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Expert Review of Clinical Pharmacology Jun 2021: Acne is a chronic, inflammatory, and immune-mediated disease of the pilosebaceous unit, highly prevalent in adolescents. However, an increasing number of adults over... (Review)
Review
: Acne is a chronic, inflammatory, and immune-mediated disease of the pilosebaceous unit, highly prevalent in adolescents. However, an increasing number of adults over 25 years old with facial acne, particularly women, have been observed. It is considered a different disease when compared to acne vulgaris. Face is the mainly involved area with inflammatory lesions and more sensitive skin, pointing out the need of a holistic approach.: We performed a comprehensive literature search on PubMed database, up to January 2021, regarding adult female acne. We synthesized data about pathogenesis; differences compared to acne vulgaris; and treatment, with focus in the management challenges and perspectives.: It is essential to value the negative impact on quality of life of adult female acne, independently of severity. The disease has prolonged evolution, and patient might be resilient once the improvement, regardless of the treatment option, will just be noticeable after 3 months. Aggravating factors should be clearly discussed, such as the need of changing many habits, especially lesions manipulation. The therapeutic regimen includes make-up and tailored skin care (considering proneness to sensitivity), while anti-acne drugs should be chosen in accordance with desire to be pregnant, presence of pregnancy or breastfeeding.
Topics: Acne Vulgaris; Adult; Animals; Cosmetics; Dermatologic Agents; Female; Humans; Quality of Life; Severity of Illness Index; Skin Care; Time Factors
PubMed: 33957838
DOI: 10.1080/17512433.2021.1917376 -
Acta Dermato-venereologica Sep 2023Body dysmorphic disorder is a mental health disorder characterized by a preoccupation with a perceived flaw, which is commonly seen among dermatology patients. The...
Body dysmorphic disorder is a mental health disorder characterized by a preoccupation with a perceived flaw, which is commonly seen among dermatology patients. The objective of this study was to determine the frequency of body dysmorphic disorder and assess self-esteem among a clinical sample of adolescents and young adults being managed for acne vulgaris. A total of 105 patients, age range 13-24 years, receiving acne treatment at 1 of 2 dermatology outpatient clinic were included. A self-report questionnaire was used, which included a body dysmorphic disorder screening tool (based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) diagnostic criteria) and the Rosenberg Self-Esteem Scale (RSES). Acne was graded with the Cook's acne grading scale. Out of 105 adolescents and young adults visiting a dermatologist due to acne, 13 (12.4%) screened positive for body dysmorphic disorder (95% confidence interval (95% CI) 6.8-20.2%). Patients with body dysmorphic disorder were more likely to have female gender (p = 0.020) and had lower self-esteem (RSES 15.8 vs 20.5, respectively, p = 0.013) compared with patients without body dysmorphic disorder. No differences were found in the frequency of body dysmorphic disorder with DSM-IV or DSM-5 criteria. This is the first study to report on the frequency of body dysmorphic disorder and self-esteem in adolescents and young adults with acne. Ultimately, more awareness of body dysmorphic disorder among adolescents and young adults presenting with dermatological disorders could lead to more rapid recognition and referral to psychiatric units.
Topics: Humans; Adolescent; Female; Young Adult; Adult; Body Dysmorphic Disorders; Acne Vulgaris; Referral and Consultation; Self Concept; Self Report
PubMed: 37707293
DOI: 10.2340/actadv.v103.6232 -
Dermatology (Basel, Switzerland) 2021Acne is a common condition. Sometimes acne or acne-like features are a part of autoinflammatory diseases such as PAPA spectrum disorders. Our objective wasto determine... (Review)
Review
BACKGROUND
Acne is a common condition. Sometimes acne or acne-like features are a part of autoinflammatory diseases such as PAPA spectrum disorders. Our objective wasto determine whether acne in PAPA spectrum disorders has specific phenotypic traits.
SUMMARY
This is aliterature review on reported cases of patients with PAPA, PAMI, PASH, PAPASH, PsAPASH, PAC or PASS syndrome. Acne was classified into four categories: moderate, severe, nodulocystic, acne fulminans.One hundred patients were included. Age of onset of acne and topography were the same as in acne vulgaris. Acne's phenotype was at least severe (including acne fulminans, nodulocystic and severe) in 83% of cases. Genetic mutations or variants with potential pathological significance were reported in 49 patients. The addition of isotretinoin to biotherapies was required to control acne in several patients.
Topics: Acne Vulgaris; Anti-Inflammatory Agents; Arthritis, Infectious; Dermatologic Agents; Diagnosis, Differential; Humans; Pyoderma Gangrenosum
PubMed: 32937626
DOI: 10.1159/000509874 -
Journal of Drugs in Dermatology : JDD Jul 2021Acne vulgaris is among the most common dermatologic diagnoses observed, including skin color (SOC) populations. This project sought to help clarify the existing...
BACKGROUND
Acne vulgaris is among the most common dermatologic diagnoses observed, including skin color (SOC) populations. This project sought to help clarify the existing published data and provide consensus statements on acne presentation, prevention, treatment, and maintenance in SOC populations to help improve patient outcomes.
METHODS
Six SOC dermatologists convened for a virtual meeting and used a modified Delphi process to address: 1) Are there racial/ethnic differences in the clinical presentation and sequela of acne? 2) Are there racial/ethnic differences in the therapeutic endpoint of acne treatment and patient expectations? 3) Is there a need for specialized approaches to therapeutic options and skincare in acne patients with SOC? The results of a literature review and the outcome of discussions, coupled with the panel's expert opinion and experience, are intended for health care providers caring for acne patients and clinician-researchers.
RESULTS
Racial/ethnic differences in the clinical presentation, sequelae, and desired treatment outcomes for acne have been reported. Notwithstanding limitations in the number, size, and methodologies of studies to date, the available data suggest that strategies that improve outcomes in acne patients with SOC include: Early initiation and maintenance of treatment regimens and careful consideration of tolerability of active ingredients, vehicles, and dosing. Using pH-balanced, non-irritating cleansers and non-comedogenic ceramides containing moisturizers help minimize irritation or dryness.
CONCLUSIONS
There a need for specialized approaches to therapeutic options and skincare in acne patients with SOC. OTC skincare products are recommended before and during prescription therapy and as part of a maintenance regimen. J Drugs Dermatol. 2021;20(7):716-725. doi:10.36849/JDD.6169 THIS ARTICLE HAD BEEN MADE AVAILABLE FREE OF CHARGE. PLEASE SCROLL DOWN TO ACCESS THE FULL TEXT OF THIS ARTICLE WITHOUT LOGGING IN. NO PURCHASE NECESSARY. PLEASE CONTACT THE PUBLISHER WITH ANY QUESTIONS.
Topics: Humans; Acne Vulgaris; Racial Groups; Skin; Skin Care; Ethnic and Racial Minorities
PubMed: 34232006
DOI: 10.36849/JDD.6169 -
Journal of Drugs in Dermatology : JDD Mar 2022Post-inflammatory hyperpigmentation (PIH) is a typical complication of inflammatory dermatoses that more frequently and severely affects people with darker skin.... (Review)
Review
Post-inflammatory hyperpigmentation (PIH) is a typical complication of inflammatory dermatoses that more frequently and severely affects people with darker skin. External insults to the skin, such as burn injuries, dermatologic treatments, and intrinsic skin disorders (eg, eczema and acne), are common causes of PIH. Individuals with darker skin are prone to develop PIH, which can cause substantial psychological suffering. PIH can be prevented or alleviated. When this happens, it is essential to point out what is causing it and treat it as soon as possible to prevent inflammation and PIH from progressing. If the inflammatory symptoms go away or there is no evidence of inflammation at the time of diagnosis, PIH treatments should be evaluated. To hasten the resolution of PIH, treatment should begin as soon as possible. Treatment begins with the care of the initial inflammatory condition. Topical medications, chemical peels, laser and light-based treatment, phototherapy, and other therapeutic modalities are offered to treat PIH. Understanding the therapy options available helps the physician in choosing the best treatment for each patient. With these backgrounds, the current review aimed to discuss the epidemiology, pathogenesis, clinical presentation, and available treatment options for the PIH. J Drugs Dermatol. 2022;21(3):276-283. doi:10.36849/JDD.6485.
Topics: Acne Vulgaris; Chemexfoliation; Dermatitis; Humans; Hyperpigmentation; Skin
PubMed: 35254763
DOI: 10.36849/JDD.6485 -
American Journal of Clinical Dermatology Dec 2020Antibiotic resistance in acne was first observed in the 1970s, and since the 1980s has become a major concern in dermatologic daily practice. The mechanisms for this... (Review)
Review
Antibiotic resistance in acne was first observed in the 1970s, and since the 1980s has become a major concern in dermatologic daily practice. The mechanisms for this type of resistance include biofilm formation that promotes virulence and the transmission of resistant bacterial strains. Genetic mutations with modification of ribosomal RNA, alteration in efflux pumps, and enzymatic inactivation are able to create resistance to tetracyclines and macrolides. The state of art in acne treatment is no longer to use antimicrobials as monotherapy. There should be a time limit for its use plus the employment of non-antibiotic maintenance. Earlier initiation of oral isotretinoin therapy should be considered in patients with insufficient response to antimicrobials, severe acne, or a history of repeated antimicrobial use. A better understanding of acne pathogenesis, the subtypes of Propionibacterium (also known as Cutibacterium) acnes, homeostasis of the skin microbiota, and the mechanisms of antibiotic resistance would be useful in the selection of narrow-spectrum or species-specific antimicrobials, as well as the non-antimicrobial, anti-inflammatory treatment of acne. A number of novel treatments awaiting clinical proof may include the use of bacteriophages, natural or synthetic antimicrobial peptides, probiotics, and biofilm-targeting agents, as well as the reassessment of phototherapy.
Topics: Acne Vulgaris; Administration, Cutaneous; Administration, Oral; Anti-Bacterial Agents; Anti-Inflammatory Agents; Bacteriophages; Biofilms; Combined Modality Therapy; Drug Resistance, Microbial; Drug Therapy, Combination; Humans; Isotretinoin; Microbial Sensitivity Tests; Phototherapy; Propionibacterium acnes; Severity of Illness Index; Skin; Treatment Outcome
PubMed: 32889707
DOI: 10.1007/s40257-020-00556-6 -
Journal of Cosmetic Dermatology Mar 2023Impulsivity is the tendency to make decisions and act quickly without adequate planning and anticipating risks. Impulsivity is among the core symptoms of many...
BACKGROUND
Impulsivity is the tendency to make decisions and act quickly without adequate planning and anticipating risks. Impulsivity is among the core symptoms of many psychiatric disorders. In addition, impulsivity can affect the course of various diseases shaped by behaviors.
AIMS
This study aimed to evaluate the relationship between the presence of acne excoriee and different impulsivity dimensions.
STUDY DESIGN
A case-control study.
METHODS
Thirty patients with acne excoriee (AE+) and 30 acne vulgaris patients without excoriated lesions (AE-) enrolled in this study. Impulsivity was evaluated by The Barratt Impulsivity Scale (BIS). In addition, The Beck Anxiety Inventory, The Beck Depression Inventory, and The Skin Picking Scale were applied to assess the clinical characteristics of the participants.
RESULTS
AE+ patients had higher non-planning subscale scores of BIS than AE- patients in this study. In addition, the acne-picking severity score determined by The Skin Picking Scale was positively correlated with non-planning subscale scores of BIS. There was no significant difference between the groups regarding the Beck Depression Inventory and Beck Anxiety Inventory.
CONCLUSIONS
These results indicate that AE patients have a lack of forethought. In other words, it has been shown that impulsive personality traits, which indicate a lack of planning for the future, may be associated with the acne-picking behavior of the patients.
Topics: Humans; Case-Control Studies; Impulsive Behavior; Acne Vulgaris; Skin Diseases; Dermabrasion
PubMed: 36409553
DOI: 10.1111/jocd.15535 -
Skinmed 2020
Topics: Acne Vulgaris; Cicatrix; Female; Humans; Male
PubMed: 32501799
DOI: No ID Found -
Annals of Palliative Medicine Feb 2022First-line medications for acne vulgaris include retinoids and antibiotics. Dapsone is a topical drug approved by the U.S. Food and Drug Administration for the treatment... (Meta-Analysis)
Meta-Analysis
BACKGROUND
First-line medications for acne vulgaris include retinoids and antibiotics. Dapsone is a topical drug approved by the U.S. Food and Drug Administration for the treatment of acne. However, due to its side effects, the clinical application of dapsone has not been promoted, and the value of the medication is still unclear. The aim of this study is to determine the efficacy and safety of dapsone gel in patients with acne.
METHODS
Systematic searches were performed using the following databases on January 4, 2020: PubMed, EMBASE, Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure (CNKI), China Biomedical Literature Service System (SinoMed), China Science and Technology Journal Database (CQVIP), and Wanfang Data Knowledge Service Platform. A meta-analysis of randomized controlled trials was then conducted to analyze the efficacy and adverse events of dapsone gel treatment compared with excipient and other drug therapies. RevMan 5.3 software was used to calculate the odds ratio (OR), and the confidence interval (CI) was 95%.
RESULTS
Data of 11,424 participants across 7 trials which met the inclusion criteria were analyzed. Meta-analysis showed that dapsone gel alone or dapsone gel combined with isotretinoin was superior to excipient alone or oral isotretinoin alone in the treatment of acne (OR =1.51, 95% CI: 1.38-1.66, P<0.0001 random effects model, I2=0%). This indicates that dapsone gel is effective for the treatment of acne. We also found that dapsone gel is a more effective treatment for females (OR =1.80, 95% CI: 1.46-2.23). There was no significant difference in the incidence of adverse events between the dapsone group and the control group (OR =0.94, 95% CI: 0.82-1.14, P=0.24 random effects model; I2=29%). The common local adverse reactions in the dapsone group, such as dryness, heat, and eczema, were not statistically significant compared with those in the control group, and the side effects were transient.
DISCUSSION
Dapsone gel is effective in treating acne, and there is no significant difference in adverse events compared with other drugs.
Topics: Acne Vulgaris; Anti-Bacterial Agents; Dapsone; Eczema; Female; Humans; Treatment Outcome; United States
PubMed: 35249339
DOI: 10.21037/apm-21-3935 -
Scientific Reports Feb 2024Acne 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...
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.
Topics: Humans; Female; Young Adult; Adult; Male; Quality of Life; Students, Medical; Prevalence; Severity of Illness Index; Cross-Sectional Studies; Acne Vulgaris
PubMed: 38388743
DOI: 10.1038/s41598-024-55094-6