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Frontiers in Public Health 2023Despite a growing body of evidence that acne impacts mental disorders, the actual causality has not been established for the possible presence of recall bias and...
BACKGROUND
Despite a growing body of evidence that acne impacts mental disorders, the actual causality has not been established for the possible presence of recall bias and confounders in observational studies.
METHODS
We performed a two-sample Mendelian randomization (MR) analysis to evaluate the effect of acne on the risk of six common mental disorders, i.e., depression, anxiety, schizophrenia, obsessive-compulsive disorder (OCD), bipolar disorder, and post-traumatic stress disorder (PTSD). We acquired genetic instruments for assessing acne from the largest genome-wide association study (GWAS) of acne ( = 615,396) and collected summary statistics from the largest available GWAS for depression ( = 500,199), anxiety ( = 17,310), schizophrenia ( = 130,644), OCD ( = 9,725), bipolar disorder ( = 413,466), and PTSD ( = 174,659). Next, we performed the two-sample MR analysis using four methods: inverse-variance weighted method, MR-Egger, weighted median, and MR pleiotropy residual sum and outliers. Sensitivity analysis was also performed for heterogeneity and pleiotropy tests.
RESULTS
There was no evidence of a causal impact of acne on the risk of depression [odds ratio (OR): 1.002, = 0.874], anxiety (OR: 0.961, = 0.49), OCD (OR: 0.979, = 0.741), bipolar disorder (OR: 0.972, = 0.261), and PTSD (OR: 1.054, = 0.069). Moreover, a mild protective effect of acne against schizophrenia was observed (OR: 0.944; = 0.033).
CONCLUSION
The increased prevalence of mental disorders observed in patients with acne in clinical practice was caused by modifiable factors, and was not a direct outcome of acne. Therefore, strategies targeting the elimination of potential factors and minimization of the occurrence of adverse mental events in acne should be implemented.
Topics: Humans; Genome-Wide Association Study; Mendelian Randomization Analysis; Anxiety Disorders; Stress Disorders, Post-Traumatic; Acne Vulgaris
PubMed: 37064666
DOI: 10.3389/fpubh.2023.1156522 -
Journal of Drugs in Dermatology : JDD Jun 2022Recent changes to the iPLEDGE platform left providers without the ability to prescribe isotretinoin to their patients. A potential substitute for isotretinoin could be... (Review)
Review
BACKGROUND
Recent changes to the iPLEDGE platform left providers without the ability to prescribe isotretinoin to their patients. A potential substitute for isotretinoin could be beneficial when the drug is unavailable. Prior to the FDA approval of isotretinoin, a vitamin A derivative, vitamin A was studied for its use in acne management.
OBJECTIVE
To review the potential of vitamin A to serve as a substitute for isotretinoin when the latter drug is inaccessible.
METHODS
We conducted a review of published literature from 1931 to 2021, regarding the use of vitamin A in acne treatment, using PubMed and Google Scholar databases. Nine studies were selected after reviewing articles for relevancy to our topic.
RESULTS
Eight out of the 9 studies noted improvement in patients’ acne with vitamin A use. Ranges of doses used were 36,000 I/U daily to 500,000 I/U daily, with 100,000 I/U daily being the most common. Side effects were mainly mucocutaneous in nature.
LIMITATIONS
Many of the trials included in our review were published over 50 years prior and lack standardized components of clinical trials today.
CONCLUSION
Oral vitamin A could potentially serve as a substitute for isotretinoin in acne management for select patients. However, due to its teratogenicity, potential for toxicity, and long half-life, strict monitoring under the care of a medical provider is prudent. Since vitamin A is available without a prescription, strict monitoring cannot be assured, and especially careful patient selection and education would be essential. J Drugs Dermatol. 2022;21(6):683-686. doi:10.36849/JDD.6781.
Topics: Acne Vulgaris; Administration, Oral; Dermatologic Agents; Humans; Isotretinoin; Vitamin A
PubMed: 35674761
DOI: 10.36849/JDD.6781 -
Der Hautarzt; Zeitschrift Fur... Sep 2021Acne vulgaris is one of the most frequent dermatological diseases with a lifetime prevalence of about 85%. The clinical spectrum shows a great variety. Key factors of...
Acne vulgaris is one of the most frequent dermatological diseases with a lifetime prevalence of about 85%. The clinical spectrum shows a great variety. Key factors of pathogenesis are increased sebum production, hyperkeratinization of the follicular infundibulum, inflammatory processes, and a dysbiosis of the skin microbiome. In addition to endogenous factors (e.g., disturbances of the androgen metabolism) or other hormonal changes, exogenous factors (e.g., diet, mechanical irritation or the use of inappropriate cosmetics) can also play an important role. The clinical spectrum is broad, extending from neonatal Acne (A.) to adult A., from comedonal A. to fulminant A., from cosmetic A. to A. excoriée (skin picking disorder). The psychological effects of acne can be profound and can cause a severe reduction in quality of life. Therefore, in addition to an effective therapy with regular medical check-ups and good adherence, it is always necessary to consider psychological aspects.
Topics: Acne Vulgaris; Adult; Humans; Infant, Newborn; Quality of Life; Sebum; Skin; Skin Diseases
PubMed: 34374820
DOI: 10.1007/s00105-021-04856-8 -
Journal of Cosmetic Dermatology Sep 2022Botulin toxin (BTX) is a potent neurotoxin produced by the bacterium Clostridium botulinum, since its approval by FDA in 2002 for cosmetic purpose has been widely used....
BACKGROUND
Botulin toxin (BTX) is a potent neurotoxin produced by the bacterium Clostridium botulinum, since its approval by FDA in 2002 for cosmetic purpose has been widely used. Recent studies indicate that it exerts its activity on various type of skin cells and can be used in some dermatological disease.
OBJECTIVE
The aim of the study was to demonstrate how to use a peculiar dilution of botulinum toxin type A in the treatment of some dermatological disease like mild-to-moderate acne vulgaris and erythematotelangiectatic rosacea.
MATERIAL AND METHODS
50 patients were enrolled, 35 with mild-to-moderate acne and 15 with erythematotelangiectatic rosacea. Both group of patients were treated with a specific dilution of Onabotulinum toxin A called Microbotox. Patient images were taken before and 4 weeks after the treatment.
RESULTS
The authors and patients were extremely satisfied with their treatments. There were no immediate or delayed complication in none of both group of patients.
CONCLUSION
Botulinum toxin shows a great promise either in dermatological disease like mild-to-moderate acne vulgaris and erythematotelangiectatic rosacea. Microbotox appears to be a valid, long-lasting, and a standardized approach to treat these kind of two disease.
Topics: Acne Vulgaris; Botulinum Toxins, Type A; Cosmetic Techniques; Humans; Neurotoxins; Rosacea
PubMed: 35312149
DOI: 10.1111/jocd.14692 -
Dermatologic Therapy Apr 2022Acne vulgaris is one of the most common dermatologic complaints. Recently, isotretinoin has been used as an off-label indication for the treatment of mild-to-moderate... (Meta-Analysis)
Meta-Analysis Review
Acne vulgaris is one of the most common dermatologic complaints. Recently, isotretinoin has been used as an off-label indication for the treatment of mild-to-moderate grades of acne not responding to conventional treatment. Its conventional recommended dose is 0.5-1.0 mg/kg per day to the cumulative dose of 120-150 mg/kg. To qualify the state of evidence and analyze the efficacy of the low-daily dose and the pulsed doses of isotretinoin in treating mild-to-moderate acne patients with regards to response and relapse rates. Systematic review and meta-analysis using an electronic literature search were performed. The 320 potentially relevant articles were included and reviewed. The level of evidence is moderate to low as conducted by the GRADE quality of evidence assessment. The pooled statistical estimate for response to treatment in the group comparing low-daily doses with conventional dose showed an overall benefit for conventional dose. On the other hand, pooled data from the group comparing the low-daily dose with the pulsed doses yielded an overall beneficial effect from using the low-daily dose compared with the pulsed doses on achieving the response. Given all of the available studies, the quality of evidence is low. It appears that conventional dose isotretinoin improves the odds of prolonged remission in adults with mild-to-moderate acne vulgaris compared to the low doses.
Topics: Acne Vulgaris; Administration, Oral; Adult; Dermatologic Agents; Humans; Isotretinoin; Recurrence
PubMed: 35000295
DOI: 10.1111/dth.15311 -
Skin Research and Technology : Official... Jun 2023Acne scar is a persistent complication of acne vulgaris. However, the prevalence and risk factors are still unclear. This study aimed to assess the global prevalence and...
BACKGROUND
Acne scar is a persistent complication of acne vulgaris. However, the prevalence and risk factors are still unclear. This study aimed to assess the global prevalence and risk factors of acne scars in patients with acne.
MATERIALS AND METHODS
A systematic search of published studies in three databases was performed and the meta-analyses were conducted.
RESULTS
Finally, we included 37 studies involving 24 649 acne patients. And, the pooled prevalence of acne scars in these patients was 47% (95% confidence interval [CI]: 38-56%). Besides, the differences in prevalence were observed based on the subgroup analysis for age, gender, acne severity, source of patients, and so on. Subsequently, we quantified the relationship of three risk factors with acne scars: male gender (odds ratio [OR]: 1.58, 95% CI: 1.19-2.09), positive family history of acne (OR: 2.73, 95% CI: 1.26-5.91), and acne severity (OR for moderate acne: 2.34, 95% CI: 1.54-3.57; OR for severe acne: 5.51, 95% CI: 2.45-12.41).
CONCLUSION
Herein, we found that 47% of acne patients suffered from acne scars and identified three risk factors: male gender, positive family history of acne, and acne severity. In order to reduce acne scarring, attention and effective therapy early in the course of acne is important.
Topics: Humans; Male; Acne Vulgaris; Cicatrix; Prevalence; Risk Factors; Treatment Outcome
PubMed: 37357642
DOI: 10.1111/srt.13386 -
Actas Dermo-sifiliograficas Oct 2023Acne fulminans is a severe and rare form of inflammatory acne. Lesion severity and subsequent scarring has a negative impact on the patient's quality of life. We... (Review)
Review
Acne fulminans is a severe and rare form of inflammatory acne. Lesion severity and subsequent scarring has a negative impact on the patient's quality of life. We conducted a narrative review of the literature on acne fulminans based on a search for relevant English- and Spanish-language articles published in Medline. We included case reports and case series. The main aim was to describe the clinical and demographic characteristics of patients with acne fulminans. A secondary aim was to determine whether quality of life was affected by the site or extent of lesions. We reviewed 91 articles describing 212 cases of acne fulminans. The mean age of the patients (91.94% male) was 16.6 years. A personal and family history of acne vulgaris was reported for 97.63% and 54.90% of patients, respectively. A trigger was identified in 44.79% of cases. The main cause was pharmacologic (96.63%) and the main drug isotretinoin (65.28%). The sites most often affected were the face (89.31%), the posterior trunk (77.86%), and the anterior trunk (74.81%). The predominant disease subtype was acne fulminans with systemic symptoms (59.12%), which were mostly general (97.06%). Systemic corticosteroids were the most widely used treatment (81.03%). The impact of the disease on quality of life was reported for 2 patients. In conclusion, acne fulminans mainly affects the face and trunk of male adolescents with a history of acne vulgaris. The main subtype was acne fulminans with systemic symptoms, and most patients were treated with systemic corticosteroids. The effect of acne fulminans on quality of life is underreported.
Topics: Adolescent; Humans; Male; Female; Quality of Life; Acne Vulgaris; Isotretinoin; Adrenal Cortex Hormones
PubMed: 37245603
DOI: 10.1016/j.ad.2023.05.018 -
The Medical Letter on Drugs and... Feb 2024
Topics: Humans; Acne Vulgaris
PubMed: 38294764
DOI: 10.58347/tml.2024.1695a -
Clinical and Experimental Dermatology Dec 2020Current acne treatments present several limitations, posing the need for new effective therapies for long-term administration for recalcitrant or relapsing acne. Key... (Review)
Review
Current acne treatments present several limitations, posing the need for new effective therapies for long-term administration for recalcitrant or relapsing acne. Key players in acne that may emerge as targets for future acne treatments include the cutaneous loss of diversity of Cutibacterium (formerly Propionibacterium) acnes phylotypes and the insulin-like growth factor-1 signalling pathway. New data about the loss of diversity of microbiota in acne provides the rationale for the potential use of oral or topical probiotics. Another therapeutic approach to modulate the microbiota could be topical formulation of C. acnes bacteriophages to target specifically the pathogenic 'acnegenic' C. acnes phylotypes. Insulin-sensitizing agents such as metformin, myo-inositol and d-chiro-inositol represent promising agents, but to date there have been only limited studies and much heterogeneity in the methods of assessing acne efficacy outcomes. Moving towards a holistic approach for patients with acne is the future, by taking into account both internal and external factors, such as pollution, stress, acne family history, age, smoking habits and diet, and addressing quality of life and the psychological impact of acne.
Topics: Acne Vulgaris; Administration, Oral; Administration, Topical; Age Factors; Environmental Pollution; Female; Humans; Insulin Resistance; Insulin-Like Growth Factor I; Life Style; Male; Medical History Taking; Microbiota; Probiotics; Propionibacterium acnes; Quality of Life; Secondary Prevention; Stress, Psychological
PubMed: 32412672
DOI: 10.1111/ced.14239 -
Advances in Experimental Medicine and... 2022Acne vulgaris results from a complex interaction between environment and genetic factors. While colonization of the pilosebaceous unit with Propionibacterium was...
Acne vulgaris results from a complex interaction between environment and genetic factors. While colonization of the pilosebaceous unit with Propionibacterium was previously considered to be the main cause of acne, the contribution of host-related factors that allow the growth of the bacteria and its immune response against bacterial components are now considered to be more important. Many of these host characteristics have a genetic base that is either involved in the regulation of the immune responses or the steroid hormones metabolisms. This chapter aims to explore the functions of these genes and their role in the pathogenesis of acne.
Topics: Acne Vulgaris; Humans; Immunogenetics; Propionibacterium acnes; Skin
PubMed: 35286695
DOI: 10.1007/978-3-030-92616-8_6