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Archives of Dermatological Research Jun 2024Cannabidiol (CBD), which is derived from hemp, is gaining recognition because of its anti-inflammatory and lipid-modulating properties that could be utilized to treat...
Cannabidiol (CBD), which is derived from hemp, is gaining recognition because of its anti-inflammatory and lipid-modulating properties that could be utilized to treat acne. We conducted experiments to quantitatively assess the effects of CBD on acne-related cellular pathways. SEB-1 sebocytes and HaCaT keratinocytes were exposed to various CBD concentrations. CBD exhibited a concentration-dependent impact on cell viability and notably reduced SEB-1 viability; furthermore, it induced apoptosis and a significant increase in the apoptotic area at higher concentrations. Additionally, CBD remarkably reduced pro-inflammatory cytokines, including CXCL8, IL-1α, and IL-1β. Additionally, it inhibited lipid synthesis by modulating the AMPK-SREBP-1 pathway and effectively reduced hyperkeratinization-related protein keratin 16. Simultaneously, CBD stimulated the synthesis of elastin, collagen 1, and collagen 3. These findings emphasize the potential of CBD for the management of acne because of its anti-inflammatory, apoptotic, and lipid-inhibitory effects. Notably, the modulation of the Akt/AMPK-SREBP-1 pathway revealed a novel and promising mechanism that could address the pathogenesis of acne.
Topics: Humans; Acne Vulgaris; Cannabidiol; Apoptosis; Keratinocytes; Cell Survival; Signal Transduction; Cicatrix; Anti-Inflammatory Agents; Sterol Regulatory Element Binding Protein 1; HaCaT Cells; AMP-Activated Protein Kinases; Proto-Oncogene Proteins c-akt; Collagen Type I; Collagen Type III; Elastin; Sebaceous Glands; Interleukin-1alpha; Interleukin-1beta; Interleukin-8; Cell Line
PubMed: 38904694
DOI: 10.1007/s00403-024-03131-9 -
Frontiers in Medicine 2024Acne vulgaris, a chronic inflammatory skin condition predominantly seen in teenagers, impacts more than 640 million people worldwide. The potential use of lipid-lowering...
BACKGROUND
Acne vulgaris, a chronic inflammatory skin condition predominantly seen in teenagers, impacts more than 640 million people worldwide. The potential use of lipid-lowering medications as a treatment for acne vulgaris remains underexplored. This study seeks to investigate the impact of lipid-lowering therapies on the risk of developing acne vulgaris using two-sample Mendelian randomization (MR) analysis.
METHOD
The two-sample MR method was employed for analysis, and information on lipid-lowering drugs was obtained from the DrugBank and ChEMBL databases. The summary data for blood low-density lipoprotein (LDL) and triglycerides were sourced from the Global Lipids Genetics Consortium, while genome-wide association studies (GWAS) summary data for acne vulgaris were obtained from the FinnGen database. Heterogeneity was examined using the Q-test, horizontal pleiotropy was assessed using MR-Presso, and the robustness of analysis results was evaluated using leave-one-out analysis.
RESULTS
The MR analysis provided robust evidence for an association between lowering LDL cholesterol through two drug targets and acne vulgaris, with PCSK9 showing an odds ratio (OR) of 1.782 (95%CI: 1.129-2.812, = 0.013) and LDL receptor (LDLR) with an OR of 1.581 (95%CI: 1.071-2.334, = 0.021). Similarly, targeting the lowering of triglycerides through lipoprotein lipase (LPL) was significantly associated with an increased risk of acne vulgaris, indicated by an OR of 1.607 (95%CI: 1.124-2.299, = 0.009).
CONCLUSION
The current MR study presented suggestive evidence of a positive association between drugs targeting three genes (PCSK9, LDLR, and LPL) to lower lipids and a reduced risk of acne vulgaris.
PubMed: 38903813
DOI: 10.3389/fmed.2024.1385948 -
Cureus May 2024Background Internalized stigma (IS) is the acceptance of unfavorable stereotypes about the disease that society has created and withdrawing from society with feelings of...
Background Internalized stigma (IS) is the acceptance of unfavorable stereotypes about the disease that society has created and withdrawing from society with feelings of shame and worthlessness. Due to the visibility feature of facial skin diseases such as rosacea and acne vulgaris (AV), it is possible for them to cause IS. Objective We aimed to examine the level of IS in AV and rosacea patients and compare these patient groups as well. Methods Fifty-three AV and 46 rosacea patients aged 18-65 were included in this study. Internalized Stigma Scale (ISS) adapted for AV and rosacea were applied to all the patients. They also responded to the "Dermatology Life Quality Index" (DLQI) questionnaire. The relationship between IS levels and DLQI was investigated, and then acne and rosacea patients were compared with each other. Results Total DLQI, total ISS, and its subscales' scores of all patients were found to be positively correlated with each other. When rosacea and AV patients were compared with each other, there was no difference regarding DLQI and ISS scores. Conclusion AV and rosacea patients experience high IS, and it is significantly related to low quality of life and health status. They also have similar IS levels when compared with each other.
PubMed: 38903377
DOI: 10.7759/cureus.60731 -
NPJ Biofilms and Microbiomes Jun 2024During the COVID-19 pandemic, facemasks played a pivotal role in preventing person-person droplet transmission of viral particles. However, prolonged facemask wearing...
During the COVID-19 pandemic, facemasks played a pivotal role in preventing person-person droplet transmission of viral particles. However, prolonged facemask wearing causes skin irritations colloquially referred to as 'maskne' (mask + acne), which manifests as acne and contact dermatitis and is mostly caused by pathogenic skin microbes. Previous studies revealed that the putative causal microbes were anaerobic bacteria, but the pathogenesis of facemask-associated skin conditions remains poorly defined. We therefore characterized the role of the facemask-associated skin microbiota in the development of maskne using culture-dependent and -independent methodologies. Metagenomic analysis revealed that the majority of the facemask microbiota were anaerobic bacteria that originated from the skin rather than saliva. Previous work demonstrated direct interaction between pathogenic bacteria and antagonistic strains in the microbiome. We expanded this analysis to include indirect interaction between pathogenic bacteria and other indigenous bacteria classified as either 'pathogen helper (PH)' or 'pathogen inhibitor (PIn)' strains. In vitro screening of bacteria isolated from facemasks identified both strains that antagonized and promoted pathogen growth. These data were validated using a mouse skin infection model, where we observed attenuation of symptoms following pathogen infection. Moreover, the inhibitor of pathogen helper (IPH) strain, which did not directly attenuate pathogen growth in vitro and in vivo, functioned to suppress symptom development and pathogen growth indirectly through PH inhibitory antibacterial products such as phenyl lactic acid. Taken together, our study is the first to define a mechanism by which indirect microbiota interactions under facemasks can control symptoms of maskne by suppressing a skin pathogen.
Topics: Animals; Mice; Masks; Microbiota; Humans; COVID-19; Skin; Acne Vulgaris; SARS-CoV-2; Female; Metagenomics; Disease Models, Animal; Bacteria; Microbial Interactions; Dermatitis, Contact
PubMed: 38902263
DOI: 10.1038/s41522-024-00512-w -
Journal of Pediatric Surgery May 2024Congenital adrenal hyperplasia (CAH) is the most common cause of genital atypia in females. A dedicated multidisciplinary team (MDT) should be included for an optimal...
Genito-urinary Reconstruction in Female Children With Congenital Adrenal Hyperplasia: Favorable Surgical Outcomes can be Achieved by Contemporary Techniques and a Dedicated Multidisciplinary Management.
INTRODUCTION
Congenital adrenal hyperplasia (CAH) is the most common cause of genital atypia in females. A dedicated multidisciplinary team (MDT) should be included for an optimal management. Here, we aimed to review our surgical experience and to assess long-term urinary, gynecological and endocrine outcomes after primary genitoplasty in this specific cohort.
METHODS
Patients born with CAH and who underwent feminizing genitoplasty in our institution were retrospectively identified (2001-2021). We analyzed patients' characteristics, intraoperative details, and postoperative urinary, gynecological, and endocrine outcomes.
RESULTS
Forty patients were included and followed-up for a median (IQR) time of 7 (1-19) years. Thirty-eight (95%) had 21-hydroxylase deficiency. After multidisciplinary decision and written consent from patient and/or family, a single-stage reconstructive surgery was performed at a median age of 10 (3-165) months. Median length of hospital stay was 5 (1-7) days. Procedures were: PUM (N = 35 (87.5%)), TUM (N = 3 (7.5%)), urogenital mobilization was unnecessary in 2 (5%). Reduction clitoroplasty was done in 33 (82.5%) patients. Only 3 (7.5%) experienced significant Clavien-Dindo complications requiring additional surgery during the follow-up period. Recurrent urinary tract infections (UTI) occurred in 6 (15%), one required ureteric reimplantation for symptomatic high-grade vesicoureteric reflux. All patients over 3 years were toilet-trained without incontinence. Severe vaginal stenosis occurred in 1 (2.5%) patient. In patients who achieved puberty, 6/9 had vaginal calibration at a median age of 17.3 (16-21) years without detected stenosis. One (2.5%) had major hypertrophy of the right labia minora requiring labiaplasty. Nine (22.5%) reached puberty. Two (5%) patients developed acne/hirsutism. Short stature was noted in 11 (27.5%) and obesity in 18 (45%).
CONCLUSION
Based on our contemporary series, genitourinary reconstructive surgery for female patients born with CAH is technically feasible and safe with a low complication rate. A regular follow-up with a MDT to assess long-term complications is necessary, and it is vital to inform patients and families about the different management options with all the risks and benefits of surgery.
TYPE OF THE STUDY
original research, clinical research.
LEVEL OF EVIDENCE
Level 3 retrospective study.
PubMed: 38902168
DOI: 10.1016/j.jpedsurg.2024.05.009 -
The British Journal of General Practice... Jun 2024Acne is common and has a significant impact on quality of life. Topical treatments are first-line and effective, but non-adherence is common due to slow onset of action,...
Development and implementation of an online intervention and embedded decision aid to support self-management of acne vulgaris: qualitative interviews with healthcare professionals.
BACKGROUND
Acne is common and has a significant impact on quality of life. Topical treatments are first-line and effective, but non-adherence is common due to slow onset of action, or lack of advice on how to manage side effects.
AIM
The Acne Care Online programme is developing an online intervention to support acne self-management and help-seeking. This project aims to explore experiences and views of healthcare professionals (HCPs) treating acne to assess the acceptability and feasibility of implementing this intervention and embedded decision aid in practice.
METHOD
This qualitative study recruited HCPs working in general practice. Email invitations were sent to eight research-active practices in Southwest England, and snowball sampling was used. Purposive sampling was used to seek diverse participants. Semi-structured virtual interviews were conducted, audio-recorded, and transcribed. Data were explored using thematic analysis.
RESULTS
Nine interviews were conducted, including seven GPs, one nurse, and one pharmacist. Findings highlighted challenges faced by HCPs managing acne in time-limited consultations, particularly around patients' limited understanding of effective treatments, frequent requests from patients for non-first-line treatments, treatment non-adherence, and addressing psychosocial impact. The intervention and embedded decision aid were perceived as beneficial in addressing these challenges, improving shared decision making, and providing a reliable resource for patients. Interviewees suggested integrating the intervention into electronic practice templates for effective implementation.
CONCLUSION
HCPs were positive about the potential for the intervention to be implemented as a useful tool in practice. Potential implementation barriers need to be considered, such as making the intervention quick to access in time-limited consultations.
Topics: Humans; Acne Vulgaris; Qualitative Research; Female; England; Male; Decision Support Techniques; Self-Management; Attitude of Health Personnel; General Practice; Interviews as Topic; Health Personnel; Adult; Quality of Life
PubMed: 38902104
DOI: 10.3399/bjgp24X737805 -
Skin Research and Technology : Official... Jun 2024Acne vulgaris often results in permanent scars, with atrophic scars being the most common type and posing a significant therapeutic challenge due to their prevalence and...
BACKGROUND
Acne vulgaris often results in permanent scars, with atrophic scars being the most common type and posing a significant therapeutic challenge due to their prevalence and impact on patients' quality of life. Various treatment options exist, including the use of poly-d,l-lactic acid delivered via different methods.
OBJECTIVE
This study aimed to assess the efficacy and safety of poly-d,l-lactic acid delivered via laser-assisted needle-free microjet injection for treating atrophic scars.
METHODS
Five Korean participants with atrophic facial scars were recruited. Poly-d,l-lactic acid solution was administered via the Mirajet system in five sessions, with clinical assessments conducted at baseline, before each session, and at 12-week and 22-week follow-ups. Outcome measures included the Global Aesthetic Improvement Scale and patient satisfaction scores.
RESULTS
Positive results were observed at the 12-week and 22-week follow-ups, with high patient satisfaction and improvements in atrophic scars and skin texture. Mild discomfort and transient side effects were reported, with no adverse events observed during the follow-up period.
CONCLUSION
Poly-d,l-lactic acid delivered by a laser-assisted needle-free microjet injector was judged to be effective for improving atrophic the facial area. Further research, particularly through randomized controlled trials, is needed to validate these findings and assess the longer-term safety and sustainability of outcomes.
Topics: Humans; Cicatrix; Polyesters; Female; Adult; Male; Patient Satisfaction; Asian People; Drug Delivery Systems; Administration, Cutaneous; Treatment Outcome; Atrophy; Acne Vulgaris; Young Adult
PubMed: 38899803
DOI: 10.1111/srt.13762 -
FP Essentials Jun 2024Acne is a chronic, recurrent inflammatory condition of the pilosebaceous unit. It affects approximately 85% of adolescents and creates significant psychosocial and... (Review)
Review
Acne is a chronic, recurrent inflammatory condition of the pilosebaceous unit. It affects approximately 85% of adolescents and creates significant psychosocial and financial burdens. The pathogenesis involves altered follicular growth and differentiation, microbial colonization with , increased sebum production influenced by androgen levels, and inflammation. Evidence-based risk factors include family history and body mass index. Diagnosis of acne is clinical, according to patient age and acne morphology and severity. Setting treatment expectations is an important aspect of management. For mild acne, benzoyl peroxide is an effective first-line drug as monotherapy or in combination with a topical retinoid and/or topical antibiotic. Oral tetracyclines are first-line drugs as part of a multipart treatment regimen for moderate to severe acne for patients older than 8 years. Oral isotretinoin is the first-line drug for moderate to severe inflammatory acne. Because of its teratogenic effects, its prescribing is monitored through the iPLEDGE Risk Evaluation and Mitigation Strategy (REMS) program. Prescribing oral or topical antibiotics as monotherapy for acne is not recommended, as this may increase microbial resistance. Combined oral contraceptives and spironolactone are used as adjunctive therapies in female adolescents. Patients with skin of color, pregnant patients, and transgender or gender diverse patients warrant special considerations in acne management.
Topics: Humans; Acne Vulgaris; Adolescent; Child; Dermatologic Agents; Anti-Bacterial Agents; Isotretinoin; Female; Benzoyl Peroxide; Risk Factors; Male; Spironolactone; Retinoids
PubMed: 38896825
DOI: No ID Found -
The Journal of Dermatology Jun 2024Spironolactone (SPL) is an effective treatment for women acne, but other effects on skin biophysical properties remain to be investigated.
BACKGROUND
Spironolactone (SPL) is an effective treatment for women acne, but other effects on skin biophysical properties remain to be investigated.
OBJECTIVES
The aim of the current study was to explore the effects of oral SPL used to treat women acne on skin biophysical properties, including hydration, transepidermal water loss (TEWL), skin surface lipid (SSL) levels, mechanical properties, color, pH, and pore size.
MATERIALS AND METHODS
Twenty-five Thai women with acne treated with oral SPL were followed for 6 months. Skin hydration, TEWL, SSL levels, mechanical properties, color, pH, and pore size of the forehead, chest, and inner arm were evaluated at baseline and 2, 4, and 6 months after treatment with oral SPL. Facial and upper back pore size were also assessed. Clinical outcomes were changes in these skin biophysical properties at each visit compared with baseline.
RESULTS
Skin hydration, TEWL, SSL levels, color, pH, and pore size remained stable throughout the study. Facial skin parameters at 6 months demonstrated the following changes: hydration levels, 7.60 (95% confidence interval [CI], -59.74 to 74.94); TEWL, -2.36 (95% CI, -5.77 to 1.06); L* value, 0.51 (95% CI, -0.70 to 1.72); individual typology angle, 1.65 (95% CI -2.27 to 5.57); pH, 0.01 (95% CI -0.43 to 0.46); pore size, -0.24 (95% CI, -1.21 to 0.73); and SSL levels, 7.60 (95% CI -59.74 to 74.94). Improvement of facial mechanical properties was observed. R0 (indicating skin tightness) and R1 (indicating elasticity) showed significant decreases (-0.076 [95% CI, -0.141 to -0.010] and -0.016 [95% CI, -0.033 to -0.001]). R3 and R4 (representing tiring effects) were also improved (-0.091 [95% CI, -0.158 to -0.025] and -0.022 [95% CI, -0.044 to -0.001]). Parameters in the truncal and inner arm areas remained stable, except for skin elasticity and tiring effects, which exhibited a similar trend of improvement as the facial area. The changes were notable as early as 4 months.
CONCLUSION
Oral SPL used for acne did not impair the skin barrier. Moreover, the skin mechanical properties were improved at 4 to 6 months.
PubMed: 38895842
DOI: 10.1111/1346-8138.17333 -
International Journal of Ophthalmology 2024To investigate ocular surface disorders and tear function changes in patients with acne vulgaris and explore the potential relationship between acne vulgaris and dry eye.
AIM
To investigate ocular surface disorders and tear function changes in patients with acne vulgaris and explore the potential relationship between acne vulgaris and dry eye.
METHODS
This cross-sectional study included right eyes of 53 patients with acne vulgaris and 54 healthy controls. The participants completed the Ocular Surface Disease Index (OSDI) questionnaire. The following ocular surface-related parameters were measured: tear meniscus height (TMH), noninvasive tear breakup time (NIBUT), Schirmer I test (SIT), lipid layer thickness (LLT) score of the tear film, meibum score, meibomian gland orifice obstruction score, the ratio of meibomian gland loss, conjunctival hyperemia score, and corneal fluorescein staining (CFS) score.
RESULTS
The stability of the tear film decreased in acne vulgaris patients. In the acne group, the TMH and NIBUT were lower, whereas the OSDI, meibum score, meibomian gland orifice obstruction score, ratio of meibomian gland loss, and conjunctival hyperemia score were higher compared with controls (<0.05). There were no significant differences in the CFS score, SIT, or LLT score between the groups (>0.05). In two dry eye groups, the TMH, NIBUT, and LLT score were lower in the acne with dry eye (acne-DE) group, and the meibum score, meibomian gland orifice obstruction score, ratio of meibomian gland loss and conjunctival hyperemia score in the acne-DE group were higher (<0.05). There were no significant differences between OSDI, SIT, and CFS score (>0.05).
CONCLUSION
Patients with moderate-to-severe acne vulgaris are more likely to experience dry eye than those without acne vulgaris. Reduced tear film stability and meibomian gland structure dysfunction are more pronounced in patients with moderate-to-severe acne and dry eye.
PubMed: 38895667
DOI: 10.18240/ijo.2024.06.09