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BMC Public Health Mar 2021Acne vulgaris, a highly prevalent multifactorial inflammatory skin disease, can be categorised into different severity and scarring grades based on the type, number, and...
BACKGROUND
Acne vulgaris, a highly prevalent multifactorial inflammatory skin disease, can be categorised into different severity and scarring grades based on the type, number, and severity of lesions. While many epidemiology studies have investigated the risk factors for acne presentation, fewer studies have specifically studied the risk factors for acne severity and scarring. Therefore, this study investigated the prevalence of acne, acne severity and scarring grades, and their associated non-modifiable and modifiable epidemiological risk factors among Malaysian Chinese.
METHODS
A total of 1840 subjects (1117 cases/723 controls) completed an investigator-administered questionnaire as part of a cross-sectional study, which include socio-demographics, familial history, lifestyle factors, dietary habits, and acne history. Acne cases were further evaluated for their severity (n = 1051) and scarring (n = 1052) grades by a trained personnel.
RESULTS
Majority of the acne cases (up to 69%) had mild acne or Grade 1/2 scarring, while 21.6% had moderate/severe acne and 5.5% had Grade 3/4 scarring. Males had significantly higher risk of presenting with higher grades of acne scarring. Those who had acne, regardless of severity and scarring grades, had strong positive familial history (either in parents and/or sibling). Frequent consumption (most or all days) of foods that are commonly consumed during breakfast (butter, probiotic drinks, cereals and milk) decreased the risk for acne presentation and higher acne scarring, while periodic consumption (once/twice per week) of nuts and burgers/fast food decreased the risk for higher acne severity. Alcohol drinking was significantly associated with increased risk for acne presentation, while paternal, parental and household smoking were associated with reduced risk of more severe acne.
CONCLUSIONS
In conclusion, positive familial history is a strong predisposing factor in influencing acne presentation, severity and scarring. Frequent consumption of foods that are commonly consumed during breakfast is protective against acne presentation.
Topics: Acne Vulgaris; Animals; China; Cicatrix; Cross-Sectional Studies; Humans; Male; Risk Factors; Severity of Illness Index
PubMed: 33773591
DOI: 10.1186/s12889-021-10681-4 -
Nutrients Dec 2022Acne is a disorder of sebaceous glands, and it most commonly develops on the face. The role of the diet in triggering and treating acne is controversial and has been...
Acne is a disorder of sebaceous glands, and it most commonly develops on the face. The role of the diet in triggering and treating acne is controversial and has been widely debated in the literature. A knowledge of the environmental factors that contribute to acne could improve the patient’s physical and emotional well-being, increase the efficacy of treatment, and minimize the risk of anxiety and depressive disorders. The aim of this study was to assess the impact of acne on the daily lives and well-being of people aged 15−30 years, to analyze young people’s knowledge about the influence of various foods and other dietary factors on the prevalence, severity, and treatment of acne, as well as their adherence to an anti-acne diet. The study was conducted between April 2021 and May 2022. A total of 1329 respondents, including 963 women and 366 men, participated in the study. In 99% of men and women respondents, acne breakouts were typically located on the face. An analysis of HADS scores revealed moderate anxiety in 57% of women (F) and 22.5% of men (M) respondents. Acne breakouts located on the face were problematic for 81% of the study population (regardless of sex). More than ¾ of women and 2/3 of men claimed that acne made them feel less attractive. The impact of acne on the participants’ emotional well-being and social life differed between genders. Women experienced psychological discomfort more frequently than men (p = 0.0023). More than 50% of the participants eliminated acne-triggering foods from their diets, and 2/3 of these respondents observed a marked improvement or disappearance of skin breakouts as a result. A significantly higher number of respondents with severe/moderate anxiety were convinced that acne breakouts were affected by diet (OR 1.56; 95% CI 1.23−1.87, p < 0.001) and foods with a high glycemic index (OR 1.56; 95% CI 1.23−1.94, p < 0.001). Acne affects the patients’ emotional well-being. It can act as a barrier to social interactions and lead to mood disorders of varied severity. Persons with moderate/severe mood disorders associated with anxiety significantly more often recognized the role of dietary factors in acne aggravation, and the severity of mood disorders was directly correlated with more frequent consumption of sweets, sweetened beverages, and foods with a high glycemic index.
Topics: Humans; Male; Female; Adolescent; Diet; Acne Vulgaris; Skin; Anxiety; Anxiety Disorders
PubMed: 36558452
DOI: 10.3390/nu14245293 -
Journal of the European Academy of... May 2019Acne is a common skin disease that mostly affects teenagers, with a negative impact on quality of life. Recently, adult acne and acne relapses have increased in...
BACKGROUND
Acne is a common skin disease that mostly affects teenagers, with a negative impact on quality of life. Recently, adult acne and acne relapses have increased in frequency, for yet unknown reasons.
OBJECTIVE
This non-interventional, real-life study sought to investigate the rate of acne relapses and their impact on quality of life and productivity (loss/absenteeism) among teenagers and adults.
METHODS
An online self-administered questionnaire was proposed to ≥15-year-olds suffering from acne who spontaneously consulted their dermatologist. To ensure homogeneous assessment of acne severity, the global acne severity scale was applied. Quality of life was assessed via Cardiff Acne Disability Index (CADI), SF12-physical score and SF12-mental score questionnaires. Productivity loss or absenteeism in middle/high school was estimated based on the number of days off work or school over the last 30 days.
RESULTS
Overall, 1048 questionnaires were considered assessable, with 448 (43%) mild acne, 434 (41%) moderate acne and 166 (16%) severe acne. Overall, 755 (72%) participants were in middle/high school, 267 (25%) employed and 26 (3%) with no professional activity. Considering the population by age groups, 68% (n = 716) were ≤20-year-olds and 32% (n = 332) >20-year-olds, with a mean age of 20.26 (SD: 7.43) years. Acne relapses were reported by 44% of respondents. Analyses revealed that poorer quality of life scores was observed in acne relapsers vs. non-relapsers, with a significant difference for CADI scores (P < 0.01) in >20-year-olds. Acne-related absenteeism was recorded in 5.7% of cases. On multivariate analyses, after adjusting for other variables, acne relapse was proven a significant determinant of absenteeism/productivity loss.
CONCLUSION
This real-life study first demonstrated acne relapse rates of 44%, which appeared to be generation-dependent, affecting 39.9% of ≤20-year-olds vs. 53.3% of >20-year-olds. Acne relapses were significantly associated with impaired quality of life and productivity loss/absenteeism.
Topics: Absenteeism; Acne Vulgaris; Adolescent; Adult; Cicatrix; Efficiency; Female; Humans; Male; Quality of Life; Recurrence; Surveys and Questionnaires; Young Adult
PubMed: 30633393
DOI: 10.1111/jdv.15419 -
Anales de Pediatria Jul 2023Acne vulgaris is significantly associated with an increased burden of care and has an important impact on the quality of life (QoL) and self-esteem of affected...
INTRODUCTION
Acne vulgaris is significantly associated with an increased burden of care and has an important impact on the quality of life (QoL) and self-esteem of affected individuals. We aimed to assess the QoL of adolescents with acne and their families as well as the association of QoL with acne severity, treatment response, duration of acne and localization of lesions.
MATERIAL AND METHODS
The sample included a total of 100 adolescents with acne vulgaris, 100 healthy controls and their parents. We collected data on sociodemographic characteristics, presentation of acne, duration of acne, treatment history, treatment response, and parental sex. We used the Global Acne Severity scale, Children's Dermatology Life Quality Index (CDLQI), and the Family Dermatology Life Quality Index (FDLQI).
RESULTS
In the group of patients with acne, the mean CDLQI score in the patients was 7.89 (SD, 5.43) and the mean FDLQI score in the parents was 6.01 (SD, 6.11). In the control group, the mean CDLQI score in healthy controls was 3.92 (SD, 3.88) and the mean FDLQI score in their family members was 2.12 (SD, 2.91). We found a statistically significant difference between the acne and control groups in CDLQI and FDLQI scores (P < .001). There were also statistically significant differences in the CDLQI score based on the duration of acne and the response to treatment.
CONCLUSIONS
Patients with acne and their parents had a decreased QoL compared with healthy controls. Acne was associated with impaired QoL in family members. Assessing QoL in the family in addition to that of the patient may allow an improved management of acne vulgaris.
Topics: Child; Humans; Adolescent; Quality of Life; Parents; Acne Vulgaris
PubMed: 37316404
DOI: 10.1016/j.anpede.2023.06.009 -
CMAJ : Canadian Medical Association... Nov 2013
Topics: Acne Vulgaris; Adult; Biopsy; Diagnosis, Differential; Female; Follow-Up Studies; Humans; Lithium; Skin
PubMed: 23713068
DOI: 10.1503/cmaj.130009 -
Journal of Primary Care & Community... 2022Acne is present in about 90% of teenagers and 12% to 14% of adults. Face and trunk are the most affected areas. Lesions can result in postinflammatory hyperpigmentation...
INTRODUCTION/OBJECTIVES
Acne is present in about 90% of teenagers and 12% to 14% of adults. Face and trunk are the most affected areas. Lesions can result in postinflammatory hyperpigmentation and scarring, leading to reduced quality of life. Asynchronous teledermatology has been increasingly used around the world, facilitating patient access to dermatologists. Our objectives were to assess: (1) clinical features of acne patients according to gender, age, severity, site of lesions, excoriation, postinflammatory hyperpigmentation (PIH), and atrophic scar (AS) and (2) how many referrals to in-person consultations with dermatologists could be avoided using asynchronous teledermatology in primary care attention?
METHODS
We analyzed images, demographic and clinical data of 2459 acne patients assisted by teledermatology, with the aim to confirm the diagnoses, to classify acne severity according to grades I to IV, and to search for the presence of postinflammatory hyperpigmentation, atrophic scars, and/or excoriated acne (EA). We compared the clinical and biological data, looking for associations among them.
RESULTS
Acne severity and age were associated with the most common sequels: postinflammatory hyperpigmentation (mainly on the trunk and in females, < .0001) and atrophic scars (mainly on the face and in males, < .0001). We also observed different frequencies according to age and sex: 13 to 24 years in males ( = .0023); and <12 ( = .0023) and 25 to 64 years old ( <.0001) for females; 68% of the patients had no need for in-person dermatologists' referral, being kept at primary care attention with proper diagnosis and treatment.
CONCLUSION
Clinical features of acne and its sequels differ according to gender, age, site, and severity. The new findings of PIH associated with women and AS, with men, may help offer a more personalized management to patients. Teledermatology was suitable for the majority of the acne cases in primary care.
Topics: Acne Vulgaris; Adolescent; Adult; Cicatrix; Female; Humans; Hyperpigmentation; Male; Primary Health Care; Quality of Life; Treatment Outcome
PubMed: 35098785
DOI: 10.1177/21501319221074117 -
Journal of Global Antimicrobial... Mar 2022Cutibacterium avidum, a human skin commensal bacterium, rarely causes infections. It has recently been shown that Cutibacterium acnes, another member of the genus, acts...
OBJECTIVES
Cutibacterium avidum, a human skin commensal bacterium, rarely causes infections. It has recently been shown that Cutibacterium acnes, another member of the genus, acts as an opportunistic pathogen in surgical site infections. However, the antimicrobial susceptibility and pathogenicity of C. avidum remain unknown.
METHODS
We investigated the epidemiological features and antimicrobial susceptibility of C. avidum isolated from patients with acne vulgaris and other infections.
RESULTS
Cutibacterium avidum strains were isolated from patients with acne vulgaris (29 strains) and other infections (12 strains). Clarithromycin and clindamycin resistance was observed in 65.9% (27/41) of strains. In addition, ciprofloxacin resistance was observed in 34.1% (14/41) of strains, of which 13 also exhibited resistance to macrolides and clindamycin. Notably, the macrolide-clindamycin resistance gene erm(X) was found on the chromosome of 92.6% (25/27) of clindamycin-resistant strains and may be prevalent owing to transmission among C. avidum strains. Ciprofloxacin-resistant strains developed amino acid substitutions in GyrA owing to the use of antimicrobial agents. Pulsed-field gel electrophoresis (PFGE) analysis revealed that only a few strains exhibited 100% similarity. Additionally, no clustering associated with antimicrobial resistance, biofilm-forming ability or type of infection was observed.
CONCLUSION
Our study revealed that erm(X) may be frequently disseminated in C. avidum, and multidrug-resistant C. avidum strains may colonise the skin of patients with acne vulgaris and other infections. Therefore, the prevalence of multidrug-resistant C. avidum and the use of antimicrobial agents for the treatment of acne vulgaris and other infections associated with C. avidum should be monitored.
Topics: Acne Vulgaris; Anti-Bacterial Agents; Anti-Infective Agents; Ciprofloxacin; Clindamycin; Humans; Macrolides; Propionibacteriaceae
PubMed: 35017069
DOI: 10.1016/j.jgar.2021.12.021 -
JAMA Dermatology Sep 2021Acne often persists into adulthood in women. However, few studies have specifically explored the lived experience of acne in adult populations.
INTRODUCTION
Acne often persists into adulthood in women. However, few studies have specifically explored the lived experience of acne in adult populations.
OBJECTIVE
To examine the lived experience of acne and its treatment among a cohort of adult women.
DESIGN, SETTING, AND PARTICIPANTS
A qualitative analysis was conducted from free listing and open-ended, semistructured interviews of patients at a large academic health care system (University of Pennsylvania Health System) and a private practice (Dermatologists of Southwest Ohio). Fifty women 18 to 40 years of age with moderate to severe acne participated in interviews conducted between August 30, 2019, and December 31, 2020.
MAIN OUTCOMES AND MEASURES
Free-listing data from interviews were used to calculate the Smith S, a measure of saliency for each list item. Semistructured interviews were examined to detect themes about patient perspectives regarding their acne and its treatment.
RESULTS
Fifty participants (mean [SD] age, 28 [5.38] years; 24 [48%] White) described acne-related concerns about their appearance that affected their social, professional, and personal lives, with many altering their behavior because of their acne. Depression, anxiety, and social isolation were commonly reported. Participants described successful treatment as having completely clear skin over time or a manageable number of blemishes. Many participants described frustration with finding a dermatologist with whom they were comfortable and with identifying effective treatments for their acne.
CONCLUSIONS AND RELEVANCE
The results of this qualitative study suggest that women with acne have strong concerns about appearance and experience mental and emotional health consequences and disruption of their personal and professional lives. In addition, many patients describe challenges finding effective treatments and accessing care. Future trials to understand the optimal treatment approaches for women with acne are needed to improve outcomes in this population.
Topics: Acne Vulgaris; Adult; Cohort Studies; Female; Humans; Qualitative Research; Skin; Treatment Outcome
PubMed: 34319378
DOI: 10.1001/jamadermatol.2021.2185 -
Medicina (Kaunas, Lithuania) Dec 2022In Saudi Arabia, Acne vulgaris is a very predominant ailment among adolescents, especially female university students, and self-medication has become a trend to manage... (Observational Study)
Observational Study
In Saudi Arabia, Acne vulgaris is a very predominant ailment among adolescents, especially female university students, and self-medication has become a trend to manage this condition. To determine the prevalence of Acne vulgaris among health care students and to access the scenario of its self-medication in light of students' knowledge, attitude, and practice towards it. This was an observational study conducted at King Saud University, Riyadh, Kingdom of Saudi Arabia, from January 2022 to March 2022. The study was undertaken using a pre-structured questionnaire. A total of 550 university students were recruited and the incidence of acne was observed to be 78.5% (432 out of 550) with a female predominance. A total of 56.0% (244 of 432) students used self-medications for acne without a prescription and the most used prescription drugs were topical and oral antibiotics (38.1%), followed by Isotretinoin (22.55), and topical adaplene (20.9%). Female students ( = 181, 63.5%) were significantly more likely to self-medicate compared to male students ( = 63, 42.9%, ≤ 0.001). Almost 60% of medical students had proper knowledge of medication for acne. Acne vulgaris is a highly prevalent condition among university students of Saudi Arabia and use of self-medication among acne sufferers is high. Education programs should be made to raise awareness about acne and its treatment.
Topics: Adolescent; Humans; Male; Female; Saudi Arabia; Universities; Prevalence; Students, Medical; Acne Vulgaris
PubMed: 36676676
DOI: 10.3390/medicina59010052 -
Archives of Dermatological Research Aug 2023Pityrosporum folliculitis (PF) is a fungal acneiform disease of the hair follicles that often presents with pruritic papules and pustules on the upper body and face This... (Review)
Review
Pityrosporum folliculitis (PF) is a fungal acneiform disease of the hair follicles that often presents with pruritic papules and pustules on the upper body and face This condition is commonly mistaken for acne vulgaris and can be distinguished from bacterial acne by the presence of fungal spores in the follicular lumen Although studies have been performed to describe PF in cohorts, little work has been done to aggregate these data. Thus, the goal of this review is to describe the clinical characteristics and treatment outcomes of PF in immunocompetent patients. PubMed, Web of Science, and Embase were searched using the terms "Pityrosporum folliculitis" or "Malassezia folliculitis." All cohorts reporting PF characteristics in patients classified as immunocompetent were reviewed. A total of 15 studies were included. Majority of patients were male (64%) with the average age of presentation of 24.26 years. The most common locations of lesions were the chest (70%) and back/shoulders (69.2%). Pruritus was reported by the majority of patients (71.7%). Additionally, 40.5% of patients reported a history of unsuccessful treatment regimens. Treatment was most successful with an oral antifungal (92%), followed by a topical antifungal (81.6%). In conclusion, majority of patients with PF were younger males. Many patients were primarily treated incorrectly, suggesting the importance of proper diagnosis. PF may be distinguishable from acne vulgaris by the presence of pruritus or suggested when a new acneiform eruption develops following antibiotic therapy or immunosuppression. When properly diagnosed, majority of cases of PF achieve complete response with oral or topical antifungals.
Topics: Humans; Male; Female; Young Adult; Adult; Antifungal Agents; Malassezia; Dermatomycoses; Folliculitis; Acne Vulgaris; Pruritus; Treatment Outcome
PubMed: 36517586
DOI: 10.1007/s00403-022-02506-0