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Pietrangelo L, Magnifico I, Guerrera A, Cutuli MA, Petronio GP, Venditti N, Covelli M, Buccieri N, Garofalo S, Di Marco R. LimpiAD foam and the potential control of the pressure ulcers onset. Biomed Pharmacother 2021; 144:112327. [PMID: 34653756 DOI: 10.1016/j.biopha.2021.112327] [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: 08/11/2021] [Revised: 10/07/2021] [Accepted: 10/08/2021] [Indexed: 10/20/2022] Open
Abstract
Pressure ulcers development is an undesirable event that often worsens the clinical condition of patients already affected by severe pathologies. Since the aetiology of this clinical complication is unclear yet, at current the primary approach to treat the problem is the adoption of suitable patients' assistance procedures. At the same time, the research focuses on finding medicaments or treatment strategies that could prevent the lesions and/or accelerate their healing. The international market's wide range of cosmetic/pharmaceuticals products is mainly topical preparations based on emollient agents to preserve or restore skin homeostasis. On the other hand, the skin microbiome's implication in the pressure ulcers occurrence is mainly unknown. Based on these assumptions, here we tested an innovative preparation, the LimpiAD foam, as a potential preventive strategy of pressure ulcers onset. The active component of this product is composed of hyaluronic acid conjugated with a bacterial cell wall fragment of C. acnes DSM 28251. For LimpiAD foam, we hypothesised a combined action of the two components on the skin tissue, an emollient effect due to the hyaluronic acid properties together with a modulatory effect on the skin microbiota carried out by the component of bacterial derivation. Our results supported the hypothesis and suggested a potential role of LimpiAD foam in pressure ulcers prevention.
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Affiliation(s)
- Laura Pietrangelo
- Università degli Studi del Molise, Dipartimento di Medicina e Scienze della Salute "V. Tiberio", Campobasso, Italy.
| | - Irene Magnifico
- Università degli Studi del Molise, Dipartimento di Medicina e Scienze della Salute "V. Tiberio", Campobasso, Italy.
| | - Antonella Guerrera
- Università degli Studi del Molise, Dipartimento di Medicina e Scienze della Salute "V. Tiberio", Campobasso, Italy.
| | - Marco Alfio Cutuli
- Università degli Studi del Molise, Dipartimento di Medicina e Scienze della Salute "V. Tiberio", Campobasso, Italy.
| | - Giulio Petronio Petronio
- Università degli Studi del Molise, Dipartimento di Medicina e Scienze della Salute "V. Tiberio", Campobasso, Italy.
| | - Noemi Venditti
- Università degli Studi del Molise, Dipartimento di Medicina e Scienze della Salute "V. Tiberio", Campobasso, Italy.
| | - Matteo Covelli
- Gea Medica srl, Istituto Europeo di Riabilitazione, Isernia, Italy.
| | | | - Silvio Garofalo
- Università degli Studi del Molise, Dipartimento di Medicina e Scienze della Salute "V. Tiberio", Campobasso, Italy; UOC Laboratorio Analisi P.O. "A. Cardarelli", Campobasso, Italy.
| | - Roberto Di Marco
- Università degli Studi del Molise, Dipartimento di Medicina e Scienze della Salute "V. Tiberio", Campobasso, Italy.
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Fuchs CSK, Ortner VK, Hansen FS, Philipsen PA, Haedersdal M. Subclinical effects of adapalene-benzoyl peroxide: a prospective in vivo imaging study on acne micromorphology and transfollicular delivery. J Eur Acad Dermatol Venereol 2021; 35:1377-1385. [PMID: 33508886 DOI: 10.1111/jdv.17140] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 01/14/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND Adapalene-benzoyl peroxide (A-BPO) is a first-line topical treatment for acne vulgaris. In vivo reflectance confocal microscopy (RCM) and optical coherence tomography (OCT) detect micromorphological changes over time and visualize transfollicular delivery. OBJECTIVES To visualize temporal, subclinical effects of A-BPO on acne micromorphology using RCM and OCT, and evaluate their impact on transfollicular delivery of microparticulate carrier systems. METHODS Fifteen patients with mild to moderate acne received a 6-week course of A-BPO. Micromorphological changes were evaluated at time 0, 3 and 6 weeks with RCM (n = 1190 images) and OCT (n = 210 scans). Transfollicular delivery of microparticles was assessed at baseline and week 6. RESULTS In vivo imaging visualized steady normalization of skin micromorphology in response to A-BPO over 6 weeks, including decreased hyperkeratinization of follicular borders (RCM median decrease -71.2%, P < 0.05), reduced intrafollicular keratinous content (RCM median decrease -47.7%, P < 0.05) and increased epidermal thickness (OCT median increase of 25.25%, P < 0.05). Imaging visualized microparticles in the follicular unit. Despite a visible reduction in keratin and sebum, transfollicular microparticle delivery appeared unaffected. CONCLUSIONS Reflectance confocal microscopy and OCT detect A-BPO-induced changes in micromorphology and visualize transfollicular microparticle delivery. Keratolysis and sebolysis did not have a measurable effect on transfollicular delivery of microparticles.
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Affiliation(s)
- C S K Fuchs
- Department of Dermatology, University of Copenhagen, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
| | - V K Ortner
- Department of Dermatology, University of Copenhagen, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
| | - F S Hansen
- Department of Dermatology, University of Copenhagen, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
| | - P A Philipsen
- Department of Dermatology, University of Copenhagen, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
| | - M Haedersdal
- Department of Dermatology, University of Copenhagen, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
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Rusu A, Tanase C, Pascu GA, Todoran N. Recent Advances Regarding the Therapeutic Potential of Adapalene. Pharmaceuticals (Basel) 2020; 13:E217. [PMID: 32872149 PMCID: PMC7558148 DOI: 10.3390/ph13090217] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 08/26/2020] [Accepted: 08/26/2020] [Indexed: 12/12/2022] Open
Abstract
Adapalene (ADP) is a representative of the third retinoids generation and successfully used in first-line acne treatment. ADP binds to retinoic acid nuclear receptors. The comedolytic, anti-inflammatory, antiproliferative, and immunomodulatory are the known ADP effects. Its safety profile is an advantage over other retinoids. ADP recently was found to be effective in the treatment of several dermatological diseases and photoaging besides the utility in the treatment of acne vulgaris. New biological effects of adapalene with therapeutic potential are highlighted in this review paper. Thus, adapalene could be a valuable therapeutic drug into the treatment of several types of cancer. Additionally, some neurodegenerative diseases could be treated with a suitable formulation for intravenous administration. The antibacterial activity against methicillin-resistant Staphylococcus aureus of an analogue of ADP has been proven. In different therapeutic schemes, ADP is more effective in combination with other active substances. New topical combinations with adapalene include ketoconazole (antifungal), mometasone furoate (anti-inflammatory corticosteroid), nadifloxacin (fluoroquinolone), and alfa and beta hydroxy acids. Combination with oral drugs is a new trend that enhances the properties of topical formulations with adapalene. Several studies have investigated the effects of ADP in co-administration with azithromycin, doxycycline, faropenem, isotretinoin, and valganciclovir. Innovative formulations of ADP also aim to achieve a better bioavailability, increased efficacy, and reduced side effects. In this review, we have highlighted the current studies on adapalene regarding biological effects useful in various treatment types. Adapalene has not been exploited yet to its full biological potential.
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Affiliation(s)
- Aura Rusu
- Pharmaceutical and Therapeutical Chemistry Department, Faculty of Pharmacy, George Emil Palade, University of Medicine, Pharmacy, Science and Technology of Târgu Mureş, 540139 Târgu Mureş, Romania;
| | - Corneliu Tanase
- Pharmaceutical Botany Department, Faculty of Pharmacy, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureş, 540139 Târgu Mureş, Romania
| | | | - Nicoleta Todoran
- Pharmaceutical Technology and Cosmetology, Faculty of Pharmacy, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureş, 540139 Târgu Mureş, Romania;
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Abstract
BACKGROUND Acne is a common, economically burdensome condition that can cause psychological harm and, potentially, scarring. Topical benzoyl peroxide (BPO) is a widely used acne treatment; however, its efficacy and safety have not been clearly evaluated. OBJECTIVES To assess the effects of BPO for acne. SEARCH METHODS We searched the following databases up to February 2019: the Cochrane Skin Specialised Register, CENTRAL, MEDLINE, Embase, and LILACS. We also searched five trials registers and checked the reference lists of relevant randomised controlled trials (RCTs) and systematic reviews. SELECTION CRITERIA We included RCTs that compared topical BPO used alone (including different formulations and concentrations of BPO) or as part of combination treatment against placebo, no treatment, or other active topical medications for clinically diagnosed acne (used alone or in combination with other topical drugs not containing BPO) on the face or trunk. DATA COLLECTION AND ANALYSIS We used standard methodological procedures as expected by Cochrane. Primary outcome measures were 'participant global self-assessment of acne improvement' and 'withdrawal due to adverse events in the whole course of a trial'. 'Percentage of participants experiencing any adverse event in the whole course of a trial' was a key secondary outcome. MAIN RESULTS We included 120 trials (29,592 participants randomised in 116 trials; in four trials the number of randomised participants was unclear). Ninety-one studies included males and females. When reported, 72 trials included participants with mild to moderate acne, 26 included participants with severe acne, and the mean age of participants ranged from 18 to 30 years. Our included trials assessed BPO as monotherapy, as add-on treatment, or combined with other active treatments, as well as BPO of different concentrations and BPO delivered through different vehicles. Comparators included different concentrations or formulations of BPO, placebo, no treatment, or other active treatments given alone or combined. Treatment duration in 80 trials was longer than eight weeks and was only up to 12 weeks in 108 trials. Industry funded 50 trials; 63 trials did not report funding. We commonly found high or unclear risk of performance, detection, or attrition bias. Trial setting was under-reported but included hospitals, medical centres/departments, clinics, general practices, and student health centres. We reported on outcomes assessed at the end of treatment, and we classified treatment periods as short-term (two to four weeks), medium-term (five to eight weeks), or long-term (longer than eight weeks). For 'participant-reported acne improvement', BPO may be more effective than placebo or no treatment (risk ratio (RR) 1.27, 95% confidence interval (CI) 1.12 to 1.45; 3 RCTs; 2234 participants; treatment for 10 to 12 weeks; low-certainty evidence). Based on low-certainty evidence, there may be little to no difference between BPO and adapalene (RR 0.99, 95% CI 0.90 to 1.10; 5 RCTs; 1472 participants; treatment for 11 to 12 weeks) or between BPO and clindamycin (RR 0.95, 95% CI 0.68 to 1.34; 1 RCT; 240 participants; treatment for 10 weeks) (outcome not reported for BPO versus erythromycin or salicylic acid). For 'withdrawal due to adverse effects', risk of treatment discontinuation may be higher with BPO compared with placebo or no treatment (RR 2.13, 95% CI 1.55 to 2.93; 24 RCTs; 13,744 participants; treatment for 10 to 12 weeks; low-certainty evidence); the most common causes of withdrawal were erythema, pruritus, and skin burning. Only very low-certainty evidence was available for the following comparisons: BPO versus adapalene (RR 1.85, 95% CI 0.94 to 3.64; 11 RCTs; 3295 participants; treatment for 11 to 24 weeks; causes of withdrawal not clear), BPO versus clindamycin (RR 1.93, 95% CI 0.90 to 4.11; 8 RCTs; 3330 participants; treatment for 10 to 12 weeks; causes of withdrawal included local hypersensitivity, pruritus, erythema, face oedema, rash, and skin burning), erythromycin (RR 1.00, 95% CI 0.07 to 15.26; 1 RCT; 60 participants; treatment for 8 weeks; withdrawal due to dermatitis), and salicylic acid (no participants had adverse event-related withdrawal; 1 RCT; 59 participants; treatment for 12 weeks). There may be little to no difference between these groups in terms of withdrawal; however, we are unsure of the results because the evidence is of very low certainty. For 'proportion of participants experiencing any adverse event', very low-certainty evidence leaves us uncertain about whether BPO increased adverse events when compared with placebo or no treatment (RR 1.40, 95% CI 1.15 to 1.70; 21 RCTs; 11,028 participants; treatment for 10 to 12 weeks), with adapalene (RR 0.71, 95% CI 0.50 to 1.00; 7 RCTs; 2120 participants; treatment for 11 to 24 weeks), with erythromycin (no participants reported any adverse events; 1 RCT; 89 participants; treatment for 10 weeks), or with salicylic acid (RR 4.77, 95% CI 0.24 to 93.67; 1 RCT; 41 participants; treatment for 6 weeks). Moderate-certainty evidence shows that the risk of adverse events may be increased for BPO versus clindamycin (RR 1.24, 95% CI 0.97 to 1.58; 6 RCTs; 3018 participants; treatment for 10 to 12 weeks); however, the 95% CI indicates that BPO might make little to no difference. Most reported adverse events were mild to moderate, and local dryness, irritation, dermatitis, erythema, application site pain, and pruritus were the most common. AUTHORS' CONCLUSIONS Current evidence suggests that BPO as monotherapy or add-on treatment may be more effective than placebo or no treatment for improving acne, and there may be little to no difference between BPO and either adapalene or clindamycin. Our key efficacy evidence is based on participant self-assessment; trials of BPO versus erythromycin or salicylic acid did not report this outcome. For adverse effects, the evidence is very uncertain regarding BPO compared with adapalene, erythromycin, or salicylic acid. However, risk of treatment discontinuation may be higher with BPO compared with placebo or no treatment. Withdrawal may be linked to tolerability rather than to safety. Risk of mild to moderate adverse events may be higher with BPO compared with clindamycin. Further trials should assess the comparative effects of different preparations or concentrations of BPO and combination BPO versus monotherapy. These trials should fully assess and report adverse effects and patient-reported outcomes measured on a standardised scale.
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Affiliation(s)
- Zhirong Yang
- School of Clinical Medicine, University of CambridgePrimary Care Unit, Department of Public Health and Primary CareStrangeways Research Laboratory, 2 Worts’ CausewayCambridgeUKCB1 8RN
- School of Public Health, Peking UniversityCentre for Evidence Based Medicine and Clinical Research, Department of Epidemiology and BiostatisticsBeijingChina100191
| | - Yuan Zhang
- McMaster UniversityDepartment of Health Research Methods, Evidence, and Impact1280 Main Street WestHamiltonONCanadaL8S 4K1
| | - Elvira Lazic Mosler
- Catholic University of CroatiaDepartment of NursingIlica 242ZagrebCroatia10000
- General Hospital "Dr. Ivo Pedišić"Department for Dermatology and VenereologyJ.J. Strossmayera 59SisakCroatia44000
| | - Jing Hu
- School of Public Health, Peking UniversityCentre for Evidence Based Medicine and Clinical Research, Department of Epidemiology and BiostatisticsBeijingChina100191
| | - Hang Li
- Peking University First HospitalDepartment of Dermatology and Venereology8 Xishiku Main StreetBeijingXicheng DistrictChina100034
- Beijing Key Laboratory of Molecular Diagnosis on DermatosesBeijingChina
- National Clinical Research Center for Skin and Immune DiseasesBeijingChina
| | - Yanchang Zhang
- Yale School of Public HealthDepartment of Chronic Disease Epidemiology367 Cedar ST RM 704New HavenConnecticutUSA06510
| | - Jia Liu
- Xuanwu Hospital, Capital Medical UniversityDepartment of NeurologyChangchun Street 45BeijingChina100053
| | - Qian Zhang
- The University of Nottinghamc/o Cochrane Skin GroupA103, King's Meadow CampusLenton LaneNottinghamUKNG7 2NR
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Dreno B, Tan J, Rivier M, Martel P, Bissonnette R. Adapalene 0.1%/benzoyl peroxide 2.5% gel reduces the risk of atrophic scar formation in moderate inflammatory acne: a split-face randomized controlled trial. J Eur Acad Dermatol Venereol 2016; 31:737-742. [DOI: 10.1111/jdv.14026] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Accepted: 10/18/2016] [Indexed: 01/12/2023]
Affiliation(s)
| | - J. Tan
- Windsor Clinical Research Inc. and Western University; Windsor ON Canada
| | - M. Rivier
- Galderma R&D; Sophia Antipolis France
| | - P. Martel
- Galderma R&D; Sophia Antipolis France
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Dréno B, Araviiskaia E, Berardesca E, Gontijo G, Sanchez Viera M, Xiang LF, Martin R, Bieber T. Microbiome in healthy skin, update for dermatologists. J Eur Acad Dermatol Venereol 2016; 30:2038-2047. [PMID: 27735094 PMCID: PMC6084363 DOI: 10.1111/jdv.13965] [Citation(s) in RCA: 129] [Impact Index Per Article: 16.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Accepted: 08/04/2016] [Indexed: 12/19/2022]
Abstract
The skin is a complex barrier organ made of a symbiotic relationship between microbial communities and host tissue via complex signals provided by the innate and the adaptive immune systems. It is constantly exposed to various endogenous and exogenous factors which impact this balanced system potentially leading to inflammatory skin conditions comprising infections, allergies or autoimmune diseases. Unlike the gut and stool microbiome which has been studied and described for many years, investigations on the skin or scalp microbiome only started recently. Researchers in microbiology and dermatology started using modern methods such as pyrosequencing assays of bacterial 16S rRNA genes to identify and characterize the different microorganisms present on the skin, to evaluate the bacterial diversity and their relative abundance and to understand how microbial diversity may contribute to skin health and dermatological conditions. This article aims to provide an overview on the knowledge about the skin microbiota, the microbiome and their importance in dermatology.
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Affiliation(s)
- B Dréno
- Department of Dermato-cancerology, Nantes University, Nantes, France
| | - E Araviiskaia
- Department of Dermatology, First Pavlov State Medical University of St. Petersburg, St. Petersburg, Russia
| | - E Berardesca
- San Gallicano Dermatological Institute, Rome, Italy
| | - G Gontijo
- Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - M Sanchez Viera
- Institute for Dermatology, Skin Health, Aging and Cancer, Madrid, Spain
| | - L F Xiang
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - R Martin
- L'Oréal Research and Innovation, Tours, France
| | - T Bieber
- Department of Dermatology and Allergy, University Medical Center, Bonn, Germany
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7
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Inhibitory effect of imperatorin on insulin-like growth factor-1-induced sebum production in human sebocytes cultured in vitro. Life Sci 2016; 144:49-53. [DOI: 10.1016/j.lfs.2015.11.027] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Revised: 11/17/2015] [Accepted: 11/25/2015] [Indexed: 01/06/2023]
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8
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Kaur J, Sehgal VK, Gupta AK, Singh SP. A comparative study to evaluate the efficacy and safety of combination topical preparations in acne vulgaris. Int J Appl Basic Med Res 2015; 5:106-10. [PMID: 26097817 PMCID: PMC4456883 DOI: 10.4103/2229-516x.157155] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Accepted: 01/12/2015] [Indexed: 11/18/2022] Open
Abstract
Background: The combinations of topical keratolytics with anti-microbials and topical retinoids with antimicrobials are commonly prescribed in the treatment of acne. Aim: The present study was undertaken with the aim of comparing the efficacy and safety of topical benzoyl peroxide and clindamycin versus topical benzoyl peroxide and nadifloxacin versus topical tretinoin and clindamycin in patients of acne vulgaris. Materials and Methods: 100 patients between 15 and 35 years having ≥2 and ≤30 inflammatory and/or noninflammatory lesions with Investigator's Global Assessment (IGA) score 2/3 were randomly divided into 3 groups. Group A was prescribed benzoyl peroxide 2.5% gel and clindamycin 1% gel, Group B was prescribed benzoyl peroxide 2.5% gel and nadifloxacin 1% cream and Group C was prescribed tretinoin 0.025% and clindamycin 1% gel. Total number of lesions and adverse effects during the treatment were assessed at 0, 4, 8, 12 weeks with IGA score. Results: There was statistically significant reduction in total number of lesions with better improvement in Group A. Adverse drug reactions during the study showed a better safety profile of Group B which is found to be statistically significant also. Conclusion: These findings confirm that Group A is more efficacious and Group B is safest among the other two groups.
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Affiliation(s)
- Jasleen Kaur
- Department of Pharmacology, Government Medical College, Patiala, Punjab, India
| | - Vijay K Sehgal
- Department of Pharmacology, Government Medical College, Patiala, Punjab, India
| | - Anita K Gupta
- Department of Pharmacology, Government Medical College, Patiala, Punjab, India
| | - Surinder P Singh
- Department of Dermatology and Venereal Diseases, Rajindra Hospital, Government Medical College, Patiala, Punjab, India
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Gollnick H, Friedrich M, Peschen M, Pettker R, Pier A, Streit V, Jöstingmeyer P, Porombka D, Rojo Pulido I, Jäckel A. Safety and efficacy of adapalene 0.1% / benzoyl peroxide 2.5% in the long-term treatment of predominantly moderate acne with or without concomitant medication - results from the non-interventional cohort study ELANG. J Eur Acad Dermatol Venereol 2015; 29 Suppl 4:15-22. [DOI: 10.1111/jdv.13194] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2015] [Accepted: 04/07/2015] [Indexed: 12/15/2022]
Affiliation(s)
- H.P.M. Gollnick
- Department of Venerology and Dermatology; Otto-von-Guericke University; Magdeburg Germany
| | - M. Friedrich
- Dermatologist in Private Practice; Oranienburg Germany
| | - M. Peschen
- Dermatologist in Private Practice; Freiburg Germany
| | - R. Pettker
- Dermatologist in Private Practice; Berlin Germany
| | - A. Pier
- Dermatologist in Private Practice; Lippstadt Germany
| | - V. Streit
- Dermatologist in Private Practice; Buchholz in der Nordheide Germany
| | | | - D. Porombka
- Galderma Laboratorium GmbH; Düsseldorf Germany
| | | | - A. Jäckel
- Galderma Laboratorium GmbH; Düsseldorf Germany
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Leccia MT, Auffret N, Poli F, Claudel JP, Corvec S, Dreno B. Topical acne treatments in Europe and the issue of antimicrobial resistance. J Eur Acad Dermatol Venereol 2015; 29:1485-92. [PMID: 25677763 DOI: 10.1111/jdv.12989] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2014] [Accepted: 01/06/2015] [Indexed: 12/31/2022]
Abstract
Acne vulgaris (acne) is a chronic inflammatory disease of the sebaceous gland, characterized by follicular hyperkeratinization, excessive colonization by Propionibacterium acnes (P. acnes) as well as immune reactions and inflammation. Despite an armamentarium of topical treatments available including benzoyl peroxide, retinoids and azelaic acid, topical antibiotics in monotherapies, especially erythromycin and clindamycin, are still used in Europe to treat acne. This intensive use led to antimicrobial-resistant P. acnes and staphylococci strains becoming one of the main health issues worldwide. This is an update on the current topical acne treatments available in Europe, their mechanism of action, their potential to induce antimicrobial resistance and their clinical efficacy and safety.
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Affiliation(s)
- M T Leccia
- Clinique de Dermatologie, Allergologie et Photobiologie, CHU A Michallon, Grenoble, France
| | - N Auffret
- Hôpital Européen Georges Pompidou, Paris, France
| | - F Poli
- Hôpital Européen Georges Pompidou, Paris, France
| | | | - S Corvec
- Institut de Biologie des Hôpitaux de Nantes, Service de Bactériologie-Hygiène, CHU de Nantes, Nantes, France
| | - B Dreno
- Clinique de Dermatologie, University Hospital, Nantes, France
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Abstract
INTRODUCTION Acne is the most common skin condition in the US. The mainstay of acne therapy includes: topical retinoids, topical antibiotics, benzoyl peroxide (BP), and oral isotretinoin for severe cases. Although these treatment options are highly effective they do have certain drawbacks. Current acne treatment regimens often require patients to use multiple medications, some of which may have irritating side effects. Furthermore, Propionibacterium acnes resistance to antibiotics has become an increasing problem due to the rise in antibiotic use. AREAS COVERED New therapies that have either been released onto the market or that are being developed include: adapalene-BP combination agent, dapsone 5% gel, minocycline foam, topical nitric oxide-releasing agent, cortexolone 17 α-propionate, and CIP isotretinoin. Some of these new therapies address the challenges faced with existing treatment options. For instance, the relatively new combination therapy, adapalene-BP, limits antibiotic resistance and also helps simplify treatment regimens. The newly developed topical nitric oxide-releasing agent also holds potential in limiting antibiotic resistance. EXPERT OPINION Many of the new therapies discussed in this paper are still in early stages of testing so it is difficult to predict their outlook; however, based on preliminary findings, these therapies seem to be promising.
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Affiliation(s)
- Imran Aslam
- Wake Forest School of Medicine, Center for Dermatology Research, Department of Dermatology, Medical Center Boulevard , Winston-Salem, NC 27157-1071 , USA
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