysis, age and the BDI score predicted the YIAS-SF score significantly. Conclusions Our findings support the previous findings that acne vulgaris patients are prone to depression and loneliness, and expand these findings to the vulnerability against internet addiction. Loneliness and depression should be assessed and, if found, targeted by psychological means to prevent internet addiction in acne vulgaris patients.
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Affiliation(s)
- Coşkun Öztekin
- Department of Family Medicine, Faculty of Medicine, Hitit University, 19000 Çorum, Turkey
| | - Aynure Öztekin
- Department of Dermatology, Faculty of Medicine, Hitit University, Çorum, Turkey
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Estrella Porter J, Camacho M, Viteri MI, Aguilar K, Belhadi D, Bettoli V, Buestán ADR, Dréno B, Endara P, Layton A, Machado N, Mateus R, Tan J, Terán E, Yépez P, Guillemot J. Pilot study for the evaluation and adaptation of a Four Item-Acne-Scar Risk Assessment Tool (4-ASRAT): a resource to estimate the risk of acne-induced scars. F1000Res 2020; 9:651. [PMID: 32850122 PMCID: PMC7431969 DOI: 10.12688/f1000research.23737.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/11/2020] [Indexed: 11/20/2022] Open
Abstract
Background: Acne-induced scarring is associated with a similar burden as acne, i.e. diminished quality of life, and may be avoided if patients receive appropriate and timely acne treatment. In 2017, a four item-Acne-Scar Risk Assessment Tool (4-ASRAT) was designed by Tan
et al. to categorise patients with acne into lower-risk or higher-risk for acne scarring. Its applicability outside the initial study population (France, Brazil and United States) remains to be determined. Methods: A study protocol was developed to create a systematic approach for validating and adapting 4-ASRAT to different populations, Ecuador in this case. The protocol was reviewed by 11 local and international dermatologists and pilot-tested in an Ecuadorian population using a sample of 10 participants who currently had or had had acne. Feedback from the pilot study was used to improve the study protocol. The results of the pilot study are included here, and the final study protocol is available as extended data. Results: The protocol proved to be applicable. Images taken of participants were a valuable resource for dermatological evaluation about the presence or absence of acne scars. Tangential light is necessary for this evaluation. Although dermatological assessments varied, we concluded that assessment by three local dermatologists for each participant was adequate for reaching a consensus on the presence or absence of acne scars. Conclusions: Considering the morbidity related to acne and acne scars, tools designed as prevention that alert patients about risk of developing scarring are necessary. The proposed protocol shows a feasible way of validating and adapting 4-ASRAT to different populations.
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Affiliation(s)
- Jorge Estrella Porter
- Escuela de Medicina, Universidad San Francisco de Quito USFQ, Quito, Pichincha, 170901, Ecuador.,Health Research Group, Universidad San Francisco de Quito USFQ, Quito, Pichincha, 170901, Ecuador
| | - Mikaela Camacho
- Escuela de Medicina, Universidad San Francisco de Quito USFQ, Quito, Pichincha, 170901, Ecuador.,Health Research Group, Universidad San Francisco de Quito USFQ, Quito, Pichincha, 170901, Ecuador
| | - María Isabel Viteri
- Escuela de Medicina, Universidad San Francisco de Quito USFQ, Quito, Pichincha, 170901, Ecuador.,Health Research Group, Universidad San Francisco de Quito USFQ, Quito, Pichincha, 170901, Ecuador
| | - Katherine Aguilar
- SISTEMAS MÉDICOS SIME, Universidad San Francisco de Quito USFQ, Quito, Pichincha, 170157, Ecuador
| | - Drifa Belhadi
- Hôpitaux Universitaires Paris Nord Val de Seine (Bichât Claude Bernard), Paris, 75018, France
| | - Vincenzo Bettoli
- Azienda Ospedaliero-Universitaria di Ferrara, Ferrara, 44122, Italy
| | - Anita Del Rocío Buestán
- SISTEMAS MÉDICOS SIME, Universidad San Francisco de Quito USFQ, Quito, Pichincha, 170157, Ecuador
| | - Brigitte Dréno
- Centre Hospitalier Universitaire de Nantes, Nantes, 44000, France
| | - Pablo Endara
- Escuela de Medicina, Universidad San Francisco de Quito USFQ, Quito, Pichincha, 170901, Ecuador
| | - Alison Layton
- Harrogate and District NHS Foundation Trust, Harrogate, HG2 7SX, UK
| | - Nelly Machado
- SISTEMAS MÉDICOS SIME, Universidad San Francisco de Quito USFQ, Quito, Pichincha, 170157, Ecuador
| | - Rosa Mateus
- SISTEMAS MÉDICOS SIME, Universidad San Francisco de Quito USFQ, Quito, Pichincha, 170157, Ecuador
| | - Jerry Tan
- University of Western Ontario, London, N6A 5B9, Canada
| | - Enrique Terán
- Escuela de Medicina, Universidad San Francisco de Quito USFQ, Quito, Pichincha, 170901, Ecuador
| | - Paola Yépez
- Escuela de Medicina, Universidad San Francisco de Quito USFQ, Quito, Pichincha, 170901, Ecuador.,Health Research Group, Universidad San Francisco de Quito USFQ, Quito, Pichincha, 170901, Ecuador
| | - Jonathan Guillemot
- Escuela de Medicina, Universidad San Francisco de Quito USFQ, Quito, Pichincha, 170901, Ecuador.,Health Research Group, Universidad San Francisco de Quito USFQ, Quito, Pichincha, 170901, Ecuador.,SISTEMAS MÉDICOS SIME, Universidad San Francisco de Quito USFQ, Quito, Pichincha, 170157, Ecuador
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Bell KA, Brumfiel CM, Haidari W, Boger L. Trifarotene for the Treatment of Facial and Truncal Acne. Ann Pharmacother 2020; 55:111-116. [PMID: 32567361 DOI: 10.1177/1060028020934892] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE This article reviews clinical trials to assess the efficacy, safety, and clinical application of trifarotene 0.005% cream (Aklief). DATA SOURCES A systematic review of the literature was performed using the terms trifarotene OR Aklief OR CD5789 in MEDLINE (PubMed) and EMBASE databases. Articles prior to May 2020 were considered for inclusion. Bibliographies and ClinicalTrials.gov were also searched to identify further studies. STUDY SELECTION AND DATA EXTRACTION Relevant English language and human studies related to pharmacology, clinical trials, and safety were considered. DATA SYNTHESIS In the 52-week phase III trial, treatment success rates for facial acne (Investigator Global Assessment [IGA] rating of no or almost no acne) and truncal acne (Physician's Global Assessment [PGA] rating of no or almost no acne) were 65.1% and 66.9%, respectively. Overall success rates (IGA and PGA success in the same patient) were 57.9%; 52.8% of patients had a Dermatology Quality of Life Index score of 0 or 1, compared with 22.6% at baseline. Trifarotene was well tolerated, with pruritus, irritation, and sunburn as the most common adverse effects. RELEVANCE TO PATIENT CARE AND CLINICAL PRACTICE Trifarotene is a newly Food and Drug Administration-labeled fourth-generation topical retinoid that shows particular promise in the treatment of facial and truncal acne vulgaris. It is an effective and safe addition to currently available retinoids. CONCLUSION Trifarotene is effective and safe for treatment of facial and truncal acne. Future trials should compare its efficacy and tolerability with that of the older, clinically established retinoids. Despite efficacy, cost may be a prohibitive factor.
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Affiliation(s)
- Katheryn A Bell
- Georgetown University School of Medicine, Washington, DC, USA
| | | | - Wasim Haidari
- Georgetown University School of Medicine, Washington, DC, USA
| | - Laura Boger
- MedStar Washington Hospital Center and MedStar Georgetown University Hospital, Washington, DC, USA
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50
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Ye T, Wu J, Xu Z, Chai J, Zeng Q, Zeng B, Gao Y, Guo R, Chen X, Xu X. Esc-1GN shows therapeutic potentials for acne vulgaris and inflammatory pain. J Pept Sci 2020; 26:e3269. [PMID: 32558003 DOI: 10.1002/psc.3269] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 05/16/2020] [Accepted: 05/25/2020] [Indexed: 02/03/2023]
Abstract
The inflammatory response plays important roles in acne vulgaris and pain pathogenesis. In previous study, Esc-1GN with anti-inflammatory, antimicrobial, and lipopolysacchride (LPS) binding activity was identified from the skin of the frog Hylarana guentheri. Here, we report its therapeutic potentials for acne vulgaris and inflammatory pain. Esc-1GN destroyed the cell membrane of Propionibacteria acnes in the membrane permeability assays. In addition, bacterial agglutination test suggested that Esc-1GN triggered the agglutination of P. acnes, which was affected by LPS and Ca2+ . Meanwhile, in vivo anti-P. acnes and anti-inflammatory effects of Esc-1GN were confirmed by reducing the counts of P. acnes in mice ear, relieving P. acnes-induced mice ear swelling, decreasing mRNA expression and the production of pro-inflammatory cytokines, and attenuating the infiltration of inflammatory cells. Moreover, Esc-1GN also displayed antinociceptive effect in mice induced by acetic acid and formalin. Therefore, Esc-1GN is a promising candidate drug for treatment of acne vulgaris and inflammatory pain.
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Affiliation(s)
- Tiaofei Ye
- Department of Pulmonary and Critical Care Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, 510282, China.,Guangdong Provincial Key Laboratory of New Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou, 510060, China
| | - Jiena Wu
- Guangdong Provincial Key Laboratory of New Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou, 510060, China
| | - Zhengnan Xu
- Guangzhou Zhixin High School, Guangzhou, 510515, China
| | - Jinwei Chai
- Guangdong Provincial Key Laboratory of New Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou, 510060, China
| | - Qingye Zeng
- Guangdong Provincial Key Laboratory of New Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou, 510060, China
| | - Baishuang Zeng
- Guangdong Provincial Key Laboratory of New Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou, 510060, China
| | - Yahua Gao
- Guangdong Provincial Key Laboratory of New Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou, 510060, China
| | - Ruiyin Guo
- Guangdong Provincial Key Laboratory of New Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou, 510060, China
| | - Xin Chen
- Department of Pulmonary and Critical Care Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, 510282, China
| | - Xueqing Xu
- Guangdong Provincial Key Laboratory of New Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou, 510060, China
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