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Acne Vulgaris (acne + vulgari)
Selected AbstractsAcne vulgaris in richly pigmented patientsDERMATOLOGIC THERAPY, Issue 3 2007Article first published online: 30 AUG 200 First page of article [source] Acne vulgaris in Nigerian adolescents , prevalence, severity, beliefs, perceptions, and practicesINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 5 2009Husain Yahya MSc Background, Community-based studies of acne vulgaris conducted in many parts of the world show that it is very common in adolescents but little is known from Africa. Methods, In a cross-sectional study, 539 randomly selected students aged 11,19 years in a secondary school in Kaduna, Nigeria were administered a questionnaire to assess self-report of acne, its severity and impact; beliefs and perceptions of causes, and treatments used. 418 students were later examined to detect and grade acne severity. Results, 274 (50.8%) were male while 265 (49.2%) were female. Mean age for respondents was 16 years. 320 students (59.4%) self-reported acne. Of 418 students examined, 379 had acne giving a prevalence of 90.7%. There was no significant gender difference in prevalence at all ages of adolescence. Prevalence of acne increased with age (76.7% at age 10,13 years; 88.2% at age 14,16 years; 97.1% at age 17,19 years). 353 of 379 (93.1%) had mild acne while 26 of 379 (6.9%) had moderate acne. The severity of acne was similar in boys and girls. 47.7% of students reported feeling "very sad/unhappy" about their acne although in more than 70% of those who self-reported, this did not interfere with relationship with family, friends or school work. Diet was the commonest factor believed to cause acne. Cleansing agents were the most commonly used treatments. Conclusions, Acne vulgaris is very common in Nigerian adolescents, although it is mild acne in most. [source] Change in pattern of skin disease in Kaduna, north-central NigeriaINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 9 2007Husain Yahya MSc Background, We report our experience on the pattern of skin disease in Kaduna, north-central Nigeria over a 6-year period, and compare it with a similar survey conducted in the same area 30 years ago and with surveys from Nigeria and from other parts of Africa. Methods, The medical records of new patients attending the dermatology outpatient clinics of Barau Dikko Specialist Hospital and Habbat Medical Center from March 2000 to December 2005 were retrieved. Demographic data (age and sex) and the diagnoses of skin disease were extracted and analyzed. Results, A total of 5982 cases was seen. Forty-nine per cent were males and 51% were females. One-third of the patients were aged under 20 years, and three quarters were aged below 40 years. Eczematous dermatitis was the most common skin disorder seen, making up 35% of cases, and had replaced dermatophyte infections and scabies, which were the most dominant skin diseases 30 years previously (now constituting 6% and 1.4% of cases, respectively). Atopic dermatitis had more than doubled in frequency (13.8% vs. 5.2%), and contact dermatitis had tripled in frequency (5.8% vs. 1.8%). Acne vulgaris (6.7%), pigmentary disorders (3.9%), urticaria (3.6%), papular urticaria (3.6%), hair disorders (3.3%), lichen simplex chronicus (3%), viral warts (2.9%), and drug eruptions (2.7%) had also increased. Human immunodeficiency virus-related skin disease constituted 4.3% of cases, with pruritic papular eruption being the most common condition. Conclusion, These changes in skin disease can be attributed mainly to an increase in urbanization and improved socio-economic conditions. [source] Demographic features and seasonal variations in patients with acne vulgaris in Saudi Arabia: a hospital-based studyINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 12 2002Ali M. Al-Ameer MD Aim To review the demographic features and seasonal variations of acne vulgaris in patients diagnosed at the Dermatology Outpatient Clinic, King Fahad Hospital of the University (KFHU), Al-Khobar, Saudi Arabia. Methods Two hundred and twenty cases (142 females, 78 males; mean age, 14.8 and 16.3 years, respectively) seen between January 1, 1999 and December 31, 2000 were studied. Results Patients suffering from acne vulgaris made up 19.6% of the new cases seen at the clinic. The male to female ratio was 1 : 1.8. The mean age of onset was 16.3 ± 2.1 years for males and 14.8 ± 3.9 years for females (P = 0.003). The largest numbers of patients were seen during the cold months of the year (November to February). Conclusions Acne vulgaris constituted nearly one fifth of all visits to the dermatologist with female predominance. It appears nearly one and a half years earlier in females than in males. Seasonal variations were observed in acne as the condition exacerbates in winter, while if often improves during the summer months. [source] Quality of medical care of patients with acne vulgaris in Germany , nationwide survey of pharmacy clientsJOURNAL DER DEUTSCHEN DERMATOLOGISCHEN GESELLSCHAFT, Issue 12 2009Nadine Franzke Summary Background: No empirical "real world" data on the health care of patients with acne vulgaris in Germany currently exist. The objective of this study was to get an informative basis of health care of patients with acne vulgaris in Germany, taking into account both doctor-prescribed medication and self-medication. Patients and Methods: Surveying both medically and self-treated patients, n = 504 patients with acne vulgaris were interviewed in 48 pharmacies nationwide. In addition to socio-demographic data, the duration of illness, localization and therapy as well as patient-relevant outcomes such as patient benefit, psychological strain and markers of compliance were evaluated. The participation and significance of individual treatment providers were also evaluated. Results: A large percentage of the patients found acne vulgaris to be burdensome. Despite the longstanding necessity of treatment and the chronic course of the illness, the treatment of acne vulgaris was deemed a rather satisfactory experience by most of those affected. Dermatologists were most frequently consulted for treatment. A great number of medicinal products were further acquired through self-medication or after consulting with a pharmacist. The medically regulated therapies predominantly complied with the latest guidelines. Conclusions: Acne vulgaris is a burdensome, socio-economically relevant illness, and dermatologists treat most cases in Germany. Surveying across a network of pharmacies offers a unique access to relevant treatment data. Selection effects, particularly by choice of doctors and self-medication, were minimized. [source] The frequency of polycystic ovary syndrome in females with resistant acne vulgarisJOURNAL OF COSMETIC DERMATOLOGY, Issue 2 2010Azar Hadi Maluki MD, CABMS (DV), FICMS (DV), MBCHB Summary Background, Acne vulgaris in females may be resistant to treatment in spite of topical and systemic therapy for a sufficient period. In this condition, acne may be a manifestation of underlying endocrine conditions such as polycystic ovary syndrome (PCOS). Objective, To evaluate the frequency of PCOS in females with resistant acne vulgaris. Patients and methods, This case-controlled study was conducted in the Department of Dermatology and Venereology in The Teaching Hospital in Al-Najaf during the period from October 2007 to November 2008. One hundred and twenty-three female patients with resistant acne vulgaris were included in this study. One hundred and twenty-three women, age-matched, without acne were enrolled as a control group. Detailed history, clinical examination, abdominal ultrasound study, and hormonal assays were obtained for the patients and the control group. Results, One hundred and twenty-three females with resistant acne were included; their ages ranged from 17 to 40 years with a mean of 25.016 ± 6.041 (SD). One hundred and twenty-three control women without acne were enrolled; their ages ranged from 17,40 years with a mean of 26.014 ± 6.251 (SD). The patients and the control group are age-matched (P = 0.192). It was found that 63 patients (51.2%) with resistant acne have PCOS in comparison to only eight control women (6.2%). The difference is highly significant. Conclusion, Polycystic ovary syndrome is an important contributing factor in females with resistant acne vulgaris. [source] Microbiological effect of photodynamic therapy (PDT) in healthy volunteers: a comparative study using methyl aminolaevulinate and hexyl aminolaevulinate creamCLINICAL & EXPERIMENTAL DERMATOLOGY, Issue 6 2007A. Yung Summary Background., Acne vulgaris is a common skin problem that affects up to 90% of adolescents. Colonization of the duct with Propionibacterium species is one of the factors implicated in the development of acne. Owing to the increasing incidence of antibiotic resistance, there has been an greater interest in the development of new methods to treat acne. Early studies have shown that photodynamic therapy (PDT) with aminolaevulinic acid (ALA) can lead to prolonged improvement in acne. Newer derivatives of ALA such as methyl aminolaevulinate hydrochloride (MAL) and hexyl aminolaevulinate hydrochloride (HAL) have been developed for use in PDT, with the potential benefits of higher lipophilicity and penetration potential. Objectives., To determine the microbiological effect and tolerability of a single application of HAL-PDT and to compare it with MAL-PDT in healthy volunteers. Methods., This was a randomised double-blind study to examine the microbiological effects and safety of a single application of MAL-PDT and HAL-PDT on normal skin in 18 healthy volunteers. Bacterial skin samples for Propionibacterium spp. and Micrococceae were obtained at baseline and 2, 4, 7 and 14 days. Results., Following PDT with MAL and HAL, a statistically significant transient reduction in mean density of Propionibacterium spp. 2 days after treatment using each agent (P < 0.05 for both) was found. There were no significant changes in mean number of Micrococceae for the duration of the study period. Treatment with HAL-PDT and MAL-PDT was well tolerated. Overall, HAL-PDT was associated with fewer side-effects compared with MAL-PDT (P < 0.01) over the 14 day study period. Conclusion., HAL-PDT and MAL-PDT transiently reduce density of Propionibacterium spp. density to a similar degree in normal healthy individuals. The transient reduction in Propionibacterium spp. suggests that the prolonged antiacne effect of PDT relies on factors independent of bacterial density. HAL-PDT appears to be better tolerated than MAL-PDT. [source] Comparison of efficacy of azithromycin vs. doxycycline in the treatment of acne vulgarisCLINICAL & EXPERIMENTAL DERMATOLOGY, Issue 3 2005S. Kus Summary Acne vulgaris is a common inflammatory disorder of the skin. Oral antibiotics are known to be effective in its treatment. A randomized, investigator-blinded study was performed to compare the efficacy of azithromycin with doxycycline. Fifty-one patients were randomized to receive either azithromycin 500 mg/day on 3 consecutive days per week in the first, on 2 consecutive days per week in the second, and on 1 day per week in the third month. The other group was given doxycycline twice a day for the first month and once a day for the second and third months. Clinical assessment was made at baseline, at the end of first, second, third, and post-treatment first and second months. Side effects were recorded. Statistically significant improvement for the facial lesions were obtained with both drugs. Neither drug was shown to be more effective than the other. The beneficial effect continued until 2 months after treatment. In the azithromycin group three patients had diarrohea, while photosensitivity was seen in two patients using doxycycline. This study indicates that azithromycin is at least as effective as doxycycline in the treatment of acne. [source] Minimally Ablative Erbium:YAG Laser Resurfacing of Facial Atrophic Acne Scars in Asian Skin: A Pilot StudyDERMATOLOGIC SURGERY, Issue 5 2008YONG-KWANG TAY MD BACKGROUND Atrophic scars are dermal depressions caused by collagen damage most commonly occurring after inflammatory acne vulgaris. There are little published data regarding the effectiveness and safety of minimally invasive lasers in the treatment of atrophic acne scars in darker skin types. OBJECTIVE The purpose was to evaluate the efficacy and safety of a low-fluence 2,940-nm erbium:YAG laser in the treatment of atrophic acne scars in Asian patients. MATERIALS AND METHODS Nine patients aged 19 to 45 years with mild to moderate atrophic facial scars and Skin Types IV and V were treated with topical anesthesia and one to two passes with an erbium:YAG laser two times at 1-month intervals. Treatment parameters were 6-mm spot size, fluence of 400 mJ, pulse duration of 300 ,s, and repetition rate of 2 Hz. RESULTS At 2 months after the last treatment, mild to moderate clinical improvement was noted in all patients compared to baseline. Treatment was well tolerated. Side effects consisted of posttreatment erythema, peeling, and crusting, which resolved within 1 to 2 weeks. There was no postinflammatory hyper- or hypopigmentation, blistering, or hypertrophic scarring. CONCLUSION Low-fluence erbium:YAG facial resurfacing was effective and safe in patients with mild to moderately severe atrophic acne scarring. [source] 5-Aminolevulinic Acid Photodynamic Therapy: Where We Have Been and Where We Are GoingDERMATOLOGIC SURGERY, Issue 8 2004Michael H. Gold MD Background. Photodynamic therapy, utilizing the topical administration of 20% 5-aminolevulinic acid, has generated a great deal of interest in the dermatology community over the past several years. Objective. The purpose of this article is to review the history of photodynamic therapy in dermatology and to review recent new advances with this technology that will increase its appeal to all dermatologists. Methods. A literature review and results of new clinical trials with regards to photorejuvenation and acne vulgaris treatments with 5-aminolevulinic acid photodynamic therapy are presented. Results. Short-contact, full-face 5-aminolevulinic acid photodynamic therapy treatments with a variety of lasers and light sources have shown to be successful in treating all facets of photorejuvenation and the associated actinic keratoses as well as disorders of sebaceous glands, including acne vulgaris. The treatments are relatively pain-free, efficacious, and safe. They are also making already available laser/light source therapies work better for acne vulgaris and photorejuvenation. Conclusions. The use of 5-aminolevulinic acid photodynamic therapy with short-contact, full-face broad-application therapy is now able to bridge the world of medical and cosmetic dermatologic surgery. This therapy is available for all dermatologists to utilize in the care of their patients. [source] New and emerging treatments in dermatology: acneDERMATOLOGIC THERAPY, Issue 2 2008A. Katsambas ABSTRACT:, Topical retinoids, benzoyl peroxide, azelaic acid, and topical and oral antibiotics remain the milestone of treatment for mild to moderate acne vulgaris. Oral isotretinoin is useful for the treatment of severe nodular acne, treatment-resistant acne, and acne with a risk of physical or psychological scarring. Hormonal treatment in female acne is useful in resistant or late-onset acne. With increasing concerns regarding teratogenicity of isotretinoin and increasing antibiotic resistance, there is a clear need for therapeutic alternatives to these long-used treatments. Research in the pathogenesis of acne has allowed for new therapies and future perspectives regarding acne to evolve. They include low-dose long-term isotretinoin regimens, insulin-sensitizing agents, 5,-reductase type 1 inhibitors, topical photodynamic therapy, new combination formulations, dietary interventions, and antiinflammatory agents such as lipoxygenase inhibitors. [source] New developments in our understanding of acne pathogenesis and treatmentEXPERIMENTAL DERMATOLOGY, Issue 10 2009Ichiro Kurokawa Abstract:, Interest in sebaceous gland physiology and its diseases is rapidly increasing. We provide a summarized update of the current knowledge of the pathobiology of acne vulgaris and new treatment concepts that have emerged in the last 3 years (2005,2008). We have tried to answer questions arising from the exploration of sebaceous gland biology, hormonal factors, hyperkeratinization, role of bacteria, sebum, nutrition, cytokines and toll-like receptors (TLRs). Sebaceous glands play an important role as active participants in the innate immunity of the skin. They produce neuropeptides, excrete antimicrobial peptides and exhibit characteristics of stem cells. Androgens affect sebocytes and infundibular keratinocytes in a complex manner influencing cellular differentiation, proliferation, lipogenesis and comedogenesis. Retention hyperkeratosis in closed comedones and inflammatory papules is attributable to a disorder of terminal keratinocyte differentiation. Propionibacterium acnes, by acting on TLR-2, may stimulate the secretion of cytokines, such as interleukin (IL)-6 and IL-8 by follicular keratinocytes and IL-8 and -12 in macrophages, giving rise to inflammation. Certain P. acnes species may induce an immunological reaction by stimulating the production of sebocyte and keratinocyte antimicrobial peptides, which play an important role in the innate immunity of the follicle. Qualitative changes of sebum lipids induce alteration of keratinocyte differentiation and induce IL-1 secretion, contributing to the development of follicular hyperkeratosis. High glycemic load food and milk may induce increased tissue levels of 5,-dihydrotestosterone. These new aspects of acne pathogenesis lead to the considerations of possible customized therapeutic regimens. Current research is expected to lead to innovative treatments in the near future. [source] Role of insulin, insulin-like growth factor-1, hyperglycaemic food and milk consumption in the pathogenesis of acne vulgarisEXPERIMENTAL DERMATOLOGY, Issue 10 2009Bodo C. Melnik Abstract:, It is the purpose of this viewpoint article to delineate the regulatory network of growth hormone (GH), insulin, and insulin-like growth factor-1 (IGF-1) signalling during puberty, associated hormonal changes in adrenal and gonadal androgen metabolism, and the impact of dietary factors and smoking involved in the pathogenesis of acne. The key regulator IGF-1 rises during puberty by the action of increased GH secretion and correlates well with the clinical course of acne. In acne patients, associations between serum levels of IGF-1, dehydroepiandrosterone sulphate, dihydrotestosterone, acne lesion counts and facial sebum secretion rate have been reported. IGF-1 stimulates 5,-reductase, adrenal and gonadal androgen synthesis, androgen receptor signal transduction, sebocyte proliferation and lipogenesis. Milk consumption results in a significant increase in insulin and IGF-1 serum levels comparable with high glycaemic food. Insulin induces hepatic IGF-1 secretion, and both hormones amplify the stimulatory effect of GH on sebocytes and augment mitogenic downstream signalling pathways of insulin receptors, IGF-1 receptor and fibroblast growth factor receptor-2b. Acne is proposed to be an IGF-1-mediated disease, modified by diets and smoking increasing insulin/IGF1-signalling. Metformin treatment, and diets low in milk protein content and glycaemic index reduce increased IGF-1 signalling. Persistent acne in adulthood with high IGF-1 levels may be considered as an indicator for increased risk of cancer, which may require appropriate dietary intervention as well as treatment with insulin-sensitizing agents. [source] Acne vulgaris in Nigerian adolescents , prevalence, severity, beliefs, perceptions, and practicesINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 5 2009Husain Yahya MSc Background, Community-based studies of acne vulgaris conducted in many parts of the world show that it is very common in adolescents but little is known from Africa. Methods, In a cross-sectional study, 539 randomly selected students aged 11,19 years in a secondary school in Kaduna, Nigeria were administered a questionnaire to assess self-report of acne, its severity and impact; beliefs and perceptions of causes, and treatments used. 418 students were later examined to detect and grade acne severity. Results, 274 (50.8%) were male while 265 (49.2%) were female. Mean age for respondents was 16 years. 320 students (59.4%) self-reported acne. Of 418 students examined, 379 had acne giving a prevalence of 90.7%. There was no significant gender difference in prevalence at all ages of adolescence. Prevalence of acne increased with age (76.7% at age 10,13 years; 88.2% at age 14,16 years; 97.1% at age 17,19 years). 353 of 379 (93.1%) had mild acne while 26 of 379 (6.9%) had moderate acne. The severity of acne was similar in boys and girls. 47.7% of students reported feeling "very sad/unhappy" about their acne although in more than 70% of those who self-reported, this did not interfere with relationship with family, friends or school work. Diet was the commonest factor believed to cause acne. Cleansing agents were the most commonly used treatments. Conclusions, Acne vulgaris is very common in Nigerian adolescents, although it is mild acne in most. [source] "Hidradenitis suppurativa" is acne inversa!INTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 7 2005An appeal to (finally) abandon a misnomer The term "hidradenitis suppurativa" is firmly entrenched in the dermatological literature although it refers to a false pathogenetic concept. The term was historically coined based merely on the characteristic distribution of the apocrine glands and the anatomical coincidence with the disease process. At center stage is not a suppurative inflammation of the apocrine sweat glands but an occlusion of the hair follicles, comparable to acne vulgaris. Reviewing the literature on this subject, we were astonished to find that even articles that concluded that the entity represents a form of follicular occlusion still referred to it as hidradenitis suppurativa. The disorder shares histopathological and clinical aspects with acne vulgaris modified under the special circumstances of anatomical regions rich in apocrine glands. It is acne inversa because, in contrast to acne vulgaris, the disease involves intertriginous localizations and not the regions classically affected by acne. We suggest that the term "hidradenitis suppurativa" for this disease should (finally) be abandoned in favour of "acne inversa". [source] Vitamin E does not reduce the side-effects of isotretinoin in the treatment of acne vulgarisINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 3 2005Sadiye Kus Background, Isotretinoin is widely used in the treatment of severe, recalcitrant, nodular acne. Mucocutaneous side-effects are seen in the great majority of patients and some of them have elevations in their serum lipid and liver enzyme profiles. Recently, it has been shown that addition of vitamin E decreased the toxicity of high-dose retinoids. Objective, The purpose of this investigator-blinded, randomized study was to assess whether vitamin E would reduce the side-effects of isotretinoin in the treatment of acne vulgaris. Methods, Eighty two patients were randomly assigned to one of two treatment groups with isotretinoin (1 mg/kg/day) alone or combined with vitamin E (800 IU/day). The treatment duration was 16 weeks. Mucocutaneous side-effects such as facial erythema, facial dryness, cheilitis and serum lipid and liver enzyme profiles were assessed. Results, There was no difference in the incidence and severity of side-effects related to isotretinoin between the two treatment groups. Conclusion, Eight hundred IU/day vitamin E did not improve the side-effects of 1 mg/kg/day of isotretinoin in the treatment of acne vulgaris. [source] Microbiology's principle of biofilms as a major factor in the pathogenesis of acne vulgarisINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 12 2003Craig N. Burkhart MSBS Propionibacterium acnes reside within the pilosebaceous unit in a biofilm. As such, they live in a community of bacteria that encase themselves within an extracellular polysaccharide lining, which the organisms secrete after adherence to the surface. This gylcocalyx polymer acts as a protective exoskeleton and serves as a physical barrier, limiting effective antimicrobial concentrations within the biofilm microenvironment. The gylcocalyx polymer secreted by P. acnes as a biofilm may explain the immunogenicity of the organism as well as the clinical course of the disease. The P. acnes' biofilm model explains many aspects of acne pathogenesis and therapy, including why prolonged antibiotic treatment is needed, why antibiotic resistance is not a reliable assessment of treatment outcome, why accutane offers long-lasting effectiveness, and why benzoyl peroxide radicals are beneficial. This microbiologic principle of biofilms as applied to acne leads to numerous new pathways of assessment and exploration. [source] Study of the skin disease spectrum occurring in an Afro-Caribbean populationINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 4 2003Patricia Dunwell MBBS Background There is a scarcity of recent up-to-date studies on the incidence of skin disease among Afro-Caribbeans. Methods One thousand patients were retrospectively studied for the commonest diagnoses made over a 5-month period from January to May 2001. Results The commonest skin diseases seen were acne vulgaris (29.21%), seborrhoeic eczema (22.02%), pigmentary disorders (16.56%), and atopic eczema (6.1%). Other notable common diagnoses included keratosis pilaris, tinea infection, hirsuitism, folliculitis keloidalis nuchae, viral warts, dermatosis papulosa nigra, and confluent and reticulate papillomatosis. Conclusion The pattern of skin disease seen in the Afro-Caribbean population studied, more closely resembles those seen in developed countries than those seen in developing countries. [source] Demographic features and seasonal variations in patients with acne vulgaris in Saudi Arabia: a hospital-based studyINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 12 2002Ali M. Al-Ameer MD Aim To review the demographic features and seasonal variations of acne vulgaris in patients diagnosed at the Dermatology Outpatient Clinic, King Fahad Hospital of the University (KFHU), Al-Khobar, Saudi Arabia. Methods Two hundred and twenty cases (142 females, 78 males; mean age, 14.8 and 16.3 years, respectively) seen between January 1, 1999 and December 31, 2000 were studied. Results Patients suffering from acne vulgaris made up 19.6% of the new cases seen at the clinic. The male to female ratio was 1 : 1.8. The mean age of onset was 16.3 ± 2.1 years for males and 14.8 ± 3.9 years for females (P = 0.003). The largest numbers of patients were seen during the cold months of the year (November to February). Conclusions Acne vulgaris constituted nearly one fifth of all visits to the dermatologist with female predominance. It appears nearly one and a half years earlier in females than in males. Seasonal variations were observed in acne as the condition exacerbates in winter, while if often improves during the summer months. [source] Quality of medical care of patients with acne vulgaris in Germany , nationwide survey of pharmacy clientsJOURNAL DER DEUTSCHEN DERMATOLOGISCHEN GESELLSCHAFT, Issue 12 2009Nadine Franzke Summary Background: No empirical "real world" data on the health care of patients with acne vulgaris in Germany currently exist. The objective of this study was to get an informative basis of health care of patients with acne vulgaris in Germany, taking into account both doctor-prescribed medication and self-medication. Patients and Methods: Surveying both medically and self-treated patients, n = 504 patients with acne vulgaris were interviewed in 48 pharmacies nationwide. In addition to socio-demographic data, the duration of illness, localization and therapy as well as patient-relevant outcomes such as patient benefit, psychological strain and markers of compliance were evaluated. The participation and significance of individual treatment providers were also evaluated. Results: A large percentage of the patients found acne vulgaris to be burdensome. Despite the longstanding necessity of treatment and the chronic course of the illness, the treatment of acne vulgaris was deemed a rather satisfactory experience by most of those affected. Dermatologists were most frequently consulted for treatment. A great number of medicinal products were further acquired through self-medication or after consulting with a pharmacist. The medically regulated therapies predominantly complied with the latest guidelines. Conclusions: Acne vulgaris is a burdensome, socio-economically relevant illness, and dermatologists treat most cases in Germany. Surveying across a network of pharmacies offers a unique access to relevant treatment data. Selection effects, particularly by choice of doctors and self-medication, were minimized. [source] The frequency of polycystic ovary syndrome in females with resistant acne vulgarisJOURNAL OF COSMETIC DERMATOLOGY, Issue 2 2010Azar Hadi Maluki MD, CABMS (DV), FICMS (DV), MBCHB Summary Background, Acne vulgaris in females may be resistant to treatment in spite of topical and systemic therapy for a sufficient period. In this condition, acne may be a manifestation of underlying endocrine conditions such as polycystic ovary syndrome (PCOS). Objective, To evaluate the frequency of PCOS in females with resistant acne vulgaris. Patients and methods, This case-controlled study was conducted in the Department of Dermatology and Venereology in The Teaching Hospital in Al-Najaf during the period from October 2007 to November 2008. One hundred and twenty-three female patients with resistant acne vulgaris were included in this study. One hundred and twenty-three women, age-matched, without acne were enrolled as a control group. Detailed history, clinical examination, abdominal ultrasound study, and hormonal assays were obtained for the patients and the control group. Results, One hundred and twenty-three females with resistant acne were included; their ages ranged from 17 to 40 years with a mean of 25.016 ± 6.041 (SD). One hundred and twenty-three control women without acne were enrolled; their ages ranged from 17,40 years with a mean of 26.014 ± 6.251 (SD). The patients and the control group are age-matched (P = 0.192). It was found that 63 patients (51.2%) with resistant acne have PCOS in comparison to only eight control women (6.2%). The difference is highly significant. Conclusion, Polycystic ovary syndrome is an important contributing factor in females with resistant acne vulgaris. [source] Minocycline hyperpigmentation isolated to the subcutaneous fatJOURNAL OF CUTANEOUS PATHOLOGY, Issue 7 2005Zakia Rahman We present a 15-year-old girl with bilateral lower extremity discoloration of one-year duration while taking minocycline for acne vulgaris. The clinical characteristics best supported type II minocycline hyperpigmentation, but the histology revealed that the pigmentation was solely limited to the subcutaneous adipose tissue, completely sparing the dermis. Special stain for iron was negative. This is the first case to our knowledge with pigment exclusively located in the subcutaneous fat and with the unusual finding of a negative stain for iron. [source] Tea tree oil concentration in follicular casts after topical delivery: Determination by high-performance thin layer chromatography using a perfused bovine udder modelJOURNAL OF PHARMACEUTICAL SCIENCES, Issue 2 2005S.S. Biju Abstract Tea tree oil, a popular antimicrobial agent is recommended for the treatment of acne vulgaris, a disease of the pilosebaceous unit. Tea tree oil formulations (colloidal bed, microemulsion, multiple emulsion, and liposomal dispersion containing 5% w/w tea tree oil) were applied to bovine udder skin. The follicular uptake of tea tree oil upon application was determined by a cyanoacrylate method. Tea tree oil was determined by quantifying terpinen-4-ol content using high-performance thin layer chromatography. The accumulation of tea tree oil in the follicular casts was 0.43,±,0.01, 0.41,±,0.009, 0.21,±,0.006, and 0.16,±,0.005 percentage by weight (milligram oil/gram of sebum plug) for microemulsion, liposomal dispersion, multiple emulsion, and colloidal bed, respectively. This is the first study of its kind to quantify tea tree oil concentration in the follicles. © 2004 Wiley-Liss, Inc. and the American Pharmacists Association J Pharm Sci 94:240,245, 2005 [source] Prospective, open-label, comparative study of clindamycin 1%/benzoyl peroxide 5% gel with adapalene 0.1% gel in Asian acne patients: efficacy and tolerabilityJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 3 2009H-C Ko Abstract Background, Used as individual agents, topical antibiotics and benzoyl peroxide are known to be effective in treatment of acne. Clindamycin phosphate 1% with benzoyl peroxide 5% (CDP/BPO) is a new combination gel, made by rationale, in that combination drug is more effective than either ingredients used alone. Adapalene 0.1% (ADA) is the third-generation retinoid, shown to be as effective as other topical retinoid with well tolerability. Objectives, To compare the efficacy and tolerability in combination of CDP/BPO in comparison with ADA in Asian patients with mild to moderate acne vulgaris. Methods, Total of 69 patients, including 31 patients for CDP/BPO group and 38 for ADA group, with mild to moderate acne vulgaris were enrolled for a 12-week prospective, randomized, open-label comparative study of topical agents. Efficacy was assessed by lesion counts, acne grading system, and global improvement. Adverse events were also evaluated in scale of 0 (none) to 3 (severe). Results, Both CDP/BPO and ADA were effective in reducing lesion counts and acne severity scale and showed significant global improvement. However, CDP/BPO offered greater efficacy against inflammatory lesions than ADA. Both drugs were well tolerated with minimal adverse drug reactions. Conclusion, Combination formulation of CDP/BPO and ADA were shown to be both effective in decreasing total, inflammatory, and non-inflammatory lesion counts along with well tolerability in Asian patients with mild to moderate acne vulgaris. Conflicts of interest None declared [source] Evidence-based review of lasers, light sources and photodynamic therapy in the treatment of acne vulgarisJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 3 2008M Hædersdal Abstract Background, There is a considerable need for effective and safe treatment for acne vulgaris. Objective, In a systematic review with an evidence-based approach to assess the effects of optical treatments for acne vulgaris. Methods, Original publications of controlled clinical trials were identified through searches in PubMed and the Cochrane Library. Results, A total of 16 randomized controlled trials (RCT) and 3 controlled trials (CT) were identified, involving a total of 587 patients. Interventions included photodynamic therapy (PDT; 5 RCTs), infrared lasers (4 RCTs), broad-spectrum light sources (3 RCTs, 1 CT), pulsed dye lasers (PDL; 2 RCTs, 1 CT), intense pulsed light (IPL; 1 RCTs, 2 CTs), and potassium titanyl phosphate laser (1 RCT). The randomization method was mentioned in 6 of 16 RCTs, and one trial described adequate allocation concealment. Most trials were intraindividual trials (12 of 19), which applied blinded response evaluations (12 of 19) and assessed a short-term efficacy up to 12 weeks after treatment (17 of 19). Based on the present best available evidence, we conclude that optical treatments possess the potential to improve inflammatory acne on a short-term basis with the most consistent outcomes for PDT [up to 68% improvement, aminolevulinic acid (ALA), methyl-aminolevulinic acid (MAL) and red light]. IPL-assisted PDT seems to be superior to IPL alone. Only two trials compare optical vs. conventional treatments, and further studies are needed. Side-effects from optical treatments included pain, erythema, oedema, crusting, hyperpigmentation, pustular eruptions and were more intense for treatments combined with ALA or MAL. Conclusion, Evidence from controlled clinical trials indicates a short-term efficacy from optical treatments for acne vulgaris with the most consistent outcomes for PDT. We recommend that patients are preoperatively informed of the existing evidence, which indicates that optical treatments today are not included among first line treatments. [source] Is oral isotretinoin the treatment of choice in moderate and severe inflammatory acne vulgaris?JOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 9 2007CD Verros [source] Quality of life in mild to moderate acne: relationship to clinical severity and factors influencing change with treatmentJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 2 2007M Jones-Caballero Abstract Background, Because of its effects on quality of life, acne vulgaris is more than a merely physiological or cosmetic entity. Objectives, To describe the influence of mild to moderate acne on patients' quality of life, measured using Skindex-29, and to correlate changes in Skindex-29 scores with changes in objective and subjective indices in clinical severity after treatment with topical 4% erythromycin 0.2% zinc. Also, to evaluate efficacy and side-effects of the treatment. Methods, Observational, prospective study of 1878 patients cared for by 252 clinicians in Spain. Data included epidemiological information and responses to Skindex-29, a subjective change and objective severity index. Results, Baseline Skindex scale scores were worse in women, older patients, and those with more severe clinical disease. Skindex was sensitive to changes in objective severity but changes in Skindex scale scores were also related to other factors. Patients who reported their skin condition to be ,the same' or ,worse' at the end of the study had significantly worse baseline scores on the ,symptoms' and ,emotions' scales but ,functioning' scores were not worse than for those who reported their condition had improved. Conclusion, The effects of acne vulgaris on quality of life and changes in quality of life after treatment are not only explainable by objective severity of acne. Patients' and clinicians' judgements about acne severity are different. [source] A review of the European Directive for prescribing systemic isotretinoin for acne vulgarisJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 7 2006AM Layton Abstract Since the introduction of generic oral isotretinoin there have been discussions around harmonizing the summary of product characteristics of each formulation. As a result of these discussions, a European Directive concerned with the prescribing of oral isotretinoin has been introduced and the FDA (Food and Drugs Administration) has recently implemented new regulations. The aims of this article are to summarize the history of the processes involved, outline the new recommendations and discuss the impact of these changes in clinical practice. [source] Improved efficacy and tolerability of retinoic acid in acne vulgaris: a new topical formulation with cyclodextrin complex ,JOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 4 2004RY Anadolu ABSTRACT Objectives, Retinoic acid (RA) has long been used, both topically and systemically, for disorders of keratinization, acne and related disorders. In the present study, the efficacy and tolerability of topical RA prepared as a cyclodextrin beta complex (,-CD) is investigated in 66 acne vulgaris patients. Methods, This randomized, double-blind, placebo-controlled study compares nightly topical application of RA/,-CD complex hydrogel formulation (0.025%), RA/,-CD complex in moisturizing base (0.025%), hydrogel base, moisturizer base or a commercial RA gel (0.05%) in acne vulgaris patients. Improvement of acne was assessed using a 5-point improvement scale and by measuring sebum and moisture content of the skin using an SM 810 sebumeter/corneometer. Results, After 3 months of treatment, mean scores of acne improvement on the 5-point scale were 4 with the RA/,-CD complex hydrogel formulation, 4.1 with the RA/,-CD complex in moisturizing base, 1.2 with hydrogel placebo base, 1.1 with moisturizer placebo base and 3 with the commercial RA product. All patients treated with the commercial product experienced local side-effects. One patient discontinued due to severe irritation. None of the patients treated with the RA/,-CD complex in the moisturizing base and hydrogel formulation experienced significant local irritation, although the sebum content of the skin decreased after application of the RA/,-CD preparations. This change was not significant compared to controls. The moisture content of the skin was better preserved in the group treated with the RA/,-CD complex in the moisturizing base. Conclusion, The topical RA/,-CD complex, in hydrogel and moisturizing base, was more effective than the twice concentrated commercial RA product. There were few topical side-effects with this new formulation, which increases patient compliance. Topical RA/,-CD (0.025% RA) did not significantly reduce sebum secretion but may help to preserve optimum epidermal moisture content with the proper base formulation. This is the first study in the literature reporting efficacy and tolerability of the topical RA/,-CD complex in acne vulgaris. We conclude that the topical RA/,-CD complex displays an improved efficacy and tolerability profile and is an effective treatment alternative for acne vulgaris. [source] Intense pulsed light (IPL): A reviewLASERS IN SURGERY AND MEDICINE, Issue 2 2010Philipp Babilas MD Abstract Background Intense pulsed light (IPL) devices use flashlamps and bandpass filters to emit polychromatic incoherent high-intensity pulsed light of determined wavelength spectrum, fluence, and pulse duration. Similar to lasers, the basic principle of IPL devices is a more or less selective thermal damage of the target. The combination of prescribed wavelengths, fluences, pulse durations, and pulse intervals facilitates the treatment of a wide spectrum of skin conditions. Objective To summarize the physics of IPL, to provide guidance for the practical use of IPL devices, and to discuss the current literature on IPL in the treatment of unwanted hair growth, vascular lesions, pigmented lesions, acne vulgaris, and photodamaged skin and as a light source for PDT and skin rejuvenation. Methods A systematic search of several electronic databases, including Medline and PubMed and the authors experience on intense pulsed light. Results Numerous trials show the effectiveness and compatibility of IPL devices. Conclusion Most comparative trials attest IPLs similar effectiveness to lasers (level of evidence: 2b to 4, depending on the indication). However, large controlled and blinded comparative trials with an extended follow-up period are necessary. Lasers Surg. Med. 42:93,104, 2010. © 2009 Wiley-Liss, Inc. 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