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The Yale Journal of Biology and Medicine Dec 2022Antimicrobial resistance is an increasing public health problem worldwide. The interest of a focus on antimicrobial resistance in acne lies on the facts that acne... (Review)
Review
Antimicrobial resistance is an increasing public health problem worldwide. The interest of a focus on antimicrobial resistance in acne lies on the facts that acne vulgaris (acne) is the most common skin disease worldwide, that the bacterium (, formerly ) plays a key role in the pathogenesis of acne, while at the same time being part of the skin flora, and that antibiotics are commonly recommended for acne treatment. The overuse of topical and/or systemic antibiotics, the long treatment courses used for acne, and the availability of over-the-counter antibiotic preparations, have led to the worldwide emergence of resistant strains in acne patients. In this review, we discuss the epidemiological trends of antimicrobial resistance in acne, the need to avoid the perturbation of the skin microbiome caused by anti-acne antibiotics, and the clinical practice considerations related to the emergence of resistant strains in acne patients. In light of the increasing risk of antimicrobial resistance, raising concerns over the misuse of antibiotics, prescribing patterns can be a critical target for antibiotic stewardship efforts. Also, the selection of non-antibiotic therapies for acne, whenever possible, may offer significant advantages.
Topics: Humans; Anti-Bacterial Agents; Drug Resistance, Bacterial; Acne Vulgaris; Skin; Propionibacterium acnes
PubMed: 36568833
DOI: No ID Found -
Journal Der Deutschen Dermatologischen... Oct 2018Today we see more cases of acne after adolescence, with a greater prevalence in females than males. Adult female acne has a distinct clinical presentation and is... (Review)
Review
Today we see more cases of acne after adolescence, with a greater prevalence in females than males. Adult female acne has a distinct clinical presentation and is associated with a number of specific pathophysiological features and gender-specific triggers. The psychological impact of acne is generally significant and largely underestimated; stress during professional and private life, anxiety and sleep quality, in particular, have a reciprocal relationship with disease susceptibility and severity. It is essential to compare with males. Acne in females often causes greater distress in adults than in adolescents. The impact of disease may therefore be greater for female patients, triggering higher levels of psychosocial anguish and increasing the likelihood of sequelae such as skin picking and the risks of cutaneous superinfection, scarring and PIH and acne recurrence. The management of adult female acne should encompass not just medical treatment of the symptoms, but also a comprehensive, holistic approach to the patient as a whole, her individual lifestyle factors and the impact of acne on her quality of life. Future management of this disease should aim to improve patient adherence to therapy and to develop validated outcomes of treatment regarding overall skin appearance and quality of life.
Topics: Acne Vulgaris; Adult; Anxiety; Combined Modality Therapy; Diagnosis, Differential; Female; Holistic Health; Humans; Life Style; Quality of Life; Risk Factors; Sex Factors
PubMed: 30248242
DOI: 10.1111/ddg.13664 -
Journal of the American Academy of... Feb 2020
Topics: Acne Vulgaris; Humans
PubMed: 31859048
DOI: 10.1016/j.jaad.2019.01.092 -
Pediatric Annals Mar 2020Acne is the most common skin condition observed in adolescent and preadolescent patients. Pediatric providers are on the forefront of managing the disease, often as a... (Review)
Review
Acne is the most common skin condition observed in adolescent and preadolescent patients. Pediatric providers are on the forefront of managing the disease, often as a secondary concern in a busy practice. Therefore, every provider needs to have an acne treatment plan that is effective, easy to communicate, and simple to follow. This article provides treatment rationale and guidelines-based recommendations for the initial treatment of acne, tips for troubleshooting any side effects, and a plan for subsequent follow-up to maintain good control. [Pediatr Ann. 2020;49(3):e109-e115.].
Topics: Acne Vulgaris; Adolescent; Child; Humans; Pediatrics; Physicians, Primary Care; Practice Guidelines as Topic
PubMed: 32155276
DOI: 10.3928/19382359-20200211-01 -
International Journal of Molecular... May 2017Acne vulgaris affects most people at some point in their lives. Due to unclear etiology, likely with multiple factors, targeted and low-risk treatments have yet to be... (Meta-Analysis)
Meta-Analysis Review
Acne vulgaris affects most people at some point in their lives. Due to unclear etiology, likely with multiple factors, targeted and low-risk treatments have yet to be developed. In this review, we explore the multiple causes of acne and how plant-based foods and supplements can control these. The proposed causative factors include insulin resistance, sex hormone imbalances, inflammation and microbial dysbiosis. There is an emerging body of work on the human gut microbiome and how it mediates feedback between the foods we eat and our bodies. The gut microbiome is also an important mediator of inflammation in the gut and systemically. A low-glycemic load diet, one rich in plant fibers and low in processed foods, has been linked to an improvement in acne, possibly through gut changes or attenuation of insulin levels. Though there is much interest in the human microbiome, there is much more unknown, especially along the gut-skin axis. Collectively, the evidence suggests that approaches such as plant-based foods and supplements may be a viable alternative to the current first line standard of care for moderate acne, which typically includes antibiotics. Though patient compliance with major dietary changes is likely much lower than with medications, it is a treatment avenue that warrants further study and development.
Topics: Acne Vulgaris; Dietary Supplements; Gastrointestinal Microbiome; Humans; Plants, Edible; Probiotics; Skin; Skin Physiological Phenomena
PubMed: 28513546
DOI: 10.3390/ijms18051070 -
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 -
Journal Der Deutschen Dermatologischen... Dec 2006More than a cosmetic nuisance, acne can produce anxiety, depression, and other psychological problems that affect patients' lives in ways comparable to life-threatening... (Comparative Study)
Comparative Study Review
More than a cosmetic nuisance, acne can produce anxiety, depression, and other psychological problems that affect patients' lives in ways comparable to life-threatening or disabling diseases. Emotional problems due to the disease should be taken seriously and included in the treatment plan. A purely dermatological therapy by itself may not achieve its purpose. Even mild to moderate disease can be associated with significant depression and suicidal ideation, and psychologic change does not necessarily correlate with disease severity. Acne patients suffer particularly under social limitations and reduced quality of life. Psychological comorbidities in acne are probably greater than generally assumed. Attention should be paid to psychosomatic aspects especially if depressive-anxious disorders are suspected, particularly with evidence of suicidal tendencies, body dysmorphic disorders, or also in disrupted compliance.Therefore, patients who report particularly high emotional distress or dysmorphic tendencies due to the disease should be treated, if possible, by interdisciplinary therapy. The dermatologist should have some knowledge of the basics of psychotherapy and psychopharmacology, which sometimes must be combined with systemic and topical treatment of acne in conjunction with basic psychosomatic treatment.
Topics: Acne Vulgaris; Adolescent; Adult; Child; Cohort Studies; Depression; Diagnosis, Differential; Diet; Emotions; Female; Humans; Male; Patient Satisfaction; Physician-Patient Relations; Prospective Studies; Psychotherapy; Quality of Life; Risk Factors; Stress, Psychological; Surveys and Questionnaires
PubMed: 17176410
DOI: 10.1111/j.1610-0387.2006.06110.x -
Pediatric Clinics of North America Nov 1973
Review
Topics: Acne Vulgaris; Administration, Topical; Adolescent; Adrenal Cortex Hormones; Anti-Bacterial Agents; Astringents; Cicatrix; Cosmetics; Cryosurgery; Dermatitis, Seborrheic; Diet Therapy; Diuretics; Estrogens; Humans; Immunotherapy; Progesterone; Tetracycline; Ultraviolet Rays; Vitamin A
PubMed: 4270929
DOI: 10.1016/s0031-3955(16)32918-2 -
The Journal of Investigative Dermatology Mar 1974
Review
Topics: Acne Vulgaris; Epithelial Cells; Epithelium; Fatty Acids; Gonadal Steroid Hormones; Models, Biological; Propionibacterium acnes; Sebaceous Glands; Sebum
PubMed: 4274209
DOI: 10.1111/1523-1747.ep12724280 -
Southern Medical Journal Jun 1990The pathogenesis of acne fulminans remains obscure despite extensive investigations discussed in this review, but evidence points toward an immune mediated phenomenon... (Review)
Review
The pathogenesis of acne fulminans remains obscure despite extensive investigations discussed in this review, but evidence points toward an immune mediated phenomenon (eg, hypergammaglobulinemia, depressed complement, circulating immune complexes, hematuria, lytic bone lesions, or inflammatory myositis). Whether acne fulminans begins as an autoimmune process de novo, or whether the process is somehow triggered by minimal inflammation in susceptible individuals remains to be elucidated. Acne fulminans is a rare, disfiguring, and disabling disease. It is associated with many problems, including abnormalities revealed in the laboratory or on roentgenogram. We have reviewed past and present therapies. In conclusion, we emphasize the importance of early diagnosis and treatment to decrease the significant morbidity of acne fulminans.
Topics: Acne Vulgaris; Acute Disease; Adolescent; Anti-Bacterial Agents; Autoimmune Diseases; Fever; Humans; Leukocytosis; Male; Time Factors
PubMed: 2141435
DOI: 10.1097/00007611-199006000-00030