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Sample records for acne disability index

  1. Translation, cultural adaptation and validation for Brazilian Portuguese of the Cardiff Acne Disability Index instrument*

    PubMed Central

    Grando, Luciana Rosa; Horn, Roberta; Cunha, Vivian Trein; Cestari, Tania Ferreira

    2016-01-01

    BACKGROUND The Cardiff Acne Disability Index was originally developed in English for measuring quality of life of acne patients. Considering the psychosocial impact of this disease, it is important to have instruments culturally and linguistically validated for use in Brazilian adolescents. OBJECTIVE To translate the Cardiff Acne Disability Index into Brazilian Portuguese, culturally adapt it, and verify its reliability and validity in adolescent patients with acne. METHODS In the first step, the Cardiff Acne Disability Index was translated and validated linguistically to Brazilian Portuguese in accordance with international guidelines published. In the second step, the validation of the Cardiff Acne Disability Index into Brazilian Portuguese instrument was performed, when patients aged from 12 to 20 years with acne were selected. The participants were interviewed to collect demographic data, submitted to the classification of acne by the Global Acne Grading System and invited to respond the Cardiff Acne Disability Index into Brazilian Portuguese version and DLQI (>16 years) or CDLQI (≤16 years). The internal consistency of Cardiff Acne Disability Index into Brazilian Portuguese was assessed by Cronbach’s alpha coefficient and concurrent validity was measured by the Spearman correlation coefficient and Student ‘s t-test for paired samples. RESULTS The study included 100 adolescents. The Cardiff Acne Disability Index into Brazilian Portuguese version showed good reliability and internal consistency (Cronbach’s alpha = 0.73). The concurrent validity of the scale was supported by a strong and significant correlation with CDLQI / DLQI instruments (rs=0.802;p<0.001). CONCLUSIONS Cardiff Acne Disability Index into Brazilian Portuguese version is a reliable, valid and valuable tool to measure the impact of acne on quality of life in adolescent patients. PMID:27192517

  2. Acne

    MedlinePlus

    ... Home Body Looking and feeling your best Acne Acne Whether you call them pimples, zits, or acne, ... treatments? What doesn’t cause acne? What causes acne? top Acne happens when your pores get clogged ...

  3. Acne

    MedlinePlus

    Acne is a common skin disease that causes pimples. Pimples form when hair follicles under your skin ... neck, back, chest, and shoulders. Anyone can get acne, but it is common in teenagers and young ...

  4. Acne

    MedlinePlus

    ... can try different ones to see which helps. Products with benzoyl peroxide (say: BEN-zoil peh - ROK - side) or salicylic (say: sal-uh-SIL - ick) acid in them are usually pretty helpful for treating acne. Benzoyl peroxide kills the bacteria that can lead to acne and it also ...

  5. Acne

    MedlinePlus

    ... acne and scarring may try a medicine called isotretinoin (Accutane). You will be watched closely when taking this ... its side effects. Pregnant women should NOT take Accutane, because it causes severe birth defects. Women taking ...

  6. Effects of isotretinoin on body mass index, serum adiponectin, leptin, and ghrelin levels in acne vulgaris patients

    PubMed Central

    Ayvaz, Havva Hilal; Ozturk, Gulfer; Ergin, Can; Akıs, Havva Kaya; Gonul, Muzeyyen; Arzuhal, Ercan

    2016-01-01

    Introduction Isotretinoin has been successfully used for the treatment of acne vulgaris. Aim To investigate the effects of isotretinoin on body mass index (BMI), to determine whether isotretinoin causes any changes in serum adiponectin, leptin, and ghrelin levels in acne vulgaris patients, and to correlate variables. Material and methods Thirty-two patients were included in this study. Oral isotretinoin was begun at a dose of 0.5–0.6 mg/kg and raised to 0.6–0.75 mg/kg. Pretreatment and posttreatment third-month BMI and adiponectin, leptin, and ghrelin serum levels were measured. Results The pre- and posttreatment BMI values were not significantly different. In addition, serum adiponectin and leptin levels were significantly increased following isotretinoin therapy while serum ghrelin levels were not different. Conclusions Isotretinoin may exert its anti-inflammatory activity by increasing leptin and adiponectin levels.

  7. Effects of isotretinoin on body mass index, serum adiponectin, leptin, and ghrelin levels in acne vulgaris patients

    PubMed Central

    Ayvaz, Havva Hilal; Ozturk, Gulfer; Ergin, Can; Akıs, Havva Kaya; Gonul, Muzeyyen; Arzuhal, Ercan

    2016-01-01

    Introduction Isotretinoin has been successfully used for the treatment of acne vulgaris. Aim To investigate the effects of isotretinoin on body mass index (BMI), to determine whether isotretinoin causes any changes in serum adiponectin, leptin, and ghrelin levels in acne vulgaris patients, and to correlate variables. Material and methods Thirty-two patients were included in this study. Oral isotretinoin was begun at a dose of 0.5–0.6 mg/kg and raised to 0.6–0.75 mg/kg. Pretreatment and posttreatment third-month BMI and adiponectin, leptin, and ghrelin serum levels were measured. Results The pre- and posttreatment BMI values were not significantly different. In addition, serum adiponectin and leptin levels were significantly increased following isotretinoin therapy while serum ghrelin levels were not different. Conclusions Isotretinoin may exert its anti-inflammatory activity by increasing leptin and adiponectin levels. PMID:27605902

  8. Epidemiology of acne vulgaris.

    PubMed

    Bhate, K; Williams, H C

    2013-03-01

    Despite acne being an almost universal condition in younger people, relatively little is known about its epidemiology. We sought to review what is known about the distribution and causes of acne by conducting a systematic review of relevant epidemiological studies. We searched Medline and Embase to the end of November 2011. The role of Propionibacterium acnes in pathogenesis is unclear: antibiotics have a direct antimicrobial as well as an anti-inflammatory effect. Moderate-to-severe acne affects around 20% of young people and severity correlates with pubertal maturity. Acne may be presenting at a younger age because of earlier puberty. It is unclear if ethnicity is truly associated with acne. Black individuals are more prone to postinflammatory hyperpigmentation and specific subtypes such as 'pomade acne'. Acne persists into the 20s and 30s in around 64% and 43% of individuals, respectively. The heritability of acne is almost 80% in first-degree relatives. Acne occurs earlier and is more severe in those with a positive family history. Suicidal ideation is more common in those with severe compared with mild acne. In the U.S.A., the cost of acne is over 3 billion dollars per year in terms of treatment and loss of productivity. A systematic review in 2005 found no clear evidence of dietary components increasing acne risk. One small randomized controlled trial showed that low glycaemic index (GI) diets can lower acne severity. A possible association between dairy food intake and acne requires closer scrutiny. Natural sunlight or poor hygiene are not associated. The association between smoking and acne is probably due to confounding. Validated core outcomes in future studies will help in combining future evidence.

  9. Disabled workers and the indexing of Social Security benefits.

    PubMed

    Strand, Alexander; Rupp, Kalman

    2007-01-01

    We examine how benefit amounts and family income would change in response to changing the Social Security (Old-Age, Survivors, and Disability Insurance, OASDI) benefit indexing scheme. We are interested in a class of reform options designed to gradually slow the growth of benefits across the board. These options include the "price indexing" and "longevity indexing" proposals that have been part of the recent Social Security reform debate in the United States as well as a range of proposals developed in Europe. In this article, we focus on the distributional effects on the disabled. This focus leads to two comparisons. First, we compare disabled-worker beneficiaries to another group that would be affected by the changes, retired-worker beneficiaries. Second, we examine relative changes for particularly vulnerable subgroups of disabled workers. In the empirical analysis, we use two illustrative examples of potential indexing changes: Shifting from wage indexing to price indexing of the initial level of OASDI benefits; and Adjusting the initial benefit level for changes in life expectancy at retirement, that is, longevity indexing. We employ a historical counterfactual simulation to evaluate outcomes that would have resulted from changing the indexing scheme at one particular point in time. The hypothetical implementation period begins with the historical start of the current regime of indexing in 1979 and ends with one of the reference periods of the 1996 Survey of Income and Program Participation (SIPP), a 17-year period. However, we briefly assess the extent to which the results would be applicable to other time horizons. The analysis uses a cross-sectional sample of OASDI beneficiaries from the 1996 SIPP matched to Social Security administrative records. Further, we use total income from the SIPP (as adjusted to correspond to the calculated OASDI benefit amounts) to simulate eligibility for Supplemental Security Income (SSI) and SSI benefit amounts. Our overall

  10. Disabled workers and the indexing of Social Security benefits.

    PubMed

    Strand, Alexander; Rupp, Kalman

    2007-01-01

    We examine how benefit amounts and family income would change in response to changing the Social Security (Old-Age, Survivors, and Disability Insurance, OASDI) benefit indexing scheme. We are interested in a class of reform options designed to gradually slow the growth of benefits across the board. These options include the "price indexing" and "longevity indexing" proposals that have been part of the recent Social Security reform debate in the United States as well as a range of proposals developed in Europe. In this article, we focus on the distributional effects on the disabled. This focus leads to two comparisons. First, we compare disabled-worker beneficiaries to another group that would be affected by the changes, retired-worker beneficiaries. Second, we examine relative changes for particularly vulnerable subgroups of disabled workers. In the empirical analysis, we use two illustrative examples of potential indexing changes: Shifting from wage indexing to price indexing of the initial level of OASDI benefits; and Adjusting the initial benefit level for changes in life expectancy at retirement, that is, longevity indexing. We employ a historical counterfactual simulation to evaluate outcomes that would have resulted from changing the indexing scheme at one particular point in time. The hypothetical implementation period begins with the historical start of the current regime of indexing in 1979 and ends with one of the reference periods of the 1996 Survey of Income and Program Participation (SIPP), a 17-year period. However, we briefly assess the extent to which the results would be applicable to other time horizons. The analysis uses a cross-sectional sample of OASDI beneficiaries from the 1996 SIPP matched to Social Security administrative records. Further, we use total income from the SIPP (as adjusted to correspond to the calculated OASDI benefit amounts) to simulate eligibility for Supplemental Security Income (SSI) and SSI benefit amounts. Our overall

  11. Acne Vulgaris and Quality of Life Among Young Adults in South India

    PubMed Central

    Durai, Priya Cinna T; Nair, Dhanya G

    2015-01-01

    Acne vulgaris is a chronic condition affecting more than 85% of adolescents and young adults. It is one of the most common diseases affecting humanity and its impact on quality of life (QoL) is important. The impact of acne on QoL in Indian patients remains undocumented. The study was undertaken to detect the impact of acne vulgaris and related factors that may influence the QoL. Materials and Methods: This was a hospital-based, prospective, cross-sectional, prestructured, questionnaire-based study done on 140 consenting individuals, who attended the Dermatology outpatient department. Acne vulgaris was graded using simple grading system. QoL was measured using a combination of skin disease-specific (Dermatological Life Quality Index (DLQI)) and acne-specific (Cardiff Acne Disability Index (CADI)) questionnaires. Results: Majority of our study population were students (103, 73.6%). Face (139, 99.3%) was the commonest site of acne and comedones 133, 95% were the commonest type of lesion. Most of the individuals 66, 47.1% were observed to have grade 1 acne. The mean DLQI score was 6.91 and the mean CADI score was 5.2. Association between the scores was statistically significant. Age, occupation, marital status, family, and treatment history played a role in affecting the QoL. Diet, smoking, and alcohol did not influence the QoL. Conclusion: Though acne had impact on patient's QoL, it was less severe in our study. It is important for health professionals to incorporate QoL measurements when managing acne patients to provide better and appropriate care. PMID:25657394

  12. [Acne vulgaris].

    PubMed

    Zouboulis, C C

    2014-08-01

    Acne vulgaris is worldwide the most common skin disease. Acne is an inflammatory disorder in whose emergence androgens, PPAR ligands, the IGF-1 signaling pathway, regulating neuropeptides and environmental factors are probably involved. These factors interrupt the natural cycling process in the sebaceous gland follicle and support the transition of microcomedones to comedones and inflammatory lesions. Proinflammatory lipids and cytokines are mediators for the development of acne lesions. Bacterial antigens can potentate the inflammatory phenomena. Acne is predominantly treated with combination therapy. Selecting a treatment regimen depends on the exact classification of acne type and severity. The development of scars is the main criterion for the choice of systemic therapy. Retinoids for mild comedonal acne and the combination of retinoids with antibiotics and/or benzoyl peroxide for mild to moderate papulopustular acne are the drugs of first choice for topical treatment. The use of topical antibiotics is not recommended any more because of the development of resistant bacterial strains. Systemic antibiotics, in combination with topical retinoids and/or benzoyl peroxide, for moderate papular/nodular acne and isotretinoin for severe nodular/conglobate acne are the columns of systemic acne treatment. Systemic anti-androgens are used in women against moderate papulopustular acne. Due to advances in the understanding of the underlying inflammatory mechanisms in recent years the development of new therapeutic agents with good efficacy and better side effect profile should be expected in the future.

  13. The Psychosocial Impact of Acne Vulgaris

    PubMed Central

    Hazarika, Neirita; Archana, M

    2016-01-01

    Background: Acne vulgaris causes erythematous papulopustular lesions in active stage and often leave behind residual scarring and pigmentation. Its onset in adolescence may add to the emotional and psychological challenges experienced during this period. Aims: To assess the impact of acne on the various psychosocial domains of daily life. Materials and Methods: This was a prospective, cross-sectional study done in the dermatology out-patient department of a tertiary care hospital from January to March 2015. A total of 100 consecutive, newly diagnosed patients of acne vulgaris, aged 15 years and above were included in this study. The relationship between acne vulgaris and its sequelae was analyzed with ten different domains of daily life by using dermatology life quality index (DLQI) questionnaire. Results: Females (56%), 15–20 year olds (61%), facial lesions (60%), and Grade II acne (70%) were most common. Acne scars were noted in 75% patients, whereas 79% cases had post-acne hyperpigmentation. Thirty-seven percent patients had DLQI scores of (6–10) interpreted as moderate effect on patient's life. Statistically significant correlation (P < 0.05) found were as follows: Physical symptoms with grade of acne; embarrassment with site and grade of acne; daily activities with grade of acne and post-acne pigmentation; choice of clothes with site of acne; social activities with gender, site and grade of acne; effect on work/study with grade of acne; interpersonal problems with site and post-acne pigmentation; sexual difficulties with grade of acne. Limitation: It was a hospital-based study with small sample size. Conclusion: Significant impact of acne and its sequelae was noted on emotions, daily activities, social activities, study/work, and interpersonal relationships. Assurance and counseling along with early treatment of acne vulgaris is important to reduce disease-related psychosocial sequelae and increase the efficacy of treatment. PMID:27688440

  14. The Psychosocial Impact of Acne Vulgaris

    PubMed Central

    Hazarika, Neirita; Archana, M

    2016-01-01

    Background: Acne vulgaris causes erythematous papulopustular lesions in active stage and often leave behind residual scarring and pigmentation. Its onset in adolescence may add to the emotional and psychological challenges experienced during this period. Aims: To assess the impact of acne on the various psychosocial domains of daily life. Materials and Methods: This was a prospective, cross-sectional study done in the dermatology out-patient department of a tertiary care hospital from January to March 2015. A total of 100 consecutive, newly diagnosed patients of acne vulgaris, aged 15 years and above were included in this study. The relationship between acne vulgaris and its sequelae was analyzed with ten different domains of daily life by using dermatology life quality index (DLQI) questionnaire. Results: Females (56%), 15–20 year olds (61%), facial lesions (60%), and Grade II acne (70%) were most common. Acne scars were noted in 75% patients, whereas 79% cases had post-acne hyperpigmentation. Thirty-seven percent patients had DLQI scores of (6–10) interpreted as moderate effect on patient's life. Statistically significant correlation (P < 0.05) found were as follows: Physical symptoms with grade of acne; embarrassment with site and grade of acne; daily activities with grade of acne and post-acne pigmentation; choice of clothes with site of acne; social activities with gender, site and grade of acne; effect on work/study with grade of acne; interpersonal problems with site and post-acne pigmentation; sexual difficulties with grade of acne. Limitation: It was a hospital-based study with small sample size. Conclusion: Significant impact of acne and its sequelae was noted on emotions, daily activities, social activities, study/work, and interpersonal relationships. Assurance and counseling along with early treatment of acne vulgaris is important to reduce disease-related psychosocial sequelae and increase the efficacy of treatment.

  15. Acne vulgaris.

    PubMed

    Moradi Tuchayi, Sara; Makrantonaki, Evgenia; Ganceviciene, Ruta; Dessinioti, Clio; Feldman, Steven R; Zouboulis, Christos C

    2015-01-01

    Acne vulgaris is a chronic inflammatory disease - rather than a natural part of the life cycle as colloquially viewed - of the pilosebaceous unit (comprising the hair follicle, hair shaft and sebaceous gland) and is among the most common dermatological conditions worldwide. Some of the key mechanisms involved in the development of acne include disturbed sebaceous gland activity associated with hyperseborrhoea (that is, increased sebum production) and alterations in sebum fatty acid composition, dysregulation of the hormone microenvironment, interaction with neuropeptides, follicular hyperkeratinization, induction of inflammation and dysfunction of the innate and adaptive immunity. Grading of acne involves lesion counting and photographic methods. However, there is a lack of consensus on the exact grading criteria, which hampers the conduction and comparison of randomized controlled clinical trials evaluating treatments. Prevention of acne relies on the successful management of modifiable risk factors, such as underlying systemic diseases and lifestyle factors. Several treatments are available, but guidelines suffer from a lack of data to make evidence-based recommendations. In addition, the complex combination treatment regimens required to target different aspects of acne pathophysiology lead to poor adherence, which undermines treatment success. Acne commonly causes scarring and reduces the quality of life of patients. New treatment options with a shift towards targeting the early processes involved in acne development instead of suppressing the effects of end products will enhance our ability to improve the outcomes for patients with acne. PMID:27189872

  16. Acne vulgaris.

    PubMed

    Moradi Tuchayi, Sara; Makrantonaki, Evgenia; Ganceviciene, Ruta; Dessinioti, Clio; Feldman, Steven R; Zouboulis, Christos C

    2015-09-17

    Acne vulgaris is a chronic inflammatory disease - rather than a natural part of the life cycle as colloquially viewed - of the pilosebaceous unit (comprising the hair follicle, hair shaft and sebaceous gland) and is among the most common dermatological conditions worldwide. Some of the key mechanisms involved in the development of acne include disturbed sebaceous gland activity associated with hyperseborrhoea (that is, increased sebum production) and alterations in sebum fatty acid composition, dysregulation of the hormone microenvironment, interaction with neuropeptides, follicular hyperkeratinization, induction of inflammation and dysfunction of the innate and adaptive immunity. Grading of acne involves lesion counting and photographic methods. However, there is a lack of consensus on the exact grading criteria, which hampers the conduction and comparison of randomized controlled clinical trials evaluating treatments. Prevention of acne relies on the successful management of modifiable risk factors, such as underlying systemic diseases and lifestyle factors. Several treatments are available, but guidelines suffer from a lack of data to make evidence-based recommendations. In addition, the complex combination treatment regimens required to target different aspects of acne pathophysiology lead to poor adherence, which undermines treatment success. Acne commonly causes scarring and reduces the quality of life of patients. New treatment options with a shift towards targeting the early processes involved in acne development instead of suppressing the effects of end products will enhance our ability to improve the outcomes for patients with acne.

  17. Intense pulsed light versus photodynamic therapy using liposomal methylene blue gel for the treatment of truncal acne vulgaris: a comparative randomized split body study.

    PubMed

    Moftah, Nayera Hassan; Ibrahim, Shady Mahmoud; Wahba, Nadine Hassan

    2016-05-01

    Acne vulgaris is an extremely common skin condition. It often leads to negative psychological consequences. Photodynamic therapy (PDT) using intense pulsed light has been introduced for effective treatment of acne. The objective was to study the effect of PDT in truncal acne vulgaris using liposomal methylene blue (LMB) versus IPL alone. Thirty-five patients with varying degrees of acne were treated with topical 0.1 % LMB hydrogel applied on the randomly selected one side of the back, and after 60 min the entire back was exposed to IPL. The procedure was done once weekly for three sessions and patients were re-evaluated 1 month after the third session by two independent dermatologists. Acne severity was graded using the Burton scale. Patient satisfaction using Cardiff Acne Disability Index (CADI) was recorded before and after treatment. On LMB-pretreated side, inflammatory acne lesion counts were significantly decreased by 56.40 % compared with 34.06 % on IPL alone. Marked improvement was seen on LMB-pretreated side in 11.5 % of patients compared with 2.8 % on IPL alone. There was a correlation between CADI score and overall improvement. Our study concluded that LMB-IPL is more effective than IPL alone, safe with tolerable pain in the treatment of acne vulgaris on the back. LMB-IPL is more effective than IPL alone, safe with tolerable pain in the treatment of acne vulgaris on the back.

  18. Facial disability index (FDI): Adaptation to Spanish, reliability and validity

    PubMed Central

    Gonzalez-Cardero, Eduardo; Cayuela, Aurelio; Acosta-Feria, Manuel; Gutierrez-Perez, Jose-Luis

    2012-01-01

    Objectives: To adapt to Spanish the facial disability index (FDI) described by VanSwearingen and Brach in 1995 and to assess its reliability and validity in patients with facial nerve paresis after parotidectomy. Study Design: The present study was conducted in two different stages: a) cross-cultural adaptation of the questionnaire and b) cross-sectional study of a control group of 79 Spanish-speaking patients who suffered facial paresis after superficial parotidectomy with facial nerve preservation. The cross-cultural adaptation process comprised the following stages: (I) initial translation, (II) synthesis of the translated document, (III) retro-translation, (IV) review by a board of experts, (V) pilot study of the pre-final draft and (VI) analysis of the pilot study and final draft. Results: The reliability and internal consistency of every one of the rating scales included in the FDI (Cronbach’s alpha coefficient) was 0.83 for the complete scale and 0.77 and 0.82 for the physical and the social well-being subscales. The analysis of the factorial validity of the main components of the adapted FDI yielded similar results to the original questionnaire. Bivariate correlations between FDI and House-Brackmann scale were positive. The variance percentage was calculated for all FDI components. Conclusions: The FDI questionnaire is a specific instrument for assessing facial neuromuscular dysfunction which becomes a useful tool in order to determine quality of life in patients with facial nerve paralysis. Spanish adapted FDI is equivalent to the original questionnaire and shows similar reliability and validity. The proven reproducibi-lity, reliability and validity of this questionnaire make it a useful additional tool for evaluating the impact of facial nerve paralysis in Spanish-speaking patients. Key words:Parotidectomy, facial nerve paralysis, facial disability. PMID:22926474

  19. Acne Scars

    MedlinePlus

    ... scars. Cryosurgery : This treatment freezes the scar tissue. Freezing the tissue causes it to die and gradually ... et al . “Which Type of Atrophic Acne Scar (Ice-pick, Boxcar, or Rolling) Responds to Nonablative Fractional ...

  20. Acne: Treatment

    MedlinePlus

    ... the-counter medicines for acne. These medicines kill bacteria, dry up skin oil, and make your skin ... Antibiotics such as minocycline, doxycycline, and tetracycline reduce bacteria and inflammation, and can be used in combination ...

  1. Severity and impact of acne vulgaris on the quality of life of adolescents in Nigeria

    PubMed Central

    Ogedegbe, Evelyn E; Henshaw, Eshan B

    2014-01-01

    Background Acne vulgaris is a common skin condition, which affects most adolescents at some point in their lives. It has been found to have a significant impact on their psychological well-being and has been associated with depression and suicide ideation. Many studies have assessed the impact of acne vulgaris on the quality of life (QoL) in different population subgroups around the world, but there is a dearth of reports from the African subcontinent. This study thus seeks to assess the severity of acne vulgaris and determine its effect on the QoL of adolescents in Lagos, Nigeria. Methods In a cross-sectional survey employing a two-stage sampling method, the severity of acne vulgaris and its impact on the QoL of adolescents attending a senior secondary school in Lagos, Nigeria was assessed using the Global Acne Grading Scale (GAGS) and the Cardiff Acne Disability Index (CADI), respectively. The correlation between the results of the GAGS and CADI was also determined. Results One hundred and sixty adolescent students with acne were recruited, with males accounting for 51.9% and females 48.1%. The mean and standard deviation of the GAGS severity scores were 11.3±5.4 for males and 11.9±5.4 for females. Only one student had severe acne vulgaris (GAGS, 31–38), 10% moderate (GAGS, 19–30), and 89.4% mild (GAGS, 1–18). The overall CADI score was 3.4±3.0, which suggests mild impairment in QoL; however, the solitary student with severe acne had severe QoL impairment. There was a weak positive correlation between the GAGS and the CADI score. Conclusion Most adolescents in our study had mild acne vulgaris, and the overall impact on their QoL was mild. However, the correlation between the psychosocial impact and acne severity was weak. There is a need for similar studies in other parts of the country and for further studies to determine the adequacy of the existing instruments in assessing the impact of acne vulgaris in Nigerian adolescents. PMID:25525376

  2. [Solar acne].

    PubMed

    Padilha-Gonçalves, A; Alvimar Ferreira, J

    1977-01-01

    Acne solaris a form of acne that appears and relapses after sun exposure, is almost always itchy and is preferably localized on the upper anterior chest, the deltoid regions and the shoulders. The use of greasy or oily sun protectors helps in the obstructions of the follicular openings, which is seen in the tissue sections, presumably initiated by sun irradiation causing initially hyperkeratosis. The essential lesion is a small hemispheric or conic erythematous papule which may show a yellow point in its top. True comedos are not seen and compression after punction provokes the appearance of a yellow mass-essentially keratinic and sebaceous. The usual treatment of acne vulgaris is useful specially if a topical corticosteroid is associated. The systemic use of corticosteroids usually worsens the disease.

  3. Can Acne Scars Be Removed?

    MedlinePlus

    ... Can I Help a Friend Who Cuts? Can Acne Scars Be Removed? KidsHealth > For Teens > Can Acne ... eliminarse las marcas de acne? Different Types of Acne Scars from acne can seem like double punishment — ...

  4. Does lumbar paraspinal muscle fatty degeneration correlate with aerobic index and Oswestry disability index?

    PubMed Central

    Prasarn, Mark L.; Kostantinos, Vasalos; Coyne, Ellen; Wright, John; Rechtine, Glenn R.

    2015-01-01

    Background: We sought to analyze whether the amount of paraspinal fatty degeneration correlates with a patient's physical fitness, and to determine if these findings on lumbar magnetic resonance imaging (MRI) scans can help predict functional outcomes. Methods: A retrospective review was performed on 172 patients. Inclusion criteria involved being seen by a spine surgeon for low back pain, having aerobic index (AI), body mass index (BMI), Oswestry disability index (ODI), and body fat percentage measured recently, and having had a recent lumbar MRI scan. The percentage of fatty muscle degeneration was graded by three reviewers using T2-weighted axial images at L3 and L5 using a newly proposed system that was validated independently. The system is graded as follows: Grade 1: 0-24%, Grade 2: 25-49%, Grade 3: 50-74%, and Grade 4: 75-100%. An independent t-test was used for comparisons. Results: The average AI was 34.87, and the cohort was divided into two groups: above-average AI (89 patients) and below-average AI (83 patients). For all paraspinal fat measurements and body fat percentage, the difference between the above- and below-average AI groups was statistically significant (P < 0.05), with the least amount of paraspinal fatty degeneration and body fat in the greater AI group. Weight alone and BMI were not found to be significantly different between those with above-average AI when compared to those with below-average AI (P = 0.491 and P = 0.122, respectively). There was a trend for lower ODI scores in the above-average AI group (41.9 vs 46.1), but this did not reach statistical significance between the two groups (P = 0.075). For all patients it was shown that there was significantly less paraspinal fat at the L3 level as compared to L5 (P < 0.001). Conclusions: We were able to show that patients with a higher AI have lower body fat percentages and lower amounts of fatty degeneration in their lumbar paraspinal musculature. The amount of paraspinal fatty

  5. Acne vulgaris.

    PubMed

    Aydemir, Ertuğrul H

    2014-03-01

    Acne vulgaris is a chronic inflammatory disease of the pilosebaceous unit and it is observed equally in both sexes and nearly all races. It generally begins at puberty, but the healing period is variable. There is no known etiological factor, except genetic tendency. Androgens play a very limited role in some female patients. The effects of cosmetics, foods and drinks are also discussible and too limited. There are four factors in acne pathogenesis: Increase of the sebum excretionKeratinization of infrainfundibulumBacterial colonization of the follicleInflammation It is mainly observed on the face and back, shoulders and chest. Initial lesions are comedons. Papules, pustules and cysts of severe types follow it. The most important factor in treatment is a very good patient-physician communication. Topical or systemic treatment or both can be used depending on the severity of acne. Benzoyl peroxyde, azelaic acid, AHA's antibiotics, retinoic acid and derivatives are the topical choices. For systemic treatment antibiotics are the most commonly used medicines, but isotretinoine has a very spesific place with the possibility of permanent healing. All kind of treatments need approximately six months for a good result.

  6. [Acne and diet].

    PubMed

    Melnik, B C

    2013-04-01

    In industrialized countries acne presents as an epidemic disease of civilization affecting sebaceous follicles of adolescents and young adults, associated with increased body mass index and insulin resistance. "Western style" diet, characterized by high glycaemic load and increased consumption of insulinotropic milk proteins, plays an important role in acne pathogenesis. On the cellular level, nutrient-derived metabolic signals are sensed by the metabolic transcription factor FoxO1 and integrated by the regulatory kinase mTORC1. mTORC1, the central hub of protein- and lipid biosynthesis, cell growth and proliferation, is activated by insulin, IGF-1 and branched-chain essential amino acids, especially leucine. The understanding of Western diet-mediated nutrient signalling with over-activated mTORC1 offers a reasonable approach for dietary intervention in acne by lowering glycaemic load and consumption of milk and milk products. A suitable diet attenuating increased mTORC1 activity is a Palaeolithic-like diet with reduced intake of sugar, hyperglycaemic grains, milk and milk products but enriched consumption of vegetables and fish.

  7. Body mass index and the risk of incident functional disability in elderly Japanese

    PubMed Central

    Zhang, Shu; Tomata, Yasutake; Sugiyama, Kemmyo; Kaiho, Yu; Honkura, Kenji; Watanabe, Takashi; Tanji, Fumiya; Sugawara, Yumi; Tsuji, Ichiro

    2016-01-01

    Abstract The relationship between the body mass index (BMI) and the incidence of cause-specific disability remains unclear. We conducted a prospective cohort study of 12,376 Japanese individuals aged ≥65 years who were followed up for 5.7 years. Information on BMI and other lifestyle factors was collected via a questionnaire in 2006. Functional disability data were retrieved from the public Long-term Care Insurance database. BMI was divided into 6 groups (<21, 21–<23, 23–<25, 25–<27[reference], 27–<29 and ≥29). Hazard ratios and 95% confidence intervals for cause-specific disability were estimated using Cox proportional hazards regression models. A U-shaped relationship between BMI and functional disability was observed, with a nadir at 26. The nadir BMI values with the lowest disability risk were 28 for dementia, 25 for stroke, and 23 for joint disease. A low BMI (<23) was a risk factor for disability due to dementia, the HR values (95% CI) being 2.48 (1.70–3.63) for BMI <21 and 2.25 (1.54–3.27) for BMI 21 to <23; a high BMI (≥29) was a risk factor for disability due to joint disease, the HR value (95% CI) being 2.17 (1.40–3.35). There was no significant relationship between BMI and disability due to stroke. The BMI nadirs for cause-specific disability differed: a low BMI (<23) was a risk factor for disability due to dementia, and a high BMI (≥29) was a risk factor for disability due to joint disease. Because BMI values of 23 to <29 did not pose a significantly higher risk for each cause of disability, this range should be regarded as the optimal one for the elderly population. PMID:27495075

  8. INDEXED BIBLIOGRAPHY ON THE EDUCATIONAL MANAGEMENT OF CHILDREN WITH LEARNING DISABILITIES (MINIMAL BRAIN DYSFUNCTION).

    ERIC Educational Resources Information Center

    CLEMENTS, SAM D.; EDGINGTON, RUTH

    THE 370 CITATIONS ON LEARNING DISABILITIES ARE INDEXED TABULARLY INTO 19 SUBJECT AREAS (SUCH AS CEREBRAL DOMINANCE, PERCEPTION, BEHAVIOR DISORDERS). EACH CITATION IS FURTHER IDENTIFIED AS BACKGOUND AND THEORY, ASSESSMENT, OR TRAINING. PUBLICATION DATES RANGE FROM 1896 TO 1966 ALTHOUGH ONLY 19 ENTRIES ARE PRE-1950. THIS DOCUMENT WAS PUBLISHED BY…

  9. Insulin resistance in severe acne vulgaris

    PubMed Central

    Cengiz, Fatma Pelin; Kemeriz, Funda

    2015-01-01

    Introduction Acne vulgaris is a pilosebaceous gland disease that usually affects people from puberty to young adulthood. It is seen especially on the face, neck, trunk and arms. Its severity differs from patient to patient and its pathogenesis is multifactorial. The main pathogenic factors of acne are high sebaceous gland secretion, follicular hyperproliferation, high androgen effects, propionibacterium acnes colonization and inflammation. Diet is always thought a probable reason for acne and many studies are done about acne and diet. Aim To determine the effect of insulin resistance in severe acne vulgaris. Material and methods Two hundred and forty-three acne vulgaris patients and 156 healthy controls were enrolled into the study. The blood levels of insulin and glucose were measured. Homeostasis Model Assessment (HOMA) Index was calculated. The values were compared with the control group. Results All of the patients were in the severe acne group according to their scores on the global acne scoring scale. While fasting blood glucose levels were not different between the groups (p > 0.05, 82.91 ±9.76 vs. 80.26 ±8.33), the fasting insulin levels were significantly higher in the patient group than in the control group (p < 0.001, 14.01 ±11.94 vs. 9.12 ±3.53). Additionally, there was a highly significant difference between the patient and control groups in terms of HOMA values (p < 0.001, 2.87 ±2.56 vs. 1.63 ±0.65). Conclusions These results suggest that insulin resistance may have a role in the pathogenesis of acne. PMID:26366152

  10. Propionibacterium acnes in the pathogenesis and immunotherapy of acne vulgaris.

    PubMed

    Liu, Pei-Feng; Hsieh, Yao-Dung; Lin, Ya-Ching; Two, Aimee; Shu, Chih-Wen; Huang, Chun-Ming

    2015-01-01

    Acne vulgaris, a multi-factorial disease, is one of the most common skin diseases, affecting an estimated 80% of Americans at some point during their lives. The gram-positive and anaerobic Propionibacterium acnes (P. acnes) bacterium has been implicated in acne inflammation and pathogenesis. Therapies for acne vulgaris using antibiotics generally lack bacterial specificity, promote the generation of antibiotic-resistant bacterial strains, and cause adverse effects. Immunotherapy against P. acnes or its antigens (sialidase and CAMP factor) has been demonstrated to be effective in mice, attenuating P. acnes-induced inflammation; thus, this method may be applied to develop a potential vaccine targeting P. acnes for acne vulgaris treatment. This review summarizes reports describing the role of P. acnes in the pathogenesis of acne and various immunotherapy-based approaches targeting P. acnes, suggesting the potential effectiveness of immunotherapy for acne vulgaris as well as P. acnes-associated diseases.

  11. Propionibacterium acnes in the pathogenesis and immunotherapy of acne vulgaris.

    PubMed

    Liu, Pei-Feng; Hsieh, Yao-Dung; Lin, Ya-Ching; Two, Aimee; Shu, Chih-Wen; Huang, Chun-Ming

    2015-01-01

    Acne vulgaris, a multi-factorial disease, is one of the most common skin diseases, affecting an estimated 80% of Americans at some point during their lives. The gram-positive and anaerobic Propionibacterium acnes (P. acnes) bacterium has been implicated in acne inflammation and pathogenesis. Therapies for acne vulgaris using antibiotics generally lack bacterial specificity, promote the generation of antibiotic-resistant bacterial strains, and cause adverse effects. Immunotherapy against P. acnes or its antigens (sialidase and CAMP factor) has been demonstrated to be effective in mice, attenuating P. acnes-induced inflammation; thus, this method may be applied to develop a potential vaccine targeting P. acnes for acne vulgaris treatment. This review summarizes reports describing the role of P. acnes in the pathogenesis of acne and various immunotherapy-based approaches targeting P. acnes, suggesting the potential effectiveness of immunotherapy for acne vulgaris as well as P. acnes-associated diseases. PMID:26264195

  12. Make-up improves the quality of life of acne patients without aggravating acne eruptions during treatments.

    PubMed

    Hayashi, Nobukazu; Imori, Mizuho; Yanagisawa, Midori; Seto, Yoko; Nagata, Osamu; Kawashima, Makoto

    2005-01-01

    Boehncke et al. suggested that decorative cosmetics can improve the quality of life (QOL) of skin diseases. But dermatologists sometimes discourage female acne patients from applying make-up since decorative cosmetics are considered one of the aggravating factors for acne eruptions. The purpose of this study is to assess whether make-up application interferes with acne treatments and how QOL changes when the make-up items are designed for acne patients and used in order to disguise acne eruptions. Eighteen female acne patients were trained by a make-up artist and advised to apply acne-designed basic and decorative cosmetics for 2 to 4 weeks while their acne was appropriately treated. The acne-severity and QOL of patients were assessed before and after the study. The results revealed that the number of acne eruptions decreased even though patients were applying make-up. The QOL scores of Skindex-16, GHQ30 and anxiety state index greatly improved. Our results suggest that dermatologists should encourage acne patients to utilize appropriate make-up to improve their QOL.

  13. Temporomandibular joint effusion and its relationship with perceived disability assessed using musculoskeletal ultrasound and a patient-reported disability index

    PubMed Central

    Bird, Lance; Bright, Phillip

    2015-01-01

    The relationship between effusion of the temporomandibular joint (TMJ) and patient-reported disability is poorly researched. This pilot study explored the link between TMJ inflammation as measured by ultrasound and patient disability assessed by the Steigerwald Maher TMD Disability Index (SMTDI). The study design used a prospective correlational approach involving a sample with TMJ dysfunction (TMD). Twenty-four patients were recruited from the European School of Osteopathy and a Kent dental practice. Participants completed the SMTDI to determine the level of TMD (symptomatic score >20). A SonoSite SLA “Hockey Stick” [13-6 MHz] musculo-skeletal transducer was placed over the TMJ in a transverse direction and effusion was calculated indirectly by measuring capsular width. An upper left quadrant protocol was used throughout. A regression analysis was run with participants’ gender, age and capsular width as predictor variables modelled against reported SMTDI. Larger capsular widths were found to be significant predictors of SMTDI scores (r = 0.803, p < 0.0001). The patient profile matched with the previous studies and the TMD sufferer population, indicating external validity. Results suggest that the SMTDI could be integrated into practice life as a quick, accessible and easy tool to monitor patients’ progress and assess levels of inflammation, without the need for repetitive imaging. The study design proved reproducible and a larger scale study is indicated. PMID:27433242

  14. Can I Prevent Acne?

    MedlinePlus

    ... I Help a Friend Who Cuts? Can I Prevent Acne? KidsHealth > For Teens > Can I Prevent Acne? Print A A A Text Size What's ... too. Although there is no surefire way to prevent acne, try these tips to help reduce the ...

  15. Acne in hirsute women

    PubMed Central

    Pupovci, Hatixhe Latifi; Berisha, Violeta Lokaj; Goçi, Aferdita Uka; Gerqari, Antigona

    2014-01-01

    Introduction Acne and hirsutism are common manifestations of hyperandrogenism. Aim To investigate whether or not acne is present in women with hirsutism, associated with different clinical, endocrine and ultrasonographic features. Material and methods The prospective study included 135 women with hirsutism, aged 14–46 years. We measured the levels of hormones with radioimmunoassay/immunoradiometric assay methods. Results Acne were present in 63 (47.6%) women with hirsutism. Sixty women had mild forms of acne, including: whiteheads, blackheads, papules and pustules. Only 3 women had moderate to severe acne, including nodules. In a group of women with hirsutism and acne, 6 (9.5%) were obese. In our study we found a high prevalence of androgen excess among hirsute women with acne: total testosterone was increased in 79%, free testosterone in 20.6%, androstenedione in 69.8%, dehydroepiandrosterone sulfate (DHEAS) in 30.1%, 17-OH-progesterone 68.2% and sex hormone-binding globulin (SHBG) was decreased in 33.3% of women. Women with hirsutism and acne have received oral contraceptives for a year, without or in a combination with other medication. Thirty-four (53.9%) women have shown improvement in hirsutism and acne. Conclusions In this study we found a high prevalence of acne in hirsute women. The prevalence of acne was higher in polycystic ovarian syndrome. Since these women have associated endocrine changes it is important to correct them with hormonal therapy. PMID:25610349

  16. Acne in women.

    PubMed

    Ramos-e-Silva, M; Ramos-e-Silva, S; Carneiro, S

    2015-07-01

    This review focuses on the subject of acne in women, a disease that is increasingly common and that can also affect men. Adult acne differs from the type of acne that occurs in teenagers, and it may persist beyond adolescence or have its onset at an older age (adult-onset acne or late acne). Acne can have a negative impact on the quality of life of patients at any age, leading to a negative body image and decrease in self-esteem, and in older patients it can result in discrimination in the workplace and in other social environments. Acne in women must be understood as a specific problem, and here we discuss the pathogenesis, clinical presentation, psychology and treatment of this very prevalent problem. PMID:25597414

  17. Acne in women.

    PubMed

    Ramos-e-Silva, M; Ramos-e-Silva, S; Carneiro, S

    2015-07-01

    This review focuses on the subject of acne in women, a disease that is increasingly common and that can also affect men. Adult acne differs from the type of acne that occurs in teenagers, and it may persist beyond adolescence or have its onset at an older age (adult-onset acne or late acne). Acne can have a negative impact on the quality of life of patients at any age, leading to a negative body image and decrease in self-esteem, and in older patients it can result in discrimination in the workplace and in other social environments. Acne in women must be understood as a specific problem, and here we discuss the pathogenesis, clinical presentation, psychology and treatment of this very prevalent problem.

  18. Relationship between Barthel index with physical tests in adults with intellectual disabilities.

    PubMed

    Cuesta-Vargas, Antonio I; Pérez-Cruzado, David

    2014-01-01

    We usually find low levels of fitness condition affect other aspects of living for people with ID like dependency in carrying out activivities of daily living. Therefore we find high levels of dependency in activities of daily living due to poor fitness condition. The aim of the study is to explore the criterion validity of the Barthel index with a physical fitness test. An observational cross-sectional study was conducted. Data from the Barthel index and a physical fitness test were measured in 122 adults with intellectual disability. The data were analysed to find out the relationship between four categories of the physical fitness test and the Barthel index. It needs to be stressed that the correlations between the Barthel index and leg, abdominal and arm strength can confirm that these physical test are predictive of the Barthel index. The correlations between the balance variables as functional reach and single-leg stance with eyes open shown relationships with Barthel Index. We found important correlations between the physical fitness test and the Barthel index, so we can affirm that some physical fitness features are predictor variables of the Barthel index. PMID:25332853

  19. Acne: What's New.

    PubMed

    Stein Gold, Linda F

    2016-06-01

    Acne vulgaris is one of the most prevalent skin conditions. Antibiotics, when considered, are most effective in combination with other therapies, and limited evidence suggests that submicrobial doses of antibiotics may improve acne without increasing the risk for antibiotic resistance. A small but significant risk for inflammatory bowel disease has also been identified in children treated with multiple courses of antibiotics. New topical agents are expanding therapeutic options for acne. Semin Cutan Med Surg 35(supp6):S114-S116. PMID:27538054

  20. Management of severe acne.

    PubMed

    Zouboulis, C C; Bettoli, V

    2015-07-01

    Acne is the most common skin disease, affecting up to 95% of adolescents. Severe episodes of acne can cause considerable physical and psychological scarring, and overexpression of transforming growth factor-β can lead to formation of hypertrophic scars and keloids. The severity of acne in adolescence is associated with a positive history of severe acne in first-degree relatives, especially the mother. In most cases acne is a chronic disease, and it is often a component of systemic diseases or syndromes. All forms of severe acne require systemic treatment. The available options include oral antibiotics, hormonal antiandrogens for female patients and oral isotretinoin, as well as other combination treatments. Oral isotretinoin is the only drug available that affects all four pathogenic factors of acne. However, due to possible serious side-effects, a European directive states that oral isotretinoin should be used only as a second-line therapy in cases of severe, nodular and conglobate acne. The pharmaceutical quality of generic isotretinoin products and the obtainability of isotretinoin through e-pharmacies without prescription raise new therapeutic problems. New anti-inflammatory compounds, such as the 5-lipoxygenase inhibitor zileuton, may replace systemic antibiotics in the future, especially under the scope of antibiotic resistance prevention. This review looks into the various options and latest approaches, and factors to consider, when combating severe acne.

  1. Hormone therapy in acne.

    PubMed

    Lakshmi, Chembolli

    2013-01-01

    Underlying hormone imbalances may render acne unresponsive to conventional therapy. Relevant investigations followed by initiation of hormonal therapy in combination with regular anti-acne therapy may be necessary if signs of hyperandrogenism are present. In addition to other factors, androgen-stimulated sebum production plays an important role in the pathophysiology of acne in women. Sebum production is also regulated by other hormones, including estrogens, growth hormone, insulin, insulin-like growth factor-1, glucocorticoids, adrenocorticotropic hormone, and melanocortins. Hormonal therapy may also be beneficial in female acne patients with normal serum androgen levels. An understanding of the sebaceous gland and the hormonal influences in the pathogenesis of acne would be essential for optimizing hormonal therapy. Sebocytes form the sebaceous gland. Human sebocytes express a multitude of receptors, including receptors for peptide hormones, neurotransmitters and the receptors for steroid and thyroid hormones. Various hormones and mediators acting through the sebocyte receptors play a role in the orchestration of pathogenetic lesions of acne. Thus, the goal of hormonal treatment is a reduction in sebum production. This review shall focus on hormonal influences in the elicitation of acne via the sebocyte receptors, pathways of cutaneous androgen metabolism, various clinical scenarios and syndromes associated with acne, and the available therapeutic armamentarium of hormones and drugs having hormone-like actions in the treatment of acne.

  2. [Charles Bukowski's acne].

    PubMed

    Bahmer, F A; Bahmer, J A

    2012-04-01

    In his autobiography, Charles Bukowski (1920-1994) describes his severe acne conglobata, his experience with therapy, family conflicts and emotional tension. Despite the stigmatization by his acne scars, Bukowski became a philobatic writer and a true chronist of the American way of life in the second half of the 20th century, writing in a coarse and obscene language.

  3. Moisturizers for Acne

    PubMed Central

    Chularojanamontri, Leena; Tuchinda, Papapit; Kulthanan, Kanokvalai

    2014-01-01

    Acne is a chronic inflammatory disease of the pilosebaceous unit that affects almost all teenagers. Different treatments offer different modes of action, but aim to target acne pathology. Topical therapies, such as benzoyl peroxide, retinoids, antibiotics with alcohol-based preparations, and salicylic acid, can cause skin irritation resulting in a lack of patient adherence. Some physicians recommend patients use moisturizers as adjunctive treatment of acne, especially when either topical benzoyl peroxide or a retinoid is prescribed. Furthermore, some evidence shows that moisturizers can contribute independently to improve signs and symptoms of acne. Moisturizers contain three main properties, which are occlusive, humectant, and emollient effects. Currently, many moisturizers claim to be suitable for acne treatment. This article aims to provide a review of the active ingredients and properties of those moisturizers. Fifty-two moisturizers for acne were included for analysis. Most of the products (92%) have anti-inflammatory properties apart from occlusive, humectant, and emollient effects. Anti-acne medications, including salicylic acid, benzoyl peroxide, and retinol, were found respectively in 35, 10, and 8 percent of the moisturizer products containing anti-inflammatory properties. More than half of the products contain dimethicone and/or glycerin for its moisturizer property. Aloe vera and witch hazel are botanical anti-inflammatories that were commonly found in this study. Scientific data regarding some ingredients are discussed to provide a guide for physicians in selecting moisturizers for acne patients. PMID:24847408

  4. [Charles Bukowski's acne].

    PubMed

    Bahmer, F A; Bahmer, J A

    2012-04-01

    In his autobiography, Charles Bukowski (1920-1994) describes his severe acne conglobata, his experience with therapy, family conflicts and emotional tension. Despite the stigmatization by his acne scars, Bukowski became a philobatic writer and a true chronist of the American way of life in the second half of the 20th century, writing in a coarse and obscene language. PMID:22406763

  5. Evaluation and Management of Acne.

    PubMed

    Botros, Paul A; Tsai, Gary; Pujalte, George G A

    2015-12-01

    Acne is a common complaint in the primary care clinics. It has not only physical implications but also psychological. This article discusses the epidemiology, pathophysiology, and criteria for making the diagnosis. It also discusses endocrine disorders that may be the cause of acne. Treatment and management are discussed by subtype. Acne mechanica or sports-related acne is also discussed. PMID:26612368

  6. Body mass index and the risk of incident functional disability in elderly Japanese: The OHSAKI Cohort 2006 Study.

    PubMed

    Zhang, Shu; Tomata, Yasutake; Sugiyama, Kemmyo; Kaiho, Yu; Honkura, Kenji; Watanabe, Takashi; Tanji, Fumiya; Sugawara, Yumi; Tsuji, Ichiro

    2016-08-01

    The relationship between the body mass index (BMI) and the incidence of cause-specific disability remains unclear.We conducted a prospective cohort study of 12,376 Japanese individuals aged ≥65 years who were followed up for 5.7 years. Information on BMI and other lifestyle factors was collected via a questionnaire in 2006. Functional disability data were retrieved from the public Long-term Care Insurance database. BMI was divided into 6 groups (<21, 21-<23, 23-<25, 25-<27[reference], 27-<29 and ≥29). Hazard ratios and 95% confidence intervals for cause-specific disability were estimated using Cox proportional hazards regression models.A U-shaped relationship between BMI and functional disability was observed, with a nadir at 26. The nadir BMI values with the lowest disability risk were 28 for dementia, 25 for stroke, and 23 for joint disease. A low BMI (<23) was a risk factor for disability due to dementia, the HR values (95% CI) being 2.48 (1.70-3.63) for BMI <21 and 2.25 (1.54-3.27) for BMI 21 to <23; a high BMI (≥29) was a risk factor for disability due to joint disease, the HR value (95% CI) being 2.17 (1.40-3.35). There was no significant relationship between BMI and disability due to stroke.The BMI nadirs for cause-specific disability differed: a low BMI (<23) was a risk factor for disability due to dementia, and a high BMI (≥29) was a risk factor for disability due to joint disease. Because BMI values of 23 to <29 did not pose a significantly higher risk for each cause of disability, this range should be regarded as the optimal one for the elderly population. PMID:27495075

  7. Management strategies for acne vulgaris

    PubMed Central

    Whitney, Kristen M; Ditre, Chérie M

    2011-01-01

    Clinical question: What are the most effective treatment(s) for mild, moderate, severe, and hormonally driven acne? Results: Mild acne responds favorably to topical treatments such as benzoyl peroxide, salicylic acid, and a low-dose retinoid. Moderate acne responds well to combination therapy comprising-topical benzoyl peroxide, antibiotics, and/or retinoids, as well as oral antibiotics in refractory cases and oral contraceptive pills for female acne patients. Severe nodulocystic acne vulgaris responds best to oral isotretinoin therapy. In female patients with moderate to severe acne, facial hair, loss of scalp hair and irregular periods, polycystic ovarian syndrome should be considered and appropriate treatment with hormonal modulation given. Adjunctive procedures can also be considered for all acne patients. Implementation: Pitfalls to avoid when treating acne: treatment of acne in women of child-bearing age; familiarization of all acne treatments in order to individualize management for patients; indications for specialist referral. PMID:21691566

  8. Acne and smoking

    PubMed Central

    Capitanio, Bruno; Ottaviani, M; Bordignon, V; Amantea, A; Picardo, M

    2009-01-01

    Background. Post-adolescent acne is an inflammatory disorder, whose cause is unknown. Contrasting data are available on correlation between acne and smoking habit. Objectives. To verify the frequency of clinically non-inflammatory (atypical) post-adolescent acne (APAA) among women, a possible correlation with cigarette smoking, possible differences in sebum composition in a group of female smokers with acne compared to healthy smokers and non-smokers. Method and results. 1046 randomly selected women (25–50-years-old) participated at the study. In 60 selected female subjects we analyzed sebum composition for α-tocopherol, squalene and squalene monohydroperoxide. We found a high prevalence of APAA among women (74.6%), a strong correlation with smoking habit (p < 0.0001), as well as an increase in the grade of sebum peroxidation (p < 0.05) with a reduction in vitamin E (p = 0.02), in the subjects with acne compared to the controls. Conclusions. Clinical evidence and experimental data showed a straight correlation between smoking habit and post-pubertal acne in which the clinically non-inflammatory type—APAA—is the most frequent. In the more severe cases we could consider APAA as a new entity (smoker’s acne). PMID:20436880

  9. Isotretinoin, tetracycline and circulating hormones in acne.

    PubMed

    Palatsi, R; Ruokonen, A; Oikarinen, A

    1997-09-01

    Isotretinoin, used to treat severe acne, has been shown to induce hormonal changes, especially to reduce 5 alpha-reductase in the production of the tissue-derived dihydrotestosterone (DHT) metabolite 3 alpha-Adiol G. However, the effects of isotretinoin on other pituitary, adrenal or gonadal hormones have not been thoroughly elucidated. In the present study, isotretinoin administered at a dose of 0.5 mg/kg/day for 4 weeks caused no marked changes in the serum levels of pituitary, adrenal or gonadal hormones or 3 alpha-Adiol G in patients with severe papulopustulotic acne (n = 19). After 12 weeks of therapy, there was a decrease in the levels of the precursor androgens androstenedione, testosterone and 3 alpha-Adiol G in 6/9 patients. Acne improved after 4.5 months in all but 2 male patients, who had very low serum hormone binding globulins (SHBG) and a high free androgen index (FAI). Isotretinoin did not affect the elevated LH/FSH ratio in a patient with the polycystic ovarian syndrome (PCOS); nor did it change the high FAI or low SHBG in the male patients. For comparison, tetracycline had no effects on the serum hormonal levels of patients with mild acne (n = 19) after 7 days of treatment. This study confirms that the effects of isotretinoin on the serum hormone levels are small and unlikely to be of relevance for the resolution of acne or the suppression of sebum excretion. PMID:9298137

  10. Treatment of acne scarring.

    PubMed

    Alam, M; Dover, J S

    Acne scarring is common but surprisingly difficult to treat. Scars can involve textural change in the superficial and deep dermis, and can also be associated with erythema, and less often, pigmentary change. In general, treatment of acne scarring is a multistep procedure. First, examination of the patient is necessary to classify the subtypes of scarring that are present. Then, the patient's primary concerns are elicited, and the patient is offered a menu of procedures that may address the various components of the scarring process. It is important to emphasize to the patient that acne scarring can be improved but never entirely reversed. PMID:17180246

  11. Optical treatments for acne.

    PubMed

    Ross, E Victor

    2005-01-01

    Light-based treatments for acne are becoming increasingly commonplace in dermatology. This article reviews various light approaches in acne therapy. Methods are discussed from an anatomical and a functional perspective. The emphasis is on the practicality of treatment as well as the pros and cons of various devices. Also, a review of the recent literature is presented. The article is intended to give the reader a panoramic view of this still-young and developing area. Most likely, light-based acne treatment will receive more popularity as dermatologists learn how to integrate this type of therapy within the context of more established drug agents. PMID:16229726

  12. The socioeconomic inequality in traffic-related disability among Chinese adults: the application of concentration index.

    PubMed

    Chen, He; Du, Wei; Li, Ning; Chen, Gong; Zheng, Xiaoying

    2013-06-01

    Traffic crashes have become the fifth leading cause of burden of diseases and injuries in China. More importantly, it may further aggravate the degree of health inequality among Chinese population, which is still under-investigated. Based on a nationally representative data, we calculated the concentration index (CI) to measure the socioeconomic inequality in traffic-related disability (TRD), and decomposed CI into potential sources of the inequality. Results show that more than 1.5 million Chinese adults were disabled by traffic crashes and the adults with financial disadvantage bear disproportionately heavier burden of TRD. Besides, strategies of reducing income inequality and protecting the safety of poor road users, are of great importance. Residence appears to counteract the socioeconomic inequality in TRD, however, it does not necessarily come to an optimistic conclusion. In addition to the worrying income gap between rural and urban areas, other possible mechanisms, e.g. the low level of post-crash medical resources in rural area, need further studies. China is one of the developing countries undergoing fast motorization and our findings could provide other countries in similar context with some insights about how to maintain socioeconomic equality in road safety.

  13. Teens and Acne Treatment

    MedlinePlus

    ... Types of treatments Benzoyl peroxide Benzoyl peroxide wash, lotion, or gel—the most effective acne treatment you ... and make it redder than the wash or lotion, so try the wash or lotion first. How ...

  14. Bacteriophages Infecting Propionibacterium acnes

    PubMed Central

    2013-01-01

    Viruses specifically infecting bacteria, or bacteriophages, are the most common biological entity in the biosphere. As such, they greatly influence bacteria, both in terms of enhancing their virulence and in terms of killing them. Since the first identification of bacteriophages in the beginning of the 20th century, researchers have been fascinated by these microorganisms and their ability to eradicate bacteria. In this review, we will cover the history of the Propionibacterium acnes bacteriophage research and point out how bacteriophage research has been an important part of the research on P. acnes itself. We will further discuss recent findings from phage genome sequencing and the identification of phage sequence signatures in clustered regularly interspaced short palindromic repeats (CRISPRs). Finally, the potential to use P. acnes bacteriophages as a therapeutic strategy to combat P. acnes-associated diseases will be discussed. PMID:23691509

  15. Atrophic Acne Scarring

    PubMed Central

    Graber, Emmy M.

    2015-01-01

    Background: Scarring is an unfortunate and frequent complication of acne, resulting in significant psychological distress for patients. Fortunately, numerous treatment options exist for acne scarring. Objectives: To extensively review the literature on treatment options for atrophic acne scarring. Materials and methods: A comprehensive literature search was conducted on the following topics: dermabrasion, subcision, punch techniques, chemical peels, tissue augmentation, and lasers. Results: The literature supports the use of various treatment modalities; superior results may be achieved when multiple modalities are combined for a multi-step approach to scarring. Conclusion: The safety and efficacy of various treatment devices for acne scarring is well established, but there is a paucity of split-face trials comparing modalities. PMID:25610524

  16. Bacteriophages infecting Propionibacterium acnes.

    PubMed

    Brüggemann, Holger; Lood, Rolf

    2013-01-01

    Viruses specifically infecting bacteria, or bacteriophages, are the most common biological entity in the biosphere. As such, they greatly influence bacteria, both in terms of enhancing their virulence and in terms of killing them. Since the first identification of bacteriophages in the beginning of the 20th century, researchers have been fascinated by these microorganisms and their ability to eradicate bacteria. In this review, we will cover the history of the Propionibacterium acnes bacteriophage research and point out how bacteriophage research has been an important part of the research on P. acnes itself. We will further discuss recent findings from phage genome sequencing and the identification of phage sequence signatures in clustered regularly interspaced short palindromic repeats (CRISPRs). Finally, the potential to use P. acnes bacteriophages as a therapeutic strategy to combat P. acnes-associated diseases will be discussed.

  17. Acne: Diet and acnegenesis

    PubMed Central

    Danby, F. William (Bill)

    2011-01-01

    Acne is a manifestation of hormonal overstimulation of the pilosebaceous units of genetically susceptible individuals. Endogenous reproductive and growth hormones, exogenous reproductive hormones, insulin and endogenous insulin-like growth hormone-1, sourced from and stimulated by dairy and high glycemic load foods, all appear to contribute to this overstimulation. A postulated molecular mechanism linking food and acne is reported and integrated into the clinical picture. PMID:23130204

  18. The epidemiology of acne vulgaris in late adolescence

    PubMed Central

    Lynn, Darren D; Umari, Tamara; Dunnick, Cory A; Dellavalle, Robert P

    2016-01-01

    Importance Acne vulgaris is the most common skin condition affecting late adolescents across the globe. Although prior studies have evaluated epidemiologic patterns of acne vulgaris in various ethnicities and regions, adequate understanding of the worldwide burden of the disease associated with patients in their late adolescence (15–19-year olds) remains lacking. Objective To assess the global burden of the disease associated with acne vulgaris for late adolescents (15–19-year olds) and provide an overview of the epidemiology, pathophysiology, and treatment options for acne in this population. Design Database summary study. Setting Global Burden of Disease Study 2010 database. Participants Global Burden of Disease regions comprised countries with prevalence of acne vulgaris between the ages of 15 and 19 years. Main outcomes and measures Geographic region-level disability-adjusted life year rates (per 100,000 persons) associated with acne vulgaris in years 1990 through 2010. Median percentage change in disability-adjusted life year rates was estimated for each region across the specified study period. Conclusion and relevance Acne vulgaris-associated disease burden exhibits global distribution and has continued to grow in prevalence over time within this population. This continued growth suggests an unmet dermatologic need worldwide for this disorder and potential opportunities for improved access and delivery of dermatologic care. Our analysis of the literature reveals numerous opportunities for enhanced patient care. To that end, we highlight some of the effective and promising treatments currently available and address important factors, such as sex, nationality, genetics, pathophysiology, and diet, as they relate to acne vulgaris in late adolescence. PMID:26955297

  19. Acne and diet.

    PubMed

    Wolf, Ronni; Matz, Hagit; Orion, Edith

    2004-01-01

    Forbidden foods? "The first law of dietetics seems to be: If it tastes good, it's bad for you" (Isaac Asimov, Russian-born biochemist and science fiction writer). This was essentially the Magna Carta for dermatologists of the 1950s: anything coveted by the teenage palate was suspect for morning after acne. Today, half a century later, although the slant has shifted away for this line of thinking in our dermatologic textbooks, several articles on the beliefs and perceptions of acne patients showed that nothing much has changed and that they expect us to give them detailed instructions of what "acne-related" foods they should avoid. In one such study(1), diet was the third most frequently implicated factor (after hormones and genetics) as the cause of the disease, with 32% of the respondents selecting diet as the main cause, and 44% thinking that foods aggravate acne. In another study that analyzed knowledge about causes of acne among English teenagers, 11% of the responders blamed greasy food as the main cause of the disease(2), whereas in another study found that 41% of final-year medical students of the University of Melbourne chose diet as an important factor of acne exacerbation on a final examination.(3)

  20. Treatment Modalities for Acne.

    PubMed

    Fox, Lizelle; Csongradi, Candice; Aucamp, Marique; du Plessis, Jeanetta; Gerber, Minja

    2016-01-01

    Acne is a common inflammatory skin disease which affects the pilosebaceous units of the skin. It can have severe psychological effects and can leave the patient with severe skin scarring. There are four well-recognized pathological factors responsible for acne which is also the target for acne therapy. In this review, different treatment options are discussed, including topical (i.e., retinoids, and antibiotics) and systemic (i.e., retinoids, antibiotics, and hormonal) treatments. Since the general public has been showing an increasing interest in more natural and generally safer treatment options, the use of complementary and alternative medicines (CAM) for treating acne was also discussed. The use of physical therapies such as comedone extraction, cryoslush therapy, cryotherapy, electrocauterization, intralesional corticosteroids and optical treatments are also mentioned. Acne has been extensively researched with regards to the disease mechanism as well as treatment options. However, due to the increasing resistance of Propionibacterium acnes towards the available antibiotics, there is a need for new treatment methods. Additionally, the lack of necessary evidence on the efficacy of CAM therapies makes it necessary for researchers to investigate these treatment options further. PMID:27529209

  1. Effect of exhalation exercise on trunk muscle activity and oswestry disability index of patients with chronic low back pain

    PubMed Central

    Kang, Jeong-Il; Jeong, Dae-Keun; Choi, Hyun

    2016-01-01

    [Purpose] This study investigated the effect of exhalation exercises on trunk muscle activity and Oswestry Disability Index by inducing trunk muscle activity through increasing intra-abdominal pressure and activating muscles, contributing to spinal stability. [Subjects and Methods] This intervention program included 20 male patients with chronic low back pain. A total of 10 subjects each were randomly assigned to an exhalation exercise group as the experimental group and a spinal stabilization exercise group as the control group. [Results] There were significant differences in the activities of the rectus abdominis, transverse abdominis, external oblique abdominal, and erector spinae muscles as well as in the Oswestry Disability Index within the experimental group. There were meaningful differences in the activities of the rectus abdominis, external oblique abdominal, and erector spinae muscles and in the Oswestry Disability Index within the control group. In addition, there was a meaningful intergroup difference in transverse abdominis muscle activity alone and in the Oswestry Disability Index. [Conclusion] The breathing exercise effectively increased muscle activity by training gross and fine motor muscles in the trunk. Moreover, it was verified as a very important element for strengthening body stability because it both released and prevented low back pain. PMID:27390406

  2. Effect of exhalation exercise on trunk muscle activity and oswestry disability index of patients with chronic low back pain.

    PubMed

    Kang, Jeong-Il; Jeong, Dae-Keun; Choi, Hyun

    2016-06-01

    [Purpose] This study investigated the effect of exhalation exercises on trunk muscle activity and Oswestry Disability Index by inducing trunk muscle activity through increasing intra-abdominal pressure and activating muscles, contributing to spinal stability. [Subjects and Methods] This intervention program included 20 male patients with chronic low back pain. A total of 10 subjects each were randomly assigned to an exhalation exercise group as the experimental group and a spinal stabilization exercise group as the control group. [Results] There were significant differences in the activities of the rectus abdominis, transverse abdominis, external oblique abdominal, and erector spinae muscles as well as in the Oswestry Disability Index within the experimental group. There were meaningful differences in the activities of the rectus abdominis, external oblique abdominal, and erector spinae muscles and in the Oswestry Disability Index within the control group. In addition, there was a meaningful intergroup difference in transverse abdominis muscle activity alone and in the Oswestry Disability Index. [Conclusion] The breathing exercise effectively increased muscle activity by training gross and fine motor muscles in the trunk. Moreover, it was verified as a very important element for strengthening body stability because it both released and prevented low back pain.

  3. Effect of exhalation exercise on trunk muscle activity and oswestry disability index of patients with chronic low back pain.

    PubMed

    Kang, Jeong-Il; Jeong, Dae-Keun; Choi, Hyun

    2016-06-01

    [Purpose] This study investigated the effect of exhalation exercises on trunk muscle activity and Oswestry Disability Index by inducing trunk muscle activity through increasing intra-abdominal pressure and activating muscles, contributing to spinal stability. [Subjects and Methods] This intervention program included 20 male patients with chronic low back pain. A total of 10 subjects each were randomly assigned to an exhalation exercise group as the experimental group and a spinal stabilization exercise group as the control group. [Results] There were significant differences in the activities of the rectus abdominis, transverse abdominis, external oblique abdominal, and erector spinae muscles as well as in the Oswestry Disability Index within the experimental group. There were meaningful differences in the activities of the rectus abdominis, external oblique abdominal, and erector spinae muscles and in the Oswestry Disability Index within the control group. In addition, there was a meaningful intergroup difference in transverse abdominis muscle activity alone and in the Oswestry Disability Index. [Conclusion] The breathing exercise effectively increased muscle activity by training gross and fine motor muscles in the trunk. Moreover, it was verified as a very important element for strengthening body stability because it both released and prevented low back pain. PMID:27390406

  4. Development of a New Index of Balance in Adults with Intellectual and Developmental Disabilities

    PubMed Central

    Cuesta-Vargas, Antonio; Giné-Garriga, Maria

    2014-01-01

    Purposes The first objective was to propose a new model representing the balance level of adults with intellectual and developmental disabilities (IDD) using Principal Components Analysis (PCA); and the second objective was to use the results from the PCA recorded by regression method to construct and validate summative scales of the standardized values of the index, which may be useful to facilitate a balance assessment in adults with IDD. Methods A total of 801 individuals with IDD (509 males) mean 33.1±8.5 years old, were recruited from Special Olympic Games in Spain 2009 to 2012. The participants performed the following tests: the timed-stand test, the single leg stance test with open and closed eyes, the Functional Reach Test, the Expanded Timed-Get-up-and-Go Test. Data was analyzed using principal components analysis (PCA) with Oblimin rotation and Kaiser normalization. We examined the construct validity of our proposed two-factor model underlying balance for adults with IDD. The scores from PCA were recorded by regression method and were standardized. Results The Component Plot and Rotated Space indicated that a two-factor solution (Dynamic and Static Balance components) was optimal. The PCA with direct Oblimin rotation revealed a satisfactory percentage of total variance explained by the two factors: 51.6 and 21.4%, respectively. The median score standardized for component dynamic and static of the balance index for adults with IDD is shown how references values. Conclusions Our study may lead to improvements in the understanding and assessment of balance in adults with IDD. First, it confirms that a two-factor model may underlie the balance construct, and second, it provides an index that may be useful for identifying the balance level for adults with IDD. PMID:24789336

  5. The Qualification of Outcome after Cervical Spine Surgery by Patients Compared to the Neck Disability Index

    PubMed Central

    Donk, Roland; Verbeek, Andre; Verhagen, Wim; Groenewoud, Hans; Hosman, Allard

    2016-01-01

    Objective The Neck Disability Index (NDI) is a patient self-assessed outcome measurement tool to assess disability, and that is frequently used to evaluate the effects of the treatment of neck-related problems. In individualized medicine it is mandatory that patients can interpret data in order to choose a treatment. A change of NDI or an absolute NDI is generally meaningless to a patient. Therefore, a correlation between the qualification of the clinical situation rated by the patient and the NDI score was evaluated. Methods Patients who completed an NDI after anterior surgery because of symptomatic single level degenerative cervical disc disease were asked one month after completion of the NDI to qualify their clinical situation of a 5-item Likert scale varying from excellent to bad. Since a clear distinction between the categories was not possible based on the total NDI score, a ROC-curve was built, and the AUC computed in order to estimate best dichotomization in qualification of the clinical situation. The best corresponding cut-off point for the NDI total score was found by studying sensitivity and specificity for all possible cut-off points. Results 102 patients were included. The highest AUC was obtained by dichotomizing the qualification into a group with good outcome and less-good outcome. The highest sensitivity and specificity for the dichotomized qualification as good outcome corresponded to a NDI ≤ 7. Sensitivity was 81.08% and specificity was 78.57%. Conclusion This is the first study that correlated the qualification of the situation by the patients themselves and NDI. An NDI ≤ 7 corresponded to a good outcome according to the patients. This is valuable information to inform patients in their decision for any treatment. PMID:27551964

  6. Neonatal and infantile acne vulgaris: an update.

    PubMed

    Serna-Tamayo, Cristian; Janniger, Camila K; Micali, Giuseppe; Schwartz, Robert A

    2014-07-01

    Acne may present in neonates, infants, and small children. Neonatal and infantile acne vulgaris are not considered to be rare. The presentation of acne in this patient population sometimes represents virilization and may portend later development of severe adolescent acne. Neonatal and infantile acne vulgaris must be distinguished from other cutaneous disorders seen in newborns and infants. Infantile acne tends to be more pleomorphic and inflammatory, thus requiring more vigorous therapy than neonatal acne.

  7. The Impact of Body Mass Index and Weight Changes on Disability Transitions and Mortality in Brazilian Older Adults

    PubMed Central

    Drumond Andrade, Flávia Cristina; Mohd Nazan, Ahmad Iqmer Nashriq; Lebrão, Maria Lúcia; de Oliveira Duarte, Yeda Aparecida

    2013-01-01

    The aim of this study was to examine the association between body mass index and weight changes on disability transitions and mortality among Brazilian older adults. Longitudinal data from the Health, Well-Being, and Aging in Latin America and the Caribbean Study conducted in São Paulo, Brazil (2000 and 2006), were used to examine the impact of obesity on disability and mortality and of weight changes on health transitions related to disability. Logistic and multinomial regression models were used in the analyses. Individuals who were obese were more likely than those of normal weight to have limitations on activities of daily living (ADL), instrumental activity of daily living (IADL), and Nagi's limitations. Obesity was associated with higher incidence of ADL and IADL limitations and with lower recovery from Nagi's limitations. Compared to those who maintained their weight, those who gained weight experienced higher incidence of ADL and Nagi's limitations, even after controlling for initial body mass index. Higher mortality among overweight individuals was only found when the reference category was “remaining free of Nagi limitations.” The findings of the study underline the importance of maintaining normal weight for preventing disability at older ages. PMID:23691319

  8. Oxidants and anti-oxidants status in acne vulgaris patients with varying severity.

    PubMed

    Al-Shobaili, Hani A

    2014-01-01

    Acne vulgaris is a common dermatological disorder with a multifactorial pathogenesis. Oxidative status has been implicated in the pathogenesis of several skin diseases, including acne. This study was aimed to investigate the levels of oxidative stress biomarkers in acne vulgaris patients with varying severities. The study involved 156 patients with acne and 46 healthy human controls. Based on clinical examination, patients were grouped into 3 subgroups as follows: mild, moderate, and severe acne. Oxidative stress was examined by measuring plasma levels of catalase (CAT), superoxide dismutase (SOD), total antioxidant capacity (TAC), and malondialdehyde (MDA). Plasma levels of MDA in acne patients were significantly higher as compared with that of the controls, whereas activities of the antioxidant enzymes SOD and CAT were lower. Moreover, TAC was also low in acne patients as compared with that of the controls. Higher MDA levels in the severe acne subgroup as compared with that of the mild and moderate subgroups were also observed. Furthermore, in the severe acne subgroup, a significant negative correlation was observed between MDA and CAT levels. The data suggests that oxidative stress plays a key role in acne progress and may be employed as a biomarker index to assess the disease's activity and to monitor its treatment.

  9. Acne - self-care

    MedlinePlus

    ... It may help to use a wash with salicylic acid or benzoyl if your skin is oily and prone to acne. Remove all ... products may contain benzoyl peroxide, sulfur, resorcinol, or ... bacteria, drying up skin oils, or causing the top layer of your ...

  10. Serum Uric Acid, Hyperuricemia and Body Mass Index in Children and Adolescents with Intellectual Disabilities

    ERIC Educational Resources Information Center

    Lin, Jin-Ding; Lin, Pei-Ying; Lin, Lan-Ping; Hsu, Shang-Wei; Yen, Chia-Feng; Fang, Wen-Hui; Wu, Sheng-Ru; Chien, Wu-Chien; Loh, Ching-Hui; Chu, Cordia M.

    2009-01-01

    The aims of the preset study were to describe the profile of serum uric acid, the prevalence of hyperuricemia and its risk factors among children and adolescents with intellectual disabilities. We conducted a cross-sectional study of 941 children and adolescents with intellectual disabilities (aged 4-18 years) who participated in annual health…

  11. [Acne vulgaris. Role of cosmetics].

    PubMed

    Korting, H C; Borelli, C; Schöllmann, C

    2010-02-01

    Appropriate cosmetics for skin cleansing are capable of contributing to a reduction of especially inflammatory lesions in acne-prone patients and to support pharmacological intervention in patients with manifest acne. Cleansing of acne-prone skin should employ acidified synthetic cleansers with a pH of 5.5 rather than soap. Furthermore, the ingredients of certain skin care products, i.e. nicotinamide, lactic acid, triethyl acetate/ethyllineolate, and prebiotic plant extracts, affect different mechanisms of acne pathogenesis and therefore may contribute to a decrease in acne lesions. At least some of these ingredients underscore the concept of evidence-based cosmetics. In contrast, the problem of acne lesions caused by comedogenic ingredients in cosmetics today is negligible. PMID:20107752

  12. Perimenstrual Flare of Adult Acne

    PubMed Central

    Geller, Lauren; Rosen, Jamie; Frankel, Amylynne; Goldenberg, Gary

    2014-01-01

    Background: Acne is typically regarded as an adolescent disease. A significant body of literature suggests a post-adolescent or adult form of acne. Female patients are known to experience perimenstrual acne flares, the exact prevalence of which is unknown. Objective: To establish a pattern of perimenstrual acne flare in adult women in order to better characterize the disorder. Methods: Subjects aged 18 and over were recruited during previously scheduled visits with their dermatologist at Mount Sinai Hospital in New York. An anonymous survey was distributed to women who reported their first menses at least six months earlier and had a complaint of acne within the last 30 days. Women <18 years of age and postmenopausal women were excluded from the study population. Results: Participants included women 18- to 29-years old (67%) and women 30- to 49-years old (33%). The ethnicity of respondents was Caucasian (50%), African American (20%), Latino (19%), Asian (5%), and Other (6%). The majority of participants with perimenstrual acne reported the onset of acne between the ages of 12 and 18 years. Sixty-five percent of participants reported that their acne symptoms were worse with their menses. Of those who reported perimenstrual acne symptoms, 56 percent reported worsening symptoms in the week preceding their menses, 17 percent reported worsening symptoms during their menses, three percent reported worsening symptoms after their menses, and 24 percent reported worsening symptoms throughout their cycle. Thirty-five percent of patients with perimenstrual acne reported oral contraceptive pill use. Conclusion: A significant number of adult women have perimenstrual acne symptoms. This study has proven to be useful in characterizing perimenstrual acne flare and is one of the first qualitative documentations of the presence and degree of this disorder. PMID:25161758

  13. Cervical radiculopathy: a systematic review on treatment by spinal manipulation and measurement with the Neck Disability Index.

    PubMed

    Rodine, Robert J; Vernon, Howard

    2012-03-01

    Cervical radiculopathy (CR), while less common than conditions with neck pain alone, can be a significant cause of neck pain and disability; thus the determination of adequate treatment options for patients is essential. Currently, inadequate scientific literature restricts specific conservative management recommendations for CR. Despite a paucity of evidence for high-velocity low-amplitude (HVLA) spinal manipulation in the treatment for CR, this strategy has been frequently labeled as contraindicated. Scientific support for appropriate outcome measures for CR is equally deficient. While more scientific data is needed to draw firm conclusions, the present review suggests that spinal manipulation may be cautiously considered as a therapeutic option for patients suffering from CR. With respect to outcome measures, the Neck Disability Index appears well-suited for spinal manipulative treatment of CR.

  14. Cervical radiculopathy: a systematic review on treatment by spinal manipulation and measurement with the Neck Disability Index

    PubMed Central

    Rodine, Robert J.; Vernon, Howard

    2012-01-01

    Cervical radiculopathy (CR), while less common than conditions with neck pain alone, can be a significant cause of neck pain and disability; thus the determination of adequate treatment options for patients is essential. Currently, inadequate scientific literature restricts specific conservative management recommendations for CR. Despite a paucity of evidence for high-velocity low-amplitude (HVLA) spinal manipulation in the treatment for CR, this strategy has been frequently labeled as contraindicated. Scientific support for appropriate outcome measures for CR is equally deficient. While more scientific data is needed to draw firm conclusions, the present review suggests that spinal manipulation may be cautiously considered as a therapeutic option for patients suffering from CR. With respect to outcome measures, the Neck Disability Index appears well-suited for spinal manipulative treatment of CR. PMID:22457538

  15. The Utility of the Personal Wellbeing Index Intellectual Disability Scale in an Australian Sample

    ERIC Educational Resources Information Center

    McGillivray, J. A.; Lau, A. L. D.; Cummins, R. A.; Davey, G.

    2009-01-01

    Background: Subjective wellbeing (SWB) in people with intellectual disabilities has been the focus of increased interest in the identification of support needs and as an outcome measure for interventions and service delivery evaluations. It is therefore important to conduct further research in this area, and to develop appropriate scales to…

  16. Acne pathogenesis: history of concepts.

    PubMed

    Tilles, Gérard

    2014-01-01

    From the first reliable descriptions of acne in the early 19th century, dermatologists recognized it as a disease of the pilosebaceous follicle. Until the middle of the 20th century, they hypothesized that seborrhoea, follicular keratosis and microorganisms could be individually responsible for the acne lesions. Inflammation was only regarded as the final and inescapable step of the acne process. Although the importance of these factors has been reevaluated, recent works still regarded them as mandatory. In the 1970s, the onset of isotretinoin dramatically improved acne management. It also provided great opportunities for a better understanding of the pathogenic factors of acne. This study analyzes their genesis and development from the seminal contributions until recent advances.

  17. Quality of life, self-esteem and psychosocial factors in adolescents with acne vulgaris*

    PubMed Central

    Vilar, Gustavo Nunes; dos Santos, Laís Araújo; Sobral Filho, Jader Freire

    2015-01-01

    Background Dermatological diseases, among which acne vulgaris, have psychological impact on the affected generating feelings of guilt, shame and social isolation. Objectives To compare quality of life, self-esteem and other psychosocial variables amongst adolescents with and without acne vulgaris, and between levels of severity. Methods Cross-sectional observational study in a sample of 355 high school students from the city of João Pessoa. Data collection was performed with questionnaires and clinical-dermatological evaluation. The primary variables were the incidence of AV; quality of life, set by the Children's Dermatology Quality of Life Index and Dermatology Quality of Life Index; and self-esteem, measured by the Rosenberg Self-Esteem Scale. For calculation of statistical tests, we used the SPSS 20.0 software, considering p=0.05. Results The sample, with an average age of 16, showed 89.3% prevalence of acne vulgaris. The most prevalent psychosocial issue was "afraid that acne will never cease", present in 58% of affected youth. The median score of Quality of Life in Children's Dermatology Index was different amongst students with and without acne vulgaris (p=0.003), as well as the Quality of Life in Dermatology (p=0.038) scores, so that students with acne vulgaris have worse QoL. There was a correlation between the severity of acne vulgaris and worse quality of life. Self-esteem was not significantly associated with the occurrence or severity of acne vulgaris. Conclusions acne vulgaris assumes significance in view of its high prevalence and the effect on quality of life of adolescents, more severe at the more pronounced stages of disease (p<0.001). The psychosocial impact of acne vulgaris should be valued in the management of patients with this condition. PMID:26560206

  18. Correlation among scapular asymmetry, neck pain, and neck disability index (NDI) in young women with slight neck pain

    PubMed Central

    Kim, Su-Rim; Kang, Mi-Hee; Bahng, Sun-Young; An, Jin-Kyoung; Lee, Ji-Young; Park, Sang-Young; Kim, Seong-Gil

    2016-01-01

    [Purpose] This study aimed to investigate the correlations among scapular asymmetry, neck pain, and neck disability index in women in their 20s with slight neck pain. [Subjects and Methods] A total of 60 female students at U university in Gyeongsangbuk-do, South Korea, participated in this study. The lateral scapular slide test, which measures the distance between the thorax and scapula, was used to analyze the scapular asymmetry. The lateral scapular slide test was performed in three positions. The visual analogue scale and neck disability index were used to measure neck pain. [Results] In the lateral scapular slide test in position 3 (shoulder abduction at 90 degrees), the scapular left-right asymmetry and VAS showed a moderate positive linear relationship, with r=0.344. The VAS and NDI showed a moderate positive linear relationship, with r = 0.632. [Conclusion] Scapular asymmetry indicates imbalance of surrounding muscles of the scapula and is related to neck pain based on the results of measuring the distance from the thorax to the scapula. PMID:27313361

  19. Cross-cultural adaptation and psychometric properties of an Arabic version of the Shoulder Pain and Disability Index.

    PubMed

    Alsanawi, Hisham A; Alghadir, Ahmad; Anwer, Shahnawaz; Roach, Kathryn E; Alawaji, Alia

    2015-09-01

    The aim of the present study was to translate, culturally adapt, and validate the Arabic version of the shoulder Pain and Disability Index (SPADI). This was an observational reliability and validity study. We recruited 64 patients with shoulder pain and dysfunction with a wide variety of diagnoses. Patients completed the following questionnaires: Arabic SPADI, Quick Disability of the arm, shoulder and hand (Quick DASH), and the numerical rating scale (NRS) for pain. The active shoulder range of motion (ROM) was also assessed. Internal consistency was tested using Cronbach α. Reproducibility was assessed by asking the patients to complete another SPADI questionnaire 2 days after the first. Validity was assessed by calculating the Pearson correlation coefficient between the SPADI and the Quick DASH, NRS, and active shoulder ROM. The Cronbach α values for the pain score (0.96), disability score (0.98), and total score (0.98) of Arabic SPADI were all high. Similarly, the intraclass correlation coefficient (ICC) values for the pain, disability, and total score (ICC, 0.87, 0.96, and 0.95, respectively) of Arabic SPADI were all high. With respect to validity, there was a moderate to strong correlation between the Arabic SPADI and the Quick DASH, NRS, and active shoulder ROM. The translated version of SPADI in the Arabic language showed excellent internal consistency and test-retest reliability. Validity was shown by substantial correlations between SPADI and Quick DASH, NRS, and active shoulder ROM. The Arabic SPADI is recommended for the evaluation of patients with shoulder dysfunction. PMID:25954858

  20. Cross-cultural adaptation and psychometric properties of an Arabic version of the Shoulder Pain and Disability Index.

    PubMed

    Alsanawi, Hisham A; Alghadir, Ahmad; Anwer, Shahnawaz; Roach, Kathryn E; Alawaji, Alia

    2015-09-01

    The aim of the present study was to translate, culturally adapt, and validate the Arabic version of the shoulder Pain and Disability Index (SPADI). This was an observational reliability and validity study. We recruited 64 patients with shoulder pain and dysfunction with a wide variety of diagnoses. Patients completed the following questionnaires: Arabic SPADI, Quick Disability of the arm, shoulder and hand (Quick DASH), and the numerical rating scale (NRS) for pain. The active shoulder range of motion (ROM) was also assessed. Internal consistency was tested using Cronbach α. Reproducibility was assessed by asking the patients to complete another SPADI questionnaire 2 days after the first. Validity was assessed by calculating the Pearson correlation coefficient between the SPADI and the Quick DASH, NRS, and active shoulder ROM. The Cronbach α values for the pain score (0.96), disability score (0.98), and total score (0.98) of Arabic SPADI were all high. Similarly, the intraclass correlation coefficient (ICC) values for the pain, disability, and total score (ICC, 0.87, 0.96, and 0.95, respectively) of Arabic SPADI were all high. With respect to validity, there was a moderate to strong correlation between the Arabic SPADI and the Quick DASH, NRS, and active shoulder ROM. The translated version of SPADI in the Arabic language showed excellent internal consistency and test-retest reliability. Validity was shown by substantial correlations between SPADI and Quick DASH, NRS, and active shoulder ROM. The Arabic SPADI is recommended for the evaluation of patients with shoulder dysfunction.

  1. The effects of lumbar stabilization exercise with thoracic extension exercise on lumbosacral alignment and the low back pain disability index in patients with chronic low back pain.

    PubMed

    Woo, Seong-Dae; Kim, Tae-Ho

    2016-01-01

    [Purpose] To determine the effects of lumbar stabilization exercise with thoracic extension exercise on chronic low back pain patients. [Subjects and Methods] Thirty patients with chronic low back pain were randomly divided into a lumbar stabilization exercise group (group A) and a lumbar stabilization exercise with thoracic extension exercise group (group B). Group B did 15 min of lumbar stabilization exercises and 15 min of thoracic extension exercises, while group A did 30 min of lumbar stabilization exercises five times a week for 4 weeks. For assessing lumbosacral alignment, the lordotic angle, lumbosacral angle, and sacral angle were evaluated. The Oswestry disability index was used for assessment of disability due to low back pain. [Results] Both groups showed improvement in lumbosacral alignment and in the disability index. Group B showed greater changes in the lordotic angle and in the Oswestry disability index than group A, although the differences were not statistically significant. [Conclusion] Lumbar stabilization exercise with thoracic extension exercise can be recommended for improvement of chronic low back pain, although the improvements seen in lumbosacral alignment and low back pain disability index in this study did not achieve statistical significance.

  2. The effects of lumbar stabilization exercise with thoracic extension exercise on lumbosacral alignment and the low back pain disability index in patients with chronic low back pain

    PubMed Central

    Woo, Seong-Dae; Kim, Tae-Ho

    2016-01-01

    [Purpose] To determine the effects of lumbar stabilization exercise with thoracic extension exercise on chronic low back pain patients. [Subjects and Methods] Thirty patients with chronic low back pain were randomly divided into a lumbar stabilization exercise group (group A) and a lumbar stabilization exercise with thoracic extension exercise group (group B). Group B did 15 min of lumbar stabilization exercises and 15 min of thoracic extension exercises, while group A did 30 min of lumbar stabilization exercises five times a week for 4 weeks. For assessing lumbosacral alignment, the lordotic angle, lumbosacral angle, and sacral angle were evaluated. The Oswestry disability index was used for assessment of disability due to low back pain. [Results] Both groups showed improvement in lumbosacral alignment and in the disability index. Group B showed greater changes in the lordotic angle and in the Oswestry disability index than group A, although the differences were not statistically significant. [Conclusion] Lumbar stabilization exercise with thoracic extension exercise can be recommended for improvement of chronic low back pain, although the improvements seen in lumbosacral alignment and low back pain disability index in this study did not achieve statistical significance. PMID:27065563

  3. Predictors of Shoulder Pain and Disability Index (SPADI) and work status after 1 year in patients with subacromial shoulder pain

    PubMed Central

    2010-01-01

    Background Shoulder pain is a common complaint in primary health care and has an unfavourable outcome in many patients. The objectives were to identify predictors for pain and disability (SPADI) and work status in patients with subacromial shoulder pain. Methods Secondary analyses of data from a randomized clinical controlled trial were performed. Outcome measures were the absolute values of the combined Shoulder Pain and Disability Index (SPADI) and work status 1 year after treatment with supervised exercises (SE) or radial extracorporeal shockwave therapy (rESWT). Predictors of outcome were investigated using multiple linear regression (SPADI) and logistic regression (work status). Results 104 patients were included. Low education (≤ 12 years), previous shoulder pain, and a high baseline SPADI score predicted poor results with these variables explaining 29.9% of the variance in SPADI score at 1 year. Low education and poor self-reported health status predicted a work status of "not working": Odds Ratio, OR = 4.3(95% CI (1.3 to 14.9)), p = 0.02 for education, and OR = 1.06 (95% CI (1.0 to 1.1)), p = 0.001 for self-reported health status, respectively. Adjustments for age, gender, and treatment group were performed, but did not change the results. Conclusion Education was the most consistent predictor of pain and disability, and work status at 1 year follow-up. Also, baseline SPADI score, previous shoulder pain and self-reported health status predicted outcome. Trial registration Clinical trials NCT00653081 PMID:20863369

  4. The effects of prone bridge exercise on the Oswestry disability index and proprioception of patients with chronic low back pain.

    PubMed

    Kong, Yong-Soo; Jang, Gwon-Uk; Park, Seol

    2015-09-01

    [Purpose] The purpose of this study was to investigate the effect of bridge exercises on the Oswestry disability index (ODI) scores and proprioception among patients with chronic low back pain (CLBP). [Subjects and Methods] A total of 38 patients participated in this study. After eight weeks of bridge exercise, the joint position angle of the body trunk was measured and the ODI was used in survey form to investigate the intensity of the patients' low back pain. [Results] After eight weeks of exercise, the ODI showed significant differences in all three groups. Subjects' joint position sense of the trunk in both lumbar flexion and extension was also significantly different after completing the exercise program; this was true for all three groups. [Conclusion] Performing the prone bridge exercise for eight weeks improved proprioceptive function and reduced pain and impediment of activity, showing it a more effective exercise than other bridge exercises.

  5. The effects of prone bridge exercise on the Oswestry disability index and proprioception of patients with chronic low back pain.

    PubMed

    Kong, Yong-Soo; Jang, Gwon-Uk; Park, Seol

    2015-09-01

    [Purpose] The purpose of this study was to investigate the effect of bridge exercises on the Oswestry disability index (ODI) scores and proprioception among patients with chronic low back pain (CLBP). [Subjects and Methods] A total of 38 patients participated in this study. After eight weeks of bridge exercise, the joint position angle of the body trunk was measured and the ODI was used in survey form to investigate the intensity of the patients' low back pain. [Results] After eight weeks of exercise, the ODI showed significant differences in all three groups. Subjects' joint position sense of the trunk in both lumbar flexion and extension was also significantly different after completing the exercise program; this was true for all three groups. [Conclusion] Performing the prone bridge exercise for eight weeks improved proprioceptive function and reduced pain and impediment of activity, showing it a more effective exercise than other bridge exercises. PMID:26504285

  6. The effects of prone bridge exercise on the Oswestry disability index and proprioception of patients with chronic low back pain

    PubMed Central

    Kong, Yong-Soo; Jang, Gwon-Uk; Park, Seol

    2015-01-01

    [Purpose] The purpose of this study was to investigate the effect of bridge exercises on the Oswestry disability index (ODI) scores and proprioception among patients with chronic low back pain (CLBP). [Subjects and Methods] A total of 38 patients participated in this study. After eight weeks of bridge exercise, the joint position angle of the body trunk was measured and the ODI was used in survey form to investigate the intensity of the patients’ low back pain. [Results] After eight weeks of exercise, the ODI showed significant differences in all three groups. Subjects’ joint position sense of the trunk in both lumbar flexion and extension was also significantly different after completing the exercise program; this was true for all three groups. [Conclusion] Performing the prone bridge exercise for eight weeks improved proprioceptive function and reduced pain and impediment of activity, showing it a more effective exercise than other bridge exercises. PMID:26504285

  7. Why Do I Get Acne?

    MedlinePlus

    ... you've been exercising. Many over-the-counter lotions and creams containing salicylic acid or benzoyl peroxide ... Sometimes even though they wash properly and try lotions and oil-free makeup, people get acne anyway — ...

  8. Acne: hormonal concepts and therapy.

    PubMed

    Thiboutot, Diane

    2004-01-01

    Acne vulgaris is the most common skin condition observed in the medical community. Although we know that hormones are important in the development of acne, many questions remain unanswered regarding the mechanisms by which hormones exert their effects. Androgens such as dihydrotestosterone (DHT) and testosterone, the adrenal precursor dehydroepiandrosterone sulfate (DHEAS), estrogens such as estradiol, and other hormones, including growth hormone and insulin-like growth factors (IGFs), may be important in acne. It is not known whether these hormones are taken up from the serum by the sebaceous gland, whether they are produced locally within the gland, or whether a combination of these processes is involved. Finally, the cellular and molecular mechanisms by which these hormones exert their influence on the sebaceous gland have not been fully elucidated. Hormonal therapy is an option in women with acne not responding to conventional treatment or with signs of endocrine abnormalities. PMID:15556729

  9. Photodynamic therapy of acne vulgaris.

    NASA Astrophysics Data System (ADS)

    Ershova, Ekaterina Y.; Karimova, Lubov N.; Kharnas, Sergey S.; Kuzmin, Sergey G.; Loschenov, Victor B.

    2003-06-01

    Photodynamic therapy (PDT) with topical 5-aminolevulinic acid (ALA) was tested for the treatment of acne vulgaris. Patients with acne were treated with ALA plus red light. Ten percent water solution of ALA was applied with 1,5-2 h occlusion and then 18-45 J/cm2 630 nm light was given. Bacterial endogenous porphyrins fluorescence also was used for acne therapy. Treatment control and diagnostics was realized by fluorescence spectra and fluorescence image. Light sources and diagnostic systems were used: semiconductor laser (λ=630 nm, Pmax=1W), (LPhT-630-01-BIOSPEC); LED system for PDT and diagnostics with fluorescent imager (λ=635 nm, P=2W, p=50 mW/cm2), (UFPh-630-01-BIOSPEC); high sensitivity CCD video camera with narrow-band wavelength filter (central wavelength 630 nm); laser electronic spectrum analyzer for fluorescent diagnostics and photodynamic therapy monitoring (LESA-01-BIOSPEC). Protoporphyrin IX (PP IX) and endogenous porphyrins concentrations were measured by fluorescence at wavelength, correspondingly, 700 nm and 650 nm. It was shown that topical ALA is converted into PP IX in hair follicles, sebaceous glands and acne scars. The amount of resulting PP IX is sufficient for effective PDT. There was good clinical response and considerable clearance of acne lesion. ALA-PDT also had good cosmetic effect in treatment acne scars. PDT with ALA and red light assist in opening corked pores, destroying Propionibacterium acnes and decreasing sebum secretion. PDT treatment associated with several adverse effects: oedema and/or erytema for 3-5 days after PDT, epidermal exfoliation from 5th to 10th day and slight pigmentation during 1 month after PDT. ALA-PDT is effective for acne and can be used despite several side effects.

  10. Treatment of Acne in Pregnancy.

    PubMed

    Chien, Anna L; Qi, Ji; Rainer, Barbara; Sachs, Dana L; Helfrich, Yolanda R

    2016-01-01

    Acne vulgaris is a common disease of the pilosebaceous unit and affects adolescents and adults. Because high-quality guidelines regarding treatment of acne in pregnancy are scarce, management of this condition can be challenging. We describe the safety profile of common therapies and outline approaches based on available evidence. Topical azelaic acid or benzoyl peroxide can be recommended as baseline therapy. A combination of topical erythromycin or clindamycin with benzoyl peroxide is recommended for inflammatory acne. Oral erythromycin or cephalexin is generally considered safe for moderate to severe inflammatory acne when used for a few weeks. A short course of oral prednisolone may be useful for treating fulminant nodular cystic acne after the first trimester. In general, topical and oral antibiotics should not be used as monotherapy, but combined with topical benzoyl peroxide to decrease bacterial resistance. Oral retinoids are teratogenic and absolutely contraindicated for women who are pregnant or considering pregnancy. Although some complementary therapies including micronutrients and nonpharmacologic treatments seem to be well tolerated, limited data exist regarding their safety and efficacy, and they are not currently recommended during pregnancy. The risk-to-benefit ratio, efficacy, acceptability, and costs are considerations when choosing a treatment for acne in pregnancy. PMID:26957383

  11. Acne, cystic on the face (image)

    MedlinePlus

    The face is the most common location of acne. Here, there are 4 to 6 millimeter red ( ... scars and fistulous tract formation (connecting passages). Severe acne may have a profound psychological impact and may ...

  12. Acne, vulgaris on the back (image)

    MedlinePlus

    Acne frequently occurs on the back. Here, there are 2 to 6 millimeter wide erythematous (red) pustules ... Permanent scarring may follow a severe case of acne. Men are more often affected on their shoulders ...

  13. Fillers for the improvement in acne scars

    PubMed Central

    Wollina, Uwe; Goldman, Alberto

    2015-01-01

    Acne is a common inflammatory disease. Scarring is an unwanted end point of acne. Both atrophic and hypertrophic scar types occur. Soft-tissue augmentation aims to improve atrophic scars. In this review, we will focus on the use of dermal fillers for acne scar improvement. Therefore, various filler types are characterized, and available data on their use in acne scar improvement are analyzed. PMID:26491364

  14. Vaccination Targeting a Surface Sialidase of P. acnes: Implication for New Treatment of Acne Vulgaris

    PubMed Central

    Nakatsuji, Teruaki; Liu, Yu-Tsueng; Huang, Cheng-Po; Gallo, Richard L.; Huang, Chun-Ming

    2008-01-01

    Background Acne vulgaris afflicts more than fifty million people in the United State and the severity of this disorder is associated with the immune response to Propionibacterium acnes (P. acnes). Systemic therapies for acne target P. acnes using antibiotics, or target the follicle with retinoids such as isotretinoin. The latter systemic treatment is highly effective but also carries a risk of side effects including immune imbalance, hyperlipidemia, and teratogenicity. Despite substantial research into potential new therapies for this common disease, vaccines against acne vulgaris are not yet available. Methods and Findings Here we create an acne vaccine targeting a cell wall-anchored sialidase of P. acnes. The importance of sialidase to disease pathogenesis is shown by treatment of a human sebocyte cell line with recombinant sialidase that increased susceptibility to P. acnes cytotoxicity and adhesion. Mice immunized with sialidase elicit a detectable antibody; the anti-sialidase serum effectively neutralized the cytotoxicity of P. acnes in vitro and P. acnes-induced interleukin-8 (IL-8) production in human sebocytes. Furthermore, the sialidase-immunized mice provided protective immunity against P. acnes in vivo as this treatment blocked an increase in ear thickness and release of pro-inflammatory macrophage inflammatory protein (MIP-2) cytokine. Conclusions Results indicated that acne vaccines open novel therapeutic avenues for acne vulgaris and other P. acnes-associated diseases. PMID:18253498

  15. Acne, dairy and cancer

    PubMed Central

    2009-01-01

    A potent link to dairy seems to exist for three hormone-responsive glands. Acne, breast cancer and prostate cancer have all been linked epidemiologically to dairy intake. Although mechanisms postulated here remain to be accurately defined, the likely link involves Insulin-like Growth Factor-1 as a general stimulant, synergized by the steroid hormones present in milk. The IGF-1 may be either absorbed from milk, or stimulated by its ingestion, or both. The 5alpha-reduced compound 5alpha-pregnanedione (5α-P) present in milk is a direct precursor of dihydrotestosterone and may act through that pathway in prostate cancer, but 5α-P has also recently been shown to be capable of inducing estrogen receptors in breast cancer cells, upregulating cancer cells' sensitivity to estrogen. The introduction of exogenous hormones and growth factors into tissues that have not evolved defensive feedback inhibition of their corresponding endogenous sources is postulated as a direct stimulatory threat to these organ systems, whether for hyperplasia or neoplasia. PMID:20046583

  16. [Topical cimetidine treatment of acne].

    PubMed

    Schmidt, J B; Spona, J

    1986-08-01

    We present first results of topically applied cimetidine in acne. Ten patients suffering from papulopustular and comedone acne administered 2% cimetidine in indifferent lotion on their face twice a day. Clinical controls were performed every two weeks; sebum was monthly determined. After treatment of 13 weeks on the average, the clinical success was generally good. Comedones responded best, followed by papules. Pustules were hardly reduced. There was no significant reduction of SER and the lipid fractions at the end of treatment. Low concentration or insufficient penetration might be possible explanations. The efficient reduction of comedones might be an antiandrogenic effect due to modulation of the keratinization in the follicle excretory duct. Immune-modulatory effects of cimetidine and effects on the skin vessels are other possible explanations for the clinical efficacy of topical application of cimetidine in acne.

  17. Acne tetrad in a family.

    PubMed

    Zisova, L; Sakakushev, B

    1994-01-01

    The authors report, for the first time in Bulgarian literature, a case of acne tetrad syndrome in a family. The patients were sisters who were found to have three of the four components of the syndrome: hidradenitis suppurativa, acne conglobata, and cysta pillaris. There was no evidence or anamnestic data for perifolliculitis capitis abscedens et suffodiens. In one of the sisters the syndrome showed a more precipitate clinical picture and was combined with other skin disorders (lichen ruber planus, neurodermitis circumscripta, hirsutismus). The patients had a familial predisposition to acne and pilar cycts. The complete blood analysis, all biochemical parameters, the cytogenetic analysis and hormonal status (testosterone and estrogens) showed no deviation from normal values. The patients did not report any disturbances during their menstrual cycles. The cellular immunity in one of the sisters was depressed. The patients and their children will be closely monitored. PMID:8698287

  18. Acne Vulgaris and the Epidermal Barrier

    PubMed Central

    Thiboutot, Diane

    2013-01-01

    Acne vulgaris is a common dermatological disorder that predominantly affects teenagers, but can also affect preadolescents and post-teen individuals. Despite the fact that acne vulgaris is the most common skin disorder encountered in ambulatory dermatology practice in the United States, there has been limited research on the epidermal permeability barrier in untreated skin of people with acne vulgaris and also after use of acne therapies. This article reviews the research results and discusses the available literature on this subject area. The importance of proper skin care as a component of the management of acne vulgaris is supported by the information that is currently available. PMID:23441236

  19. Heredity of acne in Korean patients.

    PubMed

    Cho, Eun Byul; Ha, Ji Min; Park, Eun Joo; Kim, Kwang Ho; Kim, Kwang Joong

    2014-10-01

    Acne is a chronic inflammatory disease of the pilocebaceous unit that presents with various spectrum and severity. Genetic backgrounds and environmental factors are also considered to be relevant, but few studies have focused on Korean patients. A cross-sectional epidemiologic study on family history of Korean acne patients was performed to analyze family history of acne, and to compare the severity and characteristics of acne in association with family history. A total of 221 patients were enrolled, 98 male (44.3%) and 123 female (55.7%). Patients were grouped as patients with (A+) or without (A-) family history of acne. In a second analysis, patients with any experience of acne treatment were evaluated. Severity of acne was measured with Burton's grading system and Korean Acne Grading System (KAGS). Female patients had a higher tendency to have family history than males (P = 0.002). Group A+ had statistically significant earlier onset of acne (P = 0.002). In inexperienced patients, patients with family history showed a relatively earlier onset (P = 0.084). This study confirmed the role of heredity in acne. Family history of acne is associated with earlier onset of the disease, and more non-inflammatory lesions.

  20. The Impact of Post-Acne Scars on the Quality of Life Among Young Adults in Singapore

    PubMed Central

    Chuah, Sai Yee; Goh, Chee Leok

    2015-01-01

    Background and Objectives: Post-acne scarring is a common and well-known sequelae of acne vulgaris. We aim to study the impact of post-acne scarring on the quality of life (QOL) among young adults in Singapore. Settings and Design: This was a non-interventional prospective study. Materials and Methods: Patients aged 21-40 years with atrophic and hypertrophic acne scars who attended the National Skin Centre, Singapore were recruited in the study. They answered a simple questionnaire and the clinical severity of their acne scars were assessed by the doctor. Statistical Analysis Used: Descriptive analyses using absolute and percentage frequencies were performed on all data. The test of significance was two-sided and was set at 5% (P ≤ 0.05). Differential analyses were conducted using the parametric, independent two-sample t-test and non-parametric Mann–Whitney U-test. The statistical assessments were performed using SPSS version 18.0. Results: A total of 100 patients were studied. The mean patients’ subjective self-scoring on the severity of their post-acne scars was 5.78/10 and the mean Dermatology Life Quality Index (DLQI) for post-acne scars was 5.61. Many (36%, n = 36) were self-conscious of their acne scars and 24%, (n = 24) felt that their acne scars was affecting their social activities. Conclusions: Our study showed that post-acne scars have a significant negative effect on the QOL of young adults. It highlights the need to increase public awareness of acne vulgaris and its sequelae through education programs and advocating early treatment to reduce the risk of scarring. PMID:26644739

  1. Sensitivity of Propionibacterium acnes isolated from acne patients: comparative study of antimicrobial agents.

    PubMed

    Nishijima, S; Kurokawa, I; Kawabata, S

    1996-01-01

    The antimicrobial susceptibility of Propionibacterium acnes isolated before and after treatment of acne patients was measured. The four female and three male acne patients were treated with an oral acne medication, roxithromycin or minocycline, and/or a topical acne medication, nadifloxacin cream or clindamycin hydrochloride lotion for 1-8 weeks. The isolated strains were tested for their susceptibility to the antimicrobial action of: nadifloxacin, ofloxacin, erythromycin, clindamycin hydrochloride, tetracycline hydrochloride, minocycline, doxycycline, ampicillin, cephalexin and gentamycin. No resistant strains of P. acnes were observed.

  2. The effect of feedback respiratory exercise on muscle activity, craniovertebral angle, and neck disability index of the neck flexors of patients with forward head posture

    PubMed Central

    Kang, Jeong-il; Jeong, Dae-Keun; Choi, Hyun

    2016-01-01

    [Purpose] This study aimed to simultaneously investigate the activities of the sternocleidomastoid muscle and scalenus anterior muscle, which are agonists of neck and breathing accessory muscles, by implementing breathing exercises. [Subjects and Methods] Thirteen subjects were selected for the experimental group, which performed feedback respiratory exercises with McKenzie exercises, and 12 subjects were selected for the control group, which performed McKenzie exercises alone. The intervention program was performed for 30 minutes a session, once a day, four times a week, and for 2 weeks before conducting the experiment. Before intervention, muscle activity was measured using surface electromyogram, and the neck disability index was evaluated. [Results] There were meaningful differences in activities of the sternocleidomastoid muscle and the scalenus anterior muscle, craniovertebral angle, and neck disability index within both the experimental group and control group after intervention. There also were meaningful differences in sternocleidomastoid muscle and neck disability index changes between groups. [Conclusion] Neck flexors as accessory respiratory muscle can affect inefficient respiratory imbalance of forward head posture patients. Multimodal intervention method should be studied continually and not be exposed to upper chest breathing patterns by preventing such phenomenon. PMID:27799674

  3. Comparative interrater reliability of Asian Stroke Disability Scale, modified Rankin Scale and Barthel Index in patients with brain infarction

    PubMed Central

    Ghandehari, Kavian; Ghandehari, Kosar; Saffarian-Toosi, Ghazaleh; Masoudinezhad, Shahram; Yazdani, Siamak; Nooraddin, Ali; Ebrahimzadeh, Saeed; Ahmadi, Fahimeh; Abrishamchi, Fatemeh

    2012-01-01

    BACKGROUND This study tried to develop an Asian Stroke Disability Scale (ASDS) and compared its interrater reliability with modified Rankin Scale (mRS) and Barthel Index (BI). METHODS Three items including self-care, mobility, and daily activities were selected as variables for development of the ASDS. The variables were provisionally graded on a 2- to 4-point scale based on the importance of each item. Each of the variables was categorized into 3 categories. Afterward, 125 rater-patient assessments for each scale (mRS, BI, and ASDS) were performed on 25 stroke patients by 5 raters. For categorization of functional impairment as minor or major, the scores of mRS, BI and ASDS were categorized as ≤ 2 and > 2, < 90 and ≥ 90, and < 3 and ≥ 3, respectively.125 rater-patient assessments for each of the mRS, BI, and ASDS were performed on 25 stroke patients by five raters. RESULTS The quantitative variability of BI, mRS, and ASDS scores was not significant (P = 0.379; P = 0.780; and P = 0.835, respectively). Interrater variability of mRS, BI, and ASDS scores based on qualitative categorization was not significant (P = 1.000; P = 0.978; and P = 0.901, respectively). Paired interrater variability of mRS, BI, and ASDS scores based on qualitative categorization was not significant (P > 0.05). CONCLUSION The ASDS is easy to use, requires less than 1 minute to complete and is as valid as mRS and BI in assessment of functional impairment of patients with stroke. PMID:23359790

  4. NdYag Laser for Acne Keloidalis Nuchae

    ClinicalTrials.gov

    2013-03-27

    Acne Keloidalis Nuchae; NdYag Laser; AKN; Acne Keloidalis; AK; Dermatitis Papillaris Capillitii; Folliculitis Keloidalis Nuchae; Sycosis Nuchae; Acne Keloid; Keloidal Folliculitis; Lichen Keloidalis Nuchae; Folliculitis Nuchae Scleroticans; Sycosis Framboesiformis

  5. Topically applied antibiotics in acne vulgaris: clinical response and suppression of Corynebacterium acnes in open comedones.

    PubMed

    Resh, W; Stoughton, R B

    1976-02-01

    Topical antibiotics were used on patients with acne vulgaris. Corynebacterium acnes organisms from open comedones were quantitated during treatment, and the progress of the disease was evaluated. Clindamycin lotion completely suppressed the growth of C acnes organisms, whereas erythromycin and tetracycline did not depress the C acnes counts. Taken as a group, these antibiotics gave a substantial improvement of the disease on the treated side as compared with paired untreated sides of the face and back.

  6. Acne Scars: Pathogenesis, Classification and Treatment

    PubMed Central

    Fabbrocini, Gabriella; Annunziata, M. C.; D'Arco, V.; De Vita, V.; Lodi, G.; Mauriello, M. C.; Pastore, F.; Monfrecola, G.

    2010-01-01

    Acne has a prevalence of over 90% among adolescents and persists into adulthood in approximately 12%–14% of cases with psychological and social implications. Possible outcomes of the inflammatory acne lesions are acne scars which, although they can be treated in a number of ways, may have a negative psychological impact on social life and relationships. The main types of acne scars are atrophic and hypertrophic scars. The pathogenesis of acne scarring is still not fully understood, but several hypotheses have been proposed. There are numerous treatments: chemical peels, dermabrasion/microdermabrasion, laser treatment, punch techniques, dermal grafting, needling and combined therapies for atrophic scars: silicone gels, intralesional steroid therapy, cryotherapy, and surgery for hypertrophic and keloidal lesions. This paper summarizes acne scar pathogenesis, classification and treatment options. PMID:20981308

  7. Treatment of acne with topical antibiotics.

    PubMed

    Frank, S B

    1977-06-01

    The introduction of topical antibiotics for acne vulgaris has ushered in a new era in the treatment of this troublesome disorder. Tetracycline, erythromycin, and clindamycin can now be prepared in lotion form in vehicles that are capable of carrying the antibiotic into the follicular canal, where the primary lesion of acne occurs. Topical antibiotics are practically as effective as oral antibiotics in treating acne and are particularly useful for mild papular acne of puberty and early adolescence and papular-pustular acne of adult women. Use of topical antibiotics avoids the possibility of the adverse effects of systemic therapy; the side effects from the formulations reported here are negligible. Above all, antibiotic lotions do not produce the dryness and scaling that occur with most other topical acne preparations.

  8. Acne vulgaris related to androgens - a review.

    PubMed

    Khondker, L; Khan, S I

    2014-01-01

    Sebum production is stimulated by androgens and is the key in the development of acne vulgaris. Several investigators have looked for direct relationships between serum androgen levels, sebum secretion rate and the presence of acne. The presence of acne in prepubertal girls and sebum production in both sexes correlate with serum dehydroepiandrosterone sulfate (DHEAS) levels. Although increased serum androgen levels correlate with the presence of severe nodular acne in men and women, these levels are often within the normal range in mild to moderate acne. This raises the question of whether there is an increased local production of androgens within the sebaceous gland of patients with acne vulgaris that leads to increased sebum secretion.

  9. A Review of Acne in Ethnic Skin

    PubMed Central

    Davis, Erica C.

    2010-01-01

    Acne vulgaris is one of the most common conditions for which all patients, including those with skin of color (Fitzpatrick skin types IV–VI), seek dermatological care. The multifactorial pathogenesis of acne appears to be the same in ethnic patients as in Caucasians. However, there is controversy over whether certain skin biology characteristics, such as sebum production, differ in ethnic patients. Clinically, acne lesions can appear the same as those seen in Caucasians; however, histologically, all types of acne lesions in African Americans can be associated with intense inflammation including comedones, which can also have some degree of inflammation. It is the sequelae of the disease that are the distinguishing characteristics of acne in skin of color, namely postinflammatory hyperpigmentation and keloidal or hypertrophic scarring. Although the medical and surgical treatment options are the same, it is these features that should be kept in mind when designing a treatment regimen for acne in skin of color. PMID:20725545

  10. Physical modalities for treating acne and rosacea.

    PubMed

    Jalian, H Ray; Levin, Yakir; Wanner, Molly

    2016-06-01

    Physical modalities provide an important adjunct to medical treatment of acne and rosacea. In patients who cannot tolerate or fail medical treatments, physical modalities offer an alternative approach. For cases of acne scarring, phymatous changes of rosacea, and rosacea-associated telangiectasia, physical modalities such as laser and light treatments represent the treatment of choice. We will review the use of laser and light treatments, photodynamic therapy, and other physical modalities such as targeted therapies for the treatment of acne and rosacea.

  11. Acne keloidalis nuchae and tufted hair folliculitis.

    PubMed

    Luz Ramos, M; Muñoz-Pérez, M A; Pons, A; Ortega, M; Camacho, F

    1997-01-01

    Acne keloidalis nuchae is a chronic, scarring folliculitis that affects mostly black patients and is located on the back of the neck of young adults. The course is progressive and leads to hypertrophic scarring, chronic abscesses and hair loss. We discuss the relationship between acne keloidalis and tufted hair folliculitis, pointing out the possibility that tufted hair folliculitis is not a specific disease but secondary to other progressive folliculitis like folliculitis decalvans, dissecting cellulitis or acne keloidalis. PMID:9031798

  12. [Using combined magnetotherapy in patients with acne].

    PubMed

    Kul'chitskaia, D B; Orekhova, E M; Vasil'eva, E S

    2004-01-01

    Laser Doppler flowmetry discovered microcirculatory disorders in acne patients. Affected are arterioles as well as capillaries and venules. Combination of magnetotherapy with medication improves microcirculation in acne patients. More marked positive changes occurred in the microcirculatory system due to combined treatment compared to medication therapy only. Thus, laser Doppler flowmetry is a new, noninvasive method of assessing microcirculation in acne patients and can serve an objective criterion of treatment efficacy. PMID:15449670

  13. Pediatric Acne: Clinical Patterns and Pearls.

    PubMed

    Maroñas-Jiménez, Lidia; Krakowski, Andrew C

    2016-04-01

    Acne vulgaris presenting from birth to preadolescence can be confusing to diagnose and even more challenging to evaluate and manage. The differential diagnosis of acne varies by age and, in some cases (especially when it presents in midchildhood), deserves a thorough evaluation to rule out underlying systemic abnormalities. Acne management strategies, including factors affecting adherence to the treatment regimen, may be influenced by the patient's age. This article presents an overview of the clinical presentations of acne by age and our approach to evaluation and management of this common condition. PMID:27015779

  14. Isotretinoin for acne and rosacea.

    PubMed

    Watson, Kendra D; Miest, Rachel Y; Tollefson, Megha M

    2016-06-01

    Isotretinoin is a revolutionary medicine for the treatment of acne vulgaris, with new studies showing evidence of excellent clinical outcomes in treating rosacea. After 30 years of clinical experience, new insights are being gained into dosing strategies, recurrence prevention, and dose-related side effects. Previous controversial associations with inflammatory bowel diseases and mood disorders have hampered the use of this medication in some clinical situations, with new evidence disproving these claims. The teratogenicity of this medication mandates iPLEDGE compliance with government regulations. Clinicians should be knowledgeable about this medication including its side effects, teratogenicity, and its controversies in order to adequately counsel patients, dissuade fears, and obtain the best clinical outcome when treating acne and rosacea. PMID:27416313

  15. Over-the-counter Acne Treatments

    PubMed Central

    Graber, Emmy M.

    2012-01-01

    Acne is a common dermatological disorder that most frequently affects adolescents; however, individuals may be affected at all ages. Many people who suffer from acne seek treatment from both prescription and over-the-counter acne medications. Due to convenience, lower cost, and difficulty getting an appointment with a dermatologist, the use of over-the-counter acne treatments is on the rise. As the plethora of over-the-counter acne treatment options can be overwhelming, it is important that dermatologists are well-versed on this subject to provide appropriate information about treatment regimens and potential drug interactions and that their patients see them as well-informed. This article reviews the efficacy of various over-the-counter acne treatments based on the current literature. A thorough literature review revealed there are many types of over-the-counter acne treatments and each are designed to target at least one of the pathogenic pathways that are reported to be involved in the development of acne lesions. Many of the key over-the-counter ingredients are incorporated in different formulations to broaden the spectrum and consumer appeal of available products. Unfortunately, many over-the-counter products are not well-supported by clinical studies, with a conspicuous absence of double-blind or investigator-blind, randomized, vehicle-controlled studies. Most studies that do exist on over-the-counter acne products are often funded by the manufacturer. Use of over-the-counter acne treatments is a mainstay in our society and it is important that dermatologists are knowledgeable about the different options, including potential benefits and limitations. Overall, over-the-counter acne therapies can be classified into the following five major groups: cleansers, leave-on products, mechanical treatments, essential oils, and vitamins. PMID:22808307

  16. Dissecting the taxonomic heterogeneity within Propionibacterium acnes: proposal for Propionibacterium acnes subsp. acnes subsp. nov. and Propionibacterium acnes subsp. elongatum subsp. nov.

    PubMed

    Dekio, Itaru; Culak, Renata; Misra, Raju; Gaulton, Tom; Fang, Min; Sakamoto, Mitsuo; Ohkuma, Moriya; Oshima, Kenshiro; Hattori, Masahira; Klenk, Hans-Peter; Rajendram, Dunstan; Gharbia, Saheer E; Shah, Haroun N

    2015-12-01

    Propionibacterium acnes subsp. acnes subsp. nov. and Propionibacterium acnes subsp. elongatum subsp. nov. are described. These emanate from the three known phylotypes of P. acnes, designated types I, II and III. Electron microscopy confirmed the filamentous cell shape of type III, showing a striking difference from types I/II, which were short rods. Biochemical tests indicated that, in types I/II, either the pyruvate, l-pyrrolidonyl arylamidase or d-ribose 2 test was positive, whereas all of these were negative among type III strains. Matrix-assisted laser-desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) spectra, which profile mainly their ribosomal proteins, were different between these two groups. Surface-enhanced laser-desorption/ionization time-of-flight mass spectrometry (SELDI-TOF MS) spectra of all phylotypes revealed a specific protein biomarker that was overexpressed in type III strains compared with types I/II only when grown aerobically. Reference strains had high whole-genome similarity between types I (>91 %) and II (>75 %), but a considerably lower level of 72 % similarity with type III. recA and gyrB sequence dendrograms confirmed the distant relatedness of type III, indicating the presence of two distinct centres of variation within the species P. acnes. On the other hand, cellular fatty acid profiles and 16S rRNA gene sequence relatedness (>99.3 %) circumscribed the species. Thus, we propose two subspecies, Propionibacterium acnes subsp. acnes subsp. nov. for types I/II and Propionibacterium acnes subsp. elongatum subsp. nov. for type III. The type strain of Propionibacterium acnes subsp. acnes is NCTC 737T ( = ATCC 6919T = JCM 6425T = DSM 1897T = CCUG 1794T), while the type strain of Propionibacterium acnes subsp. elongatum is K124T ( = NCTC 13655T = JCM 18919T). PMID:26432704

  17. Benzoyl peroxide lotion (20 percent) in acne.

    PubMed

    Smith, E B; Padilla, R S; McCabe, J M; Becker, L E

    1980-01-01

    A double-blind, controlled study was performed to determine the effectiveness of 20 percent benzoyl peroxide lotion in the mangement of mild to moderate acne vulgaris. The results of our study have shown that this new, higher concentration formulation of benzoyl peroxide is effective in reducing the lesions of acne and is relatively nonirritating.

  18. [Hormonal factors in etiology of common acne].

    PubMed

    Bergler-Czop, Beata; Brzezińska-Wcisło, Ligia

    2004-05-01

    Common acne is steatorrhoeic chronic disease, to which specific is, among others, the presence of blackheads, papulopustular eruptions, purulent cysts and cicatrices. Such hormonal factors belong to elements inherent in etiology of the affection. Sebaceous glands have cell receptors on their surface for androgens. In etiopathogenesis of common/simple acne, a decisive role is played by a derivative of testosterone, i.e. 5-alpha-dihydrotestosterone (DHT). However, some experts are of opinion that there is no correlation between the increased intensity of common acne and other symptoms of hyperandrogenism. Numerous authors assume, however, that common acne-affected patients may be sometimes subjected to intense reactions caused by sebaceous glands against physiological androgens concentrations. Naturally, estrogens can inhibit release of such androgens. Under physiological conditions, natural progesterone does not conduct to intensification of the seborrhea, but the activity of sebum secretion may be triggered off by its synthetic counterparts. Hormonal etiology can be very distinctly visible in the steroid, androgenic, premenstrual, menopausal acne, as well as in juvenile acne and acne neonatorum. In case of females affected by acne, hormonal therapy should be persistently supported and consulted with dermatologists, endocrinologists and gynecologists. Antiandrogenic preparations are applied, such as: cyproterone acetate concurrently administered with estrogens and, as well as not so frequently with chlormadinone acetate (independently or during estrogenic therapy). PMID:15518435

  19. Zapping Those Zits: Helping Teens Handle Acne.

    ERIC Educational Resources Information Center

    Martin, Paul

    1992-01-01

    Describes five types of acne and stresses the importance of appropriate treatment. Some dermatologists believe diet is critical in improving acne. Other treatments include the use of drying lotions and soaps, astringents, abrasive cleansers, prescription drugs, face peels, and dermabrasion. (SM)

  20. Inadequacy of 3-month Oswestry Disability Index outcome for assessing individual longer-term patient experience after lumbar spine surgery.

    PubMed

    Asher, Anthony L; Chotai, Silky; Devin, Clinton J; Speroff, Theodore; Harrell, Frank E; Nian, Hui; Dittus, Robert S; Mummaneni, Praveen V; Knightly, John J; Glassman, Steven D; Bydon, Mohamad; Archer, Kristin R; Foley, Kevin T; McGirt, Matthew J

    2016-08-01

    OBJECTIVE Prospective longitudinal outcomes registries are at the center of evidence-driven health care reform. Obtaining real-world outcomes data at 12 months can be costly and challenging. In the present study, the authors analyzed whether 3-month outcome measurements sufficiently represent 12-month outcomes for patients with degenerative lumbar disease undergoing surgery. METHODS Data from 3073 patients undergoing elective spine surgery for degenerative lumbar disease were entered into a prospective multicenter registry (N(2)QOD). Baseline, 3-month, and 12-month follow-up Oswestry Disability Index (ODI) scores were recorded. The absolute differences between actual 12- and 3-month ODI scores was evaluated. Additionally, the authors analyzed the absolute difference between actual 12-month ODI scores and a model-predicted 12-month ODI score (the model used patients' baseline characteristics and actual 3-month scores). The minimal clinically important difference (MCID) for ODI of 12.8 points and the substantial clinical benefit (SCB) for ODI of 18.8 points were used based on the previously published values. The concordance rate of achieving MCID and SCB for ODI at 3-and 12-months was computed. RESULTS The 3-month ODI scores differed from 12-month scores by an absolute difference of 11.9 ± 10.8, and predictive modeling estimations of 12-month ODI scores differed from actual 12-month scores by a mean (± SD) of 10.7 ± 9.0 points (p = 0.001). Sixty-four percent of patients (n = 1982) achieved an MCID for ODI at 3 months in comparison with 67% of patients (n = 2088) by 12 months; 51% (n = 1731) and 61% (n = 1860) of patients achieved SCB for ODI at 3 months and 12 months, respectively. Almost 20% of patients had ODI scores that varied at least 20 points (the point span of an ODI functional category) between actual 3- and 12-month values. In the aggregate analysis of achieving MCID, 77% of patients were concordant and 23% were discordant in achieving or not achieving

  1. Inadequacy of 3-month Oswestry Disability Index outcome for assessing individual longer-term patient experience after lumbar spine surgery.

    PubMed

    Asher, Anthony L; Chotai, Silky; Devin, Clinton J; Speroff, Theodore; Harrell, Frank E; Nian, Hui; Dittus, Robert S; Mummaneni, Praveen V; Knightly, John J; Glassman, Steven D; Bydon, Mohamad; Archer, Kristin R; Foley, Kevin T; McGirt, Matthew J

    2016-08-01

    OBJECTIVE Prospective longitudinal outcomes registries are at the center of evidence-driven health care reform. Obtaining real-world outcomes data at 12 months can be costly and challenging. In the present study, the authors analyzed whether 3-month outcome measurements sufficiently represent 12-month outcomes for patients with degenerative lumbar disease undergoing surgery. METHODS Data from 3073 patients undergoing elective spine surgery for degenerative lumbar disease were entered into a prospective multicenter registry (N(2)QOD). Baseline, 3-month, and 12-month follow-up Oswestry Disability Index (ODI) scores were recorded. The absolute differences between actual 12- and 3-month ODI scores was evaluated. Additionally, the authors analyzed the absolute difference between actual 12-month ODI scores and a model-predicted 12-month ODI score (the model used patients' baseline characteristics and actual 3-month scores). The minimal clinically important difference (MCID) for ODI of 12.8 points and the substantial clinical benefit (SCB) for ODI of 18.8 points were used based on the previously published values. The concordance rate of achieving MCID and SCB for ODI at 3-and 12-months was computed. RESULTS The 3-month ODI scores differed from 12-month scores by an absolute difference of 11.9 ± 10.8, and predictive modeling estimations of 12-month ODI scores differed from actual 12-month scores by a mean (± SD) of 10.7 ± 9.0 points (p = 0.001). Sixty-four percent of patients (n = 1982) achieved an MCID for ODI at 3 months in comparison with 67% of patients (n = 2088) by 12 months; 51% (n = 1731) and 61% (n = 1860) of patients achieved SCB for ODI at 3 months and 12 months, respectively. Almost 20% of patients had ODI scores that varied at least 20 points (the point span of an ODI functional category) between actual 3- and 12-month values. In the aggregate analysis of achieving MCID, 77% of patients were concordant and 23% were discordant in achieving or not achieving

  2. Body Mass Index in Adults with Intellectual Disability: Distribution, Associations and Service Implications--A Population-Based Prevalence Study

    ERIC Educational Resources Information Center

    Bhaumik, S.; Watson, J. M.; Thorp, C. F.; Tyrer, F.; McGrother, C. W.

    2008-01-01

    Background: Previous studies of weight problems in adults with intellectual disability (ID) have generally been small or selective and given conflicting results. The objectives of our large-scale study were to identify inequalities in weight problems between adults with ID and the general adult population, and to investigate factors associated…

  3. Development of a Frailty Index for Older People with Intellectual Disabilities: Results from the HA-ID Study

    ERIC Educational Resources Information Center

    Schoufour, Josje D.; Mitnitski, Arnold; Rockwood, Kenneth; Evenhuis, Heleen M.; Echteld, Michael A.

    2013-01-01

    Background: Although there is no strict definition of frailty, it is generally accepted as a state of high vulnerability for adverse health outcomes at older age. Associations between frailty and mortality, dependence, and hospitalization have been shown. We measured the frailty level of older people with intellectual disabilities (ID).…

  4. The effects of abdominal draw-in maneuver and core exercise on abdominal muscle thickness and Oswestry disability index in subjects with chronic low back pain

    PubMed Central

    Park, Seong-Doo; Yu, Seong-Hun

    2013-01-01

    The purpose of this study was to effects of abdominal draw-in maneuver and core exercise with 4 weeks using the musculoskeletal ultrasonography on muscle thickness and disability in subjects with low back pain. Twenty patients with nonspecific back pain (abdominal draw-in maneuver group: n= 10, core exercise group: n= 10) were recruited in the study. Both group received exercise intervention 3 times a week for 4weeks. The test were based on muscle thickness (transversus abdominis; Tra, internal oblique; IO and external oblique; EO), disability (Oswestry disability index; ODI) measured immediately before and after intervention. The data was measured by SPSS program 12.0 version and analyzed by Paired t-test and Independent t-test. The following results were obtained. The thickness of IO, EO for both group significantly improved except for muscle thickness of Tra. The ODI were significant difference for both groups. As the results of this study, we suggest that it may be effective method to apply to increase for the thickness of Tra, EO using abdominal draw-in maneuver and thickness of IO using core exercise. PMID:24278873

  5. Transitional Forms of Corynebacterium acnes in Disease

    PubMed Central

    Zierdt, C. H.; Wertlake, P. T.

    1969-01-01

    A clear-cut triad of sequential Corynebacterium acnes transitional forms from disease has been discovered. This entity includes three major forms which are capable of stabilization in culture, the spherical, the intermediate, and the definitive C. acnes. During conversion or reversion among the three forms, a variety of forms with mixed characteristics was observed. The spherical form was gram-negative and osmotically fragile, but it possessed a vestigial cell wall and mesosomes which excluded it from the L forms. In lieu of the L-form designation, the term “transitional” was adopted for all forms leading up to the definitive C. acnes. Culture of the spherical form was successful only on Mycoplasma-type media. The intermediate form was gram-negative, had mixed spherical and filamentous morphology, and bore a striking resemblance to Streptobacillus moniliformis. Like the spherical form, it was nutritionally exacting. The definitive form of C. acnes was preceded by gram-positive transitional forms of C. acnes morphology. It lacked, however, the carbohydrases and proteinases of C. acnes and susceptibility to C. acnes bacteriophages. Reversion was often blocked at this stage. A series of blood cultures from a patient with endocarditis was studied. Postmortem stain sections of the heart-valve lesion included intracellular masses of gram-negative spherical organisms. Indirect fluorescent antibody staining of these masses was strongly positive with antiserum to the spherical form and weakly positive with antiserum to the intermediate form. Images PMID:4886295

  6. Preparation, characterization, and in vitro antimicrobial assessment of nanocarrier based formulation of nadifloxacin for acne treatment.

    PubMed

    Kumar, A; Agarwal, S P; Ahuja, A; Ali, J; Choudhry, R; Baboota, S

    2011-02-01

    The objective of the present study was to develop a nanocarrier based formulation of nadifloxacin and to investigate its in vitro antimicrobial effect against Propionibacterium acnes. Nanocarrier based microemulsion formulations were prepared by aqueous titration method, using oleic acid as oil phase, Tween-80 as surfactant and ethanol as co-surfactant in different ratios. This procedure yielded monodisperse microemulsions exhibiting a mean droplet size in the range of 95-560 nm. This range of particle size is good to treat follicle related disorders like acne vulgaris because the size of follicles is in the range of 50-100 microm. Furthermore the optimized formulations were characterized for surface morphology by transmission electron microscopy and refractive index. The permeation studies were carried out using rat skin mounted in Franz diffusion cells. Flux of the optimised formulation was 2.24 times that of control. The diameter of inhibition zone of the microemulsion was found good but smaller than that of a clindamycin disc because of the higher therapeutic efficacy of clindamycin against P. acnes. The results indicated that the developed microemulsion shows promising results against P. acnes bacteria and may be a good approach for acne treatment. PMID:21434572

  7. Comparison effect of azithromycin gel 2% with clindamycin gel 1% in patients with acne

    PubMed Central

    Mokhtari, Fatemeh; Faghihi, Gita; Basiri, Akram; Farhadi, Sadaf; Nilforoushzadeh, Mohammadali; Behfar, Shadi

    2016-01-01

    Background: Acne vulgaris is the most common skin disease. Local and systemic antimicrobial drugs are used for its treatment. But increasing resistance of Propionibacterium acnes to antibiotics has been reported. Materials and Methods: In a double-blind clinical trial, 40 patients with mild to moderate acne vulgaris were recruited. one side of the face was treated with Clindamycin Gel 1% and the other side with Azithromycin Topical Gel 2% BID for 8 weeks and then they were assessed. Results: Average age was 21. 8 ± 7 years. 82.5% of them were female. Average number of papules, pustules and comedones was similarly reduced in both groups and, no significant difference was observed between the two groups (P > 0.05, repeated measurs ANOVA). The mean indexes of ASI and TLC also significantly decreased during treatment in both groups, no significant difference was observed between the two groups. (P > 0.05, repeated measurs ANOVA). Also, impact of both drugs on papules and pustules was 2-3 times greater than the effect on comedones. Average satisfaction score was not significant between the two groups (P = 0.6, repeated measurs ANOVA). finally, frequency distribution of complications was not significant between the two groups (P > 0.05, Fisher Exact test). Conclusion: Azithromycin gel has medical impact at least similar to Clindamycin Gel in treatment of mild to moderate acne vulgaris, and it may be consider as suitable drug for resistant acne to conventional topical therapy. PMID:27169103

  8. Acne image analysis: lesion localization and classification

    NASA Astrophysics Data System (ADS)

    Abas, Fazly Salleh; Kaffenberger, Benjamin; Bikowski, Joseph; Gurcan, Metin N.

    2016-03-01

    Acne is a common skin condition present predominantly in the adolescent population, but may continue into adulthood. Scarring occurs commonly as a sequel to severe inflammatory acne. The presence of acne and resultant scars are more than cosmetic, with a significant potential to alter quality of life and even job prospects. The psychosocial effects of acne and scars can be disturbing and may be a risk factor for serious psychological concerns. Treatment efficacy is generally determined based on an invalidated gestalt by the physician and patient. However, the validated assessment of acne can be challenging and time consuming. Acne can be classified into several morphologies including closed comedones (whiteheads), open comedones (blackheads), papules, pustules, cysts (nodules) and scars. For a validated assessment, the different morphologies need to be counted independently, a method that is far too time consuming considering the limited time available for a consultation. However, it is practical to record and analyze images since dermatologists can validate the severity of acne within seconds after uploading an image. This paper covers the processes of region-ofinterest determination using entropy-based filtering and thresholding as well acne lesion feature extraction. Feature extraction methods using discrete wavelet frames and gray-level co-occurence matrix were presented and their effectiveness in separating the six major acne lesion classes were discussed. Several classifiers were used to test the extracted features. Correct classification accuracy as high as 85.5% was achieved using the binary classification tree with fourteen principle components used as descriptors. Further studies are underway to further improve the algorithm performance and validate it on a larger database.

  9. Hormonal treatment of acne vulgaris: an update

    PubMed Central

    Elsaie, Mohamed L

    2016-01-01

    Acne vulgaris is a common skin condition associated with multiple factors. Although mostly presenting alone, it can likewise present with features of hyperandrogenism and hormonal discrepancies. Of note, hormonal therapies are indicated in severe, resistant-to-treatment cases and in those with monthly flare-ups and when standard therapeutic options are inappropriate. This article serves as an update to hormonal pathogenesis of acne, discusses the basics of endocrinal evaluation for patients with suspected hormonal acne, and provides an overview of the current hormonal treatment options in women. PMID:27621661

  10. [How do I treat acne and rosacea?].

    PubMed

    Böcker, K H

    1986-04-01

    Regarding treatment of acne vulgaris and rosacea, there is not much difference between hospital and practice nor among practicing dermatologists. Most of the assistants performing the important physical-manual treatment have had the same training. After analytical conversation and etiologic as well as diagnostic classification, the patients undergo the following manual treatment: cleansing, astringing, removing of comedones, massage, face pack, and covering with tinted emulsion. At home, acne: cleansing, massage, skin lotion, vitamin A acid, benzoylperoxide, antibacterial therapy; in serious male cases of acne conglobata, Roaccutan. Rosacea: antiseptic (antibiotic) treatment (topically and systemically), metronidazole (Arilin); in serious male cases, Roaccutan.

  11. Hormonal treatment of acne vulgaris: an update

    PubMed Central

    Elsaie, Mohamed L

    2016-01-01

    Acne vulgaris is a common skin condition associated with multiple factors. Although mostly presenting alone, it can likewise present with features of hyperandrogenism and hormonal discrepancies. Of note, hormonal therapies are indicated in severe, resistant-to-treatment cases and in those with monthly flare-ups and when standard therapeutic options are inappropriate. This article serves as an update to hormonal pathogenesis of acne, discusses the basics of endocrinal evaluation for patients with suspected hormonal acne, and provides an overview of the current hormonal treatment options in women.

  12. Hormonal treatment of acne vulgaris: an update.

    PubMed

    Elsaie, Mohamed L

    2016-01-01

    Acne vulgaris is a common skin condition associated with multiple factors. Although mostly presenting alone, it can likewise present with features of hyperandrogenism and hormonal discrepancies. Of note, hormonal therapies are indicated in severe, resistant-to-treatment cases and in those with monthly flare-ups and when standard therapeutic options are inappropriate. This article serves as an update to hormonal pathogenesis of acne, discusses the basics of endocrinal evaluation for patients with suspected hormonal acne, and provides an overview of the current hormonal treatment options in women. PMID:27621661

  13. Acne and whey protein supplementation among bodybuilders.

    PubMed

    Simonart, Thierry

    2012-01-01

    Accumulative evidence supports the role of nutritional factors in acne. I report here 5 healthy male adult patients developing acne after the consumption of whey protein, a favorite supplement of those engaged in bodybuilding. These observations are in line with biochemical and epidemiological data supporting the effects of milk and dairy products as enhancers of insulin/insulin-like growth factor 1 signaling and acne aggravation. Further prospective studies are required to determine the possible role of dietary supplements in the fitness and bodybuilding environment.

  14. Physical modalities for treating acne and rosacea.

    PubMed

    Jalian, H Ray; Levin, Yakir; Wanner, Molly

    2016-06-01

    Physical modalities provide an important adjunct to medical treatment of acne and rosacea. In patients who cannot tolerate or fail medical treatments, physical modalities offer an alternative approach. For cases of acne scarring, phymatous changes of rosacea, and rosacea-associated telangiectasia, physical modalities such as laser and light treatments represent the treatment of choice. We will review the use of laser and light treatments, photodynamic therapy, and other physical modalities such as targeted therapies for the treatment of acne and rosacea. PMID:27416315

  15. Association between Propionibacterium acnes and frozen shoulder: a pilot study

    PubMed Central

    Bunker, Tim D; Gallacher, Sian; Auckland, Cressida R; Kitson, Jeff; Smith, Chris D

    2014-01-01

    Background Frozen shoulder has not previously been shown to be associated with infection. The present study set out to confirm the null hypothesis that there is no relationship between infection and frozen shoulder using two modern scientific methods, extended culture and polymerase chain reaction (PCR) for bacterial nucleic acids. Methods A prospective cohort of 10 patients undergoing arthroscopic release for stage II idiopathic frozen shoulder had two biopsies of tissue taken from the affected shoulder joint capsule at the time of surgery, along with control biopsies of subdermal fat. The biopsies and controls were examined with extended culture and PCR for microbial nucleic acid. Results Eight of the 10 patients had positive findings on extended culture in their shoulder capsule and, in six of these, Propionibacterium acnes was present. Conclusions The findings mean that we must reject the null hypothesis that there is no relationship between infection and frozen shoulder. More studies are urgently needed to confirm or refute these findings. If they are confirmed, this could potentially lead to new and effective treatments for this common, painful and disabling condition. Could P. acnes be the Helicobacter of frozen shoulder? PMID:27582943

  16. Complementary therapies for acne vulgaris

    PubMed Central

    Cao, Huijuan; Yang, Guoyan; Wang, Yuyi; Liu, Jian Ping; Smith, Caroline A; Luo, Hui; Liu, Yueming

    2015-01-01

    Background Acne is a chronic skin disease characterised by inflamed spots and blackheads on the face, neck, back, and chest. Cysts and scarring can also occur, especially in more severe disease. People with acne often turn to complementary and alternative medicine (CAM), such as herbal medicine, acupuncture, and dietary modifications, because of their concerns about the adverse effects of conventional medicines. However, evidence for CAM therapies has not been systematically assessed. Objectives To assess the effects and safety of any complementary therapies in people with acne vulgaris. Search methods We searched the following databases from inception up to 22 January 2014: the Cochrane Skin Group Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL; 2014, Issue 1), MEDLINE (from 1946), Embase (from 1974), PsycINFO (from 1806), AMED (from 1985), CINAHL (from 1981), Scopus (from 1966), and a number of other databases listed in the Methods section of the review. The Cochrane CAM Field Specialised Register was searched up to May 2014. We also searched five trials registers and checked the reference lists of articles for further references to relevant trials. Selection criteria We included parallel-group randomised controlled trials (or the first phase data of randomised cross-over trials) of any kind of CAM, compared with no treatment, placebo, or other active therapies, in people with a diagnosis of acne vulgaris. Data collection and analysis Three authors collected data from each included trial and evaluated the methodological quality independently. They resolved disagreements by discussion and, as needed, arbitration by another author. Main results We included 35 studies, with a total of 3227 participants. We evaluated the majority as having unclear risk of selection, attrition, reporting, detection, and other biases. Because of the clinical heterogeneity between trials and the incomplete data reporting, we could only include four

  17. Properties of herbal extracts against Propionibacterium acnes for biomedical application

    NASA Astrophysics Data System (ADS)

    Lim, Youn-Mook; Kim, Sung Eun; Kim, Yong Soo; Shin, Young Min; Jeong, Sung In; Jo, Sun-Young; Gwon, Hui-Jeong; Park, Jong-seok; Nho, Young-Chang; Kim, Jong-Cheol; Kim, Seong-Jang; Shin, HeungSoo

    2012-10-01

    Propionibacterium acnes (P. acnes), one of the anaerobic bacterium, causes inflammatory acne. To find a novel medication for treating the inflammation caused by P. acnes, we investigated the anti-bacterial and anti-inflammatory activities of several herbal extracts against P. acnes. The aqueous extracts from five dried herbs, Phellodendron amurense Rupr., Paeonia lactiflora Pallas., Houttuynia cordata Thunb., Agrimonia pilosa Ledeb. and Glycyrrhiza uralensis Fisch., were prepared and mixed. In this experiment, 1 mg/ml of the herbal extract mixture caused a decrease in the growth of P. acnes and reduced the production of pro-inflammatory cytokines, TNF-α, IL-8, IL-1β and IL-6, in human monocytic THP-1 cells treated with heat-killed P. acnes. Therefore, this herbal extract mixture may possess both anti-bacterial and anti-inflammatory activities against P. acnes and can be a novel therapeutic agent for treating inflammatory acne.

  18. Making the case for early treatment of acne.

    PubMed

    Zaenglein, Andrea L

    2010-01-01

    Early acne can be defined as the occurrence of acne at its onset, primarily in preteens, or as acne at its earliest severity (ie, mild to moderate). Although the majority of patients with acne are treated by dermatologists, most, particularly mild to moderate cases, could be successfully managed by primary care physicians. Therefore, it is important for physicians to understand the benefits of treating all types of acne, not just the most severe. Awareness of the emotional impact of acne, particularly in adolescence, as well as recognition of possible scarring are important considerations. To achieve optimal results, physicians should be familiar with classification and severity grading of acne. Also, in-depth knowledge of available acne medications will streamline and optimize treatment regimens. Recognizing, treating, and monitoring the progress of early acne may lead to quicker, better clinical outcomes and improved quality of life.

  19. Making the case for early treatment of acne.

    PubMed

    Zaenglein, Andrea L

    2010-01-01

    Early acne can be defined as the occurrence of acne at its onset, primarily in preteens, or as acne at its earliest severity (ie, mild to moderate). Although the majority of patients with acne are treated by dermatologists, most, particularly mild to moderate cases, could be successfully managed by primary care physicians. Therefore, it is important for physicians to understand the benefits of treating all types of acne, not just the most severe. Awareness of the emotional impact of acne, particularly in adolescence, as well as recognition of possible scarring are important considerations. To achieve optimal results, physicians should be familiar with classification and severity grading of acne. Also, in-depth knowledge of available acne medications will streamline and optimize treatment regimens. Recognizing, treating, and monitoring the progress of early acne may lead to quicker, better clinical outcomes and improved quality of life. PMID:19738184

  20. What's new in the physiopathology of acne?

    PubMed

    Suh, D H; Kwon, H H

    2015-07-01

    There are four central factors that contribute to acne physiopathology: the inflammatory response, colonization with Propionibacterium acnes, increased sebum production and hypercornification of the pilosebaceous duct. In addition, research in the areas of diet and nutrition, genetics and oxidative stress is also yielding some interesting insights into the development of acne. In this paper we review some of the most recent research and novel concepts revealed in this work, which has been published by researchers from diverse academic disciplines including dermatology, immunology, microbiology and endocrinology. We discuss the implications of their findings (particularly in terms of opportunities to develop new therapies), highlight interrelationships between these novel factors that could contribute to the pathology of acne, and indicate where gaps in our understanding still exist.

  1. The influence of sex hormones on acne.

    PubMed

    Förström, L

    1980-01-01

    The sebaceous glands are stimulated by androgens produced in the skin itself. This explains why elevated androgen levels are seldom found in blood and urine from patients with acne. The most potent androgen is dihydrotestosterone (DHT), which is formed in the target cells, i.e. in the sebaceous glands, by a 5 alpha-reduction of testosterone. DHT is then bound to a specific receptor protein and translocated into the cell nucleus. In young persons genetically predisposed to acne a temporarily increased local DHT-formation has been postulated. In women androstenedione appears to be the major pre-hormone for DHT-formation. Adrenal androgens may account for prepubertal acne. Estrogens and progesterone influence acne only in high, unphysiological doses. Therapeutically we are waiting for a safe effective anti-androgen for topical use. PMID:6258368

  2. What's new in acne and rosacea?

    PubMed

    Keri, Jonette

    2016-06-01

    Acne and rosacea are common conditions seen every day by dermatologists. This review will discuss the most recent therapeutic options for patients with these conditions. Specifically, for acne, there will be a discussion of the use of isotretinoin at higher cumulative doses as well as a new formulation of isotretinoin, isotretinoin-lidose. Adult women with acne represent a growing population of patients who present for treatment of acne; the use of hormonal therapies as well as topical dapsone gel will be reviewed for these patients. For rosacea patients, the new topical agents - brimonidine gel and ivermectin cream - will be reviewed, with a discussion on possible rebound phenomenon from brimonidine. Finally, future treatments in the pipeline will be discussed. PMID:27416316

  3. Light-based therapies in acne treatment

    PubMed Central

    Pei, Susan; Inamadar, Arun C.; Adya, Keshavmurthy A.; Tsoukas, Maria M.

    2015-01-01

    The use of light and laser in the treatment of acne is increasing as these modalities are safe, effective, and associated with no or minimal complications when used appropriately. These light and laser sources are also being used in combination with pharmacological and/or physical measures to synergize their effects and optimize the therapeutic outcome. This review focuses on optical devices used in treating acne and serves to delineate the current application of various methods, including their utility and efficacy. PMID:26009707

  4. [ACNE VULGARIS--AETIOLOGY, CLASSIFICATION, TREATMENT].

    PubMed

    Janda, Katarzyna; Chwilkowska, Magdalena

    2014-01-01

    A spotless skin is a rarity. Both women and men have different problems related to the complexion. One of the most common problems is acne, which affects an increasing number of people of all ages. Seborrhea skin areas rich in sebaceous glands, the formation of comedones, inflammation, and scars are characteristic for this disease. The aim of the study was to discuss the causes of acne vulgaris, methods of treatment, and proper care of the skin affected by this problem.

  5. Hormonal Treatment of Acne in Women

    PubMed Central

    Ebede, Tobechi L.; Arch, Emily L.

    2009-01-01

    Acne vulgaris is a common and chronic disorder of the pilosebaceous unit. Standard treatment protocols include topical retinoids, topical and oral antimicrobials, and isotretinoin. Hormonal therapies can be added to the regimen in some patients. This article will review the hormonal pathogenesis of acne, discuss the basics of an endocrine evaluation, and provide an overview of the current hormonal treatment options in women. PMID:20725580

  6. Role of insulin, insulin-like growth factor-1, hyperglycaemic food and milk consumption in the pathogenesis of acne vulgaris.

    PubMed

    Melnik, Bodo C; Schmitz, Gerd

    2009-10-01

    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 5alpha-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.

  7. Complementary therapies for acne vulgaris

    PubMed Central

    Cao, Huijuan; Yang, Guoyan; Wang, Yuyi; Liu, Jian Ping; Smith, Caroline A; Luo, Hui; Liu, Yueming

    2015-01-01

    Background Acne is a chronic skin disease characterised by inflamed spots and blackheads on the face, neck, back, and chest. Cysts and scarring can also occur, especially in more severe disease. People with acne often turn to complementary and alternative medicine (CAM), such as herbal medicine, acupuncture, and dietary modifications, because of their concerns about the adverse effects of conventional medicines. However, evidence for CAM therapies has not been systematically assessed. Objectives To assess the effects and safety of any complementary therapies in people with acne vulgaris. Search methods We searched the following databases from inception up to 22 January 2014: the Cochrane Skin Group Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL; 2014, Issue 1), MEDLINE (from 1946), Embase (from 1974), PsycINFO (from 1806), AMED (from 1985), CINAHL (from 1981), Scopus (from 1966), and a number of other databases listed in the Methods section of the review. The Cochrane CAM Field Specialised Register was searched up to May 2014. We also searched five trials registers and checked the reference lists of articles for further references to relevant trials. Selection criteria We included parallel-group randomised controlled trials (or the first phase data of randomised cross-over trials) of any kind of CAM, compared with no treatment, placebo, or other active therapies, in people with a diagnosis of acne vulgaris. Data collection and analysis Three authors collected data from each included trial and evaluated the methodological quality independently. They resolved disagreements by discussion and, as needed, arbitration by another author. Main results We included 35 studies, with a total of 3227 participants. We evaluated the majority as having unclear risk of selection, attrition, reporting, detection, and other biases. Because of the clinical heterogeneity between trials and the incomplete data reporting, we could only include four

  8. Microneedling Therapy for Atrophic Acne Scars

    PubMed Central

    Barakat, Manal; Awad, Sherif; Medhat, Walid; El-Fakahany, Hasan; Farag, Hanna

    2015-01-01

    Objective: Treatment of acne scarring is always a challenge. Microneedling therapy or percutaneous collagen induction is a new addition to the treatment modalities for such scars and has been reported to be simple and effective in atrophic acne scar treatment. The aim of this study is to evaluate the clinical effect and objectively quantify the histological changes of acne scarring in response to skin microneedling. Design: A prospective clinical study. Participants: Ten patients with different types of atrophic acne scars were subjected to three months of skin microneedling treatment (six sessions at two-week intervals). Measurements: Patients were photographed, and skin biopsies were obtained at baseline as well as one and three months from the start of treatment. Histometry for epidermal thickness and quantitative evaluation of total elastin; newly synthesized tropoelastin; collagen types I, III, and VII; and newly synthesized collagen were performed for all biopsies. Results: Compared to the baseline, patients’ evaluations revealed noticeable clinical improvement in atrophic post-acne scars in response to skin microneedling. There was a statistically significant increase (p<0.05) in the mean of collagen types I, III, and VII and newly synthesized collagen, while total elastin was significantly decreased (p<0.05) after the end of treatment. Conclusions: Multiple minimally invasive sessions of skin microneedling are an effective treatment for post-acne atrophic scars as it stimulates the repair processes with the advantage of being a relatively risk-free, in-office procedure with minimal patient recovery time. PMID:26203319

  9. Imaging inflammatory acne: lesion detection and tracking

    NASA Astrophysics Data System (ADS)

    Cula, Gabriela O.; Bargo, Paulo R.; Kollias, Nikiforos

    2010-02-01

    It is known that effectiveness of acne treatment increases when the lesions are detected earlier, before they could progress into mature wound-like lesions, which lead to scarring and discoloration. However, little is known about the evolution of acne from early signs until after the lesion heals. In this work we computationally characterize the evolution of inflammatory acne lesions, based on analyzing cross-polarized images that document acne-prone facial skin over time. Taking skin images over time, and being able to follow skin features in these images present serious challenges, due to change in the appearance of skin, difficulty in repositioning the subject, involuntary movement such as breathing. A computational technique for automatic detection of lesions by separating the background normal skin from the acne lesions, based on fitting Gaussian distributions to the intensity histograms, is presented. In order to track and quantify the evolution of lesions, in terms of the degree of progress or regress, we designed a study to capture facial skin images from an acne-prone young individual, followed over the course of 3 different time points. Based on the behavior of the lesions between two consecutive time points, the automatically detected lesions are classified in four categories: new lesions, resolved lesions (i.e. lesions that disappear completely), lesions that are progressing, and lesions that are regressing (i.e. lesions in the process of healing). The classification our methods achieve correlates well with visual inspection of a trained human grader.

  10. Minocycline in acne vulgaris: benefits and risks.

    PubMed

    Ochsendorf, Falk

    2010-01-01

    Minocycline is a semi-synthetic, second-generation tetracycline. It was introduced in 1972 and has both antibacterial and anti-inflammatory properties. Minocycline is used for a variety of infectious diseases and in acne. Even today, new indications beyond the antibacterial indications are being investigated such as its use in neurologic diseases. Formerly, minocycline was thought to have a superior efficacy in the treatment of inflammatory acne, especially with respect to antibacterial-resistant Propionibacterium acnes. A thorough review of the literature, however, shows that minocycline is not more effective in acne than other tetracyclines. Compared with first-generation tetracyclines, minocycline has a better pharmacokinetic profile, and compared with doxycycline it is not phototoxic. However, minocycline has an increased risk of severe adverse effects compared with other tetracyclines. It may induce hypersensitivity reactions affecting the liver, lung, kidneys, or multiple organs (Drug Reaction with Eosinophilia and Systemic Symptoms [DRESS] syndrome) in the first weeks of treatment and, with long-term treatment, may cause autoimmune reactions (systemic lupus erythematosus, autoimmune hepatitis). In addition, CNS symptoms, such as dizziness, are more frequent compared with other tetracyclines. Long-term treatment may induce hyperpigmentation of the skin or other organs. Resistance of P. acnes to minocycline also occurs, dependent on the prescribing behavior. Considering the aspects of efficacy, its adverse effect profile, resistance, price, and alternatives, minocycline is no longer considered the first-line antibacterial in the treatment of acne.

  11. Effective Treatments of Atrophic Acne Scars

    PubMed Central

    Zhou, Bingrong

    2015-01-01

    Atrophic scarring is often an unfortunate and permanent complication of acne vulgaris. It has high prevalence, significant impact on quality of life, and therapeutic challenge for dermatologists. The treatment of atrophic acne scars varies depending on the types of acne scars and the limitations of the treatment modalities in their ability to improve scars. Therefore, many options are available for the treatment of acne scarring, including chemical peeling, dermabrasion, laser treatment, punch techniques, fat transplantation, other tissue augmenting agents, needling, subcision, and combined therapy. Various modalities have been used to treat scars, but limited efficacy and problematic side effects have restricted their application. In order to optimally treat a patient’s scar, we need to consider which treatment offers the most satisfactory result. There are also promising procedures in the future, such as stem cell therapy. In this article, the authors review the different treatment options of atrophic acne scars. This may be useful for selecting the best therapeutic strategy, whether it be single or combined therapy, in the treatment of atrophic acne scars while reducing or avoiding the side effects and complications. PMID:26029333

  12. Impaired water barrier function in acne vulgaris.

    PubMed

    Yamamoto, A; Takenouchi, K; Ito, M

    1995-01-01

    In acne vulgaris, abnormal follicular keratinization is important for comedo formation, yet the precise mechanisms of comedogenesis are not known. The present study examined the interrelationship between sebum secretion rate (SSR), lipid content and water barrier function (WBF) of the stratum corneum (SC) in 36 acne patients and 29 control subjects. All major SC lipid classes were separated and quantified by thin-layer chromatography/photodensitometry. WBF was evaluated by measuring transepidermal water loss (TEWL), and the hygroscopic properties and waterholding capacity of the SC. The SSR over a period of 3 h was significantly higher in patients with moderate acne than in control subjects, but no significant difference was noticed between patients with mild acne and control subjects. Significant differences between patients with both moderate and mild acne and control subjects were noted in the amount of sphingolipids (ceramides and free sphingosine), but not for any other lipid classes. Furthermore in acne patients, lower amounts of sphingolipids were observed corresponding with a diminished WBF. These results suggest that an impaired WBF caused by decreased amounts of ceramides may be responsible for comedo formation, since barrier dysfunction is accompanied by hyperkeratosis of the follicular epithelium.

  13. Oxidative Stress in Patients With Acne Vulgaris

    PubMed Central

    Arican, Ozer; Belge Kurutas, Ergul; Sasmaz, Sezai

    2005-01-01

    Acne vulgaris is one of the common dermatological diseases and its pathogenesis is multifactorial. In this study, we aim to determine the effects of oxidative stress in acne vulgaris. Forty-three consecutive acne patients and 46 controls were enrolled. The parameters of oxidative stress such as catalase (CAT), glucose-6-phosphate dehydrogenase (G6PD), superoxide dismutase (SOD), and malondialdehyde (MDA) in the venous blood of cases were measured spectrophotometrically. The values compared with control group, the relation between the severity and distribution of acne, and the correlation of each enzyme level were researched. CAT and G6PD levels in patients were found to be statistically decreased, and SOD and MDA levels were found to be statistically increased (P < .001). However, any statistical difference and correlation could not be found between the severity and distribution of lesions and the mean levels of enzymes. In addition, we found that each enzyme is correlated with one another. Our findings show that oxidative stress exists in the acne patients. It will be useful to apply at least one antioxidant featured drug along with the combined acne treatment. PMID:16489259

  14. Acne

    MedlinePlus

    ... suggest you also try an over-the-counter lotion or cream. These medicines may make your skin ... work, your doctor may prescribe a cream or lotion with benzoyl peroxide, resorcinol, salicylic acid, or sulfur. ...

  15. Acne

    MedlinePlus

    ... are available in many forms, such as gels, lotions, creams, soaps, or pads. In some people, OTC ... topical medicines, prescription topical medicines come as creams, lotions, solutions, gels, or pads. Your doctor will consider ...

  16. Treatment of Acne Vulgaris With Salicylic Acid Chemical Peel and Pulsed Dye Laser: A Split Face, Rater-Blinded, Randomized Controlled Trial

    PubMed Central

    Lekakh, Olga; Mahoney, Anne Marie; Novice, Karlee; Kamalpour, Julia; Sadeghian, Azeen; Mondo, Dana; Kalnicky, Cathy; Guo, Rong; Peterson, Anthony; Tung, Rebecca

    2015-01-01

    Introduction: Pulsed dye laser (PDL) has been used to treat acne lesions and scar erythema by interrupting superficial vasculature. Salicylic acid chemical peels are employed chiefly due to their lipophilic, comedolytic, and anti-inflammatory properties. Although studies have looked at peels and laser therapy independently in acne management, we examined these treatments in combination. Our primary objective was to evaluate the safety and efficacy of concurrent use of salicylic acid peels with PDL versus salicylic acid peels alone in the treatment of moderate to severe acne vulgaris. Methods: Adult patients with moderate to severe acne were included. Subjects received a total of 3 treatments at 3-week intervals. Per randomized split-face treatment, at week 0, one half of the subject’s face was treated with PDL (595 nm) followed by whole face application of a 30% salicylic acid peel. At weeks 3 and 6, the treatments were repeated. At 0 and 9 weeks, patients were assessed with the Global Evaluation Acne (GEA) scale and Dermatology Life Quality Index (DLQI) questionnaire. Results: Nineteen subjects were enrolled, and 18 completed the study. Significant improvement in acne was seen in both the combined (laser and peel) and chemical peel alone treatment arms (P < .0005 and P = .001). Using the GEA scale score, compared to week 0, the mean difference in acne improvement at week 9 was -1.61 in the combination therapy group versus -1.11 in the peel only group. Based on the GEA scale scoring, a statistically significant greater difference in acne improvement was seen, from week 0 to week 9, in the combination treatment group compared with the peel only group (P = .003). Conclusion: While acne subjects had significant benefit from the salicylic acid peel alone, they experienced greater significant benefit from PDL treatment used in conjunction with salicylic acid peels. The adjunctive utilization of PDL to salicylic acid peel therapy can lead to better outcomes in acne

  17. Effects of fish oil supplementation on inflammatory acne

    PubMed Central

    2012-01-01

    Background Given that acne is a rare condition in societies with higher consumption of omega-3 (n-3) relative to omega-6 (n-6) fatty acids, supplementation with n-3 may suppress inflammatory cytokine production and thereby reduce acne severity. Methods 13 individuals with inflammatory acne were given three grams of fish oil containing 930 mg of EPA to their unchanged diet and existing acne remedies for 12 weeks. Acne was assessed using an overall severity grading scale, total inflammatory lesion counts, and colorimetry. Findings There was no significant change in acne grading and inflammatory counts at week 12 compared to baseline. However, there was a broad range of response to the intervention on an individual basis. The results showed that acne severity improved in 8 individuals, worsened in 4, and remained unchanged in 1. Interestingly, among the individuals who showed improvement, 7 were classified as having moderate to severe acne at baseline, while 3 of the 4 whose acne deteriorated were classified as having mild acne. Conclusion There is some evidence that fish oil supplementation is associated with an improvement in overall acne severity, especially for individuals with moderate to severe acne. Divergent responses to fish oil in our pilot study indicates that dietary and supplemental lipids are worthy of further investigation in acne. PMID:23206895

  18. Acne Knowledge of Hispanic Parents of Teenagers with Mild to Moderate Acne.

    PubMed

    Lopez, Isha; Zapata, Lucio; Sosa, Juan Jesús; Rodgers, Clifford; Ruiz, Maria; Oh, Susan; Hynan, Linda S; Kimball, Alexa B; Pandya, Amit G

    2016-09-01

    We performed a cross-sectional study of Hispanic and non-Hispanic parents of children with acne using a survey designed to determine their level of awareness of acne and its treatment; 82% of Hispanic parents and 40% of non-Hispanic parents agreed that a health care provider should treat mild acne (p < 0.001). Hispanic parents of adolescents with acne agreed more frequently than non-Hispanic parents that children with mild and moderate acne should be taken to a health care provider for treatment, but they tended not to visit health care providers. Future studies should aim to determine the reasons for this discrepancy, after which culturally sensitive educational programs can be developed to address this disparity.

  19. Correlation of serum 3 alpha-androstanediol glucuronide with acne and chest hair density in men.

    PubMed

    Lookingbill, D P; Egan, N; Santen, R J; Demers, L M

    1988-11-01

    Serum 3 alpha-androstanediol glucuronide (3 alpha-Adiol-G) is considered to be an indicator of peripheral tissue androgen metabolism. Precursor circulating androgens are converted in peripheral tissue to dihydrotestosterone (DHT), which is ultimately metabolized to 3 alpha-Adiol-G and secreted from the cell. Elevated serum 3 alpha-Adiol-G concentrations have been reported in women in hyperandrogenic states. We studied 44 consecutive male medical students for chest hair density, acne, and serum dehydroepiandrosterone sulfate (DHEA-S), total testosterone (total T), free and albumin-bound (bioavailable) T (bio T), and 3 alpha-Adiol-G concentrations. Although there was considerable overlap of serum 3 alpha-Adiol-G values among the groups defined by hair density or acne scores, we found statistically significant correlations between serum 3 alpha-Adiol-G and chest hairiness (P = 0.0034), acne (P = 0.0005), and a combined chest hairiness and acne score (P = 0.0018). There was no significant correlation between these clinical parameters and the levels of precursor androgens. There was, however, a strong correlation between serum 3 alpha-Adiol-G and bio T (P = 0.0005), suggesting that in men serum 3 alpha-Adiol-G levels may be dependent upon available free and albumin-bound T. The correlations in men of serum 3 alpha-Adiol-G with chest hair density, acne, and the hairiness and acne index supports the hypothesis that the serum levels of 3 alpha-Adiol-G reflect the extent of androgen action in peripheral tissues. PMID:2972739

  20. Correlation between the severity and type of acne lesions with serum zinc levels in patients with acne vulgaris.

    PubMed

    Rostami Mogaddam, Majid; Safavi Ardabili, Nastaran; Maleki, Nasrollah; Soflaee, Maedeh

    2014-01-01

    Acne vulgaris is the most common cutaneous disorder affecting adolescents and young adults. Some studies have reported an association between serum zinc levels and acne vulgaris. We aimed to evaluate the serum zinc level in patients with acne vulgaris and compare it with healthy controls. One hundred patients with acne vulgaris and 100 healthy controls were referred to our clinic. Acne severity was classified according to Global Acne Grading System (GAGS). Atomic absorption spectrophotometry was used to measure serum zinc levels. Mean serum level of zinc in acne patients and controls was 81.31 ± 17.63 μg/dl and 82.63 ± 17.49 μg/dl, respectively. Although the mean serum zinc level was lower in acne group, it was not statistically significant (P = 0.598). There was a correlation between serum zinc levels with severity and type of acne lesions. The results of our study suggest that zinc levels may be related to the severity and type of acne lesions in patients with acne vulgaris. Relative decrease of serum zinc level in acne patients suggests a role for zinc in the pathogenesis of acne vulgaris.

  1. Acne Yields Up Secret That Points to New Treatments

    MedlinePlus

    ... html Acne Yields Up Secret That Points to New Treatments Bacteria on skin sometimes release fatty acids ... News) -- In a finding that could lead to new treatments for acne, scientists say they've discovered ...

  2. FDA OKs Non-Prescription Use of Acne Drug

    MedlinePlus

    ... 159779.html FDA OKs Non-Prescription Use of Acne Drug Differin Gel 0.1% is first retinoid ... July 8, 2016 (HealthDay News) -- Good news for acne sufferers: The U.S. Food and Drug Administration has ...

  3. Nanoparticle Stabilized Liposomes for Acne Therapy

    NASA Astrophysics Data System (ADS)

    Fu, Victoria

    Acne vulgaris is a common skin disease that affects over 40 million people in the United States alone. The main cause of acne vulgaris is Propionibacterium acnes (P. acnes), resides deep in the pores and follicles of the skin in order to feed on oil produced by the sebaceous glands. The liposome is a lipid based nanoparticle with numerous advantages over free drug molecules as an acne treatment alternative. Bare liposomes loaded with lauric acid (LipoLA) were found to show strong antimicrobial activity against P. acnes while generating minimal toxicity. However, the platform is limited by the spontaneous tendency of liposomes to fuse with each other. Attaching nanoparticles to the surface of liposomes can overcome this challenge by providing steric repulsion and reduce surface tension. Thus, carboxyl-functionalized gold nanoparticles (AuC) were attached to the surface of liposomes (AuC-liposomes) loaded with doxycycline, a general tetracycline antibiotic. These particles were found to have a diameter of 120 nm and a zeta potential of 20.0 mV. Both fluorescent and antimicrobial studies demonstrated that based on electrostatic interaction, negatively charged AuC attached to the liposome's positively charged surface and stabilized liposomes in a neutral pH environment (pH = 7.4). Upon entering the skin's acidic environment (pH = 4), AuC detached from the liposome's surface and liposomes could fuse with P. acnes residing in the pores. Furthermore, toxicity studies showed that AuC-liposomes did not induce any significant toxicity, while two of the leading over-the-counter therapies, benzoyl peroxide and salicylic acid, generated substantial skin irritation.

  4. Consequences of psychological distress in adolescents with acne.

    PubMed

    Misery, Laurent

    2011-02-01

    Acne may cause psychological distress that is associated with many psychiatric disorders. In this issue, Halvorsen et al. report suicidal ideation, mental health problems, and affective isolation to be relatively frequent in adolescents with acne. This report suggests that adverse events that have been attributed to therapies for acne, including suicidal ideation and depression, may reflect the burden of substantial acne rather than the effect of medications.

  5. 21 CFR 333.310 - Acne active ingredients.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 5 2011-04-01 2011-04-01 false Acne active ingredients. 333.310 Section 333.310... FOR HUMAN USE TOPICAL ANTIMICROBIAL DRUG PRODUCTS FOR OVER-THE-COUNTER HUMAN USE Topical Acne Drug Products § 333.310 Acne active ingredients. The active ingredient of the product consists of any of...

  6. 21 CFR 333.310 - Acne active ingredients.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 5 2013-04-01 2013-04-01 false Acne active ingredients. 333.310 Section 333.310... FOR HUMAN USE TOPICAL ANTIMICROBIAL DRUG PRODUCTS FOR OVER-THE-COUNTER HUMAN USE Topical Acne Drug Products § 333.310 Acne active ingredients. The active ingredient of the product consists of any of...

  7. 21 CFR 333.310 - Acne active ingredients.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 5 2014-04-01 2014-04-01 false Acne active ingredients. 333.310 Section 333.310... FOR HUMAN USE TOPICAL ANTIMICROBIAL DRUG PRODUCTS FOR OVER-THE-COUNTER HUMAN USE Topical Acne Drug Products § 333.310 Acne active ingredients. The active ingredient of the product consists of any of...

  8. 21 CFR 333.310 - Acne active ingredients.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 5 2012-04-01 2012-04-01 false Acne active ingredients. 333.310 Section 333.310... FOR HUMAN USE TOPICAL ANTIMICROBIAL DRUG PRODUCTS FOR OVER-THE-COUNTER HUMAN USE Topical Acne Drug Products § 333.310 Acne active ingredients. The active ingredient of the product consists of any of...

  9. Photodynamic-induced inactivation of Propionibacterium acnes

    NASA Astrophysics Data System (ADS)

    Koenig, Karsten; Teschke, M.; Eick, Stephen G.; Pfister, W.; Meyer, Herbert; Halbhuber, Karl-Juergen

    1998-05-01

    We report on photodynamically induced inactivation of the skin bacterium Propionibacterium acnes (P. acnes) using endogenous as well as exogenous photosensitizers and red light sources. P. acnes is involved in the pathogenesis of the skin disease acne vulgaris. The skin bacterium is able to synthesize the metal-free fluorescent porphyrins protoporphyrin IX (PP) and coproporphyrin (CP) as shown by in situ spectrally-resolved detection of natural autofluorescence of human skin and bacteria colonies. These naturally occurring intracellular porphyrins act as efficient endogenous photosensitizers. Inactivation of P. acnes suspensions was achieved by irradiation with He-Ne laser light in the red spectral region (632.8 nm). We monitored the photodynamically-induced death of single bacteria using a fluorescent viability kit in combination with confocal laser scanning microscopy. In addition, the photo-induced inactivation was calculated by CFU (colony forming units) determination. We found 633 nm-induced inactivation (60 mW, 0.12 cm2 exposure area, 1 hour irradiation) of 72% in the case of non-incubated bacteria based on the destructive effect of singlet oxygen produced by red light excited endogenous porphyrins and subsequent energy transfer to molecular oxygen. In order to achieve a nearly complete inactivation within one exposure procedure, the exogenous photosensitizer Methylene Blue (Mb) was added. Far red exposure of Mb-labeled bacteria using a krypton ion laser at 647 nm and 676 nm resulted in 99% inactivation.

  10. Treatment of acne vulgaris in pregnant patients.

    PubMed

    Pugashetti, Rupa; Shinkai, Kanade

    2013-01-01

    The management of acne vulgaris in the setting of pregnancy raises important clinical considerations regarding the efficacy and safety of acne treatments in this special patient population. Particular challenges include the absence of safety data, discrepancy in safety data between different safety rating systems, and lack of evidence-based recommendations for the treatment of acne during pregnancy. Nonetheless, many therapeutic options exist, and the treatment of acne in pregnant women can be safely and often effectively accomplished. For mild or moderate disease, patients can be treated with topical antimicrobial agents, anti-inflammatory agents, as well as glycolic and salicylic acid. Several topical agents, notably benzoyl peroxide, previously viewed as potentially dangerous are cited by many sources as being considered safe. When necessary, systemic therapies that can be safely added include penicillins, amoxicillin, cephalosporins, erythromycin, clindamycin, and tetracyclines or sulfonamides, depending on the stage of fetal development. Adjunct therapy may include phototherapy or laser treatments. Physicians should work with this often highly motivated, safety-conscious patient population to tailor an individualized treatment regimen. This treatment regimen will likely shift throughout the different stages of fetal development, as distinct safety considerations are raised prior to conception as well as during each of the trimesters of pregnancy. Important considerations regarding acne management in breast-feeding mothers is also discussed.

  11. Treatment of acne vulgaris and prevention of acne scarring: canadian consensus guidelines.

    PubMed

    Madden, W S; Landells, I D; Poulin, Y; Searles, G E; Smith, K C; Tan, J K; Toole, J; Zip, C M; Degreef, H

    2000-06-01

    Acne affects approximately 95% of the population at some point during their lifetime.1 This common disorder can range from mild to severe forms, cause sometimes extensive scarring, and can last well into the fourth and fifth decades. Effective therapeutic agents are available to both treat acne and prevent ongoing disease. Despite this, dermatologists frequently see patients with significant acne scarring because many patients delay seeking medical attention for acne and many practitioners procrastinate over using effective antiscarring options. In patients who already demonstrate scarring, repeated courses of antibiotics only result in recurring acne and additional scarring. This, in turn, exacerbates the despair and other adverse psychosocial effects of the disease. There are a variety of agents and devices to help acne patients with scarring. However, successful treatment cannot be guaranteed, and in most cases residual scarring will be evident. Thus, the most effective way of managing acne scarring is to prevent its occurrence in the first place. Although we currently have a number of effective antiacne agents to control the disease, such as antibiotics and hormonal agents, isotretinoina is the only agent that has been shown to induce long-term drug-free remission and curative potential.

  12. Environmental pollution and acne: Chloracne

    PubMed Central

    Zouboulis, Christos C; Xia, Longqing

    2009-01-01

    Environmental pollutants can result in a variant of acne called ‘chloracne’. Chloracne is caused by systemic exposure to certain halogenated aromatic hydrocarbons ‘chloracnegens’, and is considered to be one of the most sensitive indicators of systemic poisoning by these compounds. Dioxin is the most potent environmental chloracnegen. Most cases of chloracne have resulted from occupational and non-occupational exposures, non-occupational chloracne mainly resulted from contaminated industrial wastes and contaminated food products. Non-inflammatory comedones and straw-colored cysts are the primary clinical manifestation of chloracne. Increasing of cysts in number is a signal of aggravation of chloracne. Generalized lesions can appear on the face, neck, trunk, exterimities, genitalia, axillary and other areas. Course of chloracne is chronic. Severity of chloracne is related to dosage of exposed chloracnegens, chloracnegenic potency and individual susceptibility. Histopathology of chloracne is characterized mainly by hyperplasia of epidermal cell, while follicular and sebaceous gland are taken placed by keratinized epidermal cell. The pathogenesis of chloracne maybe related to the imbalance of epidermal stem cell. Chloracne appears to be resistant to all tested forms of treatment. The only way to control chloracne is to prevent exposure to chloracnegens. PMID:20436879

  13. Fraxelated radiofrequency device for acne scars

    NASA Astrophysics Data System (ADS)

    Rao, Babar K.; Khokher, Sairah

    2012-09-01

    Acne scars can be improved with various treatments such as topical creams, chemical peels, dermal fillers, microdermabrasion, laser, and radiofrequency devices. Some of these treatments especially lasers and deep chemical peels can have significant side effects such as post inflammatory hyperpigmentation in darker skin types. Fraxelated RF Laser devices have been reported to have lower incidence of side effects in all skin phototypes. Nine patients between ages 18 and 35 of various skin phototypes were selected from a private practice and treated with a RF fraxelated device (E-matrix) for acne scars. Outcomes were measured by physician observation, subjective feedback received by patients, and comparison of before and after photographs. In this small group of patients with various skin phototypes, fraxelated radiofrequency device improved acne scars with minimal side effects and downtime.

  14. Addressing Free Radical Oxidation in Acne Vulgaris

    PubMed Central

    Criscito, Maressa C.; Schlesinger, Todd E.; Verdicchio, Robert; Szoke, Ernest

    2016-01-01

    Objective: Comparatively little attention has been paid to the role of free radical oxidation in acne vulgaris. Here, using the traditional abnormalities cited for acne, the authors address the role of free radical oxidation throughout the pathogenesis by detailing the chemistry that may contribute to clinical changes. To probe the effects of free radical oxidation and test an antioxidant, they conducted a preliminary study of topically applied vitamin E. Methods: Seventeen patients with mild-to-moderate acne vulgaris were evaluated over an eight-week period in two private dermatology practices in this open-label study. All patients enrolled were on the same baseline regimen of salicylic acid and benzoyl peroxide. This regimen was then supplemented with topical vitamin E in sunflower seed oil. Results: At the end of the eight-week period, all patients demonstrated clinical improvement, as indicated by a reduction in the number of lesions and global mean difference. A statistically significant reduction was noted as early as Week 2. Enrolled patients also expressed a positive experience due to good tolerability and easy application. Conclusion: Although the exact pathogenesis of acne vulgaris remains unknown, the presence of excessive reactive oxygen species can be implicated in each of the major abnormalities involved. This presence, along with the positive results of the authors’ preliminary study, demonstrates the need for more exploration on the use of topical antioxidants in limiting free radical oxidation in the acne model. This paper is designed to stimulate academic discussion regarding a new way of thinking about the disease state of acne. PMID:26962389

  15. Effects of skin care and makeup under instructions from dermatologists on the quality of life of female patients with acne vulgaris.

    PubMed

    Matsuoka, Yoshie; Yoneda, Kozo; Sadahira, Chieko; Katsuura, Junko; Moriue, Tetsuya; Kubota, Yasuo

    2006-11-01

    Acne vulgaris significantly affects patients' quality of life (QOL) and their lives in various ways, including social behavior and body dissatisfaction. This may be heightened by acne's typical involvement of the face. We investigated whether the use of skin care and makeup could influence the QOL of affected patients without deteriorating conventional acne treatments. Fifty female patients with acne were recruited for our study. Twenty-five patients were instructed how to use skin care and cosmetics, while 25 patients received no specific instructions from dermatologists. Both groups received conventional topical and/or oral medication for acne during the study period for 4 weeks. Both groups did not show any significant difference in clinical improvement of acne severity. Two validated QOL questionnaires, World Health Organization (WHO)QOL26 and the Dermatology Life Quality Index (DLQI) were administered to all patients at first visit and 4 weeks later. The mean scores of psychological and overall domains in WHOQOL26 for patients with instructions were improved significantly, while only the overall score was significantly improved for patients without instructions. The total mean scores and all domains except work/school in DLQI for patients with instructions were improved significantly, while the total scores and all domains except discomfort for treatment in DLQI were significantly improved for patients without instructions. Thus, instructions on the use of skin care and cosmetics for female acne patients did not deteriorate acne treatment and influenced patients' QOL effectively. We therefore suggest that instructions for using skin care and cosmetics complement conventional medical treatments for acne.

  16. Acne Inversa: Evaluating Antimicrobial Peptides and Proteins

    PubMed Central

    Sand, Michael; Skrygan, Marina; Kreuter, Alexander; Altmeyer, Peter; Gambichler, Thilo

    2012-01-01

    Background Acne inversa is a chronic, suppurative relapsing inflammatory skin disease that primarily affects the axillae, perineum and inframammary regions. Evidence suggests that the innate immune system is involved in the pathogenesis of acne inversa. Objective To investigate the role of the innate immune system in acne inversa. Methods Skin biopsies were obtained from inflammatory skin lesions (n=17) and from non-lesional skin (intraindividual control, n=17) of patients with acne inversa. Additional skin lesions were taken from patients with chronic venous leg ulcers (interindividual control, n=5). Quantitative real-time reverse transcription-polymerase chain reaction was used to determine the mRNA levels of antimicrobial peptides and proteins (AMPs), including human β-defensin (hBD)-1, hBD-2 and hBD-3, LL-37 (cathelicidin) and Ribonuclease 7 (RNase 7). mRNA levels were also determined for inflammatory and anti-inflammatory cytokines, including tumor necrosis factor-alpha (TNF-α), matrix metalloproteinase-1 (MMP1), interleukin (IL)-1β, IL-6, IL-8 and IL-10. Results The mRNA levels of hBD-2, LL-37, IL-1β, IL-6, IL-8, IL-10 and MMP1 were significantly higher in acne inversa lesions compared to non-lesional skin (p<0.05). A significant positive correlation expression was observed between hBD-2 mRNA expression and LL-37 (ρ=0.53, p=0.03), and between hBD-2 and RNAse 7 (ρ=0.68, p=0.006). When compared to the chronic venous leg ulcer lesions, acne inversa lesions showed a significantly higher expression of RNase 7 mRNA, while IL-1 β, IL-6, IL-8, TNF-α and MMP1 mRNA expression was significantly higher in the chronic venous leg ulcer lesions (p<0.05). Conclusion The AMP, cytokine milieu and tissue proteases in acne inversa lesions differ significantly from non-lesional skin and chronic venous leg ulcers. The positively correlating up-regulation of AMPs in acne inversa indicates an important role of the innate immune system in the pathogenesis of this disorder

  17. Bioengineering a humanized acne microenvironment model: Proteomics analysis of host responses to Propionibacterium acnes infection in vivo

    PubMed Central

    Nakatsuji, Teruaki; Shi, Yang; Zhu, Wenhong; Huang, Cheng-Po; Chen, Yun-Ru; Lee, Dong-Youn; Smith, Jeffery W.; Zouboulis, Christos C.; Gallo, Richard L.; Huang, Chun-Ming

    2009-01-01

    Acne is a human disease of the sebaceous hair follicle. Unlike humans, most animals produce little or no triglycerides in hair follicles to harbor Propionibacterium acnes a fact that has encumbered the development of novel treatments for acne lesions. Although genetic mutant mice with acne-like skins have been used for screening anti-acne drugs, the mice generally have deficits in immune system that turns out to be inappropriate to generate antibodies for developing acne vaccines. Here, we employed a bioengineering approach using a tissue chamber integrated with a dermis-based cell-trapped system (DBCTS) to mimic the in vivo microenvironment of acne lesions. Human sebocyte cell lines were grown in DBCTS as a scaffold and inserted into a perforated tissue chamber. After implantation of a tissue chamber bearing human sebocytes into ICR mice, P. acnes or PBS was injected into a tissue chamber to induce host immune response. Infiltrated cells such as neutrophils and macrophages were detectable in tissue chamber fluids. In addition, a proinflammatory cytokine macrophage-inflammatory protein-2 (MIP-2) was elevated after P. acnes injection. In tissue chamber fluids, 13 proteins including secreted proteins and cell matrix derived from mouse, human cells or P. acnes were identified by proteomics using isotope-coded protein label (ICPL) coupled to nano-LC-MS analysis. After P. acnes infection, four proteins including fibrinogen, α polypeptide, fibrinogen β chain, S100A9, and serine protease inhibitor A3K showed altered concentrations in the mimicked acne microenvironment. The bioengineered acne model thus provides an in vivo microenvironment to study the interaction of host with P. acnes and offers a unique set-up for screening novel anti-acne drugs and vaccines. PMID:18651708

  18. Fluorescence guided evaluation of photodynamic therapy as acne treatment

    NASA Astrophysics Data System (ADS)

    Ericson, Marica B.; Horfelt, Camilla; Cheng, Elaine; Larsson, Frida; Larko, Olle; Wennberg, Ann-Marie

    2005-08-01

    Photodynamic therapy (PDT) is an attractive alternative treatment for patients with acne because of its efficiency and few side effects. Propionibacterium acnes (P.acnes) are bacteria present in the skin, which produce endogenous porphyrins that act as photosensitisers. In addition, application of aminolaevulinic acid or its methyl ester (mALA) results in increased accumulation of porphyrins in the pilosebaceous units. This makes it possible to treat acne with PDT. This initial study investigates the possibility of fluorescence imaging as assessment tool in adjunct to PDT of patients with acne. Twenty-four patients with acne on the cheeks have been treated with PDT with and without mALA. Fluorescence images have been obtained before and after treatment. The clinical acne score was assessed as base line before PDT, and at every follow up visit. Additionally the amount of P.acnes was determined. The clinical evaluation showed a general improvement of acne, even though no difference between treatment with and without mALA was observed. By performing texture analysis and multivariate data analsysis on the fluorescence images, the extracted texture features were found to correlate with the corresponding clinical assessment (67%) and amount of P.acnes (72%). The analysis showed that features describing the highly fluorescent pores could be related to the clinical assessment. This result suggests that fluorescence imaging can be used as an objective assessment of acne, but further improvement of the technique is possible, for example by including colour images.

  19. Alexithymia and Acne Vulgaris: A Case Control Study

    PubMed Central

    Baykir, Murat; Ateş, Gülfem; Ekşioğlu, Meral

    2011-01-01

    Objective To assess relationship between alexithymia and acne vulgaris in young people. Methods A hundred and eleven subjects between 15 and 25 years of age referred to out-patient clinic of dermatology with acne and 78 subjects applied to family physician for complaints other than acne were included in patient and control groups of the study, respectively. A questionnaire to determine demographic characteristics, an acne classification to determine severity of acne and Toronto Alexithymic Scale (TAS) to assess alexithymia were used. Results The mean scores of TAS were 52.7±10.8 and 51.7±10.7 in patient and control groups, respectively. Alexitymia was determined in 23.4% of the subjects in acne group and in 24.4% of control group. No significant differences were found between groups in terms of alexithymia, intermediate alexitymia and three-factors of TAS. Conclusion Alexithymia does not appear to be related to acne vulgaris. PMID:22216042

  20. Significance of diet in treated and untreated acne vulgaris.

    PubMed

    Kucharska, Alicja; Szmurło, Agnieszka; Sińska, Beata

    2016-04-01

    The relationship between diet and acne is highly controversial. Several studies during the last decade have led dermatologists to reflect on a potential link between diet and acne. This article presents the latest findings on a potential impact that diet can have on pathogenesis of acne vulgaris. The association between diet and acne can no longer be dismissed. Compelling evidence shows that high glycemic load diets may exacerbate acne. Dairy ingestion appears to be weakly associated with acne and the roles of omega-3 fatty acids, dietary fiber, antioxidants, vitamin A, zinc and iodine remain to be elucidated. The question of what the impact of diet is on the course of acne vulgaris still remains unclear.

  1. Significance of diet in treated and untreated acne vulgaris

    PubMed Central

    Szmurło, Agnieszka; Sińska, Beata

    2016-01-01

    The relationship between diet and acne is highly controversial. Several studies during the last decade have led dermatologists to reflect on a potential link between diet and acne. This article presents the latest findings on a potential impact that diet can have on pathogenesis of acne vulgaris. The association between diet and acne can no longer be dismissed. Compelling evidence shows that high glycemic load diets may exacerbate acne. Dairy ingestion appears to be weakly associated with acne and the roles of omega-3 fatty acids, dietary fiber, antioxidants, vitamin A, zinc and iodine remain to be elucidated. The question of what the impact of diet is on the course of acne vulgaris still remains unclear. PMID:27279815

  2. Propionibacterium acnes Induces an IL-17 Response in Acne Vulgaris that Is Regulated by Vitamin A and Vitamin D.

    PubMed

    Agak, George W; Qin, Min; Nobe, Jennifer; Kim, Myung-Hwa; Krutzik, Stephan R; Tristan, Grogan R; Elashoff, David; Garbán, Hermes J; Kim, Jenny

    2014-02-01

    Acne vulgaris is the most common skin disorder affecting millions of people worldwide and inflammation resulting from the immune response targeting Propionibacterium acnes has a significant role in its pathogenesis. In this study, we have demonstrated that P. acnes is a potent inducer of T helper 17 (Th17) and Th1, but not Th2 responses in human peripheral blood mononuclear cells (PBMCs). P. acnes stimulated expression of key Th17-related genes, including IL-17A, RORα, RORc, IL-17RA, and IL-17RC, and triggered IL-17 secretion from CD4(+), but not from CD8(+) T cells. Supernatants from P. acnes-stimulated PBMCs were sufficient to promote the differentiation of naive CD4(+)CD45RA T cells into Th17 cells. Furthermore, we found that the combination of IL-1β, IL-6, and transforming growth factor-β-neutralizing antibodies completely inhibited P. acnes-induced IL-17 production. Importantly, we showed that IL-17-expressing cells were present in skin biopsies from acne patients but not from normal donors. Finally, vitamin A (all-trans retinoic acid) and vitamin D (1,25-dihydroxyvitamin D3) inhibited P. acnes-induced Th17 differentiation. Together, our data demonstrate that IL-17 is induced by P. acnes and expressed in acne lesions and that both vitamin A and D could be effective tools to modulate Th17-mediated diseases such as acne.

  3. The effect of Propionibacterium acnes on maturation of dendritic cells derived from acne patients' peripherial blood mononuclear cells.

    PubMed

    Michalak-Stoma, Anna; Tabarkiewicz, Jacek; Olender, Alina; Juszkiewicz-Borowiec, Maria; Stoma, Filip; Pietrzak, Aldona; Pozarowski, Piotr; Bartkowiak-Emeryk, Małgorzata

    2008-01-01

    Propionibacterium acnes (P. acnes) has been implicated in the pathogenesis of acne vulgaris which is the most common cutaneous disorder. It has a proinflammatory activity and takes part in immune reactions modulating the Th1/Th2 cellular response. The exposure of dendritic cells (DCs) to whole bacteria, their components, cytokines or other inflammatory stimuli and infectious agents induces differentiation from immature DCs into antigen-presenting mature DCs. The aim of the study was to evaluate the capability of P. acnes to induce the maturation of DCs. We stimulated monocyte derived dendritic cells (Mo-DCs) from acne patients with various concetrations of heat-killed P. acnes (10(6)-10(8) bacteria/ml) cultured from acne lesions. The results showed an increase in CD80+/CD86+/DR+ and CD83+/CD1a+/DR+ cells percentage depending on the concetration of P. acnes. The expression of CD83 and CD80 (shown as the mean fluorescence intensity - MFI) increased with higher concetrations of P. acnes. There were also significant correlations between MFI of CD83, CD80, CD86 and concetration of P. acnes. The study showed that P. acnes in the concetration of 10(8) bacteria/ml is most effective in the induction of Mo-DCs maturation. Futher studies concerning the influence on the function of T cells are needed.

  4. Screening for intellectual disability in persons with a substance abuse problem: Exploring the validity of the Hayes Ability Screening Index in a Dutch-speaking sample.

    PubMed

    To, Wing Ting; Vanheule, Stijn; Vanderplasschen, Wouter; Audenaert, Kurt; Vandevelde, Stijn

    2014-11-12

    There is an increasing interest in screening instruments to detect intellectual disability (ID) in a quick and accurate way in mental health services as well as in the criminal justice system in order to provide appropriate support for people with undetected needs caused by ID. An instrument that has been proven to be useful in both settings is the Hayes Ability Screening Index (HASI). This study assessed the validity of the Dutch version of the HASI in persons with a substance abuse problem residing in mental health services, whether or not mandated to treatment by court order. The HASI was conducted along with the Wechsler Adult Intelligence Scale III as the criterion for validity to 90 participants. Additionally, the influence of psychiatric disorder and medication use on the HASI result was examined. A significant positive relationship was found between the two instruments, demonstrating convergent validity. Using a Receiver Operating Characteristic (ROC) curve analysis, the discriminative ability of the HASI with a cut-off score of 85 was found to be adequate, yielding in a good balance between sensitivity and specificity. The HASI was not distorted by the presence of the substance abuse problem or other psychiatric illnesses and medication did not influence the HASI scores in this study. These findings indicate that the HASI provides a time-efficient and resource-conscious way to detect ID in persons with a substance problem, thus addressing a critical need in mental health settings. PMID:25462510

  5. Interventions to increase adherence to acne treatment

    PubMed Central

    Moradi Tuchayi, Sara; Alexander, Tiffany M; Nadkarni, Anish; Feldman, Steven R

    2016-01-01

    Background Adherence to acne medication is poor and is a major reason why treatment plans are ineffective. Recognizing solutions to nonadherence is critical. Objective The purpose of this study is to describe the hurdles associated with acne nonadherence and to provide mechanisms on how to ameliorate them. Methods PubMed database was searched. Of the 419 search results, 29 articles were reviewed to identify hurdles to adherence and corresponding solutions. Results Hurdles to primary nonadherence where the medication is not even started, include lack of knowledge, confusion about usage, weak physician–patient relationship, fear of adverse reactions, and cost. Secondary nonadherence hurdles where the medication is started but is not taken as directed include lack of results, complex regimens, side effects, busy lifestyle, forgetfulness, inconvenience, and psychiatric comorbidity. Solutions to these hurdles include treatment simplification, technology, and dynamic education. Limitations Adherence is affected by numerous factors, but available literature analyzing acne adherence and interventions to improve adherence to treatment is limited. Conclusion There are several hurdles in adhering to acne treatment. Recognition of these hurdles and finding appropriate solutions may be as important to treatment outcomes as choosing the right medication to prescribe. PMID:27784999

  6. Topical and oral antibiotics for acne vulgaris.

    PubMed

    Del Rosso, James Q

    2016-06-01

    Antibiotics, both oral and topical, have been an integral component of the management of acne vulgaris (AV) for approximately 6 decades. Originally thought to be effective for AV due to their ability to inhibit proliferation of Propionibacterium acnes, it is now believed that at least some antibiotics also exert anti-inflammatory effects that provide additional therapeutic benefit. To add, an increase in strains of P acnes and other exposed bacteria that are less sensitive to antibiotics used to treat AV have emerged, with resistance directly correlated geographically with the magnitude of antibiotic use. Although antibiotics still remain part of the therapeutic armamentarium for AV treatment, current recommendations support the following when used to treat AV: 1) monotherapy use should be avoided; 2) use benzoyl peroxide concomitantly to reduce emergence of resistant P acnes strains; 3) oral antibiotics should be used in combination with a topical regimen for moderate-to-severe inflammatory AV; and 4) use oral antibiotics over a limited duration to achieve control of inflammatory AV with an exit plan in place to discontinue their use as soon as possible. When selecting an oral antibiotic to treat AV, potential adverse effects are important to consider.

  7. Impacts of mobility disability and high and increasing body mass index on health-related quality of life and participation in society: a population-based cohort study from Sweden

    PubMed Central

    2014-01-01

    Background Increasing obesity in adults with mobility disability has become a considerable health problem, similar to the increasing trend of obesity in the general population. The aims of this study were to investigate the association of mobility disability with overweight status and obesity in a large population-based Swedish cohort of adults, and to investigate whether mobility disability, high body mass index (BMI), and increasing BMI over time are predictors of health-related quality of life and participation in society after 8 years of follow-up. Methods The study cohort included 13,549 individuals aged 18–64 years who answered questions about mobility disability, weight, height, health-related quality of life and participation in society in the Stockholm Public Health Survey 2002 and 2010. The cohort was randomly selected from the population of Stockholm County, and divided into six subgroups based on data for mobility disability and overweight status. Multiple binary logistic regression analyses were performed to assess the likelihood for low health-related quality of life and lack of participation. Results Respondents with mobility disability had a higher mean BMI than those without mobility disability. Respondents both with and without mobility disability increased in BMI, but with no significant difference in the longitudinal changes (mean difference: 0.078; 95% CI: -0.16 - 0.32). Presence of mobility disability increased the risk of low health-related quality of life and lack of participation in 2010, irrespective of low health-related quality of life and lack of participation in 2002. The risk of pain and low general health (parts of health-related quality of life) increased for every 5 units of higher BMI reported in 2010. In respondents without low general health at baseline, the risk of obtaining low general health increased for every 5 units of higher BMI in 2010 (OR:1.60; CI: 1.47 - 1.74). Conclusions The greatest risk of low general health

  8. ICG laser therapy of acne vulgaris

    NASA Astrophysics Data System (ADS)

    Tuchin, Valery V.; Altshuler, Gregory B.; Genina, Elina A.; Bashkatov, Alexey N.; Simonenko, Georgy V.; Odoevskaya, Olga D.; Yaroslavsky, Ilya V.

    2004-07-01

    The near-infrared (NIR) laser radiation due to its high penetration depth is widely used in phototherapy. In application to skin appendages a high selectivity of laser treatment is needed to prevent light action on surrounding tissues. Indocyanine Green (ICG) dye may provide a high selectivity of treatment due to effective ICG uploading by a target and its narrow band of considerable absorption just at the wavelength of the NIR diode laser. The goal of this study is to demonstrate the efficacy of the NIR diode laser phototherapy in combination with topical application of ICG suggested for soft and thermal treatment of acne vulgaris. 28 volunteers with facile or back-located acne were enrolled. Skin sites of subjects were stained by ICG and irradiated by NIR laser-diode light (803 or 809 nm). Untreated, only stained and only light irradiated skin areas served as controls. For soft acne treatment, the low-intensity (803 nm, 10 - 50 mW/cm2, 5-10 min) or the medium-intensity (809 nm, 150 - 190 mW/cm2, 15 min) protocols were used. The single and multiple (up to 8-9) treatments were provided. The individual acne lesions were photothermally treated at 18 W/cm2 (803 nm, 0.5 sec) without skin surface cooling or at 200 W/cm2 (809 nm, 0.5 sec) with cooling. The results of the observations during 1-2 months after the completion of the treatment have shown that only in the case of the multiple-wise treatment a combined action of ICG and NIR irradiation reduces inflammation and improves skin state during a month without any side effects. At high power densities (up to 200 W/cm2) ICG stained acne inflammatory elements were destructed for light exposures of 0.5 sec. Based on the concept that hair follicle, especially sebaceous gland, can be intensively and selectively stained by ICG due to dye diffusion through pilosebaceous canal and its fast uptake by living microorganisms, by vital keratinocytes of epithelium of the canal and sebaceous duct, and by rapidly proliferating

  9. Understanding innate immunity and inflammation in acne: implications for management.

    PubMed

    Dreno, B; Gollnick, H P M; Kang, S; Thiboutot, D; Bettoli, V; Torres, V; Leyden, J

    2015-06-01

    Acne has long been understood to have a complex physiological basis involving several main factors: hormonally-stimulated sebum production, abnormal keratinization of the pilosebaceous duct, and an inflammatory immune response to Propionibacterium acnes. Recent studies at the molecular and cellular level have begun clarifying how all of these factors interact, and the role of the innate immune system is better appreciated. Inflammation has been demonstrated in all acne lesions - the preclinical microcomedo, comedones, inflammatory lesions, 'post-inflammatory' erythema or hyperpigmentation, and scarring. Inflammation localized to the pilosebaceous unit can be considered the defining feature of acne and should be addressed via multiple therapeutic pathways. Clinicians tend to think oral antibiotics should be used to 'calm' inflammatory acne, but there is good evidence showing that topical retinoids also have anti-inflammatory properties as a class effect. For best therapeutic outcomes, most patients with acne should be treated first line with a topical retinoid plus an antimicrobial agent, as has been demonstrated in thousands of patients involved in clinical trials and recommended by the Global Alliance to Improve Outcomes in Acne for more than a decade. Moving away from reliance on antibiotic therapy for acne is particularly important in an era of worsening antimicrobial resistance and worldwide calls to reduce antibiotic use. Improved understanding about the role of P. acnes and the innate immune system in acne should help clinicians in designing efficacious treatment strategies.

  10. Understanding innate immunity and inflammation in acne: implications for management.

    PubMed

    Dreno, B; Gollnick, H P M; Kang, S; Thiboutot, D; Bettoli, V; Torres, V; Leyden, J

    2015-06-01

    Acne has long been understood to have a complex physiological basis involving several main factors: hormonally-stimulated sebum production, abnormal keratinization of the pilosebaceous duct, and an inflammatory immune response to Propionibacterium acnes. Recent studies at the molecular and cellular level have begun clarifying how all of these factors interact, and the role of the innate immune system is better appreciated. Inflammation has been demonstrated in all acne lesions - the preclinical microcomedo, comedones, inflammatory lesions, 'post-inflammatory' erythema or hyperpigmentation, and scarring. Inflammation localized to the pilosebaceous unit can be considered the defining feature of acne and should be addressed via multiple therapeutic pathways. Clinicians tend to think oral antibiotics should be used to 'calm' inflammatory acne, but there is good evidence showing that topical retinoids also have anti-inflammatory properties as a class effect. For best therapeutic outcomes, most patients with acne should be treated first line with a topical retinoid plus an antimicrobial agent, as has been demonstrated in thousands of patients involved in clinical trials and recommended by the Global Alliance to Improve Outcomes in Acne for more than a decade. Moving away from reliance on antibiotic therapy for acne is particularly important in an era of worsening antimicrobial resistance and worldwide calls to reduce antibiotic use. Improved understanding about the role of P. acnes and the innate immune system in acne should help clinicians in designing efficacious treatment strategies. PMID:26059728

  11. Analysis of Complete Genomes of Propionibacterium acnes Reveals a Novel Plasmid and Increased Pseudogenes in an Acne Associated Strain

    PubMed Central

    Fitz-Gibbon, Sorel; Tomida, Shuta; Li, Huiying

    2013-01-01

    The human skin harbors a diverse community of bacteria, including the Gram-positive, anaerobic bacterium Propionibacterium acnes. P. acnes has historically been linked to the pathogenesis of acne vulgaris, a common skin disease affecting over 80% of all adolescents in the US. To gain insight into potential P. acnes pathogenic mechanisms, we previously sequenced the complete genome of a P. acnes strain HL096PA1 that is highly associated with acne. In this study, we compared its genome to the first published complete genome KPA171202. HL096PA1 harbors a linear plasmid, pIMPLE-HL096PA1. This is the first described P. acnes plasmid. We also observed a five-fold increase of pseudogenes in HL096PA1, several of which encode proteins in carbohydrate transport and metabolism. In addition, our analysis revealed a few island-like genomic regions that are unique to HL096PA1 and a large genomic inversion spanning the ribosomal operons. Together, these findings offer a basis for understanding P. acnes virulent properties, host adaptation mechanisms, and its potential role in acne pathogenesis at the strain level. Furthermore, the plasmid identified in HL096PA1 may potentially provide a new opportunity for P. acnes genetic manipulation and targeted therapy against specific disease-associated strains. PMID:23762865

  12. Treating acne with oral contraceptives: use of lower doses.

    PubMed

    Huber, Johannes; Walch, Katharina

    2006-01-01

    Oral contraceptives (OCs) have been shown to effectively treat acne. Clinical trials of various doses of ethinyl estradiol (EE) combined with progestins such as levonorgestrel, desogestrel, norgestimate, gestodene, cyproterone acetate and drospirenone in monophasic, triphasic and combiphasic formulations used to treat acne in women are reviewed here. Open-label and comparative studies beginning in the 1980s were the first to demonstrate objective and subjective reductions in the incidence of acne, severity of existing acne and seborrhea. Placebo-controlled trials have corroborated these findings with a trend toward effective acne treatment with declining doses of EE. Significant reductions in total, inflammatory and noninflammatory lesions compared with placebo have been demonstrated with an OC containing the low dose of 20 microg of EE. Collectively, these findings support the use of low-dose OCs for the treatment of acne. PMID:16371290

  13. Immunotherapy for acne vulgaris: current status and future directions.

    PubMed

    Simonart, Thierry

    2013-12-01

    There is a high unmet clinical need for new and better treatments in acne vulgaris. Propionibacterium acnes has a strong proinflammatory activity and targets molecules involved in the innate cutaneous immunity, keratinocytes and sebaceous glands of the pilosebaceous follicle. The role of P. acnes in acne confers legitimacy on the possible benefits of immunization-based approaches, which may represent a solution for limiting the development of antibiotic-resistant P. acnes. Various immunization-based approaches have been developed over the last decades, including killed pathogen-based vaccines, vaccination against cell wall-anchored sialidase, monoclonal antibodies to the Christie, Atkins, Munch-Peterson factor of P. acnes, anti-Toll-like receptors vaccines and natural antimicrobial peptides. This review summarizes the current evidence and explores the challenges to making this a realistic treatment option for the future.

  14. A global perspective on the epidemiology of acne.

    PubMed

    Tan, J K L; Bhate, K

    2015-07-01

    Acne is estimated to affect 9.4% of the global population, making it the eighth most prevalent disease worldwide. Epidemiological studies have demonstrated that acne is most common in postpubescent teens, with boys most frequently affected, particularly with more severe forms of the disease. This paper aims to provide an update on the epidemiology of acne worldwide. Recent general and institutional studies from around the world have shown that the prevalence of acne is broadly consistent globally (with the exception of specific populations, which are discussed). However, this review highlights that there is a wide range of disparate outcome measures being applied in epidemiology studies, and we emphasize the need to develop a widely accepted, credible, standard assessment scale to address this in the future. In addition we discuss special populations, such as those devoid of acne, as well as the impact of potential determinants of acne on disease epidemiology.

  15. Formulation and evaluation of herbal anti-acne moisturizer.

    PubMed

    Rasheed, Arun; Shama, Shaik Neelufar; Joy, Jyothi Mulanjananiyil; Reddy, Bobbu Sravya; Roja, Chirra

    2012-10-01

    The moisture content present in human skin makes it look young and the use of moisturizer results in fastening the moisture with a surface film of oil. Acne vulgaris is one of the most commonly seen diseases among the youth. The present study is focused on the use of herbs as moisturizer for acne treatment. The anti-acne moisturizer was formulated from herbal crude extracts and investigated the physico-chemical parameters as well as antibacterial activity of the formulation. The study revealed that ethanol extract of Andrographis paniculata, Glycyrrhiza glabra, Ocimum sanctum, Azadiracta indica and Green tea possessed the potential for inhibiting acne. It was observed that the optimal formula of anti-acne moisturizer was satisfactorily effective to control acne inducing bacteria i.e., Staphylococcus epidermis and Propionibacterium. The physico-chemical parameters of the formulation were also optimal with no signs of irritation. PMID:23010007

  16. 75 FR 9821 - Disability Determinations by State Agency Disability Examiners

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-04

    ..., Disability benefits, Old-age, Survivors and Disability Insurance, Reporting and recordkeeping requirements... set forth below: PART 404--FEDERAL OLD AGE, SURVIVORS AND DISABILITY INSURANCE (1950- ) Subpart P-- 1....gpoaccess.gov/fr/index.html . What Do Our Current Rules Provide? Under our current rules, a State...

  17. Etiopathogenesis and Therapeutic Approach to Adult Onset Acne

    PubMed Central

    Kaur, Sarabjit; Verma, Poonam; Sangwan, Ankita; Dayal, Surabhi; Jain, Vijay Kumar

    2016-01-01

    Acne vulgaris is usually considered as a skin disorder that primarily affects adolescents reaching a peak at the age of 14–17 years in females and 16–19 years in males. However, recent epidemiologic studies have shown that a significant number of female patients aged >25 years experience acne. As it is regarded as a disease of teenagers, adults are more apprehensive and experience social anxiety. Hence, adult onset acne has become a matter of concern. PMID:27512185

  18. In vitro LED and laser light photoinactivation of Propionibacterium acnes

    NASA Astrophysics Data System (ADS)

    Tuchina, Elena S.; Tuchin, Valery V.

    2008-06-01

    Acne is a genetic, hormonal disease characterized by overproduction of oil by the sebaceous glands, plugging of the sebaceous glands to form micro- and macro- comedons and, finally, action of skin bacteria on oil trapped underneath the skin to red inflammatory cystic lesions. It was shown, that Propionibacterium acnes, the bacteria responsible for acne, was rather subjected to action of red and infrared radiation. The effect of the given radiation amplified at this bacteria by various solutions of photosensitizes.

  19. Etiopathogenesis and Therapeutic Approach to Adult Onset Acne.

    PubMed

    Kaur, Sarabjit; Verma, Poonam; Sangwan, Ankita; Dayal, Surabhi; Jain, Vijay Kumar

    2016-01-01

    Acne vulgaris is usually considered as a skin disorder that primarily affects adolescents reaching a peak at the age of 14-17 years in females and 16-19 years in males. However, recent epidemiologic studies have shown that a significant number of female patients aged >25 years experience acne. As it is regarded as a disease of teenagers, adults are more apprehensive and experience social anxiety. Hence, adult onset acne has become a matter of concern. PMID:27512185

  20. Efficacy of local application of an Unani formulation in acne vulgaris

    PubMed Central

    Sultana, Shabiya; Zulkifle, Mohd.; Ansari, Abdul Haseeb; Shahnawaz

    2015-01-01

    Background and Objectives: Buthūr-i-Labaniyya (Acne vulgaris) is affecting up to 80% of adolescents and many adults at different stages of life. It is one of the commonest skin disorders which appears on cheeks and nose as white eruptions that seems like solidified milk drops. These eruptions are treated by drugs having properties of tajfīf wa taḥlīl (desiccant and resolving), as mentioned by Ibne Sina. Daood Antaki in his book Tazkira Oolulalbab recommends the local application of a paste of Shonīz (nigella sativa), Naushādar (ammonium chloride) and Būra Armani mixed with Sirka (vinegar) for effective treatment of Acne vulgaris. Methods: The study was observational self comparison before and after treatment, conducted in the OPD of the hospital which is part of the National Institute of Unani Medicine, Bangalore. The duration of study was one year. 40 Female patients with combination of comedones, papules, pustules and nodules were recruited for this purpose. The test drug, Shonīz, Būra Armani, Naushadar powder, mixed with sirka were applied locally for one month with taqlīl-i-ghidhā tadābīr (low calorie index diet). All subjects were assessed on the basis of changes in subjective and objective parameters. Results: The response of test drugs was statistically highly significant (P < 0.01) by using ANOVA repeated measure test, there was also relief in subjective parameters. Subjects reported a reduction of 82.6%, 80.9%, 66.6% in tenderness, itching and irritation respectively. Interpretation and Conclusion: The present study reveals that the test drug formulation is safe and effective in treating Acne vulgaris if used along with low calorie index diet. No side effects of drugs were reported, therefore the trial formulation can be recommended to manage Acne vulgaris of mild to severe degree as a therapy. PMID:26865747

  1. The use of hormonal agents in the treatment of acne.

    PubMed

    Hassoun, Lauren A; Chahal, Dev S; Sivamani, Raja K; Larsen, Larissa N

    2016-06-01

    Hormones and androgens play an important role in the pathogenesis of acne. Multiple hormonal modulators are now available for the treatment of acne. The efficacies and side effects of currently available hormonal agents are reviewed here including the use of oral contraceptives, spironolactone, flutamide, cyproterone acetate, finasteride, and cortexolone 17α-propionate. Hormonal therapies are an efficacious treatment option for acne among females. With the growing need to reduce antibiotic exposures, hormonal therapies should be more widely studied and incorporated into acne treatment strategies. PMID:27416311

  2. Physical Modalities (Devices) in the Management of Acne.

    PubMed

    Nestor, Mark S; Swenson, Nicole; Macri, Angela

    2016-04-01

    Treatment options for acne vulgaris are enhanced by laser and light therapy. Both visible and laser light are effective treatments for acne. Visible light and many lasers target Propionibacterium acnes porphyrins while others act as anti-inflammatory mediators or reduce sebaceous gland activity. Compared with topical and systemic therapies, laser and light therapies have few if any side effects and appear to be safe during pregnancy. If patients prefer at home light treatments, several devices are currently available and have been shown to have efficacy. Ultimately, combining laser and light with topical therapy may well become the mainstay of acne treatment. PMID:27015782

  3. Repair of acne scars with Dermicol-P35.

    PubMed

    Smith, Kevin C

    2009-01-01

    Acne vulgaris is a prevalent skin condition that can cause disfiguring residual scarring. While the complete removal of acne scars is unlikely, several treatments exist that can improve the appearance of acne scars. Dermal fillers offer a simple, nonsurgical corrective procedure that can provide improved skin texture. Dermicol-P35 (Evolence [Ortho Dermatologics, Skillman, NJ]) is a new, highly purified, ribose cross-linked, porcine collagen-based dermal filler that has demonstrated low immunogenicity and results that persist for at least 12 months. This article presents the aesthetic results of a male patient treated with Dermicol-P35 for severe facial acne scars.

  4. The antimicrobial activity of liposomal lauric acids against Propionibacterium acnes.

    PubMed

    Yang, Darren; Pornpattananangkul, Dissaya; Nakatsuji, Teruaki; Chan, Michael; Carson, Dennis; Huang, Chun-Ming; Zhang, Liangfang

    2009-10-01

    This study evaluated the antimicrobial activity of lauric acid (LA) and its liposomal derivatives against Propionibacterium acnes (P. acnes), the bacterium that promotes inflammatory acne. First, the antimicrobial study of three free fatty acids (lauric acid, palmitic acid and oleic acid) demonstrated that LA gives the strongest bactericidal activity against P. acnes. However, a setback of using LA as a potential treatment for inflammatory acne is its poor water solubility. Then the LA was incorporated into a liposome formulation to aid its delivery to P. acnes. It was demonstrated that the antimicrobial activity of LA was not only well maintained in its liposomal derivatives but also enhanced at low LA concentration. In addition, the antimicrobial activity of LA-loaded liposomes (LipoLA) mainly depended on the LA loading concentration per single liposomes. Further study found that the LipoLA could fuse with the membranes of P. acnes and release the carried LA directly into the bacterial membranes, thereby killing the bacteria effectively. Since LA is a natural compound that is the main acid in coconut oil and also resides in human breast milk and liposomes have been successfully and widely applied as a drug delivery vehicle in the clinic, the LipoLA developed in this work holds great potential of becoming an innate, safe and effective therapeutic medication for acne vulgaris and other P. acnes associated diseases. PMID:19665786

  5. Repair of acne scars with Dermicol-P35.

    PubMed

    Smith, Kevin C

    2009-01-01

    Acne vulgaris is a prevalent skin condition that can cause disfiguring residual scarring. While the complete removal of acne scars is unlikely, several treatments exist that can improve the appearance of acne scars. Dermal fillers offer a simple, nonsurgical corrective procedure that can provide improved skin texture. Dermicol-P35 (Evolence [Ortho Dermatologics, Skillman, NJ]) is a new, highly purified, ribose cross-linked, porcine collagen-based dermal filler that has demonstrated low immunogenicity and results that persist for at least 12 months. This article presents the aesthetic results of a male patient treated with Dermicol-P35 for severe facial acne scars. PMID:19577176

  6. Acne is not associated with yet-uncultured bacteria.

    PubMed

    Bek-Thomsen, M; Lomholt, H B; Kilian, M

    2008-10-01

    Current clinical and microbiological information on acne fails to demonstrate a clear association between particular species, including Propionibacterium acnes, and disease, and the disease continues to be a considerable problem. To test if acne is associated with hitherto uncultured bacteria residing in diseased skin follicles, sequencing and phylogenetic analysis of approximately 5,700 amplified and cloned 16S rRNA genes were used to determine the microbial diversity in follicles from acne patients and healthy individuals and from the superficial skin of acne patients. Follicles from healthy skin were exclusively colonized by P. acnes, whereas the follicular microbiota of acne patients included, in addition, Staphylococcus epidermidis and minor proportions of other species. In comparison, samples from superficial skin showed a complex microbiota represented by 12 to 16 bacterial species. The findings of the study exclude the possibility that acne is associated with yet-uncultured bacteria and shows that healthy skin follicles constitute a remarkably exclusive habitat allowing colonization only by P. acnes. PMID:18716234

  7. Treatment of adult female acne: a new challenge.

    PubMed

    Dréno, B

    2015-06-01

    Acne is affecting an increasing number of adult females and so can no longer be considered as a disease of adolescence. The disease has a greater negative impact on the quality of life of adult females than their younger counterparts. Adult female acne may persist from adolescence or may have its first occurrence once adulthood has been reached. The clinical presentation and pathogenesis of adult female acne may be somewhat different to that of adolescent acne and this may require a different treatment approach. Genetic and hormonal factors are thought to play key roles in the pathogenesis of adult female acne and the disease is characterized by a chronic evolution with frequent relapses requiring long-term maintenance therapy. Fixed-dose retinoid/antimicrobial combinations may be of interest for the treatment of adult female acne given that subgroup analysis of clinical trials has indicated that they are effective against both inflammatory and non-inflammatory lesions in these patients. These treatments may also be of interest, given the chronic course of the disease in adult females, the high likelihood of the presence of antibiotic-resistant P. acnes and the poor adherence of patients to other long-term therapies. Oral hormonal treatment or isotretinoin may be required in patients with severe acne or disease that is refractory to other treatments. Additional clinical studies of acne treatments specifically conducted in adult female patients are required to increase the evidence base on which future treatment recommendations can be based.

  8. Acne inversa: difficulties in diagnostics and therapy

    PubMed Central

    Hadasik, Karolina; Brzezińska-Wcisło, Ligia

    2015-01-01

    Acne inversa (hidradenitis suppurativa) is a potentially severe and chronic inflammatory disease with a significant negative influence on the quality of life. Usually, lesions are located in the areas of skin folds and it is characterized by the presence of painful nodules and fistulas with a tendency to tissue fibrosis. Currently, it is suggested that follicular occlusion by infundibular hyperkeratosis plays a crucial role in pathogenesis and an occupation of apocrine sweat glands is a secondary phenomenon. Most often, it refers to men after puberty. This article tries to present the latest theory concerning the etiology of inverted acne and methods of its treatment. It also describes the most common errors in diagnostic and therapeutic procedures, which are mainly connected with repeated and long antibiotic therapy and not radical surgical treatment. PMID:26366155

  9. A Family Physician's Approach to Acne

    PubMed Central

    Turgeon, Eugene

    1981-01-01

    Because of the potential for permanent physical and psychological sequelae, acne vulgaris should be regarded as a true disease—not the “normal” physiologic response one might infer from its near universal prevalence in adolescence. Effective therapy reduces pilosebaceous unit obstruction, minimizes secondary inflammation, and lessens the chance of significant scarring. This article reviews current therapeutic modalities, and suggests a sequence for implementation of specific agents. ImagesFig. 1Fig. 2Fig. 3Fig. 4Fig. 5 PMID:21289790

  10. Acne - Multiple Languages: MedlinePlus

    MedlinePlus

    ... this page, please enable JavaScript. Chinese - Traditional (繁體中文) Korean (한국어) Spanish (español) Vietnamese (Tiếng Việt) Chinese - Traditional ( ... Institute of Arthritis and Musculoskeletal and Skin Diseases Korean (한국어) What Is Acne? English 여드름이란 무엇인가? - 한국어 ( ...

  11. Reduced expression of dermcidin, a peptide active against propionibacterium acnes, in sweat of patients with acne vulgaris.

    PubMed

    Nakano, Toshiaki; Yoshino, Takashi; Fujimura, Takao; Arai, Satoru; Mukuno, Akira; Sato, Naoya; Katsuoka, Kensei

    2015-09-01

    Dermcidin (DCD), an antimicrobial peptide with a broad spectrum of activity against bacteria such as Propionibacterum acnes, is expressed constitutively in sweat in the absence of stimulation due to injury or inflammation. The aim of this study was to determine the relationship between DCD expression and acne vulgaris associated with P. acnes. The antimicrobial activity of recombinant full-length DCD (50 μg/ml) was 97% against Escherichia coli and 100% against Staphylococcus aureus. Antimicrobial activity against P. acnes ranged from 68% at 50 μg/ml DCD to 83% at 270 μg/ml DCD. DCD concentration in sweat from patients with acne vulgaris (median 9.8 μg/ml, range 6.9-95.3 μg/ml) was significantly lower than in healthy subjects (median 136.7 μg/ml, range 45.4-201.6 μg/ml) (p = 0.001). DCD demonstrated concentration-dependent, but partial, microbicidal activity against P. acnes. These results suggest that reduced DCD concentration in sweat in patients with inflammatory acne may permit proliferation of P. acnes in pilosebaceous units, resulting in progression of inflammatory acne.

  12. Diet and acne: an exploratory survey study of patient beliefs

    PubMed Central

    Nguyen, Quynh-Giao; Markus, Ramsey; Katta, Rajani

    2016-01-01

    Background: In the past, medical literature reflected that diet was not a proven cause of acne. However, studies in recent years have substantiated a link between certain dietary factors and acne. It is unclear whether patients are aware of recent research findings. Objectives: Acne patients were surveyed to explore beliefs regarding the link between diet and acne, to determine whether these beliefs translated into behavior change and to identify health information sources. Patients/Methods: Upon Institutional Review Board (IRB) approval, surveys were administered to 50 acne patients at an academic dermatology clinic in 2014, with 49 completed in full and included in this analysis. Results: Ninety-two percent of respondents believed that diet could affect acne. Seventy-one percent attempted to change their diet to improve acne. Seventy-one percent believed acne to be caused by fried or greasy foods, although chocolate (53%), dairy (47%), and soda drinks (35%) were highly implicated. Patients obtained information from Google searches (49%), dermatologists (43%), family members and TV (41% each), and medical websites (31%). Conclusions: In this exploratory study, patients reported utilizing a diversity of information sources, a majority from the Internet. In those surveyed, there was a persistence of long-held belief that fried/greasy foods and chocolate may serve as acne triggers, and less belief in trigger foods supported by recent research, including refined carbohydrates and sugar. Given the multiplicity of beliefs and utilized sources among acne patients in our survey, there is a need to establish up-to-date and reliable methods to educate patients on diet and acne. PMID:27222768

  13. Fractional Carbon Dioxide Laser in Treatment of Acne Scars

    PubMed Central

    Petrov, Andrej; Pljakovska, Vesna

    2016-01-01

    BACKGROUND: Scars appear as a result of skin damage during the process of the skin healing. There are two types of acne scars, depending on whether there is a loss or accumulation of collagen: atrophic and hypertrophic. In 80-90% it comes to scars with loss of collagen compared to smaller number of hypertrophic scars and keloids. AIM: The aim of the study was to determine efficiency and safety of fractional carbon dioxide laser in the treatment of acne scars. MATERIAL AND METHODS: The study was carried out in Acibadem Sistina Clinical Hospital, Skopje at the Department of Dermatovenerology, with a total of 40 patients treated with fractional carbon dioxide laser (Lutronic eCO2). The study included patients with residual acne scars of a different type. RESULTS: Comedogenic and papular acne in our material were proportionately presented in 50% of cases, while the other half were the more severe clinical forms of acne - pustular inflammatory acne and nodulocystic acne that leave residual lesions in the form of second, third and fourth grade of scars. CONCLUSION: The experiences of our work confirm the world experiences that the best result with this method is achieved in dotted ice pick or V-shaped acne scars. PMID:27275326

  14. Acne vulgaris: A review of causes and treatment options.

    PubMed

    Well, Danielle

    2013-10-10

    Acne vulgaris is a disorder of the sebaceous follicle. The cause is multifactorial, and both adolescents and adults can be affected. Acne is associated with a significant financial burden and considerable psychological distress. Treatment options are reviewed, including over-the-counter medications, prescription medications, and in-office procedures.

  15. Investigation of antibacterial activity of aspidin BB against Propionibacterium acnes.

    PubMed

    Gao, Chang; Guo, Na; Li, Na; Peng, Xiao; Wang, Peng; Wang, Wei; Luo, Meng; Fu, Yu-Jie

    2016-03-01

    In the present study, antibacterial activity of four kinds of phloroglucinol derivatives extracted from Dryopteris fragrans (L.) Schott against S. aureus, S. epidermidis and P. acnes has been tested. Aspidin BB exerted the strongest antibacterial activity with minimal inhibition concentration (MIC) values ranging from 7.81 to 15.63 μg/mL. The time-kill assay indicated that aspidin BB could kill P. acnes completely at 2 MIC (MBC) within 4 h. By using AFM, we demonstrated extensive cell surface alterations of aspidin BB-treated P. acnes. SDS-PAGE of supernatant proteins and lipid peroxidation results showed that aspidin BB dose-dependently affected membrane permeability of P. acnes. DNA damage and protein degradation of P. acnes were also verified. SDS-PAGE of precipitated proteins revealed possible targets of aspidin BB, i.e., heat shock proteins (26 kDa) and lipase (33 kDa) which could all cause inflammation. Aspidin BB also seriously increased the inhibition rate of lipase activity from 10.20 to 65.20 % to possibly inhibit the inflammation. In conclusions, the effective constituents of D. fragrans (L.) Schott to treat acne might be phloroglucinol derivatives including aspidin BB, aspidin PB, aspidinol and dryofragin. Among this, aspidin BB inhibited the growth of P. acnes by disrupting their membrane, DNA and proteins and finally leaded to the cell death. The obtained data highlighted the potential of using aspidin BB as an alternative treatment for acne vulgaris. PMID:26596576

  16. Biopolymer scaffolds for use in delivering antimicrobial Sophorolipids to the acne-causing bacterium propionibacterium acnes

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Sophorolipids (SLs) are known to possess antimicrobial properties towards many species (particularly Gram-positive, or Gram+) of bacteria. However, they can only be exerted if the SLs can be introduced to the bacterial cells in an acceptable manner. Propionibacterium acnes is the common bacterial ...

  17. An update on the management of acne vulgaris

    PubMed Central

    Keri, Jonette; Shiman, Michael

    2009-01-01

    Acne vulgaris is a common skin disorder that can affect individuals from childhood to adulthood, most often occurring in the teenage years. Acne can have a significant physical, emotional, and social impact on an individual. Many different treatment options are available for the treatment of acne vulgaris. Commonly used topical treatments include benzoyl peroxide, antibiotics, sulfur and sodium sulfacetamide, azelaic acid, and retinoids. Systemic treatment is frequently used and includes the use of systemic antibiotics, oral contraceptives, antiandrogens, and retinoids. Other treatment modalities exist such as the use of superficial chemical peels as well as using laser and light devices for the treatment of acne. With the multitude of treatment options and the rapidly expanding newer technologies available to clinicians, it is important to review and be aware of the current literature and studies regarding the treatment of acne vulgaris. PMID:21436973

  18. Antibiotic-resistant acne: getting under the skin.

    PubMed

    Sinha, Mau; Sadhasivam, Suresh; Bhattacharyya, Anamika; Jain, Shilpi; Ghosh, Shamik; Arndt, Kenneth A; Dover, Jeffrey S; Sengupta, Shiladitya

    2016-06-01

    Propionibacterium acnes is a key pathogenic factor in the development of acne. Antibiotics are the first choice of treatment for mild-to-moderate, mixed, papular/pustular, and moderate nodular acne, and an alternative choice in severe, nodular/conglobate acne. The emergence of resistance to the currently available antibiotics poses a serious set-back to this algorithm, and the reduced arsenal can diminish efficacy of treatment. This emerging situation should catalyze innovations in dermatology; for example, newer drugs and technologies such as next-generation antibiotics with excellent potency and low propensity to develop resistance, rapid diagnostic platforms to select responders and nonresponders, and delivery technologies that target the bacteria. Such innovations can dramatically expand the arsenal for dermatologists in the management of acne. PMID:27416310

  19. Antibiotic-resistant acne: getting under the skin.

    PubMed

    Sinha, Mau; Sadhasivam, Suresh; Bhattacharyya, Anamika; Jain, Shilpi; Ghosh, Shamik; Arndt, Kenneth A; Dover, Jeffrey S; Sengupta, Shiladitya

    2016-06-01

    Propionibacterium acnes is a key pathogenic factor in the development of acne. Antibiotics are the first choice of treatment for mild-to-moderate, mixed, papular/pustular, and moderate nodular acne, and an alternative choice in severe, nodular/conglobate acne. The emergence of resistance to the currently available antibiotics poses a serious set-back to this algorithm, and the reduced arsenal can diminish efficacy of treatment. This emerging situation should catalyze innovations in dermatology; for example, newer drugs and technologies such as next-generation antibiotics with excellent potency and low propensity to develop resistance, rapid diagnostic platforms to select responders and nonresponders, and delivery technologies that target the bacteria. Such innovations can dramatically expand the arsenal for dermatologists in the management of acne.

  20. Acne is not associated with abnormal plasma androgens.

    PubMed

    Levell, M J; Cawood, M L; Burke, B; Cunliffe, W J

    1989-05-01

    Plasma dehydroepiandrosterone sulphate, androstenedione, testosterone (T), dihydrotestosterone (DHT), and sex hormone binding globulin (SHBG) have been measured in 64 females and 26 males aged less than 25 years and with acne vulgaris. Oestradiol was measured in the males. Free T and free DHT were calculated. Acne was graded on three sites and the sebum excretion rate (SER) was measured in most patients. With the possible exception of free DHT, none of the plasma steroids or SHBG correlated with acne severity or with SER. Free DHT in the females showed a possible, but weak, correlation with total acne (r = 0.25, P = 0.07), but comparison with male data showed that this was not causative. The role of androgens in acne is permissive and plasma androgen measurements usually have no place in its management. PMID:2527050

  1. Serum hormone levels in men with severe acne.

    PubMed

    Aizawa, H; Niimura, M

    1992-07-01

    In order to evaluate the hormonal milieu in young men with severe acne, we measured serum estradiol (E2), total testosterone (T), free testosterone (FT), dihydrotestosterone (DHT), dehydroepiandrosterone sulfate (DHEA-S), and sex hormone binding globulin (SHBG) levels in sixteen male patients aged 20-30 years with severe acne, including twelve cases of nodular-cystic acne, and in seventeen age-matched normal controls. There were no significant differences in the serum levels of T, FT, DHT, DHEA-S, or SHBG between the patients and the controls, but serum E2 was significantly higher in the patient population. Thus, the hemodynamics of serum androgens in male patients with acne do not seem to differ significantly from that of normal controls. Elevated E2 levels might affect the inflammatory response of acne vulgaris through the release of thymic hormones, as reported in the literature. PMID:1401498

  2. Androgen status in adolescent women with acne vulgaris.

    PubMed

    Aizawa, H; Nakada, Y; Niimura, M

    1995-07-01

    Androgens are essential for the development of acne. The object of this study was to elucidate the androgen status of women with adolescent (Tanner's stage IV-V) acne alone and compare them to age-matched normal controls. We measured serum levels of total testosterone (T), free testosterone (FT), dihydrotestosterone (DHT), and dehydroepiandrosterone sulfate (DHEA-S) in 15 women with adolescent acne and 13 age-matched healthy controls. No significant differences were found between the mean levels of T, FT or DHT levels in patients and controls. However, the mean levels of DHEA-S in the patient population (1886 +/- 829 ng/ml) were significantly (p < 0.05) higher than normal controls (1287 +/- 620 ng/ml). There was also no correlation between androgen levels and acne severity. Thus it is unlikely that serum androgens play a principal role in women with adolescent acne. PMID:7560449

  3. Propionibacterium acnes biofilm - A sanctuary for Staphylococcus aureus?

    PubMed

    Tyner, Harmony; Patel, Robin

    2016-08-01

    The purpose of this study was to measure the effect of combined culture of Propionibacterium acnes and Staphylococcus aureus on biofilm formation under different oxygen concentrations. We measured planktonic growth and biofilm formation of P. acnes and S. aureus alone and together under aerobic and anaerobic conditions. Both P. acnes and S. aureus grew under anaerobic conditions. When grown under anaerobic conditions, P. acnes with or without S. aureus formed a denser biomass biofilm than did S. aureus alone. Viable S. aureus was recovered from a16-day old combined P. acnes and S. aureus biofilm, but not a monomicrobial S. aureus biofilm.

  4. Heat-killed Propionibacterium acnes is capable of inducing inflammatory responses in skin.

    PubMed

    Lyte, Peter; Sur, Runa; Nigam, Anu; Southall, Michael D

    2009-12-01

    The etiology of acne is a complex process, and acne is one of the most common skin disorders affecting millions of people. The pathogenesis of acne is closely associated with the bacterium, Propionibacterium acnes which was previously known as Corynebacterium parvum. Both viable and non-viable P. acnes/C. parvum have been shown to induce an immunostimulatory effect in vivo, suggesting that even dead bacteria continue to activate an inflammatory response. Acne treatments with lasers or devices, induce a bactericidal effect through heat generation which may not address the immunogenic activity of P. acnes and the resulting acne inflammation. Therefore, we sought to determine whether killed P. acnes is capable of inducing an inflammatory response and therefore could be a contributing factor in acne. Direct heat treatment of P. acnes cultures with temperatures ranging from 50 degrees C to 80 degrees C reduced P. acnes viability. Both viable and heat-killed P. acnes activated the p38 MAP kinase and its downstream substrate Hsp27. Stimulating keratinocytes with normal and heat-inactivated P. acnes resulted in an induction of proinflammatory nitric oxide and IL-8 production. Thus killed P. acnes is capable of inducing inflammation in skin suggesting that therapies that have both bactericidal and anti-inflammatory effects may result in a more effective treatment of patients with acne than treatments that are bactericidal alone. PMID:19624731

  5. The efficacy of autologous platelet-rich plasma combined with erbium fractional laser therapy for facial acne scars or acne.

    PubMed

    Zhu, Jiang-Ting; Xuan, Min; Zhang, Ya-Ni; Liu, Hong-Wei; Cai, Jin-Hui; Wu, Yan-Hong; Xiang, Xiao-Fei; Shan, Gui-Qiu; Cheng, Biao

    2013-07-01

    The aim of this study was to evaluate the efficacy of autologous platelet-rich plasma (PRP) combined with erbium fractional laser therapy for facial acne or acne scars. PRP combined with erbium fractional laser therapy was used for the treatment of 22 patients, including 16 patients who suffered from facial acne scars and 6 patients who suffered from acne scars concomitant with acne. Whole blood (40 ml) was collected from each patient, and following differential centrifugation, PRP was harvested. After using an erbium fractional laser, we applied PRP to the entire face of every patient. Digital photos were taken before and after the treatment for evaluation by dermatologists and the patients rated the efficacy on a 5-point scale. The erythema was moderate or mild, while its total duration was <3 days; after receiving the treatment three times, 90.9% of the patients showed an improvement of >50%, and 91% of the patients were satisfied; no acne inflammation was observed after treatment. PRP combined with erbium fractional laser therapy is an effective and safe approach for treating acne scars or acne, with minimal side-effects, and it simultaneously enhanced the recovery of laser-damaged skin.

  6. Proteomic identification of secreted proteins of Propionibacterium acnes

    PubMed Central

    2010-01-01

    Background The anaerobic Gram-positive bacterium Propionibacterium acnes is a human skin commensal that resides preferentially within sebaceous follicles; however, it also exhibits many traits of an opportunistic pathogen, playing roles in a variety of inflammatory diseases such as acne vulgaris. To date, the underlying disease-causing mechanisms remain ill-defined and knowledge of P. acnes virulence factors remains scarce. Here, we identified proteins secreted during anaerobic cultivation of a range of skin and clinical P. acnes isolates, spanning the four known phylogenetic groups. Results Culture supernatant proteins of P. acnes were separated by two-dimensional electrophoresis (2-DE) and all Coomassie-stained spots were subsequently identified by MALDI mass spectrometry (MALDI-MS). A set of 20 proteins was secreted in the mid-exponential growth phase by the majority of strains tested. Functional annotation revealed that many of these common proteins possess degrading activities, including glycoside hydrolases with similarities to endoglycoceramidase, β-N-acetylglucosaminidase and muramidase; esterases such as lysophospholipase and triacylglycerol lipase; and several proteases. Other secreted factors included Christie-Atkins-Munch-Petersen (CAMP) factors, glyceraldehyde 3-phosphate dehydrogenase (GAPDH), and several hypothetical proteins, a few of which are unique to P. acnes. Strain-specific differences were apparent, mostly in the secretion of putative adhesins, whose genes exhibit variable phase variation-like sequence signatures. Conclusions Our proteomic investigations have revealed that the P. acnes secretome harbors several proteins likely to play a role in host-tissue degradation and inflammation. Despite a large overlap between the secretomes of all four P. acnes phylotypes, distinct differences between predicted host-tissue interacting proteins were identified, providing potential insight into the differential virulence properties of P. acnes isolates

  7. High glycemic load diet, milk and ice cream consumption are related to acne vulgaris in Malaysian young adults: a case control study

    PubMed Central

    2012-01-01

    Background The role of dietary factors in the pathophysiology of acne vulgaris is highly controversial. Hence, the aim of this study was to determine the association between dietary factors and acne vulgaris among Malaysian young adults. Methods A case–control study was conducted among 44 acne vulgaris patients and 44 controls aged 18 to 30 years from October 2010 to January 2011. Comprehensive acne severity scale (CASS) was used to determine acne severity. A questionnaire comprising items enquiring into the respondent’s family history and dietary patterns was distributed. Subjects were asked to record their food intake on two weekdays and one day on a weekend in a three day food diary. Anthropometric measurements including body weight, height and body fat percentage were taken. Acne severity was assessed by a dermatologist. Results Cases had a significantly higher dietary glycemic load (175 ± 35) compared to controls (122 ± 28) (p < 0.001). The frequency of milk (p < 0.01) and ice-cream (p < 0.01) consumptions was significantly higher in cases compared to controls. Females in the case group had a higher daily energy intake compared to their counterparts in the control group, 1812 ± 331 and 1590 ± 148 kcal respectively (p < 0.05). No significant difference was found in other nutrient intakes, Body Mass Index, and body fat percentage between case and control groups (p > 0.05). Conclusions Glycemic load diet and frequencies of milk and ice cream intake were positively associated with acne vulgaris. PMID:22898209

  8. [Hidradenitis suppurativa/acne inversa: An update].

    PubMed

    Kirschke, J; Hessam, S; Bechara, F G

    2015-06-01

    Hidradenitis suppurativa/acne inversa (HS/AI) is a chronic inflammatory disease characterized by painful nodules, abscesses, fistulas, sinus tracts and scarring, which may lead to severe functional and psychological impairment. Patients often suffer for many years before the right diagnosis is finally made. HS/AI is still a therapeutic challenge. Conservative therapies play a role in mild stages of the disease; however they do not result in healing. Therapy of choice associated with the lowest recurrence rate is a radical wide excision of involved skin.

  9. Oral contraceptives as anti-androgenic treatment of acne.

    PubMed

    Lemay, André; Poulin, Yves

    2002-07-01

    Although acne is seldom associated with high serum levels of androgens, it has been shown that female acne patients have definite increases in ovarian and adrenal androgen levels when compared to appropriate controls. As shown in several pilot and in multiple open and comparative studies, oral contraceptives (OCs) are effective in causing a significant regression of mild to moderate acne. These results have been confirmed by multicentre randomized trials where low-dose OCs did not cause side effects different from those of the placebo-controlled group. The beneficial effect of OCs is related to a decrease in ovarian and adrenal androgen precursors; to an increase in sex hormone-binding globulin (SHBG), which limits free testosterone; and to a decrease in 3a-androstenediol glucuronide conjugate, the catabolite of dihydrotestosterone (DHT) formed in peripheral tissues. The estrogen-progestin combination containing cyproterone acetate (CPA) is particularly effective in treating acne, since this progestin also has a direct peripheral anti-androgenic action in blocking the androgen receptor. Only two open studies and one randomized study on small numbers of patients have reported some efficacy of spironolactone used alone or in combination with an OC in the treatment of acne. The new non-steroidal anti-androgens flutamide and finasteride are being evaluated for the treatment of hirsutism. Oral antibiotics are prescribed to patients with inflammatory lesions, where they are effective in decreasing the activity of microbes, the activity of microbial enzymes, and leukocyte chemotaxis. Concomitant intake of an OC and an antibiotic usually prescribed for acne does not impair the contraceptive efficacy of the OC. A second effective contraceptive method should be used whenever there would be decreased absorption or efficacy of the OC (digestive problems, breakthrough bleeding), lack of compliance and use of a type or dose of antibiotic different from that usually prescribed

  10. Peripheral Arterial Disease in Older People with Intellectual Disability in The Netherlands Using the Ankle-Brachial Index: Results of the HA-ID Study

    ERIC Educational Resources Information Center

    de Winter, C. F.; Bastiaanse, L. P.; Kranendonk, S. E.; Hilgenkamp, T. I. M.; Evenhuis, H. M.; Echteld, M. A.

    2013-01-01

    Older people with an intellectual disability (ID) have been shown to have similar to increased cardiovascular risks as compared to the general population. Peripheral arterial disease (PAD), atherosclerosis distal from the aortic bifurcation, is associated with increased cardiovascular morbidity and mortality. The prevalence of PAD has not been…

  11. Treatment of acne vulgaris with fractional radiofrequency microneedling.

    PubMed

    Kim, Sang Tae; Lee, Kang Hoon; Sim, Hyung Jun; Suh, Kee Suck; Jang, Min Soo

    2014-07-01

    Fractional radiofrequency microneedling is a novel radiofrequency technique that uses insulated microneedles to deliver energy to the deep dermis at the point of penetration without destruction of the epidermis. It has been used for the treatment of various dermatological conditions including wrinkles, atrophic scars and hypertrophic scars. There have been few studies evaluating the efficacy of fractional radiofrequency microneedling in the treatment of acne, and none measuring objective parameters like the number of inflammatory and non-inflammatory acne lesions or sebum excretion levels. The safety and efficacy of fractional radiofrequency microneedling in the treatment of acne vulgaris was investigated. In a prospective clinical trial, 25 patients with moderate to severe acne were treated with fractional radiofrequency microneedling. The procedure was carried out three times at 1-month intervals. Acne lesion count, subjective satisfaction score, sebum excretion level and adverse effects were assessed at baseline and at 4, 8 and 12 weeks after the first treatment as well as 4, 8 and 12 weeks after the last treatment. Number of acne lesions (inflammatory and non-inflammatory) decreased. Sebum excretion and subjective satisfaction were more favorable at every time point compared with the baseline values (P < 0.05). Inflammatory lesions responded better than non-inflammatory lesions (P < 0.05). Adverse effects such as pinpoint bleeding, pain and erythema were noted, but were transient and not severe enough to stop treatment. Fractional radiofrequency microneedling is a safe and effective treatment for acne vulgaris.

  12. Propionibacterium acnes Susceptibility and Correlation with Hemolytic Phenotype

    PubMed Central

    Wright, Travis E.; Boyle, K. Keely; Duquin, Thomas R.; Crane, John K.

    2016-01-01

    BACKGROUND Many studies have noted an increase in the number of recognized cases of invasive infections due to Propionibacterium acnes, especially after shoulder replacement surgery. The increase in the number of recognized cases of P. acnes, a nonspore-forming, anaerobic, Gram-positive organism, appears due to both an increase in the number of shoulder operations being performed and more specimens being sent for anaerobic cultures. Nevertheless, the optimal surgical and antibiotic management of P. acnes remains controversial. METHODS We tested the susceptibility of 106 P. acnes strains from sterile body sites collected at the Erie County Medical Center between 2012 and 2015, using Etest gradient antibiotic strips. RESULTS P. acnes is very susceptible to the penicillins and the first-generation cephalosporins. We noted an association between hemolytic phenotype on Brucella Blood Agar and clindamycin resistance. CONCLUSIONS Antimicrobial susceptibility testing of P. acnes should no longer just be confined to the research laboratory but expanded and incorporated into routine microbiological evaluation of P. acnes. This would improve patient care as well as help clarify the relationship between hemolysis and clindamycin resistance. PMID:27773990

  13. Staphylococcus aureus in Acne Pathogenesis: A Case-Control Study

    PubMed Central

    Khorvash, Farzin; Abdi, Fatemeh; Kashani, Hessam H.; Naeini, Farahnaz Fatemi; Narimani, Tahmineh

    2012-01-01

    Background: There is considerable evidence which suggests a possible pathogenetic role for Staphylococcus aureus (S. aureus) in acne vulgaris. Aim: The study was to determine S. aureus colonization and antibiotic susceptibility patterns in patients with acne and of healthy people. Materials and Methods: In the case-control study, a total of 324 people were screened for nasal carriage of S. aureus: 166 acne patients and 158 healthy persons. One control subject was individually matched to one case. Nasal swabs from anterior nares of individuals were cultured and identified as S. aureus. Antibiotic sensitivity was performed with recognized laboratory techniques. Results: S. aureus was detected in 21.7% of the subjects in acne, and in 26.6% of control groups. There was no statistical difference in colonization rates between two groups (P=0.3). In patient group, most of S. aureus isolates were resistant to doxicycline and tetracycline (P=0.001), and were more sensitive to rifampicin compared to other drugs. In control samples, the isolated demonstrated higher resistance to cotrimoxazole compared to patient samples (P=0.0001). There was no difference between groups regarding resistance to rifampicin, vancomycin, methicillin, and oxacillin. Conclusion: It is still unclear whether S. aureus is actually a causal agent in the pathogenesis of acne. Based on microbiological data of both healthy and acne-affected persons, we propose that contribution of S. aureus in acne pathogenesis is controversial. PMID:23181229

  14. Preliminary evidence for vitamin D deficiency in nodulocystic acne

    PubMed Central

    Yildizgören, Mustafa Turgut; Togral, Arzu Karatas

    2014-01-01

    Objective: Acne vulgaris is a chronic inflammatory disease, and hormonal influences, follicular plugging and follicular hyperkeratinization, increased sebum secretion, Propionibacterium acnes colonization, and inflammation are involved in its pathogenesis. Recently, a significant body of evidence has accumulated that describes the comedolytic properties of vitamin D and its roles as a modulator of the immune system, a regulator of the proliferation and differentiation of sebocytes and keratinocytes, and as an antioxidant. In this study, we aimed to compare serum vitamin D levels in a group of patients with nodulocystic acne with vitamin D levels in a group of control subjects to determine whether there was any relationship between the vitamin D and acne. Methods: Levels of 25-hydroxyvitamin D (25[OH]D) were measured in 43 patients with newly diagnosed nodulocystic acne and in 46 healthy control subjects, and participants were grouped according to their 25[OH]D levels as follows: normal/sufficient (>20 ng/mL) or insufficient/deficient (<20 ng/mL). Serum concentrations of calcium (Ca), phosphorus (P), alkaline phosphatase (ALP), and parathyroid hormone (PTH) were measured. Results: Forty-three patients and 46 control individuals, with mean ages of 23.13 (± 5.78) years and 25.23 (± 4.73) years, respectively, were included in this study. There were no significant differences between the groups in relation to their body mass indices and Ca, P, ALP, and PTH levels. However, the patients with nodulocystic acne had significantly lower 25[OH]D levels than the subjects in the control group (P< 0.05). Conclusion: The patients with nodulocystic acne had relatively low serum vitamin D levels compared with the subjects in the control group. The findings from this study suggest that there is a connection between low vitamin D levels and acne. Larger epidemiologic studies are needed to confirm the status of vitamin D levels in patients with acne. PMID:26413187

  15. [Use of organic acids in acne and skin discolorations therapy].

    PubMed

    Kapuścińska, Alicja; Nowak, Izabela

    2015-01-01

    Acne is one of the most frequent skin disorders that occurs in puberty, but often adults also have acne. The most important factors responsible for acne are elevated production of sebum by hyperactive sebaceous glands and blockage of the follicle because of hyperkeratosis [14]. The third etiopathogenic factor of acne is excessive microflora reproduction [8]. The most significant bacterium that is responsible for formation of skin lesions is Propionibacterium acnes, a rod-shaped Gram-positive and aerotolerant anaerobic bacterium. It is estimated that P. acnes is responsible for acne in approximately 80% of people aged 11 to 30 [27,40]. Even healed skin lesions can often cause skin discolorations and scar formation [51]. Exfoliating chemical substances that are commonly used in dermatology and cosmetology are organic acids. Exfoliating treatment using organic acids is called "chemical peeling" and consists of controlled application of those substances on the skin [38]. The depth of exfoliation depends on organic acid concentration, type of substance and contact time with the skin [41]. Using exfoliating agents seems to be helpful in excessive keratinization - one of several factors responsible for acne. Moreover, epidermis exfoliation is a popular method of removing skin discoloration [22]. Considering chemical structure, exfoliating substances that are most often used in cosmetology contain alpha-hydroxyacids (glycolic acid, lactic acid, mandelic acid and citric acid), beta-hydroxyacids (salicylic acid) and other organic acids, such as trichloroacetic acid and pyruvic acid [47]. In this article, a literature review of use of organic acids in acne and skin discoloration therapy is presented. PMID:25811473

  16. [Use of organic acids in acne and skin discolorations therapy].

    PubMed

    Kapuścińska, Alicja; Nowak, Izabela

    2015-03-22

    Acne is one of the most frequent skin disorders that occurs in puberty, but often adults also have acne. The most important factors responsible for acne are elevated production of sebum by hyperactive sebaceous glands and blockage of the follicle because of hyperkeratosis [14]. The third etiopathogenic factor of acne is excessive microflora reproduction [8]. The most significant bacterium that is responsible for formation of skin lesions is Propionibacterium acnes, a rod-shaped Gram-positive and aerotolerant anaerobic bacterium. It is estimated that P. acnes is responsible for acne in approximately 80% of people aged 11 to 30 [27,40]. Even healed skin lesions can often cause skin discolorations and scar formation [51]. Exfoliating chemical substances that are commonly used in dermatology and cosmetology are organic acids. Exfoliating treatment using organic acids is called "chemical peeling" and consists of controlled application of those substances on the skin [38]. The depth of exfoliation depends on organic acid concentration, type of substance and contact time with the skin [41]. Using exfoliating agents seems to be helpful in excessive keratinization - one of several factors responsible for acne. Moreover, epidermis exfoliation is a popular method of removing skin discoloration [22]. Considering chemical structure, exfoliating substances that are most often used in cosmetology contain alpha-hydroxyacids (glycolic acid, lactic acid, mandelic acid and citric acid), beta-hydroxyacids (salicylic acid) and other organic acids, such as trichloroacetic acid and pyruvic acid [47]. In this article, a literature review of use of organic acids in acne and skin discoloration therapy is presented.

  17. Advances in the Understanding of the Pathogenesis of Inflammatory Acne.

    PubMed

    Kircik, Leon H

    2016-01-01

    Acne vulgaris (AV) is the most common skin disorder. It was traditionally thought that AV lesions developed after abnormal desquamation of the keratinocytes that line the sebaceous follicle, leading to hyperkeratinization and microcomedone formation. However, in recent years there has been a paradigm shift with regard to understanding the pathogenesis of AV, and it is now viewed as a primary inflammatory skin disorder. Research has implicated the presence of subclinical inflammation in the normal skin of acne patients, even before microcomedone formation. This article will review the novel concepts that play a role in the new pathogenesis of acne vulgaris.

  18. Calcinosis cutis secondary to facial acne vulgaris: A rare complication.

    PubMed

    Sahu, Srimanta Kumar; Gupta, Nikhil; Vohra, Suruchi

    2015-12-01

    Acne vulgaris is a common dermatological disease commonly affecting the adolescent and young adults. It is characterized by the presence of pleomorphic skin lesions such as comadones, papules, pustules, and nodules. The common complications are postacne hyperpigmentation and scarring causing psychological impact. Calcinosis cutis is the pathologic deposition of insoluble calcium salt in the skin and subcutaneous tissue. Calcinosis cutis following acne vulgaris is rarely reported in the literature. We report a case of calcinosis cutis in acne vulgaris in a 55-year-old man.

  19. Therapeutic agents and herbs in topical application for acne treatment.

    PubMed

    Kanlayavattanakul, M; Lourith, N

    2011-08-01

    Acne vulgaris suppresses an individual's self-confidence by causing distress with regard to physical appearance, which affects a significant number of individuals during puberty and is delineated by adolescence. Several treatments have been introduced to decrease the aesthetic and psychological problems caused by acne. The topical application of therapeutic agents has been found to be more feasible than hormonal treatment and laser therapy. The ingredients in topical acne treatments, particularly herbs and naturally derived compounds, have received considerable interest as they have fewer adverse effects than synthetic agents. PMID:21401650

  20. Calcinosis cutis secondary to facial acne vulgaris: A rare complication

    PubMed Central

    Sahu, Srimanta Kumar; Gupta, Nikhil; Vohra, Suruchi

    2015-01-01

    Acne vulgaris is a common dermatological disease commonly affecting the adolescent and young adults. It is characterized by the presence of pleomorphic skin lesions such as comadones, papules, pustules, and nodules. The common complications are postacne hyperpigmentation and scarring causing psychological impact. Calcinosis cutis is the pathologic deposition of insoluble calcium salt in the skin and subcutaneous tissue. Calcinosis cutis following acne vulgaris is rarely reported in the literature. We report a case of calcinosis cutis in acne vulgaris in a 55-year-old man. PMID:26904448

  1. Relationship between the severity of acne vulgaris and antimicrobial resistance of bacteria isolated from acne lesions in a hospital in Japan.

    PubMed

    Nakase, Keisuke; Nakaminami, Hidemasa; Takenaka, Yuko; Hayashi, Nobukazu; Kawashima, Makoto; Noguchi, Norihisa

    2014-05-01

    Propionibacterium acnes and Staphylococcus epidermidis are normal skin inhabitants that are frequently isolated from lesions caused by acne, and these micro-organisms are considered to contribute to the inflammation of acne. In the present study, we examined the antimicrobial susceptibilities and resistance mechanisms of P. acnes and S. epidermidis isolated from patients with acne vulgaris in a university hospital in Japan from 2009 to 2010. Additionally, we analysed the relationship between the antimicrobial resistance of P. acnes and the severity of acne vulgaris. Some P. acnes strains (18.8 %; 13/69) were resistant to clindamycin. All strains had a mutation in the 23S rRNA gene, except for one strain that expressed erm(X) encoding a 23S rRNA methylase. Tetracycline-resistant P. acnes strains were found to represent 4.3 % (3/69) of the strains, and this resistance was caused by a mutation in the 16S rRNA gene. Furthermore, three strains with reduced susceptibility to nadifloxacin (MIC = 16 µg ml(-1)) were detected. When analysing the correlation between the antimicrobial resistance of P. acnes and S. epidermidis, more than 80 % of the patients who carried clindamycin-resistant P. acnes also carried clindamycin-resistant S. epidermidis. However, no epidemic strain that exhibited antimicrobial resistance was detected in the P. acnes strains when analysed by PFGE. Therefore, our results suggest that the antimicrobial resistance of P. acnes is closely related to antimicrobial therapy. Additionally, those P. acnes strains tended to be frequently found in severe acne patients rather than in mild acne patients. Consequently, the data support a relationship between using antimicrobial agents and the emergence of antimicrobial resistance.

  2. Disability Identity--Disability Pride

    ERIC Educational Resources Information Center

    Martin, Nicola

    2012-01-01

    This paper discusses a way of thinking about disability which has emerged out of the UK Disabled People's Movement over the last three decades in opposition to the preceding medical model of disability which viewed disability as synonymous with problem. Disabled people are increasingly challenging the notion that their embodiment is inherently…

  3. Learning Disabilities

    MedlinePlus

    ... Enhancing Diversity Find People About NINDS NINDS Learning Disabilities Information Page Table of Contents (click to jump ... Español Additional resources from MedlinePlus What are Learning Disabilities? Learning disabilities are disorders that affect the ability ...

  4. Propionibacterium acnes isolated from lymph nodes of patients with sarcoidosis.

    PubMed

    de Brouwer, Bart; Veltkamp, Marcel; Wauters, Carla A; Grutters, Jan C; Janssen, Rob

    2015-01-01

    Propionibacterium acnes has been repeatedly suggested as a candidate causative agent of sarcoidosis. It is the only microorganism that has been isolated from sarcoid lesions by bacterial culture so far and this has been described in Japanese patients only. We report two non-Japanese patients in whom mediastinoscopy was performed in order to obtain lymph node tissue for histopathology, which was suggestive for sarcoidosis. Bacterial culture of these uncontaminated mediastinal lymph nodes revealed P. acnes in both patients. As shown in these two cases, P. acnes can be isolated from sterile biopsied sarcoid lymph nodes of non-Japanese patients and supports the belief that there is an etiologic link between P. acnes sarcoidosis. Further elucidation could provide an opening to novel strategies using antibiotics for treating sarcoidosis.

  5. A NEW LOTION FOR THE TREATMENT OF ACNE VULGARIS.

    PubMed

    EREAUX, L P

    1965-01-23

    A therapeutic assessment of a new lotion containing methylprednisolone, neomycin, colloidal sulfur and aluminum chlorhydroxide complex (Neo-Medrol Acne Lotion) was carried out on 187 patients suffering from acne vulgaris.Of the 187 patients, 165 showed excellent or good response. Following enthusiastic acceptance of the lotion by the patients in the initial study, a second random study with an additional 134 subjects was undertaken to compare the active lotion with the lotion base alone.The active lotion was superior to the placebo lotion in this study, at a statistically significant level. The overall findings suggest that this lotion is an efficient preparation for the control of acne vulgaris (early and late types) and it also showed promise in the treatment of a few cases of acne rosacea and seborrheic dermatitis facialis.

  6. Propionibacterium acnes isolated from lymph nodes of patients with sarcoidosis.

    PubMed

    de Brouwer, Bart; Veltkamp, Marcel; Wauters, Carla A; Grutters, Jan C; Janssen, Rob

    2015-01-01

    Propionibacterium acnes has been repeatedly suggested as a candidate causative agent of sarcoidosis. It is the only microorganism that has been isolated from sarcoid lesions by bacterial culture so far and this has been described in Japanese patients only. We report two non-Japanese patients in whom mediastinoscopy was performed in order to obtain lymph node tissue for histopathology, which was suggestive for sarcoidosis. Bacterial culture of these uncontaminated mediastinal lymph nodes revealed P. acnes in both patients. As shown in these two cases, P. acnes can be isolated from sterile biopsied sarcoid lymph nodes of non-Japanese patients and supports the belief that there is an etiologic link between P. acnes sarcoidosis. Further elucidation could provide an opening to novel strategies using antibiotics for treating sarcoidosis. PMID:26422574

  7. Effect of Garcinia mangostana on inflammation caused by Propionibacterium acnes.

    PubMed

    Chomnawang, Mullika Traidej; Surassmo, Suvimol; Nukoolkarn, Veena S; Gritsanapan, Wandee

    2007-09-01

    The present study was aimed to investigate the activity of Thai medicinal plants on inflammation caused by Propionibacterium acnes in terms of free radical scavenging and cytokine reducing properties. P. acnes have been recognized as pus-forming bacteria triggering an inflammation in acne. Antioxidant activity was determined by DPPH scavenging and NBT reduction assay. The result showed that Garcinia mangostana possessed the most significant antioxidant activity and reduced reactive oxygen species production. Houttuynia cordata, Eupatorium odoratum, and Senna alata had a moderate antioxidant effect. In addition, Garcinia mangostana extracts could reduce the TNF-alpha production as determined by ELISA. Garcinia mangostana was highly effective in scavenging free radicals and was able to suppress the production of pro-inflammatory cytokines. This study has identified the promising source of anti-inflammatory agent which could be useful in treatment of acne vulgaris.

  8. Autophagy Induced by Intracellular Infection of Propionibacterium acnes

    PubMed Central

    Nakamura, Teruko; Furukawa, Asuka; Uchida, Keisuke; Ogawa, Tomohisa; Tamura, Tomoki; Sakonishi, Daisuke; Wada, Yuriko; Suzuki, Yoshimi; Ishige, Yuki; Minami, Junko; Akashi, Takumi

    2016-01-01

    Background Sarcoidosis is caused by Th1-type immune responses to unknown agents, and is linked to the infectious agent Propionibacterium acnes. Many strains of P. acnes isolated from sarcoid lesions cause intracellular infection and autophagy may contribute to the pathogenesis of sarcoidosis. We examined whether P. acnes induces autophagy. Methods Three cell lines from macrophages (Raw264.7), mesenchymal cells (MEF), and epithelial cells (HeLa) were infected by viable or heat-killed P. acnes (clinical isolate from sarcoid lymph node) at a multiplicity of infection (MOI) of 100 or 1000 for 1 h. Extracellular bacteria were killed by washing and culturing infected cells with antibiotics. Samples were examined by colony assay, electron-microscopy, and fluorescence-microscopy with anti-LC3 and anti-LAMP1 antibodies. Autophagy-deficient (Atg5-/-) MEF cells were also used. Results Small and large (≥5 μm in diameter) LC3-positive vacuoles containing few or many P. acnes cells (LC3-positive P. acnes) were frequently found in the three cell lines when infected by viable P. acnes at MOI 1000. LC3-positive large vacuoles were mostly LAMP1-positive. A few small LC3-positive/LAMP1-negative vacuoles were consistently observed in some infected cells for 24 h postinfection. The number of LC3-positive P. acnes was decreased at MOI 100 and completely abolished when heat-killed P. acnes was used. LC3-positive P. acnes was not found in autophagy-deficient Atg5-/- cells where the rate of infection was 25.3 and 17.6 times greater than that in wild-type Atg5+/+ cells at 48 h postinfection at MOI 100 and 1000, respectively. Electron-microscopic examination revealed bacterial cells surrounded mostly by a single-membrane including the large vacuoles and sometimes a double or multi-layered membrane, with occasional undigested bacterial cells in ruptured late endosomes or in the cytoplasm. Conclusion Autophagy was induced by intracellular P. acnes infection and contributed to intracellular

  9. Guidelines of care for the management of acne vulgaris.

    PubMed

    Zaenglein, Andrea L; Pathy, Arun L; Schlosser, Bethanee J; Alikhan, Ali; Baldwin, Hilary E; Berson, Diane S; Bowe, Whitney P; Graber, Emmy M; Harper, Julie C; Kang, Sewon; Keri, Jonette E; Leyden, James J; Reynolds, Rachel V; Silverberg, Nanette B; Stein Gold, Linda F; Tollefson, Megha M; Weiss, Jonathan S; Dolan, Nancy C; Sagan, Andrew A; Stern, Mackenzie; Boyer, Kevin M; Bhushan, Reva

    2016-05-01

    Acne is one of the most common disorders treated by dermatologists and other health care providers. While it most often affects adolescents, it is not uncommon in adults and can also be seen in children. This evidence-based guideline addresses important clinical questions that arise in its management. Issues from grading of acne to the topical and systemic management of the disease are reviewed. Suggestions on use are provided based on available evidence. PMID:26897386

  10. Guidelines of care for the management of acne vulgaris.

    PubMed

    Zaenglein, Andrea L; Pathy, Arun L; Schlosser, Bethanee J; Alikhan, Ali; Baldwin, Hilary E; Berson, Diane S; Bowe, Whitney P; Graber, Emmy M; Harper, Julie C; Kang, Sewon; Keri, Jonette E; Leyden, James J; Reynolds, Rachel V; Silverberg, Nanette B; Stein Gold, Linda F; Tollefson, Megha M; Weiss, Jonathan S; Dolan, Nancy C; Sagan, Andrew A; Stern, Mackenzie; Boyer, Kevin M; Bhushan, Reva

    2016-05-01

    Acne is one of the most common disorders treated by dermatologists and other health care providers. While it most often affects adolescents, it is not uncommon in adults and can also be seen in children. This evidence-based guideline addresses important clinical questions that arise in its management. Issues from grading of acne to the topical and systemic management of the disease are reviewed. Suggestions on use are provided based on available evidence.

  11. Over-the-counter treatments for acne and rosacea.

    PubMed

    Rosamilia, Lorraine Larsen

    2016-06-01

    Acne and rosacea are common inflammatory processes historically classified in the same disease category, but evolving understanding of their disparate pathophysiology and exacerbating factors have generated an enormous armamentarium of therapeutic possibilities. Patients seek over-the-counter therapies first when managing cutaneous disease; therefore, this review defines ingredients considered to be effective over-the-counter acne and rosacea products, their mechanisms, and safe formulations, including botanical components, oral supplements, and other anecdotal options in this vast skin care domain. PMID:27416314

  12. [Studies on ozone therapy of acne vulgaris].

    PubMed

    Gloor, M; Lipphardt, B A

    1976-02-01

    Ozone therapy using the Vapozone 9, an instrument in normal commercial usage, has been carried out on the forehead of 16 male test persons on 7 consecutive days. Before the treatment began and at the end of the treatment period the skin surface lipids on the unchanged skin (casual level) and two hours after defatting the skin (replacement sum) were taken by direct extraction and analysed by means of thin layer chromatography. The results of these investigations rule out a decrease in the free fatty acids by this therapy. As a result of this finding it may assumed that no desinfecting effect on the corynebacterium acnes and other lipasereleasing microorganisms can be attributed to ozone therapy.

  13. Evolving perspectives on the etiology and pathogenesis of acne vulgaris.

    PubMed

    Eichenfield, Lawrence F; Del Rosso, James Q; Mancini, Anthony J; Cook-Bolden, Fran; Stein Gold, Linda; Desai, Seemal; Weiss, Jonathan; Pariser, David; Zeichner, Joshua; Bhatia, Neal; Kircik, Leon

    2015-03-01

    As the pathophysiology of acne is complex and multifactorial, the continued influx of new basic science and clinical information requires careful analysis before drawing conclusions about what truly contributes to the development and progression of this chronic disease. Our objective is to review the latest evidence and highlight a number of important perspectives on the pathophysiology of acne. An improved understanding of acne pathogenesis should lead to more rational therapy and a better understanding of the role of P acnes opens new perspectives for the development of new treatments and management. Further research may be directed at targeting receptors, adhesion molecules, cytokines, chemokines or other pro-inflammatory targets implicated in the activation of immune detection and response (i.e., toll-like receptors [TLRs], protease-activated receptors [PARs]) that appear to contribute to the pathophysiology of acne. Therapeutic options that reduce the need for topical and/or oral antibiotic therapy for acne are welcome as bacterial resistance to antibiotics is a clinically relevant concern both in the United States and globally.

  14. Quality of life issues for South Africans with acne vulgaris.

    PubMed

    Mosam, A; Vawda, N B; Gordhan, A H; Nkwanyana, N; Aboobaker, J

    2005-01-01

    The adverse effects of acne on the psyche have been established in patients from 'first world' countries. There has been no in depth study in predominantly black patients from Africa addressing this issue. This was a prospective cross-sectional study of acne patients attending a dermatology unit in KwaZulu-Natal, South Africa. A questionnaire was completed and acne graded by the Global Acne Grading scale. Psychological morbidity and quality of life (QOL) were assessed by the General Health Questionnaire and Dermatology Specific Quality of Life Questionnaires, respectively. We found that clinical severity was not associated with patient perception or psychological distress. The QOL measures such as feelings, social activities, performance at work or school, activities of daily living and overall mental health were found to be associated with distress with associated P-values of 0.0002, 0.0168, 0.0032, 0.033 and < 0.0001, respectively. The severity of acne was not associated with psychological distress. Painful and bleeding lesions were associated with distress levels; P = 0.042 and P = 0.019, respectively. In conclusion, South African patients with acne vulgaris suffer significant psychological distress, which affects the quality of their lives. PMID:15663491

  15. Clinical, ultrasound and hormonal markers of androgenicity in acne vulgaris.

    PubMed

    Walton, S; Cunliffe, W J; Keczkes, K; Early, A S; McGarrigle, H H; Katz, M; Reese, R A

    1995-08-01

    Androgenic stimulation of sebaceous glands is an important factor in the development of acne. We examined 36 females (aged 14-34 years), selected because none had received oral contraceptives, anti-androgen therapy, or systemic antibiotics during the previous year, or isotretinoin therapy, prior to their participation in the study. Subjects were divided into groups on the basis of acne severity, as follows: physiological, mild and moderate. Only two patients had polycystic ovaries on ultrasound examination. Seven patients had irregular menses; none had evidence of hirsutism. We found that the severity of acne, based on the acne grade, was highly correlated with the inflammatory lesion count, and less correlated with the sebum excretion rate. Either acne grade or inflammatory lesion count could be related to some of the five androgenic hormone determinants; free testosterone (TESTOS), delta 4 androstenedione (DELTA 4), sex hormone binding globulin (SHBG), dehydroepiandrostenedione sulphate (DHEAS) and dihydrotestosterone (DHT). Multiple linear regression analysis determined the best model for predicting ACNE scores as involving DELTA 4 and DHEAS (positive effects), and SHBG (negative effect), P < 0.005, R2 = 0.36). In none of the patients were the levels of DHEAS or SHBG outside the normal range. The findings in the two patients with polycystic ovaries did not differ significantly from those in the remainder of the patients. PMID:7547392

  16. The role of topical dermocosmetics in acne vulgaris.

    PubMed

    Araviiskaia, E; Dréno, B

    2016-06-01

    Acne is a common chronic inflammatory disease and treatment modalities based on acne severity are well established. The role of dermocosmetics in dermatology, and in particular acne, is becoming more important as more research elucidates the mechanisms of action of products in the pathogenesis of acne. Dermocosmetics have the potential to be used as monotherapy or in combination with medical treatment. Therefore, it has become important for dermatologists to understand dermocosmetics to effectively and appropriately advise patients on their use. The objective of this review was to provide new insights into the role of traditional and novel ingredients in dermocosmetics for the treatment of acne, based on the authors' objective assessment of the published literature. The type of products discussed include: those which have a sebostatic effect, such as topical antioxidants and niacinamide; agents targeting abnormal keratinization, such as salicylic acid, lipo-hydroxy acid, alpha-hydroxy acids, retinol-based products and linoleic acid; agents targeting Propionibacterium acnes, such as lauric acid; and anti-inflammatory agents such as nicotinamide, alpha-linolenic acid and zinc salts. Despite the scientific advances in understanding these cosmetic ingredients, there still remains a lack of rigorous controlled studies in this area. PMID:26916232

  17. Infantile acne: a retrospective study of 16 cases.

    PubMed

    Hello, Muriel; Prey, Sorilla; Léauté-Labrèze, Christine; Khammari, Amir; Dreno, Brigitte; Stalder, Jean-François; Barbarot, Sébastien

    2008-01-01

    Infantile acne is a rare and poorly understood disorder. The objective of this study was to improve our knowledge about the epidemiology and clinical course of infantile acne, and evaluate approaches to treatment. This two-center retrospective study covered the period between 1985 and 2007. Inclusion criteria were: (i) age less than 24 months when lesions appeared; (ii) presence of both inflammatory and noninflammatory lesions; (iii) persistence of lesions for at least 2 months. The data were drawn from clinical and photographic records, followed by administration of a telephone questionnaire to parents. It was proposed that each case be reviewed on the basis of the child's appearance and score on an acne scar clinical grading scale. Sixteen children were included. Nine had a family history of severe adolescent acne. The average duration of disease was 22 months. Two patients had been effectively treated with oral isotretinoin. More than half of the patients exhibited scars. We re-examined five children (average acne scar clinical grading scale score = 12/540). On the basis of the frequency of scarring, and the severity and average duration of lesions, the use of oral retinoids in severe infantile acne warrants evaluation.

  18. Carrier-Based Drug Delivery System for Treatment of Acne

    PubMed Central

    Vyas, Amber; Kumar Sonker, Avinesh

    2014-01-01

    Approximately 95% of the population suffers at some point in their lifetime from acne vulgaris. Acne is a multifactorial disease of the pilosebaceous unit. This inflammatory skin disorder is most common in adolescents but also affects neonates, prepubescent children, and adults. Topical conventional systems are associated with various side effects. Novel drug delivery systems have been used to reduce the side effect of drugs commonly used in the topical treatment of acne. Topical treatment of acne with active pharmaceutical ingredients (API) makes direct contact with the target site before entering the systemic circulation which reduces the systemic side effect of the parenteral or oral administration of drug. The objective of the present review is to discuss the conventional delivery systems available for acne, their drawbacks, and limitations. The advantages, disadvantages, and outcome of using various carrier-based delivery systems like liposomes, niosomes, solid lipid nanoparticles, and so forth, are explained. This paper emphasizes approaches to overcome the drawbacks and limitations associated with the conventional system and the advances and application that are poised to further enhance the efficacy of topical acne formulations, offering the possibility of simplified dosing regimen that may improve treatment outcomes using novel delivery system. PMID:24688376

  19. Staphylococcus epidermidis in the human skin microbiome mediates fermentation to inhibit the growth of Propionibacterium acnes: Implications of probiotics in acne vulgaris

    PubMed Central

    Wang, Yanhan; Kuo, Sherwin; Shu, Muya; Yu, Jinghua; Huang, Stephen; Dai, Ashley; Two, Aimee; Gallo, Richard L.; Huang, Chun-Ming

    2014-01-01

    Increasing evidence demonstrates that commensal microorganisms in the human skin microbiome help fight pathogens and maintain homeostasis of the microbiome. However, it is unclear how these microorganisms maintain biological balance when one of them overgrows. The overgrowth of Propionibacterium acnes (P. acnes), a commensal skin bacterium, has been associated with the progression of acne vulgaris. Our results demonstrate that skin microorganisms can mediate fermentation of glycerol, which is naturally produced in skin, to enhance their inhibitory effects on P. acnes growth. The skin microorganisms, most of which have been identified as Staphylococcus epidermidis (S. epidermidis), in the microbiome of human fingerprints can ferment glycerol and create inhibition zones to repel a colony of overgrown P. acnes. Succinic acid, one of four short-chain fatty acids (SCFAs) detected in fermented media by nuclear magnetic resonance (NMR) analysis, effectively inhibits the growth of P. acnes in vitro and in vivo. Both intralesional injection and topical application of succinic acid to P. acnes-induced lesions markedly suppress the P. acnes-induced inflammation in mice. We demonstrate for the first time that bacterial members in the skin microbiome can undergo fermentation to rein in the overgrowth of P. acnes. The concept of bacterial interference between P. acnes and S. epidermidis via fermentation can be applied to develop probiotics against acne vulgaris and other skin diseases. In addition, it will open up an entirely new area of study for the biological function of the skin microbiome in promoting human health. PMID:24265031

  20. Staphylococcus epidermidis in the human skin microbiome mediates fermentation to inhibit the growth of Propionibacterium acnes: implications of probiotics in acne vulgaris.

    PubMed

    Wang, Yanhan; Kuo, Sherwin; Shu, Muya; Yu, Jinghua; Huang, Stephen; Dai, Ashley; Two, Aimee; Gallo, Richard L; Huang, Chun-Ming

    2014-01-01

    Increasing evidence demonstrates that commensal microorganisms in the human skin microbiome help fight pathogens and maintain homeostasis of the microbiome. However, it is unclear how these microorganisms maintain biological balance when one of them overgrows. The overgrowth of Propionibacterium acnes (P. acnes), a commensal skin bacterium, has been associated with the progression of acne vulgaris. Our results demonstrate that skin microorganisms can mediate fermentation of glycerol, which is naturally produced in skin, to enhance their inhibitory effects on P. acnes growth. The skin microorganisms, most of which have been identified as Staphylococcus epidermidis (S. epidermidis), in the microbiome of human fingerprints can ferment glycerol and create inhibition zones to repel a colony of overgrown P. acnes. Succinic acid, one of four short-chain fatty acids (SCFAs) detected in fermented media by nuclear magnetic resonance (NMR) analysis, effectively inhibits the growth of P. acnes in vitro and in vivo. Both intralesional injection and topical application of succinic acid to P. acnes-induced lesions markedly suppress the P. acnes-induced inflammation in mice. We demonstrate for the first time that bacterial members in the skin microbiome can undergo fermentation to rein in the overgrowth of P. acnes. The concept of bacterial interference between P. acnes and S. epidermidis via fermentation can be applied to develop probiotics against acne vulgaris and other skin diseases. In addition, it will open up an entirely new area of study for the biological function of the skin microbiome in promoting human health.

  1. In vivo treatment of Propionibacterium acnes infection with liposomal lauric acids.

    PubMed

    Pornpattananangkul, Dissaya; Fu, Victoria; Thamphiwatana, Soracha; Zhang, Li; Chen, Michael; Vecchio, James; Gao, Weiwei; Huang, Chun-Ming; Zhang, Liangfang

    2013-10-01

    Propionibacterium acnes (P. acnes) is a Gram-positive bacterium strongly associated with acne infection. While many antimicrobial agents have been used in clinic to treat acne infection by targeting P. acnes, these existing anti-acne agents usually produce considerable side effects. Herein, the development and evaluation of liposomal lauric acids (LipoLA) is reported as a new, effective and safe therapeutic agent for the treatment of acne infection. By incorporating lauric acids into the lipid bilayer of liposomes, it is observed that the resulting LipoLA readily fuse with bacterial membranes, causing effective killing of P. acnes by disrupting bacterial membrane structures. Using a mouse ear model, we demonstrated that the bactericidal property of LipoLA against P. acne is well preserved at physiological conditions. Topically applying LipoLA in a gel form onto the infectious sites leads to eradication of P. acnes bacteria in vivo. Further skin toxicity studies show that LipoLA does not induce acute toxicity to normal mouse skin, while benzoyl peroxide and salicylic acid, the two most popular over-the-counter acne medications, generate moderate to severe skin irritation within 24 h. These results suggest that LipoLA hold a high therapeutic potential for the treatment of acne infection and other P. acnes related diseases.

  2. Efficacy of the addition of salicylic acid to clindamycin and benzoyl peroxide combination for acne vulgaris.

    PubMed

    Akarsu, Sevgi; Fetil, Emel; Yücel, Filiz; Gül, Eylem; Güneş, Ali T

    2012-05-01

    Clindamycin phosphate (CDP), benzoyl peroxide (BPO) and salicylic acid (SA) are known to be effective acne therapy agents depending on their anti-inflammatory and comedolytic properties. The purpose of this study was to investigate the efficacy and tolerability of the addition of SA treatment to CDP and BPO (SA and CDP + BPO) and compare it with CDP + BPO in patients with mild to moderate facial acne vulgaris. Forty-nine patients were enrolled in a 12 week prospective, single-blind, randomized, comparative clinical study. Efficacy was assessed by lesion counts, global improvement, quality of life index and measurements of skin barrier functions. Local side effects were also evaluated. Both combinations were effective in reducing total lesion (TL), inflammatory lesion (IL) and non-inflammatory lesion (NIL) counts. There were statistically significant differences between treatment groups for reductions in NIL counts beyond 2 weeks, IL counts and TL counts throughout the all study weeks, and global improvement scores evaluated by patients and investigator at the end of the study in favor of SA and CDP + BPO treatment when compared to CDP + BPO treatment. Both combinations significantly decreased stratum corneum hydration, although skin sebum values decreased with SA and CDP + BPO treatment. These combinations were also well tolerated except significantly higher frequency of mild to moderate transient dryness in patients applied SA and CDP + BPO. The addition of SA to CDP + BPO treatment demonstrated significantly better and faster results in terms of reductions in acne lesion counts and well tolerated except for higher frequency of mild to moderate transient dryness.

  3. Could thoracoscopic sympathicotomy for hyperhidrosis also improve acne vulgaris?

    PubMed Central

    Gunduz, Ozge; Oznur, Bahar; Han, Serdar

    2014-01-01

    Introduction The aim of this study is to emphasize the therapeutic effect of thoracoscopic sympathicotomy performed at our clinic for facial/scalp hyperhidrosis or blushing on coincidental facial acne vulgaris based on previous reports indicating an association between the sympathetic nerve stimulus, epithelial melanocyte system and sebogenesis. Material and methods The possible therapeutic effects of sympathicotomy on facial acne vulgaris were analyzed in a study design of retrospective review with prospective collection of the data from March 2005 to March 2013. Results Forty-two patients were operated on at our clinic due to facial/scalp hyperhidrosis or blushing and 30 of these also had facial acne vulgaris. However, none harbored a systemic co-morbidity. The patients’ medical history indicated that they had used several medical therapies including topical or systemic antibiotherapies to treat their acne for several years but this had met with limited success and the treatment was stopped in all patients an average of 8 ± 2.4 months prior to the operations. Furthermore, the patients with acne vulgaris also underwent a thoracoscopic sympathicotomy procedure at the second costal head (R2) for hyperhidrosis or blushing. All 30 patients showed marked improvement of their acne grade at the first postoperative month (p < 0.01). Conclusions In this study, the patients’ facial acne vulgaris grade significantly improved after undergoing a sympathicotomy. This can be explained by the possible effect the nervous system had on the epithelial melanocyte system and sebogenesis. However, prospective studies with an increased number of patients are needed to verify our findings. PMID:26336432

  4. The efficacy of topical cyproterone acetate alcohol lotion versus placebo in the treatment of the mild to moderate acne vulgaris: a double blind study.

    PubMed

    Iraji, Fariba; Momeni, Ali; Naji, Seyed Morteza; Siadat, Amir Hossein

    2006-01-01

    Acne is an inflammatory condition of the pilosebaceous unit. One of the essential factors for development of acne lesions is increased sebum excretion that is promoted by androgen. It is shown that oral cyproterone acetate significantly reduces the sebum excretion. In this study we evaluated the efficacy of cyproterone acetate alcohol lotion (CAAL) in the treatment of the mild to moderate acne vulgaris. This was a randomized double-blind clinical trial performed on 86 female patients with mild to moderate acne. They were randomly divided into 3 groups and were treated with 0.5 percent CAAL (n = 30), 1 percent CAAL (n = 13) and placebo (n = 43). They were followed every 15 days for a period of 45 days. Response to treatment was evaluated by the total acne lesions counting (TLC) and acne severity index (ASI) and was analyzed statistically by SPSS program. The efficacy of treatment on TLC was maximum for 1 percent CAAL (90 % reduction in TLC)(P value = 0.000). CAAL at 0.5 percent was able to reduce TLC as high as 80.8 percent during 6 weeks followup. The efficacy of placebo was determined to be 38.5 percent. Regarding TLC, 1 percent CAAL was 2.33 times more effective than placebo. CAAL at 0.5 percent was 2.09 times more effective than placebo in this respect. The efficacy of treatment on ASI was maximum for 1 percent CAAL (88 % reduction in ASI)(P value = 0.000). CAAL at 0.5 percent reduced ASI as much as 79.5 percent during 6 weeks of followup. The efficacy of placebo was calculated to be 9.8 percent in reduction of ASI . Regarding ASI, 1 percent CAAL was 8.97 times more effective than placebo. CAAL at 0.5 percent was 8.06 times more effective than placebo. Regarding the results of this study, we suggest the use of cyproterone acetate alcohol lotion as one of the main treatments for mild-moderate acne in female patients and as an adjuvant treatment for moderate to severe acne vulgaris.

  5. 2010 American Conference on Neutron Scattering (ACNS 2010)

    SciTech Connect

    Billinge, Simon

    2011-06-17

    The ACNS provides a focal point for the national neutron user community to strengthen ties within this diverse group, while at the same time promoting neutron research among colleagues in related disciplines identified as “would-be” neutron users. The American Conference on Neutron Scattering thus serves a dual role as a national user meeting and a scientific meeting. As a venue for scientific exchange, the ACNS showcases recent results and provides forums for scientific discussion of neutron research in diverse fields such as hard and soft condensed matter, liquids, biology, magnetism, engineering materials, chemical spectroscopy, crystal structure, and elementary excitations, fundamental physics and development of neutron instrumentation through a combination of invited talks, contributed talks and poster sessions. As a “super-user” meeting, the ACNS fulfills the main objectives of users' meetings previously held periodically at individual national neutron facilities, with the advantage of a larger and more diverse audience. To this end, each of the major national neutron facilities (NIST, LANSCE, HFIR and SNS) have an opportunity to exchange information and update users, and potential users, of their facility. This is also an appropriate forum for users to raise issues that relate to the facilities. For many of the national facilities, this super-user meeting should obviate the need for separate user meetings that tax the time, energy and budgets of facility staff and the users alike, at least in years when the ACNS is held. We rely upon strong participation from the national facilities. The NSSA intends that the American Conference on Neutron Scattering (ACNS) will occur approximately every two years, but not in years that coincide with the International or European Conferences on Neutron Scattering. The ACNS is to be held in association with one of the national neutron centers in a rotating sequence, with the host facility providing local organization

  6. Acne: a new model of immune-mediated chronic inflammatory skin disease.

    PubMed

    Antiga, E; Verdelli, A; Bonciani, D; Bonciolini, V; Caproni, M; Fabbri, P

    2015-04-01

    Acne is a chronic inflammatory disease of the sebaceous-pilosebaceous unit. Interestingly, inflammation can be detected by histopathological examination and immuohistochemical analysis even in the apparently non-inflammatory acneic lesions, such as comedones. In the last years, it has been clearly demonstrated that acne development is linked to the combination of predisposing genetic factors and environmental triggers, among which a prominent role is played by the follicular colonization by Propionibacterium acnes (P. acnes). P. acnes displays several activities able to promote the development of acne skin lesions, including the promotion of follicular hyperkeratinisation, the induction of sebogenesis, and the stimulation of an inflammatory response by the secretion of proinflammatory molecules and by the activation of innate immunity, that is followed by a P. acnes-specific adaptive immune response. In addition, P. acnes-independent inflammation mediated by androgens or by a neurogenic activation, followed by the secretion in the skin of pro-inflammatory neuropeptides, can occur in acne lesions. In conclusion, acne can be considered as a model of immune-mediated chronic inflammatory skin disease, characterized by an innate immune response that is not able to control P. acnes followed by a Th1-mediated adaptive immune response, that becomes self-maintaining independently from P. acnes itself. PMID:25876146

  7. Investigating the Stability of Benzoyl Peroxide in Over-the-Counter Acne Medications

    ERIC Educational Resources Information Center

    Kittredge, Marina Canepa; Kittredge, Kevin W.; Sokol, Melissa S.; Sarquis, Arlyne M.; Sennet, Laura M.

    2008-01-01

    One of the most commonly used ingredients in over-the-counter acne treatments in cream, gel, and wash form is benzoyl peroxide. It is an anti-bacterial agent that kills the bacterium ("Propionibacterium acne") involved in the formation of acne. The formulation of these products is extremely difficult owing to the instability of benzoyl peroxide.…

  8. CRISPR/cas Loci of Type II Propionibacterium acnes Confer Immunity against Acquisition of Mobile Elements Present in Type I P. acnes

    PubMed Central

    Brüggemann, Holger; Lomholt, Hans B.; Tettelin, Hervé; Kilian, Mogens

    2012-01-01

    Propionibacterium acnes is a skin commensal that occasionally acts as an opportunistic pathogen. The population structure of this species shows three main lineages (I–III). While type I strains are mainly associated with sebaceous follicles of human skin and inflammatory acne, types II and III strains are more often associated with deep tissue infections. We investigated the occurrence and distribution of the clustered regularly interspaced short palindromic repeats (CRISPR) in P. acnes, assessed their immunological memory, and addressed the question if such a system could account for type-specific properties of the species. A collection of 108 clinical isolates covering all known phylotypes of P. acnes was screened for the existence of CRISPR/cas loci. We found that CRISPR loci are restricted to type II P. acnes strains. Sequence analyses of the CRISPR spacers revealed that the system confers immunity to P. acnes-specific phages and to two mobile genetic elements. These elements are found almost exclusively in type I P. acnes strains. Genome sequencing of a type I P. acnes isolate revealed that one element, 54 kb in size, encodes a putative secretion/tight adherence (TAD) system. Thus, CRISPR/cas loci in P. acnes recorded the exposure of type II strains to mobile genetic elements of type I strains. The CRISPR/cas locus is deleted in type I strains, which conceivably accounts for their ability to horizontally acquire fitness or virulence traits and might indicate that type I strains constitute a younger subpopulation of P. acnes. PMID:22479553

  9. [Antibiotics, azelaic acid and benzoyl peroxide in topical acne therapy].

    PubMed

    Fluhr, Joachim W; Degitz, Klaus

    2010-03-01

    Benzoyl peroxide was introduced as a basic treatment already in acne therapy 1934. The mechanism of action is the reduction of anaerobe bacteria by strong oxidation processes. No resistancies have been ever reported. BPO is available in 2.5, 5 and 10 % formulations. Its efficacy is slightly related to the strength of concentrations, but the side effect profile with burning, erythema and desquamation is increasing with concentrations. BPO 5% mostly is efficient enough to control acne of grades I to II according to the Kligman & Plewig classification. BPO my bleach clothes and hair. It is the most costeffective topical drug in acne of grades I-II. Inflammatory acne of the papular-pustular type I-II can also be treated by topical antibiotics such as erythromycin, clindamycin, and, less frequent and today not anymore recommended tetracyclines. Mechanism of action is not alone an antibacterial but anti inflammatory effect. The efficacy and penetration of the topical antibiotics between the groups are similar. Randomized studies have shown that concentrations of 2-4% are equivalent to oral tetracycline and minocycline in mild to moderate acne. Combinatory formulations with BPO and with retinoids enhance the efficacy significantly. Topical antibiotics plus BPO show less bacterial resistancies as topical antibiotics alone. Antibiotics should therefore not be used as monotherapy. Moreover gram negative folliculitis may develop. Azelaic acid is acting as an antimicrobial and can also reduce comedones. It can also be used in pregnancy and during the lactation period.

  10. The development of antibiotic resistance in Propionibacterium acnes.

    PubMed

    Leyden, J; Levy, S

    2001-02-01

    Two separate studies evaluated the ability of a combination topical gel consisting of 5% benzoyl peroxide and 1% clindamycin to reduce facial Propionibacterium acnes counts in vivo and to decrease the development of resistant organisms. In the first study, the combination gel was compared with 3 topical formulations of 1% clindamycin phosphate (gel, lotion, and solution) in 80 individuals. After only 1 week of treatment, a 99.7% reduction from baseline in facial P acnes count was obtained with the combination gel. This was significantly greater (P < .001) than the 30%, 56%, or 62% reduction obtained with the clindamycin gel, lotion, or solution, respectively. After 2 weeks of treatment, the reduction from baseline P acnes counts with the combination gel was increased to 99.9%, which was again significantly greater (P < .001) than that with 1% clindamycin alone, regardless of the formulation. The second study compared the combination gel with 1% clindamycin gel in 79 patients with mild to moderate acne. After 4 weeks of treatment, the combination gel was more effective than clindamycin alone in reducing the total P acnes count, consistent with the previous study. By week 12, an increase in the number of resistant bacteria appeared in samples from patients using clindamycin alone, while counts of resistant bacteria remained stable or declined in those using the combination gel.

  11. [Antibiotics, azelaic acid and benzoyl peroxide in topical acne therapy].

    PubMed

    Fluhr, Joachim W; Degitz, Klaus

    2010-03-01

    Benzoyl peroxide was introduced as a basic treatment already in acne therapy 1934. The mechanism of action is the reduction of anaerobe bacteria by strong oxidation processes. No resistancies have been ever reported. BPO is available in 2.5, 5 and 10 % formulations. Its efficacy is slightly related to the strength of concentrations, but the side effect profile with burning, erythema and desquamation is increasing with concentrations. BPO 5% mostly is efficient enough to control acne of grades I to II according to the Kligman & Plewig classification. BPO my bleach clothes and hair. It is the most costeffective topical drug in acne of grades I-II. Inflammatory acne of the papular-pustular type I-II can also be treated by topical antibiotics such as erythromycin, clindamycin, and, less frequent and today not anymore recommended tetracyclines. Mechanism of action is not alone an antibacterial but anti inflammatory effect. The efficacy and penetration of the topical antibiotics between the groups are similar. Randomized studies have shown that concentrations of 2-4% are equivalent to oral tetracycline and minocycline in mild to moderate acne. Combinatory formulations with BPO and with retinoids enhance the efficacy significantly. Topical antibiotics plus BPO show less bacterial resistancies as topical antibiotics alone. Antibiotics should therefore not be used as monotherapy. Moreover gram negative folliculitis may develop. Azelaic acid is acting as an antimicrobial and can also reduce comedones. It can also be used in pregnancy and during the lactation period. PMID:20482689

  12. Antibacterial activity of Thai herbal extracts on acne involved microorganism.

    PubMed

    Niyomkam, P; Kaewbumrung, S; Kaewnpparat, S; Panichayupakaranant, P

    2010-04-01

    Ethyl acetate and methanol extracts of 18 Thai medicinal plants were investigated for their antibacterial activity against Propionibacterium acnes, Stapylococcus aureus, and S. epidermidis. Thirteen plant extracts were capable of inhibiting the growth of P. acnes and S. epidermidis, while 14 plant extracts exhibited an inhibitory effect on S. aureus. Based on the broth dilution method, the ethyl acetate extract of Alpinia galanga (L.) Wild. (Zingiberaceae) rhizome showed the strongest antibacterial effect against P. acnes, with minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) values of 156.0 and 312.0 microg/mL, respectively. On the basis of bioassay-guided purification, the ethyl acetate extract was isolated to afford the antibacterial active compound, which was identified as 1'-acetoxychavicol acetate (1'-ACA). 1'-ACA had a strong inhibitory effect on P. acnes with MIC and MBC values of 62.0 and 250.0 microg/mL, respectively. Thus, 1'-ACA was used as an indicative marker for standardization of A. galanga extract using high performance liquid chromatography. These results suggest that A. galanga extract could be an interesting agent for further studies on an alternative treatment of acne.

  13. Comparison of fractional microneedling radiofrequency and bipolar radiofrequency on acne and acne scar and investigation of mechanism: comparative randomized controlled clinical trial.

    PubMed

    Min, Seonguk; Park, Seon Yong; Yoon, Ji Young; Suh, Dae Hun

    2015-12-01

    Fractional microneedling radiofrequency (FMR) is one of the promising methods in acne treatment. Moreover, bipolar radiofrequency (BR) generates heat thereby which induces neocollagenosis. FMR may have the potential to be a safe and effective treatment for the patients both with acne and acne scar. This study was performed to compare the efficacy and safety of FMR and BR in acne and acne scar treatment. Furthermore, mechanism of the FMR treatment was investigated through skin tissues obtained from subjects. Twenty subjects with mild-to-moderate acne and acne scars were treated in a split-face manner with FMR and BR. Two sessions of treatment was done 4 weeks apart in a total 12-week prospective single-blind, randomized clinical trial. Clinical assessment and sebum measurement were carried out for the evaluation of efficacy and safety. Skin tissues were acquired for investigation of molecular changes. FMR was more effective for acne scar especially in icepick and boxcar scar compared to BR. Both inflammatory and non-inflammatory acne lesions decreased by 80 and 65 % in the FMR-treated side at the final visit of 12 weeks, respectively. FMR treatment resulted in significant reduction of sebum excretion. Both treatments showed no severe adverse effects other than erythema. The FMR showed superior efficacy in acne and acne scar compared with BR. Increased expression of TGFβ and collagen I and decreased expression of NF-κB, IL-8 are suggested to involve in the improvement of acne scar and acne lesion by FMR. PMID:26472097

  14. Comparison of fractional microneedling radiofrequency and bipolar radiofrequency on acne and acne scar and investigation of mechanism: comparative randomized controlled clinical trial.

    PubMed

    Min, Seonguk; Park, Seon Yong; Yoon, Ji Young; Suh, Dae Hun

    2015-12-01

    Fractional microneedling radiofrequency (FMR) is one of the promising methods in acne treatment. Moreover, bipolar radiofrequency (BR) generates heat thereby which induces neocollagenosis. FMR may have the potential to be a safe and effective treatment for the patients both with acne and acne scar. This study was performed to compare the efficacy and safety of FMR and BR in acne and acne scar treatment. Furthermore, mechanism of the FMR treatment was investigated through skin tissues obtained from subjects. Twenty subjects with mild-to-moderate acne and acne scars were treated in a split-face manner with FMR and BR. Two sessions of treatment was done 4 weeks apart in a total 12-week prospective single-blind, randomized clinical trial. Clinical assessment and sebum measurement were carried out for the evaluation of efficacy and safety. Skin tissues were acquired for investigation of molecular changes. FMR was more effective for acne scar especially in icepick and boxcar scar compared to BR. Both inflammatory and non-inflammatory acne lesions decreased by 80 and 65 % in the FMR-treated side at the final visit of 12 weeks, respectively. FMR treatment resulted in significant reduction of sebum excretion. Both treatments showed no severe adverse effects other than erythema. The FMR showed superior efficacy in acne and acne scar compared with BR. Increased expression of TGFβ and collagen I and decreased expression of NF-κB, IL-8 are suggested to involve in the improvement of acne scar and acne lesion by FMR.

  15. Disability retirement

    NASA Technical Reports Server (NTRS)

    Eck, R. L.

    1975-01-01

    Eligibility for disability retirement is discussed. General guidelines and a few standards are given. Usually the same basic medical principles apply to the evaluation of claims for disability retirement as apply to determining medical suitability for initial employment.

  16. Strategic Targets in Acne: The Comedone Switch in Question.

    PubMed

    Saurat, Jean-Hilaire

    2015-01-01

    The sequence of events and mechanisms leading to the development of the primary acne lesion, the comedone, is revisited. Recent knowledge obtained both from lineage tracing experiments in the mouse and the pilosebaceous response to xenobiotics in humans provides robust models for further understanding key biological events at the cellular roots of comedogenesis. The focus is set on the LRIG1+ sebaceous stem cells in the isthmus of the pilosebaceous duct. The master switch that transforms a normally functioning sebaceous gland into a microcomedone and the hierarchy of factors involved in this process are reviewed. The key strategic target in acne care appears to be the naïve pilosebaceous follicle that is not involved yet in the acne cycle. The prevention of the comedone switch implies that the key switching factors are adequately controlled in the long term. PMID:26113292

  17. Newer approaches to the treatment of acne vulgaris.

    PubMed

    Simonart, Thierry

    2012-12-01

    The multifactorial etiology of acne vulgaris makes it challenging to treat. Current treatments include topical retinoids, benzoyl peroxide, topical and systemic antibiotics, azelaic acid, and systemic isotretinoin. Adjunctive and/or emerging approaches include topical dapsone, taurine bromamine, resveratrol, chemical peels, optical treatments, as well as complementary and alternative medications. The purpose of this paper is to discuss the therapies available for acne and their latest developments, including new treatment strategies (i.e. re-evaluation of the use of oral antibiotics and avoidance of topical antibiotic monotherapy, use of subantimicrobial antibiotic dosing, use of low-dose isotretinoin, optical treatments), new formulations (microsponges, liposomes, nanoemulsions, aerosol foams), new combinations (fixed-combination products of topical retinoids and topical antibiotics [essentially clindamycin] or benzoyl peroxide), new agents (topical dapsone, taurine bromamine, resveratrol) and their rationale and likely place in treatment. Acne vaccines, topical natural antimicrobial peptides, and lauric acid represent other promising therapies. PMID:22920095

  18. Study of lipid profile in adult women with acne

    PubMed Central

    da Cunha, Marisa Gonzaga; Batista, Anna Luiza Fonseca; Macedo, Marzia Silva; Machado Filho, Carlos D’Aparecida Santos; Fonseca, Fernando Luiz Affonso

    2015-01-01

    Objective The aim of this study was to establish the lipid profile of female patients with acne in the Acne-in-Adult-Women Ambulatory Care Clinic in order to observe the prevalence of dyslipidemia in those patients. Methods This is a retrospective transversal study that evaluated the medical records of 416 patients who attended at the Acne-in-Adult-Women Ambulatory Care Clinic, at the Dermatology Department, Faculdade de Medicina do ABC, Santo André, São Paulo, Brazil, in the year 2012. Relevant data included age and clinical classification of acne. The lipid profile was analyzed according to the results of laboratory tests ordered during outpatient visits, which included total and fractionated cholesterol levels and triglycerides. Results The epidemiological study sample was of 219 patients, with ages ranging from 21 to 61 years (mean of 32.23 years). The predominant clinical grade was papule-pustule acne (grade II) with 156 patients (71%). Regarding the lipid profile of the patients, there was a high increase in total cholesterol levels in 17.35% of the cases. High-density lipoprotein levels were low in 11.42% of the patients, with normal prevalence in 194 subjects. Low-density lipoprotein levels were normal in most patients (60.27%). Very-low-density lipoprotein values were normal in almost all patients (94.06%) and increased in only 13 patients (5.94%). Only 18 patients presented high levels of triglycerides (8.22%). Conclusion The conclusion was that patients with grades II and III acne are more likely to have total cholesterol and low-density lipoprotein altered. A correct and early diagnosis can be an important measure for the prevention of the metabolic syndrome in these patients. PMID:26316790

  19. Photopneumatic Technology in Acne Treatment and Skin Rejuvenation: Histological Assessment

    PubMed Central

    Omi, Tokuya

    2012-01-01

    Background and Aims: Recent reports indicate that a variety of light-based devices have been used for acne treatment and skin rejuvenation. A new technology combining intense pulsed light with negative pressure, photopneumatic technology, has recently attracted interest. The present study assessed acne treatment and skin rejuvenation with this novel approach Subjects and Methods: Acne, 450 nm tip. Five Japanese volunteers (1 male, 4 female; mean age 28.6 yr; skin type III) with mild to moderate/moderate active acne participated. The face was treated with 2 sessions, 2 weeks apart. Biopsies were obtained immediately after the first session and 1 week after the second session, and routinely processed for transmission electron microscopy (TEM). Rejuvenation, profusion tip with topical preparation. In 5 Japanese volunteers (3 male, 2 female; mean age 37.6 yr, skin type III), the volar aspect of both forearms was treated with the 530 nm head at P6 (around 12 J/cm2). The left arm was then treated with a pre-infused profusion tip and vacuum only. Four sessions were given, 14-day intervals. Biopsies were taken from both arms 2 weeks after the 2nd session and 3 weeks after the 4th session. One-half of each biopsy was assessed with histo-and immunohistochemistry, and the other with TEM. Results Acne trial: A combination of physical extraction of comedones, mild photothermal damage of the follicle and damage to identified bacilli was noted post-treatment, with macroscopic improvement of the skin. Rejuvenation with profusion: Significant morphological and immunohistochemical differences were seen between the control and profusion-treated arms at the first assessment. These differences became less significant at the 2nd assessment. Conclusions Macroscopically and histologically, photopneumatic technology improved acne lesions, suggesting a synergistic effect between the components of the technology. In skin rejuvenation, the profusion therapy accelerated the regenerative

  20. The use of photodynamic therapy for treatment of acne vulgaris.

    PubMed

    Nestor, Mark S

    2007-01-01

    Current topical and most oral therapies for acne vulgaris have limited efficacy, especially in moderate to severe cases. Photodynamic therapy with 5-aminolevulinic acid and recently methyl aminolevulinate has been shown to be a safe and effective modality for the treatment of acne vulgaris. Consensus guidelines suggest that 30 to 60 minutes is sufficient 5-aminolevulinic acid contact time before photoactivation with blue light, red light, yellow light, broadband light, halogen, or pulsed dye laser devices. An average of three treatment can yield significant long-term improvement. PMID:17126741

  1. [Acne therapy with topical benzoyl peroxide, antibiotics and azelaic acid].

    PubMed

    Worret, Wolf-Ingo; Fluhr, Joachim W

    2006-04-01

    Benzoyl peroxide (BPO) was introduced in the treatment of acne in 1934. Despite the fact that only few randomized trials have been published, BPO is considered the standard in topical acne treatment. Anaerobic bacteria are reduced by oxidative mechanisms and the induction of resistant strains is reduced. Topical formulations are available at concentrations of 2.5, 5, 10 and 20 %. The effect is dose-dependent, but the irritation increases with higher concentrations. Usually 5 % BPO is sufficient to control acne grade I-II. Due to its strong oxidative potential, patients should be advised that BPO may bleach colored and dark clothing, bedding and even hair. BPO is safe for use in pregnant and lactating females because it is degraded to benzoic acid. It is a cost-effective treatment for acne grade I-II. Patients with papulopustular acne grade I-II, particularly with marked inflammation, show satisfactory improvement with topical antibiotic treatment. The following compounds are available and effective: erythromycin, clindamycin and tetracycline (the latter being less frequently used). A review in 1990 suggested that topical tetracycline was ineffective in the treatment of acne. Along with eliminating Propionibacterium acnes, the main mechanism of topical antibiotics is their antiinflammatory effect. All three penetrate the epidermal barrier well and are similarly efficacious. Randomized trials have shown that in concentrations of 2-4 %, their effects are comparable to oral tetracycline and minocycline. Combination therapy with retinoids or benzoyl peroxide (BPO) increases efficacy. Retinoids increase penetration and reduce comedones, while topical antibiotics primarily address inflammation. One side effect of topical antibacterial treatment is an increase in drug-resistant resident skin flora with gram-negative microorganisms prevailing, which can lead to gram-negative folliculitis. All three antibiotics fluoresce under black light which may produce interesting

  2. Turning acne on/off via mTORC1

    PubMed Central

    Danby, F William

    2013-01-01

    Over the past 10 years, the increase in comprehension of the mechanisms behind acne has been truly exponential. Starting with the ethnological work of Cordain, accelerated by the epidemiological work of Adebamowo, supported by the clinical trials of Smith and Mann, Kwon, DiLandro and others, the interface of diet and acne is coming into focus. Melnik now presents an exceptional pair of papers that illustrate for dermatologists what translational research is all about. The Western diet, the role of dairy, FoxO1 and mTORC1, the interplay of agonists and antagonists, therapeutics present and future – the jigsaw puzzle is coming together. PMID:23800069

  3. [Acne therapy with topical benzoyl peroxide, antibiotics and azelaic acid].

    PubMed

    Worret, Wolf-Ingo; Fluhr, Joachim W

    2006-04-01

    Benzoyl peroxide (BPO) was introduced in the treatment of acne in 1934. Despite the fact that only few randomized trials have been published, BPO is considered the standard in topical acne treatment. Anaerobic bacteria are reduced by oxidative mechanisms and the induction of resistant strains is reduced. Topical formulations are available at concentrations of 2.5, 5, 10 and 20 %. The effect is dose-dependent, but the irritation increases with higher concentrations. Usually 5 % BPO is sufficient to control acne grade I-II. Due to its strong oxidative potential, patients should be advised that BPO may bleach colored and dark clothing, bedding and even hair. BPO is safe for use in pregnant and lactating females because it is degraded to benzoic acid. It is a cost-effective treatment for acne grade I-II. Patients with papulopustular acne grade I-II, particularly with marked inflammation, show satisfactory improvement with topical antibiotic treatment. The following compounds are available and effective: erythromycin, clindamycin and tetracycline (the latter being less frequently used). A review in 1990 suggested that topical tetracycline was ineffective in the treatment of acne. Along with eliminating Propionibacterium acnes, the main mechanism of topical antibiotics is their antiinflammatory effect. All three penetrate the epidermal barrier well and are similarly efficacious. Randomized trials have shown that in concentrations of 2-4 %, their effects are comparable to oral tetracycline and minocycline. Combination therapy with retinoids or benzoyl peroxide (BPO) increases efficacy. Retinoids increase penetration and reduce comedones, while topical antibiotics primarily address inflammation. One side effect of topical antibacterial treatment is an increase in drug-resistant resident skin flora with gram-negative microorganisms prevailing, which can lead to gram-negative folliculitis. All three antibiotics fluoresce under black light which may produce interesting

  4. Acne in Klinefelter Syndrome-46XY/47XXY Mosaicism?

    PubMed

    Lakshmi, Chembolli; Swarnalakshimi, Selvaraj

    2015-01-01

    Klinefelter syndrome (KFS) is the most common non-heritable sex chromosome anomaly caused by nondisjunction during cell division and contains two or more X chromosomes. More than two third of all cases are homogenous (47XXY) and the remaining are mosaic (46XY/47XXY). Lower limb ulcers are frequently observed and attributed to impaired fibrinolysis. A case of KFS with post acne scars and leg ulcers is presented. The rarity of acne in this syndrome is explained by the phenomenon of mosaicism. PMID:26538700

  5. What is the role of antimicrobial peptides (AMP) in acne vulgaris?

    PubMed

    Harder, Jürgen; Tsuruta, Daisuke; Murakami, Masamoto; Kurokawa, Ichiro

    2013-06-01

    Acne vulgaris is the most common disorder of the pilosebaceous unit leading to inflamed skin characterized by the formation of comedones, papules, pustules and scarring. There is increasing evidence that the abundance of Propionibacterium acnes (P. acnes) in the inflamed acne lesions triggers inflammation. Therefore, in addition to treatment with retinoids, the use of antimicrobial agents has been established as a treatment option for acne. This indicates that antimicrobial mechanisms to control the growth of P. acnes may have an important influence on the severity of inflammatory acne. One import antimicrobial innate defense system comprises the production of antimicrobial peptides (AMP), small molecules with a broad spectrum of antimicrobial activity as well as immunomodulatory properties. Although the role of AMP in acne is still emerging, there is increasing evidence that AMP may be of importance in acne. The aim of this viewpoint is to provide some hypotheses about the potential function of AMP in the pathogenesis of acne and to discuss potential AMP-based therapies for the treatment of acne.

  6. Exploring Valrubicin's Effect on Propionibacterium Acnes-Induced Skin Inflammation in Vitro and in Vivo

    PubMed Central

    Rottboell, Louise; de Foenss, Sarah; Thomsen, Kenneth; Christiansen, Helle; Andersen, Stine M.; Dam, Tomas N.; Rosada, Cecilia

    2015-01-01

    Acne is a common skin disease involving colonization with Propionibacterium acnes (P. acnes), hyperproliferation of the follicular epithelium and inflammatory events. Valrubicin is a second-generation anthracycline, non-toxic upon contact, and available in a topical formulation. Valrubicin’s predecessor doxorubicin possesses antibacterial effects and previously we demonstrated that valrubicin inhibits keratinocyte proliferation and skin inflammation suggesting beneficial topical treatment of acne with valrubicin. This study aims to investigate valrubicin’s possible use in acne treatment by testing valrubicin’s antibacterial effects against P. acnes and P. acnes-induced skin inflammation in vitro and in vivo. Valrubicin was demonstrated not to possess antibacterial effects against P. acnes. Additionally, valrubicin was demonstrated not to reduce mRNA and protein expression levels of the inflammatory markers interleukin (IL)-1β, IL-8, and tumor necrosis factor (TNF)-α in vitro in human keratinocytes co-cultured with P. acnes. Moreover, in vivo, valrubicin, applied both topically and intra-dermally, was not able to reduce signs of inflammation in mouse ears intra-dermally injected with P. acnes. Taken together, this study does not support beneficial antibacterial and anti inflammatory effects of topical valrubicin treatment of acne. PMID:26734122

  7. Porphyrin Metabolisms in Human Skin Commensal Propionibacterium acnes Bacteria: Potential Application to Monitor Human Radiation Risk

    PubMed Central

    Shu, M.; Kuo, S.; Wang, Y.; Jiang, Y.; Liu, Y.-T.; Gallo, R.L.; Huang, C.-M.

    2013-01-01

    Propionibacterium acnes (P. acnes), a Gram-positive anaerobic bacterium, is a commensal organism in human skin. Like human cells, the bacteria produce porphyrins, which exhibit fluorescence properties and make bacteria visible with a Wood’s lamp. In this review, we compare the porphyrin biosynthesis in humans and P. acnes. Also, since P. acnes living on the surface of skin receive the same radiation exposure as humans, we envision that the changes in porphyrin profiles (the absorption spectra and/or metabolism) of P. acnes by radiation may mirror the response of human cells to radiation. The porphyrin profiles of P. acnes may be a more accurate reflection of radiation risk to the patient than other biodosimeters/biomarkers such as gene up-/down-regulation, which may be non-specific due to patient related factors such as autoimmune diseases. Lastly, we discuss the challenges and possible solutions for using the P. acnes response to predict the radiation risk. PMID:23231351

  8. Risk factors, psychological impacts and current treatments of acne in Shanghai area of China.

    PubMed

    Wang, Peiru; Wang, Hongwei; Ding, Huilin; Lv, Ting; Miao, Fei; Li, Jingjing; Shi, Lei; Wang, Xiuli

    2016-01-01

    Acne is one complex skin disorders, which can lead to adverse psychological effects. Multiple factors are correlated with risk of acne and several treatments have been explored. The prevalence and risk factors are suspected to be varied in different populations with different genetic backgrounds and lifestyle. Therefore, this study investigated the risk factors, psychological impacts and current treatments of acne in Shanghai area of China by a retrospective questionnaire study. This study showed that the subjects with family history (especially paternal history) were prone to develop severe acne (p<0.001). Besides, patients with severe acne might exhibit more severe psychological disorders (p<0.001). The most frequently used methods were pharmacological treatments. These results indicate that acne is prone to induce severe psychological disorders, and could be affected by multiple factors. Furthermore, these results provide valuable reference for exploring the preventive measures and treatments of acne in Shanghai area of China.

  9. Impact of acne vulgaris on quality of life and self-esteem.

    PubMed

    Hosthota, Abhineetha; Bondade, Swapna; Basavaraja, Vinay

    2016-08-01

    The psychological impact of acne is determined by various factors including age, sex, personality, grade of disease, scarring, and environmental and ethnic background. Apart from managing the clinical manifestations of acne, clinicians also have to deal with the psychological aspects of the disease by assessing patients' quality of life (QOL) and self-esteem. These measures will aid in better management of acne patients. This study examined the relationship between acne and QOL and self-esteem. The results showed that acne severity may have a considerable adverse impact on QOL and self-esteem. Dermatologists need to emphasize the psychosocial sequelae of acne through awareness programs and encourage medical treatment along with basic psychosomatic remedies in the management of acne.

  10. Cosmeceuticals based on Rhealba(®) Oat plantlet extract for the treatment of acne vulgaris.

    PubMed

    Fabbrocini, G; Saint Aroman, M

    2014-12-01

    Recent evidence suggests that acne vulgaris begins as an inflammation in and around the sebaceous gland and alterations in the lipid content of sebum, which drive hyperproliferation and increased desquamation of keratinocytes within sebaceous follicles. This prevents sebum drainage, causing the formation of microcomedones, which spontaneously regress or become acne lesions when the pilosebaceous unit is further blocked by the accumulation of corneocytes. These conditions are favourable for the proliferation of Propionibacterium acnes, which further aggravates acne by enhancing abnormal desquamation, sebum production and inflammation. Also, skin fragility due to inflammation or irritation by anti-comedogenic agents can worsen the situation. Rhealba(®) Oat plantlet extract (Pierre Fabre Dermo Cosmetique) soothes and restores fragile skin in acne by reducing inflammation and inhibits bacterial adhesion of Propionibacterium acnes. Cosmeceuticals combining Rhealba(®) Oat plantlet extract and hydro-compensating actives, which are available with or without anti-comedogenic hydroxy acids, provide a balanced, multifaceted approach for acne patients.

  11. Impact of acne vulgaris on quality of life and self-esteem.

    PubMed

    Hosthota, Abhineetha; Bondade, Swapna; Basavaraja, Vinay

    2016-08-01

    The psychological impact of acne is determined by various factors including age, sex, personality, grade of disease, scarring, and environmental and ethnic background. Apart from managing the clinical manifestations of acne, clinicians also have to deal with the psychological aspects of the disease by assessing patients' quality of life (QOL) and self-esteem. These measures will aid in better management of acne patients. This study examined the relationship between acne and QOL and self-esteem. The results showed that acne severity may have a considerable adverse impact on QOL and self-esteem. Dermatologists need to emphasize the psychosocial sequelae of acne through awareness programs and encourage medical treatment along with basic psychosomatic remedies in the management of acne. PMID:27622255

  12. Glycolic acid chemical peeling improves inflammatory acne eruptions through its inhibitory and bactericidal effects on Propionibacterium acnes.

    PubMed

    Takenaka, Yuko; Hayashi, Nobukazu; Takeda, Mikiko; Ashikaga, Sayaka; Kawashima, Makoto

    2012-04-01

    Glycolic acid chemical peeling is effective for treating comedones, and some clinical data show that it also improves inflammatory eruptions. The purpose of this study was to identify the mechanism of glycolic acid chemical peeling to improve inflammatory acne. To assess growth inhibitory and bactericidal effects of glycolic acid on Propionibacterium acnes in vitro, we used an agar diffusion method and a time-kill method. To reveal bactericidal effects in vivo, we established an agar-attached method which correlated well with the ordinary swab-wash method, and we used the agar-attached method to compare the numbers of propionibacteria on the cheek treated with glycolic acid chemical peeling. Our results show that 30% glycolic acid (at pH 1.5, 3.5 and 5.5) formed growth inhibitory circles in the agar diffusion method, but the diameters of those circles were smaller than with 1% nadifloxacin lotion or 1% clindamycin gel. In the time-kill method, 30% glycolic acid (at pH 1.5 and 3.5) or 1% nadifloxacin lotion reduced the number of P. acnes to less than 100 CFU/mL within 5 min. In contrast, in 30% glycolic acid (at pH 5.5) or in 1% clindamycin gel, P. acnes survived for more than 4 h. Chemical peeling with 35% glycolic acid (at pH 1.2) decreased the number of propionibacteria on the cheeks of patients compared with untreated controls (P < 0.01). Our results demonstrate that glycolic acid has moderate growth inhibitory and bactericidal effects on P. acnes, and that chemical peeling with glycolic acid works on inflammatory acne via those effects. PMID:21950544

  13. Glycolic acid chemical peeling improves inflammatory acne eruptions through its inhibitory and bactericidal effects on Propionibacterium acnes.

    PubMed

    Takenaka, Yuko; Hayashi, Nobukazu; Takeda, Mikiko; Ashikaga, Sayaka; Kawashima, Makoto

    2012-04-01

    Glycolic acid chemical peeling is effective for treating comedones, and some clinical data show that it also improves inflammatory eruptions. The purpose of this study was to identify the mechanism of glycolic acid chemical peeling to improve inflammatory acne. To assess growth inhibitory and bactericidal effects of glycolic acid on Propionibacterium acnes in vitro, we used an agar diffusion method and a time-kill method. To reveal bactericidal effects in vivo, we established an agar-attached method which correlated well with the ordinary swab-wash method, and we used the agar-attached method to compare the numbers of propionibacteria on the cheek treated with glycolic acid chemical peeling. Our results show that 30% glycolic acid (at pH 1.5, 3.5 and 5.5) formed growth inhibitory circles in the agar diffusion method, but the diameters of those circles were smaller than with 1% nadifloxacin lotion or 1% clindamycin gel. In the time-kill method, 30% glycolic acid (at pH 1.5 and 3.5) or 1% nadifloxacin lotion reduced the number of P. acnes to less than 100 CFU/mL within 5 min. In contrast, in 30% glycolic acid (at pH 5.5) or in 1% clindamycin gel, P. acnes survived for more than 4 h. Chemical peeling with 35% glycolic acid (at pH 1.2) decreased the number of propionibacteria on the cheeks of patients compared with untreated controls (P < 0.01). Our results demonstrate that glycolic acid has moderate growth inhibitory and bactericidal effects on P. acnes, and that chemical peeling with glycolic acid works on inflammatory acne via those effects.

  14. From new findings in acne pathogenesis to new approaches in treatment.

    PubMed

    Gollnick, H P M

    2015-06-01

    Acne is a chronic disease of the pilosebaceous unit which is most common during adolescence. Four factors are believed to play a key role in the development of acne lesions: excess sebum production, disturbed keratinization within the follicle, colonization of the pilosebaceous duct by Propionibacterium acnes, and the release of inflammatory mediators into the skin. Consequently, in order to effectively and rapidly reduce acne lesions, treatments need to address as many of these underlying factors as possible. Currently, about half of patients have poor adherence to acne treatments. To overcome this limitation, treatments need to be developed which are well tolerated by patients, and easy for them to use, handle and apply. Topical monotherapies for acne such as retinoids and antimicrobials by themselves have a restricted range of actions against the pathogenic factors of acne. Instead, the Global Alliance to Improve Outcomes in Acne Group recommends combination therapy with a topical retinoid and an antimicrobial agent as the preferred approach for almost all acne patients. The principal advantage of such combinations is that they target more of the underlying pathogenic factors of acne than individual monotherapies and this results in faster and more complete clearing of acne lesions. Fixed-dose combinations are also more convenient than applying two medications separately, which leads to improved adherence with the regimen. By normalizing desquamation, the retinoid component of these combinations allows entry of the antimicrobial agent into the pilosebaceous unit resulting in faster clearance of P. acnes. In conclusion, topical retinoid/antimicrobial fixed-dose combinations represent a rational approach for the treatment of acne. They should be considered as the cornerstone of acne management and should be used much more in the future.

  15. Improving diagnostic criteria for Propionibacterium acnes osteomyelitis: a retrospective analysis.

    PubMed

    Asseray, Nathalie; Papin, Christophe; Touchais, Sophie; Bemer, Pascale; Lambert, Chantal; Boutoille, David; Tequi, Brigitte; Gouin, François; Raffi, François; Passuti, Norbert; Potel, Gilles

    2010-07-01

    The identification of Propionibacterium acnes in cultures of bone and joint samples is always difficult to interpret because of the ubiquity of this microorganism. The aim of this study was to propose a diagnostic strategy to distinguish infections from contaminations. This was a retrospective analysis of all patient charts of those patients with >or=1 deep samples culture-positive for P. acnes. Every criterion was tested for sensitivity, specificity, and positive likelihood ratio, and then the diagnostic probability of combinations of criteria was calculated. Among 65 patients, 52 (80%) were considered truly infected with P. acnes, a diagnosis based on a multidisciplinary process. The most valuable diagnostic criteria were: >or=2 positive deep samples, peri-operative findings (necrosis, hardware loosening, etc.), and >or=2 surgical procedures. However, no single criterion was sufficient to ascertain the diagnosis. The following combinations of criteria had a diagnostic probability of >90%: >or=2 positive cultures + 1 criterion among: peri-operative findings, local signs of infection, >or=2 previous operations, orthopaedic devices; 1 positive culture + 3 criteria among: peri-operative findings, local signs of infection, >or=2 previous surgical operations, orthopaedic devices, inflammatory syndrome. The diagnosis of P. acnes osteomyelitis was greatly improved by combining different criteria, allowing differentiation between infection and contamination.

  16. Indocyanine green-laser thermolysis of acne vulgaris

    NASA Astrophysics Data System (ADS)

    Genina, Elina A.; Bashkatov, Alexey N.; Simonenko, Georgy V.; Tuchin, Valery V.; Yaroslavsky, Ilya V.; Altshuler, Gregory B.

    2005-08-01

    The near-infrared (NIR) laser radiation due to its high penetration depth is widely used in phototherapy and photothermolysis. In application to skin appendages a high selectivity of laser treatment is needed to prevent light action on surrounding tissues. Indocyanine Green (ICG) dye may provide a high selectivity of treatment due to effective ICG uploading by a target and its narrow band of considerable absorption just at the wavelength of the NIR diode laser. The goal of this study is to demonstrate the efficacy of the NIR diode laser photothermolysis in combination with topical application of ICG suggested for treatment of acne vulgaris. Two volunteers with back-located acne were enrolled. Skin sites of subjects were stained by ICG and irradiated by NIR laser-diode light (803 or 809 nm). The individual acne lesions were photothermally treated at 18 W/cm2 (803 nm, 0.5 sec) without skin surface cooling or at 200 W/cm2 (809 nm, 0.5 sec) with cooling. The results of the observations during a month after the treatment have shown that ICG stained acne inflammatory elements were destructed for light exposures of 0.5 sec.

  17. Gallium-67-citrate uptake in a case of acne vulgaris

    SciTech Connect

    Kipper, M.S.; Taylor, A.; Ashburn, W.L.

    1981-09-01

    A case of increased Ga-67 uptake in a patient with active acne vulgaris is reported. The scan was requested in a search for metastatic testicular carcinoma or bleomycin pulmonary toxicity. Careful clinical evaluation including physical examination was necessary in order to avoid an erroneous scan interpretation.

  18. Multimodal management of atrophic acne scarring in the aging face.

    PubMed

    O'Daniel, T Gerald

    2011-12-01

    Atrophic facial acne scarring is a widely prevalent condition that can have a negative impact on a patient's quality of life. The appearance of these scars is often worsened by the normal effects of aging. A number of options are available for the treatment of acne scarring, including chemical peeling, dermabrasion, ablative or nonablative laser resurfacing, dermal fillers, and surgical techniques such as subcision or punch excision. Depending on the type and extent of scarring, a multimodal approach is generally necessary to provide satisfactory results. Resurfacing techniques correct surface irregularities, long-lasting dermal fillers address the volume loss resulting from acne, and sub-superficial musculoaponeurotic system (SMAS) face-lift procedures counter the soft tissue laxity and ptosis associated with aging. This article briefly reviews the evolution of individual approaches to treating atrophic acne scarring, followed by case examples illustrating results that can be achieved using a multimodal approach. Representative cases from patients in their 30s, 40s, and 50s are presented. In the author's clinical practice, multimodal approaches incorporating fractionated laser, injectable poly-L: -lactic acid, and sub-SMAS face-lift procedures have achieved optimal aesthetic outcomes, high patient satisfaction, and durability of aesthetic effect over time. PMID:21491169

  19. Does isotretinoin therapy of acne cure or cause depression?

    PubMed

    Borovaya, Alena; Olisova, Olga; Ruzicka, Thomas; Sárdy, Miklós

    2013-09-01

    Cosmetic defects in acne may provoke a wide range of mental disorders (depressive, social-phobic, etc.). Isotretinoin is a very effective acne treatment; hence, it usually resolves the associated mental disorders. However, more available data show the possible association of taking isotretinoin and the onset of a depressive syndrome that includes frank depression and even suicidal ideation. The frequency of depressive disorders during isotretinoin treatment varies from 1% to 11% in different studies, and it is unclear whether this is a consequence of isotretinoin therapy. Since it crosses the blood-brain barrier, isotretinoin affects the expression of a broad spectrum of genes in the limbic structures, thus affecting the function of the dopaminergic, serotonergic, and noradrenergic neurons involved in the regulation of mood and emotion. It was suggested that isotretinoin in high concentrations inhibits hippocampal neurogenesis and induces apoptosis of hippocampal cells. However, some studies do not confirm this pathogenic role, and isotretinoin was even reported to have a therapeutic effect in acne-associated depression. In this review, we highlight epidemiological data, the underlying molecular pathogenesis, and the aspects of prevention concerning retinoid-induced depression in acne from the practical point of view of a dermatologist.

  20. Selected Disorders of Skin Appendages--Acne, Alopecia, Hyperhidrosis.

    PubMed

    Vary, Jay C

    2015-11-01

    This article reviewed some of the more common diseases of the skin appendages that are encountered in medicine: hyperhidrosis, acne, AA, FPHL, AGA, and TE. The pathophysiology behind the conditions and their treatments were discussed so that the clinician can make logical therapeutic choices for their affected patients.

  1. Improving diagnostic criteria for Propionibacterium acnes osteomyelitis: a retrospective analysis.

    PubMed

    Asseray, Nathalie; Papin, Christophe; Touchais, Sophie; Bemer, Pascale; Lambert, Chantal; Boutoille, David; Tequi, Brigitte; Gouin, François; Raffi, François; Passuti, Norbert; Potel, Gilles

    2010-07-01

    The identification of Propionibacterium acnes in cultures of bone and joint samples is always difficult to interpret because of the ubiquity of this microorganism. The aim of this study was to propose a diagnostic strategy to distinguish infections from contaminations. This was a retrospective analysis of all patient charts of those patients with >or=1 deep samples culture-positive for P. acnes. Every criterion was tested for sensitivity, specificity, and positive likelihood ratio, and then the diagnostic probability of combinations of criteria was calculated. Among 65 patients, 52 (80%) were considered truly infected with P. acnes, a diagnosis based on a multidisciplinary process. The most valuable diagnostic criteria were: >or=2 positive deep samples, peri-operative findings (necrosis, hardware loosening, etc.), and >or=2 surgical procedures. However, no single criterion was sufficient to ascertain the diagnosis. The following combinations of criteria had a diagnostic probability of >90%: >or=2 positive cultures + 1 criterion among: peri-operative findings, local signs of infection, >or=2 previous operations, orthopaedic devices; 1 positive culture + 3 criteria among: peri-operative findings, local signs of infection, >or=2 previous surgical operations, orthopaedic devices, inflammatory syndrome. The diagnosis of P. acnes osteomyelitis was greatly improved by combining different criteria, allowing differentiation between infection and contamination. PMID:20141491

  2. Selected Disorders of Skin Appendages--Acne, Alopecia, Hyperhidrosis.

    PubMed

    Vary, Jay C

    2015-11-01

    This article reviewed some of the more common diseases of the skin appendages that are encountered in medicine: hyperhidrosis, acne, AA, FPHL, AGA, and TE. The pathophysiology behind the conditions and their treatments were discussed so that the clinician can make logical therapeutic choices for their affected patients. PMID:26476248

  3. Linking diet to acne metabolomics, inflammation, and comedogenesis: an update.

    PubMed

    Melnik, Bodo C

    2015-01-01

    Acne vulgaris, an epidemic inflammatory skin disease of adolescence, is closely related to Western diet. Three major food classes that promote acne are: 1) hyperglycemic carbohydrates, 2) milk and dairy products, 3) saturated fats including trans-fats and deficient ω-3 polyunsaturated fatty acids (PUFAs). Diet-induced insulin/insulin-like growth factor (IGF-1)-signaling is superimposed on elevated IGF-1 levels during puberty, thereby unmasking the impact of aberrant nutrigenomics on sebaceous gland homeostasis. Western diet provides abundant branched-chain amino acids (BCAAs), glutamine, and palmitic acid. Insulin and IGF-1 suppress the activity of the metabolic transcription factor forkhead box O1 (FoxO1). Insulin, IGF-1, BCAAs, glutamine, and palmitate activate the nutrient-sensitive kinase mechanistic target of rapamycin complex 1 (mTORC1), the key regulator of anabolism and lipogenesis. FoxO1 is a negative coregulator of androgen receptor, peroxisome proliferator-activated receptor-γ (PPARγ), liver X receptor-α, and sterol response element binding protein-1c (SREBP-1c), crucial transcription factors of sebaceous lipogenesis. mTORC1 stimulates the expression of PPARγ and SREBP-1c, promoting sebum production. SREBP-1c upregulates stearoyl-CoA- and Δ6-desaturase, enhancing the proportion of monounsaturated fatty acids in sebum triglycerides. Diet-mediated aberrations in sebum quantity (hyperseborrhea) and composition (dysseborrhea) promote Propionibacterium acnes overgrowth and biofilm formation with overexpression of the virulence factor triglyceride lipase increasing follicular levels of free palmitate and oleate. Free palmitate functions as a "danger signal," stimulating toll-like receptor-2-mediated inflammasome activation with interleukin-1β release, Th17 differentiation, and interleukin-17-mediated keratinocyte proliferation. Oleate stimulates P. acnes adhesion, keratinocyte proliferation, and comedogenesis via interleukin-1α release. Thus, diet

  4. Linking diet to acne metabolomics, inflammation, and comedogenesis: an update

    PubMed Central

    Melnik, Bodo C

    2015-01-01

    Acne vulgaris, an epidemic inflammatory skin disease of adolescence, is closely related to Western diet. Three major food classes that promote acne are: 1) hyperglycemic carbohydrates, 2) milk and dairy products, 3) saturated fats including trans-fats and deficient ω-3 polyunsaturated fatty acids (PUFAs). Diet-induced insulin/insulin-like growth factor (IGF-1)-signaling is superimposed on elevated IGF-1 levels during puberty, thereby unmasking the impact of aberrant nutrigenomics on sebaceous gland homeostasis. Western diet provides abundant branched-chain amino acids (BCAAs), glutamine, and palmitic acid. Insulin and IGF-1 suppress the activity of the metabolic transcription factor forkhead box O1 (FoxO1). Insulin, IGF-1, BCAAs, glutamine, and palmitate activate the nutrient-sensitive kinase mechanistic target of rapamycin complex 1 (mTORC1), the key regulator of anabolism and lipogenesis. FoxO1 is a negative coregulator of androgen receptor, peroxisome proliferator-activated receptor-γ (PPARγ), liver X receptor-α, and sterol response element binding protein-1c (SREBP-1c), crucial transcription factors of sebaceous lipogenesis. mTORC1 stimulates the expression of PPARγ and SREBP-1c, promoting sebum production. SREBP-1c upregulates stearoyl-CoA- and Δ6-desaturase, enhancing the proportion of monounsaturated fatty acids in sebum triglycerides. Diet-mediated aberrations in sebum quantity (hyperseborrhea) and composition (dysseborrhea) promote Propionibacterium acnes overgrowth and biofilm formation with overexpression of the virulence factor triglyceride lipase increasing follicular levels of free palmitate and oleate. Free palmitate functions as a “danger signal,” stimulating toll-like receptor-2-mediated inflammasome activation with interleukin-1β release, Th17 differentiation, and interleukin-17-mediated keratinocyte proliferation. Oleate stimulates P. acnes adhesion, keratinocyte proliferation, and comedogenesis via interleukin-1α release. Thus, diet

  5. Screening for Developmental Disabilities in Developing Countries

    PubMed Central

    Bornstein, Marc H.; Hendricks, Charlene

    2012-01-01

    Despite waxing international interest in child disability, little information exists about the situation of children with disabilities in developing countries. Using a culture-free screen for child disability from the 2005–2007 Multiple Indicator Cluster Survey, this study reports percentages of children in 16 developing countries who screened positive for cognitive, language, sensory, and motor disabilities, covariation among disabilities, deviation contrasts that compare each country to the overall effect of country (including effects of age and gender and their interactions), and associations of disabilities with the Human Development Index. Developmental disabilities vary by child age and country, and younger children in developing countries with lower standards of living are more likely to screen positive for disabilities. The discussion of these findings revolves around research and policy implications. PMID:23294875

  6. Screening for developmental disabilities in developing countries.

    PubMed

    Bornstein, Marc H; Hendricks, Charlene

    2013-11-01

    Despite waxing international interest in child disability, little information exists about the situation of children with disabilities in developing countries. Using a culture-free screen for child disability from the 2005-2007 Multiple Indicator Cluster Survey, this study reports percentages of children in 16 developing countries who screened positive for cognitive, language, sensory, and motor disabilities, covariation among disabilities, deviation contrasts that compare each country to the overall effect of country (including effects of age and gender and their interactions), and associations of disabilities with the Human Development Index. Developmental disabilities vary by child age and country, and younger children in developing countries with lower standards of living are more likely to screen positive for disabilities. The discussion of these findings revolves around research and policy implications. PMID:23294875

  7. German translation of the caregiver priorities and child health index of life with disabilities questionnaire: test-retest reliability and correlation with gross motor function in children with cerebral palsy.

    PubMed

    Jung, Nikolai H; Brix, Olga; Bernius, Peter; Schroeder, A Sebastian; Kluger, Gerhard J; Beyerlein, Andreas; Weir, Shannon; von Kries, Rudiger; Narayanan, Unni G; Mall, Volker; Berweck, Steffen

    2014-10-01

    We aimed to translate the Caregiver Priorities and Child Health Index of Life with Disabilities (CPCHILD) questionnaire into German and to evaluate its reliability and validity by studying the association between CPCHILD scores and gross motor function as measured by the gross motor function classification system (GMFCS) in children with cerebral palsy (CP). The original CPCHILD questionnaire and manual were translated and back translated. It was administered to primary caregivers of persons with CP (GMFCS levels III-V) and was completed a second time 2 weeks after the first to measure test-retest reliability (n = 17). Primary caregivers of 68 children with CP; GMFCS level III (n = 14), level IV (n = 28), and level V (n = 26) completed the questionnaire. Mean total CPCHILD scores across GMFCS levels were 67.1 ± 14.9 for GMFCS level III, 56.6 ± 11.8 for level IV, and 44.3 ± 12.9 for level V. Good correlation (r =  - 0.56) was observed between GMFCS and total scores test-retest reliability showed intraclass correlation coefficients between 0.4 and 0.9. The German CPCHILD yielded similar test-retest reliability and score distributions across the GMFCS level as the original version. The best correlations were observed for domains that are close to the functional deficits.

  8. Effects of bee venom against Propionibacterium acnes-induced inflammation in human keratinocytes and monocytes.

    PubMed

    Kim, Jung-Yeon; Lee, Woo-Ram; Kim, Kyung-Hyun; An, Hyun-Jin; Chang, Young-Chae; Han, Sang-Mi; Park, Yoon-Yub; Pak, Sok Cheon; Park, Kwan-Kyu

    2015-06-01

    Propionibacterium acnes (P. acnes) cause inflammatory acne and play an important role in the pathogenesis of acne by inducing inflammatory mediators. P. acnes contributes to the inflammatory responses of acne by activating inflammatory cells, keratinocytes and sebocytes to secrete pro-inflammatory cytokines such as tumor necrosis factor-α (TNF-α), interleukin (IL)-1β and IL-8. Bee venom has traditionally been used in the treatment of certain immune-related diseases. However, there has not yet been a robust trial to prove the therapeutic effect of bee venom in skin inflammation. The aim of the present study was to investigate anti-inflammatory properties of bee venom in skin inflammation induced by P. acnes using keratinocytes (HaCaT) and monocytes (THP-1). P. acnes is known to stimulate the production of pro-inflammatory cytokines such as IL-1, IL-8, IL-12 and TNF-α. In the present study, the production of interferon-γ (IFN-γ), IL-1β, IL-8 and TNF-α was increased by P. acnes treatment in HaCaT and THP-1 cells. By contrast, bee venom effectively inhibited the secretion of IFN-γ, IL-1β, IL-8 and TNF-α. Furthermore, P. acnes treatment activated the expression of IL-8 and toll-like receptor 2 (TLR2) in HaCaT cells. However, bee venom inhibited the expression of IL-8 and TLR2 in heat-killed P. acnes. Based on these results, it is concluded that bee venom has an effective anti-inflammatory activity against P. acnes in HaCaT and THP-1 cells. Therefore, we suggest that bee venom is an alternative treatment to antibiotic therapy of acne. PMID:25872535

  9. MLST typing of antimicrobial-resistant Propionibacterium acnes isolates from patients with moderate to severe acne vulgaris.

    PubMed

    Giannopoulos, Lambros; Papaparaskevas, Joseph; Refene, Eirini; Daikos, Georgios; Stavrianeas, Nikolaos; Tsakris, Athanassios

    2015-02-01

    Molecular typing data on antimicrobial-resistant Propionibacterium strains are limited in the literature. We examined antimicrobial resistance profiles and the underlying resistance mechanisms in Propionibacterium spp. isolates recovered from patients with moderate to severe acne vulgaris in Greece. The clonallity of the resistant Propionibacterium acnes isolates was also investigated. Propionibacterium spp. isolates were detected using Tryptone-Yeast Extract-Glucose (TYG) agar plates supplemented with 4% furazolidone. Erythromycin, clindamycin, vancomycin, penicillin, co-trimoxazole, doxycycline, minocycline and ciprofloxacin MICs were determined using the gradient strip method. Erythromycin, clindamycin and tetracycline mechanisms of resistance were determined using PCR and sequencing of the domain V of 23S rRNA and 16S rRNA, as well as the presence of the ermX gene. Typing was performed using the multi locus sequence typing (MLST) methodology. Seventy nine isolates from 76 patients were collected. Twenty-three isolates (29.1%) exhibited resistance to erythromycin and clindamycin, while two additional isolates (2.5%) were resistant only to erythromycin. Resistance to tetracycline was not detected. The underlying molecular mechanisms were point mutations A2059G and A2058G. MLST typing of the P. acnes resistant isolates revealed that lineage type IA1 (ST-1, 3 and 52) prevailed (12/18; 66.7%), whilst lineage type IA2 (ST-2 and 22) accounted for five more isolates (27.8%). Susceptible isolates were more evenly distributed between ST types. Propionibacterium spp. from moderate to severe acne vulgaris in Greece are frequently resistant to erythromycin/clindamycin but not to tetracyclines, mainly due to the point mutations A2059G and A2058G. P. acnes resistant isolates were more clonally related than susceptible ones and belonged to a limited number of MLST types.

  10. Learning Disabilities

    ERIC Educational Resources Information Center

    Sittiprapaporn, Wichian, Ed.

    2012-01-01

    Learning disability is a classification that includes several disorders in which a person has difficulty learning in a typical manner. Depending on the type and severity of the disability, interventions may be used to help the individual learn strategies that will foster future success. Some interventions can be quite simplistic, while others are…

  11. Learning Disabilities.

    ERIC Educational Resources Information Center

    McCarthy, James J.; McCarthy, Joan F.

    An attempt to collate basic knowledge concerning learning disabilities, the text discusses the background and definition of learning disabilities, and its identification, etiology, and epidemiology. Guidelines for diagnostic evaluation are presented as are approaches from perceptual motor, developmental, visual, neurophysiological, linguistic, and…

  12. A brief primer on acne therapy for adolescents with skin of color.

    PubMed

    Silverberg, Nanette B

    2013-07-01

    The majority of adolescents with skin of color in the United States and other westernized civilizations develop acne vulgaris. Indigenous populations of children and teenagers with skin of color may not develop acne when raised on a paleolithic diet, suggesting the Western diet is the rudiment of acne vulgaris. Differences exist in the presentation of and therapy for acne in teenagers with skin of color, largely due to the increased risk for hyperpigmentation, scarring, and keloid formation, as well as style- and skin care-related exacerbating factors. The primary goal of acne therapy in adolescents with skin of color is the prevention of long-term sequelae such as keloid formation. This article provides a brief overview of the treatment of acne vulgaris in adolescents with skin of color. PMID:23961520

  13. Ventricular patch endocarditis caused by Propionibacterium acnes: advantages of gallium scanning.

    PubMed

    Vandenbos, F; Roger, P M; Mondain-Miton, V; Dunais, B; Fouché, R; Kreitmann, P; Carles, D; Migneco, O; Dellamonica, P

    2001-11-01

    Propionibacterium acnes is a weakly pathogenic commensal of the skin. When isolated from blood cultures it is often considered a contaminant. However, P. acnes may be responsible for severe infections and its role in certain cases of infectious endocarditis has now been definitely established.(1) We report a case of endocarditis due to P. acnes stemming from a ventricular patch and revealed by a gallium 67 scan. PMID:11869063

  14. Top Ten List of Clinical Pearls in the Treatment of Acne Vulgaris.

    PubMed

    Layton, Alison M

    2016-04-01

    Acne represents the most common inflammatory dermatosis seen worldwide and is the leading reason for seeing a dermatologist. This article provides some tips for managing acne in a safe and effective manner to minimize the physical and psychological scars that can result from acne. Tips include how to optimize available treatment regimens according to the evidence base and target therapy to pathophysiologic factors, while also tailoring treatments to patient expectation and needs. Attention is given to minimizing the emergence of antimicrobial resistance in acne patients and beyond. PMID:27015774

  15. Use of Oral Contraceptives for Management of Acne Vulgaris: Practical Considerations in Real World Practice.

    PubMed

    Harper, Julie C

    2016-04-01

    Acne vulgaris may be effectively treated with combination oral contraceptive pills (COCs) in women. COCs may be useful in any woman with acne in the absence of known contraindications. When prescribing a COC to a woman who also desires contraception, the risks of the COC are compared with the risks associated with pregnancy. When prescribing a COC to a woman who does not desire contraception, the risks of the COC must be weighed against the risks associated with acne. COCs may take 3 cycles of use to show an effect in acne lesion count reductions.

  16. Assessment of a new biological complex efficacy on dysseborrhea, inflammation, and Propionibacterium acnes proliferation

    PubMed Central

    Trompezinski, Sandra; Weber, Sophie; Cadars, Benoît; Larue, Florence; Ardiet, Nathalie; Chavagnac-Bonneville, Marlène; Sayag, Michèle; Jourdan, Eric

    2016-01-01

    Introduction Acne vulgaris is a common chronic inflammatory disease of the pilosebaceous unit triggered by Propionibacterium acnes. A bakuchiol, Ginkgo biloba extract, and mannitol (BGM) complex has been developed to provide patients with acne with a specific dermocosmetic to be used adjunctively with conventional treatments. Objective The aim of these studies was to assess the antibacterial, anti-inflammatory, and antioxidative potential of BGM complex and its individual compounds as well as its impact on sebum composition. Methods The antibacterial, anti-inflammatory, and antioxidative potential of BGM complex and its compounds was assessed through in vitro, ex vivo, and clinical studies. The clinical benefit of BGM complex formulated in a cream was assessed in subjects prone to acne through sebum composition analysis and photometric assessments. Results Results from the studies showed that the BGM complex has significant antibacterial, anti-inflammatory, and antioxidative properties. At similar concentrations, bakuchiol has up to twice the antioxidative potential than vitamin E. In subjects, BGM complex regulated the sebum composition in acne patients by increasing the level of sapienic and linolenic acid and reducing the level of oleic acid. The reduced number of porphyrins on the skin surface showed that it is also effective against P. acnes. Conclusion BGM complex provides a complete adjunctive care in patients with acne by targeting etiopathogenic factors of acne: dysseborrhea, inflammation, and P. acnes proliferation. PMID:27621660

  17. Top Ten List of Clinical Pearls in the Treatment of Acne Vulgaris.

    PubMed

    Layton, Alison M

    2016-04-01

    Acne represents the most common inflammatory dermatosis seen worldwide and is the leading reason for seeing a dermatologist. This article provides some tips for managing acne in a safe and effective manner to minimize the physical and psychological scars that can result from acne. Tips include how to optimize available treatment regimens according to the evidence base and target therapy to pathophysiologic factors, while also tailoring treatments to patient expectation and needs. Attention is given to minimizing the emergence of antimicrobial resistance in acne patients and beyond.

  18. Proteome Analysis of Human Sebaceous Follicle Infundibula Extracted from Healthy and Acne-Affected Skin

    PubMed Central

    Bek-Thomsen, Malene; Lomholt, Hans B.; Scavenius, Carsten; Enghild, Jan J.; Brüggemann, Holger

    2014-01-01

    Acne vulgaris is a very common disease of the pilosebaceous unit of the human skin. The pathological processes of acne are not fully understood. To gain further insight sebaceous follicular casts were extracted from 18 healthy and 20 acne-affected individuals by cyanoacrylate-gel biopsies and further processed for mass spectrometry analysis, aiming at a proteomic analysis of the sebaceous follicular casts. Human as well as bacterial proteins were identified. Human proteins enriched in acne and normal samples were detected, respectively. Normal follicular casts are enriched in proteins such as prohibitins and peroxiredoxins which are involved in the protection from various stresses, including reactive oxygen species. By contrast, follicular casts extracted from acne-affected skin contained proteins involved in inflammation, wound healing and tissue remodeling. Among the most distinguishing proteins were myeloperoxidase, lactotransferrin, neutrophil elastase inhibitor and surprisingly, vimentin. The most significant biological process among all acne-enriched proteins was ‘response to a bacterium’. Identified bacterial proteins were exclusively from Propionibacterium acnes. The most abundant P. acnes proteins were surface-exposed dermatan sulphate adhesins, CAMP factors, and a so far uncharacterized lipase in follicular casts extracted from normal as well as acne-affected skin. This is a first proteomic study that identified human proteins together with proteins of the skin microbiota in sebaceous follicular casts. PMID:25238151

  19. Assessment technique for acne treatments based on statistical parameters of skin thermal images.

    PubMed

    Padilla-Medina, J Alfredo; León-Ordoñez, Francisco; Prado-Olivarez, Juan; Vela-Aguirre, Noe; Ramírez-Agundis, Agustin; Díaz-Carmona, Javier

    2014-04-01

    Acne vulgaris as an inflammatory disease, with an excessive production of subdermal fat, modifies the dynamics of the bloodstream, and consequently temperature, on the affected skin zone. A high percentage of this heat interchange is manifested as electromagnetic radiation with far-infrared wavelengths, which can be captured through a thermal imaging camera. A technique based on thermal image analysis for efficiency assessment in acne vulgaris is described. The procedure is based on computing statistical parameters of thermal images captured from the affected skin zone being attended by an acne treatment. The proposed technique was used to determine the skin thermal behavior according to acne severity levels in different acne treatment stages. Infrared images of acne skin zones on eight patients, diagnosed with acne vulgaris and attended by one specific acne treatment, were weekly registered during 11 weeks. The infrared images were captured until no more improvement in affected zones was detected. The obtained results suggest a direct relationship between the used statistical parameters, particularly first- and second-order statistics, and the acne vulgaris severity level on the affected zones.

  20. Production of Superoxide Anions by Keratinocytes Initiates P. acnes-Induced Inflammation of the Skin

    PubMed Central

    Grange, Philippe A.; Chéreau, Christiane; Raingeaud, Joël; Nicco, Carole; Weill, Bernard

    2009-01-01

    Acne vulgaris is a chronic inflammatory disorder of the sebaceous follicles. Propionibacterium acnes (P. acnes), a gram-positive anareobic bacterium, plays a critical role in the development of these inflammatory lesions. This study aimed at determining whether reactive oxygen species (ROS) are produced by keratinocytes upon P. acnes infection, dissecting the mechanism of this production, and investigating how this phenomenon integrates in the general inflammatory response induced by P. acnes. In our hands, ROS, and especially superoxide anions (O2•−), were rapidly produced by keratinocytes upon stimulation by P. acnes surface proteins. In P. acnes-stimulated keratinocytes, O2•− was produced by NAD(P)H oxidase through activation of the scavenger receptor CD36. O2•− was dismuted by superoxide dismutase to form hydrogen peroxide which was further detoxified into water by the GSH/GPx system. In addition, P. acnes-induced O2•− abrogated P. acnes growth and was involved in keratinocyte lysis through the combination of O2•− with nitric oxide to form peroxynitrites. Finally, retinoic acid derivates, the most efficient anti-acneic drugs, prevent O2•− production, IL-8 release and keratinocyte apoptosis, suggesting the relevance of this pathway in humans. PMID:19629174

  1. Inhibition of propionibacterium acnes by bacteriocin-like inhibitory substances (BLIS) produced by Streptococcus salivarius.

    PubMed

    Bowe, Whitney P; Filip, Jennifer C; DiRienzo, Joseph M; Volgina, Alla; Margolis, David J

    2006-10-01

    We report the in vitro inhibition of Propionibacterium acnes (P. acnes) by a bacteriocin-like inhibitory substance (BLIS-like substance) produced by Streptococcus salivarius (S. salivarius). Bacteriocins are proteinaceous substances produced by bacteria that are capable of inhibiting the growth of similar bacterial strains. Unlike classical antibiotics, they have a relatively narrow spectrum of killing activity, resulting in a reduction in the intensity of selection for resistance. These findings suggest that BLIS may potentially be used for its anti-P. acnes activity in the treatment of acne. PMID:17039652

  2. Inhibition of Propionibacterium acnes by Bacteriocin-Like Inhibitory Substances (BLIS) Produced by Streptococcus Salivarius

    PubMed Central

    Bowe, Whitney P.; Filip, Jennifer C.; DiRienzo, Joseph M.; Volgina, Alla; Margolis, David J.

    2009-01-01

    We report the in vitro inhibition of Propionibacterium acnes (P. acnes) by a bacteriocin-like inhibitory substance (BLIS-like substance) produced by Streptococcus salivarius (S. salivarius). Bacteriocins are proteinaceous substances produced by bacteria that are capable of inhibiting the growth of similar bacterial strains. Unlike classical antibiotics, they have a relatively narrow spectrum of killing activity, resulting in a reduction in the intensity of selection for resistance. These findings suggest that BLIS may potentially be used for its anti-P. acnes activity in the treatment of acne. PMID:17039652

  3. Assessment of a new biological complex efficacy on dysseborrhea, inflammation, and Propionibacterium acnes proliferation

    PubMed Central

    Trompezinski, Sandra; Weber, Sophie; Cadars, Benoît; Larue, Florence; Ardiet, Nathalie; Chavagnac-Bonneville, Marlène; Sayag, Michèle; Jourdan, Eric

    2016-01-01

    Introduction Acne vulgaris is a common chronic inflammatory disease of the pilosebaceous unit triggered by Propionibacterium acnes. A bakuchiol, Ginkgo biloba extract, and mannitol (BGM) complex has been developed to provide patients with acne with a specific dermocosmetic to be used adjunctively with conventional treatments. Objective The aim of these studies was to assess the antibacterial, anti-inflammatory, and antioxidative potential of BGM complex and its individual compounds as well as its impact on sebum composition. Methods The antibacterial, anti-inflammatory, and antioxidative potential of BGM complex and its compounds was assessed through in vitro, ex vivo, and clinical studies. The clinical benefit of BGM complex formulated in a cream was assessed in subjects prone to acne through sebum composition analysis and photometric assessments. Results Results from the studies showed that the BGM complex has significant antibacterial, anti-inflammatory, and antioxidative properties. At similar concentrations, bakuchiol has up to twice the antioxidative potential than vitamin E. In subjects, BGM complex regulated the sebum composition in acne patients by increasing the level of sapienic and linolenic acid and reducing the level of oleic acid. The reduced number of porphyrins on the skin surface showed that it is also effective against P. acnes. Conclusion BGM complex provides a complete adjunctive care in patients with acne by targeting etiopathogenic factors of acne: dysseborrhea, inflammation, and P. acnes proliferation.

  4. Evaluation and Management of Refractory Acne Vulgaris in Adolescent and Adult Men.

    PubMed

    McCarty, Morgan

    2016-04-01

    Acne vulgaris alters the normal skin physiology, impairing stratum corneum and transepidermal water loss. A male's normal skin physiologic state is different than a female's and may have implications when choosing treatment when the skin is altered in a disease state. Transepidermal water loss, pH, and sebum production are different between the sexes. Several underlying conditions present in male acne patients at several ages that may require a more in-depth evaluation. As knowledge of the pathogenesis of acne expands, the differences in skin physiology between the sexes may alter the manner in which male patients with acne medications are approached. PMID:27015780

  5. Acne inversa goes an extra mile than hidradenitis suppurativa.

    PubMed

    Witmanowski, Henryk; Szychta, Paweł; Stępniewski, Sławomir; Mackiewicz-Wysocka, Małgorzata; Czyżewska-Majchrzak, Lucja; Wasilewska, Agnieszka

    2013-08-01

    Acne inversa (AI, hidradenitis suppurativa, Velpeau's disease, Verneuil's disease) is a severe, chronic inflammatory dermatosis of unknown etiology, detected on the basis of clinical symptoms more frequently in women than in men. Purulent lesions in the form of nodules and inflammatory tumors, fistulas and scars are present in the areas with hair follicles and apocrine glands, most commonly on the armpits, groin, around the anus and pubic region. Acne inversa can lead to physical and mental disorders. Unfortunately, it is often misdiagnosed and ineffectively treated. The paper presents a case of a 46-year-old patient who was successfully treated surgically for AI around the anus and buttocks by excision of the changes and closure of the wound with local flaps and split-thickness skin grafts, taken with dermatome from the rear surface of the thighs. Surgical treatment is the method of choice in the treatment of severe AI. PMID:24278084

  6. [Side effects of minocycline in the treatment of acne vulgaris].

    PubMed

    Hoefnagel, J J; van Leeuwen, R L; Mattie, H; Bastiaens, M T

    1997-07-19

    Minocycline is the most commonly used systemic antibiotic in the long-term treatment (weeks to months) of severe acne vulgaris. Currently much attention is being paid in the Dutch and international literature to the safety of minocycline, after several reports on serious adverse events. The clinical efficacy of minocycline in the treatment of acne vulgaris is better than that of tetracycline and equal to that of doxycycline. The serious adverse events of minocycline therapy described consist of hyperpigmentation of various tissues, autoimmune disorders (systemic lupus erythematosus, autoimmune hepatitis) and serious hypersensitivity reactions (hypersensitivity syndrome reaction, pneumonitis and eosinophilia, and serum sickness-like syndrome). In relation to the number of prescriptions, the number of serious adverse events of minocycline described is small. However, it is very important that prescribing doctors should be aware of the possibility of these adverse events occurring during long-term minocycline therapy and able to recognize the characteristic symptoms at an early stage.

  7. Childhood acne in a boy with XYY syndrome.

    PubMed

    Kasparis, Christos; Loffeld, Annette

    2014-01-01

    A 3-year-old boy was referred to the dermatology department with a 12-month history of facial erythema associated with a papular-pustular facial eruption consistent with childhood acne. He had been diagnosed with XYY syndrome identified during genetic analysis for cardiac anomalies at birth. XYY syndrome is an aneuploidy of the sex chromosomes which affects 1 in 1000 male births. It is often asymptomatic and identified incidentally following genetic analysis for other conditions. The syndrome can be associated with an increased risk of learning difficulties and delayed language skills. Early diagnosis could alert physicians to the possibility of subtle developmental and learning abnormalities and result in prompt management. Our case highlights the fact that the presence of childhood acne could aid in the early detection of XYY syndrome.

  8. Acne inversa goes an extra mile than hidradenitis suppurativa

    PubMed Central

    Szychta, Paweł; Stępniewski, Sławomir; Mackiewicz-Wysocka, Małgorzata; Czyżewska-Majchrzak, Łucja; Wasilewska, Agnieszka

    2013-01-01

    Acne inversa (AI, hidradenitis suppurativa, Velpeau’s disease, Verneuil’s disease) is a severe, chronic inflammatory dermatosis of unknown etiology, detected on the basis of clinical symptoms more frequently in women than in men. Purulent lesions in the form of nodules and inflammatory tumors, fistulas and scars are present in the areas with hair follicles and apocrine glands, most commonly on the armpits, groin, around the anus and pubic region. Acne inversa can lead to physical and mental disorders. Unfortunately, it is often misdiagnosed and ineffectively treated. The paper presents a case of a 46-year-old patient who was successfully treated surgically for AI around the anus and buttocks by excision of the changes and closure of the wound with local flaps and split-thickness skin grafts, taken with dermatome from the rear surface of the thighs. Surgical treatment is the method of choice in the treatment of severe AI. PMID:24278084

  9. Acute post-traumatic endophthalmitis secondary to Propionibacterium acnes

    PubMed Central

    Shailaja, S; Kamath, Yogish; Hazarika, Manali; Vishwanath, Shashidhar

    2013-01-01

    Propionibacterium acnes has rarely been reported as the causative organism in acute endophthalmitis following penetrating ocular trauma. We report a 53-year-old man, who presented with best corrected vision of counting fingers at 2 m, acnes. At the fifth month follow-up, the best corrected vision had improved to 20/20, N6. Thus, a good visual outcome was achieved, following appropriate treatment of a rather unusual causative organism. PMID:24096075

  10. Interaction of Propionibacterium acnes with skin lipids in vitro.

    PubMed

    Gribbon, E M; Cunliffe, W J; Holland, K T

    1993-08-01

    Propionibacterium acnes is the predominant microbial resident within the pilosebaceous follicles of sebum-rich areas of human skin. This study investigated the effects of known hydrophobic components of sebum on the physiology and nutrition of this microorganism, grown anaerobically at 33 degrees C, under defined conditions using continuous culture techniques. The medium used was chemically defined, comprising eight amino acids, with glucose as the main carbon energy source, and the culture pH was maintained at 5.6. The range of sebum lipids assayed was based on the C18 monounsaturated fatty acid 9-cis-octadecenoic acid (oleic acid). Stock micronized solutions were aseptically pulsed into continuous cultures in the presence and absence of glucose, and nutritional effects monitored. None of the lipid substrates significantly affected P. acnes growth either in terms of maximum specific growth rate (mu max) or final culture biomass yield. Glycerol (3 mg ml-1) was found to be a poor carbon/energy source in comparison to glucose. Bacterial cells did, however, adhere with varying degrees, to the different lipid species, with maximum adherence occurring with the free fatty acid. This observation was confirmed by preliminary uptake experiments using [14C]oleic acid. The interactive site for cell adherence may be the lipid-fibrillar layer associated with the cell surface of P. acnes, as discerned in electron microscopical studies. The findings of this investigation suggest that one function of the P. acnes lipase may be to aid colonization within the pilosebaceous follicle, by promoting cell adherence to components such as oleic acid.

  11. 367 cases of CO2 laser therapy on facial acne

    NASA Astrophysics Data System (ADS)

    Gao, Yunqing; Liu, Songhao; Zhang, You; Liu, T. C.

    1996-09-01

    Since 1989, we have cured 367 persons of facial acne of different course by using direct irradiation of high-power CO2 laser combing with operative therapy of low-power CO2 laser. The cure rate is 100 percent. In this paper, we stated the therapeutic approach. It was shown that this therapeutic approach is simple and effective, and its recurrence rate is zero. There are no cicatrices after healing. It is easy to accept it, and is worthy of extension.

  12. Laser treatment of acne, psoriasis, leukoderma, and scars.

    PubMed

    Railan, Divya; Alster, Tina S

    2008-12-01

    Lasers frequently are used by dermatologists for their multiple aesthetic applications, but they also can be used to treat a variety of medical dermatology conditions. Conditions such as acne vulgaris, psoriasis, and vitiligo can all be successfully treated with laser, thereby providing the patient with additional therapeutic options. Lasers have also been used for years to improve the appearance of scars. The newer fractionated lasers have been especially effective in enhancing the clinical outcomes of scar revision. PMID:19150300

  13. Skin lesion metrics: role of photography in acne.

    PubMed

    Chiang, Audris; Hafeez, Farhaan; Maibach, Howard I

    2014-04-01

    Accurate assessment of acne severity is essential for determining the appropriate treatment required. This paper reviews photographic methods for such assessment. Literature included met the following criteria: proposed photographic standards to assess acne, evaluated such standards, or offered photographic methods to improve visualization and assessment. Validity was evaluated by comparing given photographic grading methods to other methods, such as lesion counting. Many photographic standards were shown to be objective, time-efficient, and have intra-grader and inter-grader consistency. Photography also documents progress for retrospective verification. Drawbacks include not allowing determination of depth, minimization of small lesions and erythema, and difficulty in maintaining consistent settings. Fluorescence and polarized photography improve visualization beyond clinical observation alone. Advances such as computer alignment, imaging segmentation, and three-dimensional analysis methods track lesions and measure objective characteristics. The combined experience summarized here strongly promotes the use of a photographic standard in assessing acne severity. Cook's method can also be used to train and qualify graders. Photographic advancements improve accuracy of assessment by solving problems with consistent settings and depth visualization. Further advancements can improve image analysis through analysis of objective attributes.

  14. Hepatitis B, interferon, and acne fulminans in a young girl.

    PubMed

    Arora, Sandeep; Malik, Ajay; Kumar, Dharmendra; Sodhi, Neha

    2016-01-01

    Acne fulminans (AF) is a very rare severe form of acne seen in young males, characterized by a sudden and explosive onset of hemorrhagic pustules and ulceration on the trunk, systemic features in the form of fever, polyarthropathy, malaise, erythema nodosum and painful osteolytic bone involvement with leukocytosis, and an elevated erythrocyte sedimentation rate. Conventional treatment of AF includes corticosteroids or immunosuppressive agents for the initial phase followed by isotretinoin. Active hepatitis B infection with a high viral load precludes the administration of any immunosuppressive drugs. We present the case of an 18-year-old girl with a history of occasional acne who presented with AF of sudden onset following administration of interferon-alpha-2a for her recently detected hepatitis B infection. Management of hepatitis B was withheld in view of her general condition. The patient was managed with low dose isotretinoin with subsidence of lesions. AF in a young female precipitated by interferon and its management with isotretinoin in the presence of active hepatitis B infection make the case unique. PMID:27057488

  15. [Post-surgery cerebral abscess due to Propionibacterium acnes].

    PubMed

    Zárate, Mariela S; Yahni, Diego; Guevara, Martín; Smayevsky, Jorgelina

    2009-01-01

    Brain abscesses by Propioni-bacterium acnes are rare. The rapid identification of this pathogen is important in order to choice the appropriate antibiotic therapy. We describe the case of a patient with excision of a multiform glioblastoma who 9 months later presented a tumor recurrence. A subtotal tumor excision was made and implants chemotherapy were placed in the residual tumor. After one month of surgery the patient presented a brain abscess. A craniotomy for drainage was performed. P. acnes was isolated from the biopsy and from purulent material. Identification was made by conventional biochemical tests and by the API system 20 A. The Minimum Inhibitory Concentration (MIC) to clindamycin, penicillin, amoxicillin and metronidazole was determined. The values of MIC (microg/ml) obtained were: 0.250, 0.040, 0.023 and 256, respectively. The patient received cefepime and metronidazole intravenously during 30 days and completed treatment with oral clindamycin for 60 days, considering the possibility of adjacent bone involvement. Eight months after the drainage the patient had no evidence of infection or tumor recurrence. Although P. acnes is a rare cause of post-neurosurgical infection, it should be considered as a possible pathogen in postoperative brain abscesses.

  16. Combination Therapy in the Management of Atrophic Acne Scars

    PubMed Central

    Garg, Shilpa; Baveja, Sukriti

    2014-01-01

    Background: Atrophic acne scars are difficult to treat. The demand for less invasive but highly effective treatment for scars is growing. Objective: To assess the efficacy of combination therapy using subcision, microneedling and 15% trichloroacetic acid (TCA) peel in the management of atrophic scars. Materials and Methods: Fifty patients with atrophic acne scars were graded using Goodman and Baron Qualitative grading. After subcision, dermaroller and 15% TCA peel were performed alternatively at 2-weeks interval for a total of 6 sessions of each. Grading of acne scar photographs was done pretreatment and 1 month after last procedure. Patients own evaluation of improvement was assessed. Results: Out of 16 patients with Grade 4 scars, 10 (62.5%) patients improved to Grade 2 and 6 (37.5%) patients improved to Grade 3 scars. Out of 22 patients with Grade 3 scars, 5 (22.7%) patients were left with no scars, 2 (9.1%) patients improved to Grade 1and 15 (68.2%) patients improved to Grade 2. All 11 (100%) patients with Grade 2 scars were left with no scars. There was high level of patient satisfaction. Conclusion: This combination has shown good results in treating not only Grade 2 but also severe Grade 4 and 3 scars. PMID:24761094

  17. Minocycline in the treatment of acne: latest findings.

    PubMed

    Maffeis, L; Veraldi, S

    2010-06-01

    Minocycline is a semi-synthetic tetracycline antibiotic effective against a wide range of aerobic and anaerobic Gram-positive and Gram-negative bacteria. It is highly active in the pilosebaceous complex, due to its great lipophilicity, and therefore it has been used in the treatment of moderate to severe papulo-pustular acne for a long time. It has an optimal therapeutic range and the percentage of P. acnes resistant strains are still inferior to 5%. Besides the antimicrobial activity, minocycline has an anti-inflammatory action, due to the reduction in neutrophilic chemotaxis, the inhibitory effect on pro-inflammatory cytokines, and the reduction in sebum free fatty acids and bacterial lipases. In 2006 the Food and Drug Administration (FDA) approved a new extended-release formulation of minocycline. This formulation allowed the reduction of some dose-related adverse events, such as those affecting the vestibular system. Besides the dose-related events (nausea, vomiting, and dizziness), minocycline is also known to induce hyperpigmentation, even if less frequently than doxycycline, and is rarely responsible for autoimmune disorders, hypersensitivity reactions, and serum sickness-like reactions. The latest guidelines in the treatment of acne recommend a dose of 50-100 mg, once or twice a daily for the non-modified release minocycline, and 1 mg/kg daily for the new extended-release formulation. This agent is most appropriately used in combination with a topical regimen containing benzoyl peroxide and/or retinoid.

  18. Cultural characteristics and fatty acid composition of Corynebacterium acnes.

    PubMed

    Moss, C W; Dowell, V R; Lewis, V J; Schekter, M A

    1967-11-01

    A detailed study of the cultural characteristics and cellular fatty acid composition of 27 isolates of Corynebacterium acnes was performed to establish the properties by which this organism may be identified and characterized. The fatty acids were extracted directly from whole cells and examined as methyl esters by gas-liquid chromatography. Each strain possessed a similar fatty acid profile which was characterized by a large percentage of C15 branched-chain acid. Uniformity in certain biochemical reactions and cultural characteristics was also observed. All strains were catalase-positive, nonmotile, and urease-negative, reduced nitrate, liquefied gelatin, failed to hydrolyze esculin and starch, and gave a positive methyl red test. Glucose, fructose, and glycerol were fermented, but not lactose, salicin, sucrose, maltose, xylose, or arabinose. Production of hydrogen sulfide and indole, fermentation of mannitol, and hemolytic activity were variable characteristics. Two species of the genus Propionibacterium were also tested and found to be similar to C. acnes both in cultural characteristics and fatty acid composition. The results strengthen previous suggestions that C. acnes should be classified in the genus Propionibacterium.

  19. Important controversies associated with isotretinoin therapy for acne.

    PubMed

    Wolverton, Stephen E; Harper, Julie C

    2013-04-01

    Isotretinoin is a remarkably effective drug for severe, recalcitrant acne vulgaris. Soon after the drug's release in the early 1980s, a number of important adverse effects were reported subsequently leading to a variety of medical and medicolegal controversies. Three of these controversies will be highlighted concerning the putative role of isotretinoin in (1) depression and suicide, (2) inflammatory bowel disease, and (3) iPledge and pregnancy prevention programs. It appears that a very small subset of patients receiving isotretinoin for acne are at risk for depression, which is very manageable provided there is adequate patient awareness of the possibility, maximum communication between the patient and physician, and cessation of therapy if clinically important depression occurs (after which the depression rapidly resolves in a week or less). Multiple controlled studies actually suggest a very favorable effect of isotretinoin on depression and anxiety common in the population requiring isotretinoin. With regard to inflammatory bowel disease, in just one study, only ulcerative colitis association with isotretinoin reached statistical significance. The actual incidence of this association is strikingly low. Finally, it is clear that even the most recent pregnancy prevention program (iPledge) is no more successful than prior programs; there will likely always be a small number of female patients becoming pregnant while receiving isotretinoin for acne vulgaris.

  20. Hepatitis B, interferon, and acne fulminans in a young girl.

    PubMed

    Arora, Sandeep; Malik, Ajay; Kumar, Dharmendra; Sodhi, Neha

    2016-01-01

    Acne fulminans (AF) is a very rare severe form of acne seen in young males, characterized by a sudden and explosive onset of hemorrhagic pustules and ulceration on the trunk, systemic features in the form of fever, polyarthropathy, malaise, erythema nodosum and painful osteolytic bone involvement with leukocytosis, and an elevated erythrocyte sedimentation rate. Conventional treatment of AF includes corticosteroids or immunosuppressive agents for the initial phase followed by isotretinoin. Active hepatitis B infection with a high viral load precludes the administration of any immunosuppressive drugs. We present the case of an 18-year-old girl with a history of occasional acne who presented with AF of sudden onset following administration of interferon-alpha-2a for her recently detected hepatitis B infection. Management of hepatitis B was withheld in view of her general condition. The patient was managed with low dose isotretinoin with subsidence of lesions. AF in a young female precipitated by interferon and its management with isotretinoin in the presence of active hepatitis B infection make the case unique.

  1. Hepatitis B, interferon, and acne fulminans in a young girl

    PubMed Central

    Arora, Sandeep; Malik, Ajay; Kumar, Dharmendra; Sodhi, Neha

    2016-01-01

    Acne fulminans (AF) is a very rare severe form of acne seen in young males, characterized by a sudden and explosive onset of hemorrhagic pustules and ulceration on the trunk, systemic features in the form of fever, polyarthropathy, malaise, erythema nodosum and painful osteolytic bone involvement with leukocytosis, and an elevated erythrocyte sedimentation rate. Conventional treatment of AF includes corticosteroids or immunosuppressive agents for the initial phase followed by isotretinoin. Active hepatitis B infection with a high viral load precludes the administration of any immunosuppressive drugs. We present the case of an 18-year-old girl with a history of occasional acne who presented with AF of sudden onset following administration of interferon-alpha-2a for her recently detected hepatitis B infection. Management of hepatitis B was withheld in view of her general condition. The patient was managed with low dose isotretinoin with subsidence of lesions. AF in a young female precipitated by interferon and its management with isotretinoin in the presence of active hepatitis B infection make the case unique. PMID:27057488

  2. Developmental Disabilities

    MedlinePlus

    ... many causes of developmental disabilities, including Genetic or chromosome abnormalities. These cause conditions such as Down syndrome and Rett syndrome. Prenatal exposure to substances. Drinking alcohol when ... also help. NIH: National Institute of Child Health and Human Development

  3. Intellectual disability

    MedlinePlus

    ... Infectious diseases. Certain infections can lead to intellectual disability. Preventing these diseases reduces the risk. For example, rubella syndrome can be prevented through vaccination. Avoiding exposure to cat feces that can cause ...

  4. Assessment of Temperament and Character Profile with Anxiety and Depression in Patients with Acne

    PubMed Central

    Öztürk, Perihan; Orhan, Fatma Özlem; Özer, Ali; Karakaş, Tuğba; Öksüz, Ali Nuri; Yetişir, Nur Yalçın

    2013-01-01

    Background: Acne is the most common skin disease, affecting nearly 85% of the population as well as their lives. Acne can severely affect social and psychological functioning. Patients with acne may have anxiety, depression, decreased self-esteem, interpersonal difficulties, unemployment, social withdrawal, and even suicidal intent. Aims: The aim of this study was to evaluate the temperament and character inventory (TCI) of patients with acne and to compare the results with those of healthy controls. Study Design: Case-control study Methods: The study population consisted of 47 patients with acne, and 40 healthy control subjects. All participants were instructed to complete a self-administered 240-item TCI and the Hospital Anxiety and Depression Scale. Results: In this study, the scores for the temperament properties Worry and pessimism (HA1) and Dependence (RD4) and the character properties Social acceptance (C1) and Integrated conscience (C5) were found to be higher in acne patients than in healthy controls (p<0.05). Compared to the controls, depression and anxiety scores were found to be markedly higher in the patients with acne. Acne type correlated positively with the Disorderliness (NS4) subscale of Novelty seeking (NS) and anxiety. Additionally, acne type correlated negatively with the Attachment (RD3) subscale of Reward Dependence (RD), with the Transpersonal identification (ST2) and Spiritual acceptance (ST3) subscales of Self-Trancendence (ST), and with the Compassion (C4) sub-scale of Cooperativeness (C). Conclusion: Studies in this area may lead to the development of specific and focused interventions for TCI in patients with acne vulgaris. We suggest that the evaluation and treatment of acne should also include psychosomatic approaches in clinical practice. PMID:25207094

  5. Vitamin B12 modulates the transcriptome of the skin microbiota in acne pathogenesis.

    PubMed

    Kang, Dezhi; Shi, Baochen; Erfe, Marie C; Craft, Noah; Li, Huiying

    2015-06-24

    Various diseases have been linked to the human microbiota, but the underlying molecular mechanisms of the microbiota in disease pathogenesis are often poorly understood. Using acne as a disease model, we aimed to understand the molecular response of the skin microbiota to host metabolite signaling in disease pathogenesis. Metatranscriptomic analysis revealed that the transcriptional profiles of the skin microbiota separated acne patients from healthy individuals. The vitamin B12 biosynthesis pathway in the skin bacterium Propionibacterium acnes was significantly down-regulated in acne patients. We hypothesized that host vitamin B12 modulates the activities of the skin microbiota and contributes to acne pathogenesis. To test this hypothesis, we analyzed the skin microbiota in healthy subjects supplemented with vitamin B12. We found that the supplementation repressed the expression of vitamin B12 biosynthesis genes in P. acnes and altered the transcriptome of the skin microbiota. One of the 10 subjects studied developed acne 1 week after vitamin B12 supplementation. To further understand the molecular mechanism, we revealed that vitamin B12 supplementation in P. acnes cultures promoted the production of porphyrins, which have been shown to induce inflammation in acne. Our findings suggest a new bacterial pathogenesis pathway in acne and provide one molecular explanation for the long-standing clinical observation that vitamin B12 supplementation leads to acne development in a subset of individuals. Our study discovered that vitamin B12, an essential nutrient in humans, modulates the transcriptional activities of skin bacteria, and provided evidence that metabolite-mediated interactions between the host and the skin microbiota play essential roles in disease development. PMID:26109103

  6. Large-scale survey to describe acne management in Brazilian clinical practice

    PubMed Central

    Seité, Sophie; Caixeta, Clarice; Towersey, Loan

    2015-01-01

    Background Acne is a chronic disease of the pilosebaceous unit that mainly affects adolescents. It is the most common dermatological problem, affecting approximately 80% of teenagers between 12 and 18 years of age. Diagnosis is clinical and is based on the patient’s age at the time the lesions first appear, and on its polymorphism, type of lesions, and their anatomical location. The right treatment for the right patient is key to treating acne safely. The aim of this investigational survey was to evaluate how Brazilian dermatologists in private practice currently manage acne. Materials and methods Dermatologists practicing in 12 states of Brazil were asked how they manage patients with grades I, II, III, and IV acne. Each dermatologist completed a written questionnaire about patient characteristics, acne severity, and the therapy they usually prescribe for each situation. Results In total, 596 dermatologists were interviewed. Adolescents presented as the most common acneic population received by dermatologists, and the most common acne grade was grade II. The doctors could choose more than one type of treatment for each patient, and treatment choices varied according to acne severity. A great majority of dermatologists considered treatment with drugs as the first alternative for all acne grades, choosing either topical or oral presentation depending on the pathology severity. Dermocosmetics were chosen mostly as adjunctive therapy, and their inclusion in the treatment regimen decreased as acne grades increased. Conclusion This survey illustrates that Brazilian dermatologists employ complex treatment regimens to manage acne, choosing systemic drugs, particularly isotretinoin, even in some cases of grade I acne, and heavily prescribe antibiotics. Because complex regimens are harder for patients to comply with, this result notably raises the question of adherence, which is a key factor in successful treatment. PMID:26609243

  7. Vitamin B12 modulates the transcriptome of the skin microbiota in acne pathogenesis.

    PubMed

    Kang, Dezhi; Shi, Baochen; Erfe, Marie C; Craft, Noah; Li, Huiying

    2015-06-24

    Various diseases have been linked to the human microbiota, but the underlying molecular mechanisms of the microbiota in disease pathogenesis are often poorly understood. Using acne as a disease model, we aimed to understand the molecular response of the skin microbiota to host metabolite signaling in disease pathogenesis. Metatranscriptomic analysis revealed that the transcriptional profiles of the skin microbiota separated acne patients from healthy individuals. The vitamin B12 biosynthesis pathway in the skin bacterium Propionibacterium acnes was significantly down-regulated in acne patients. We hypothesized that host vitamin B12 modulates the activities of the skin microbiota and contributes to acne pathogenesis. To test this hypothesis, we analyzed the skin microbiota in healthy subjects supplemented with vitamin B12. We found that the supplementation repressed the expression of vitamin B12 biosynthesis genes in P. acnes and altered the transcriptome of the skin microbiota. One of the 10 subjects studied developed acne 1 week after vitamin B12 supplementation. To further understand the molecular mechanism, we revealed that vitamin B12 supplementation in P. acnes cultures promoted the production of porphyrins, which have been shown to induce inflammation in acne. Our findings suggest a new bacterial pathogenesis pathway in acne and provide one molecular explanation for the long-standing clinical observation that vitamin B12 supplementation leads to acne development in a subset of individuals. Our study discovered that vitamin B12, an essential nutrient in humans, modulates the transcriptional activities of skin bacteria, and provided evidence that metabolite-mediated interactions between the host and the skin microbiota play essential roles in disease development.

  8. The psychosocial impact of acne, vitiligo, and psoriasis: a review

    PubMed Central

    Nguyen, Catherine M; Beroukhim, Kourosh; Danesh, Melissa J; Babikian, Aline; Koo, John; Leon, Argentina

    2016-01-01

    Introduction Chronic skin conditions have been well reported to affect a patient’s quality of life on multiple dimensions, including the psychosocial domain. Psychosocial is defined as the interrelation of social factors with an individual’s thoughts and behavior. The assessment of the psychosocial impact of skin disease on a patient can help direct the dermatologists’ treatment goals. To evaluate the psychosocial impact of skin disease, we conducted a review of the literature on three skin conditions with onsets at various stages of life: acne, vitiligo, and psoriasis. Methods A PubMed search was conducted in March 2015 using the terms “psychosocial” AND “acne”, “psychosocial” AND “vitiligo”, and “psychosocial” AND “psoriasis”. The results were limited to articles published in English in the past 5 years studying patients of all ages. Results and their references were evaluated for relevance according to their discussion of psychosocial qualities in their patients and the validity of psychosocial assessments. The search for acne yielded 51 results, and eleven were found to be relevant; vitiligo yielded 30 results with ten found to be relevant; and psoriasis yielded 70 results with seven found to be relevant. Results According to the articles evaluated, 19.2% of adolescent patients with acne were affected in their personal and social lives. Social phobia was present in 45% of patients with acne compared to 18% of control subjects. Race and sex played a role in self-consciousness and social perceptions of the disease. Vitiligo negatively affected marriage potential and caused relationship problems in >50% of patients. Psoriasis negatively affected multiple domains of life, including work, relationships, and social activities. Anxiety and depression affected not only psoriasis patients but also their cohabitants; up to 88% of cohabitants had an impaired quality of life. Conclusion Though all three skin conditions resulted in an increase

  9. Activity of capryloyl collagenic acid against bacteria involved in acne.

    PubMed

    Fourniat, J; Bourlioux, P

    1989-12-01

    Synopsis Capryloyl collagenic acid (Lipacide C8Co) has similar bacteriostatic activity in vitro to that of benzoyl peroxide towards the bacteria found in acne lesions (Staphylococcus aureus, Staphylococcus epidermidis and Propionibacterium acnes) (MIC between 1 and 4 mg ml(-1) for C8Co, and between 0.5 and 5 mg ml(-1) for benzoyl peroxide). The presence of Emulgine M8 did not affect the bacteriostatic activity of C8Co. A 4% w/v solution of C8Co (incorporating Emulgine M8) fulfilled the criteria for an antiseptic preparation as laid down by the French Pharmacopoeia (10th Edition), and had a spectrum 5 bactericidal activity according to the French Standard AFNOR NF T 72-151. The excellent cutaneous tolerance of capryloyl collagenic acid would indicate that an aqueous solution might be of value for topical treatment of the bacterial component of acne. Résumé Activité antibactérienne de l'acide capryloyl-collagénique vis à vis des bactéries impliquées dans l'etiologie de l'acné L'acide capryloyl-collagénique (Lipacide C8Co) et le peroxyde de benzoyle présentent une activité bactériostatique in-vitroéquivalente vis à vis des espèces bactériennes retrouvées au niveau des lésions acnéiques (Staphylococcus aureus, S. epidermidis et Propionibacterium acnes) (CMI comprise entre 1 et 4 mg ml(-1) pour le lipoaminoacide, et 0,5 et 5 mg ml(-1) pour le peroxyde de benzoyle). La mise en solution aqueuse de l'acide capryloyl-collagénique en présence d'Emulgine M8 ne modifie pas son activité bactériostatique. Une telle solution, à 4% m/V d'acide capryloyl-collagénique et 5% m/V d'Emulgine M8, satisfait à l'essai d'activité des préparations antiseptiques décrit à la Pharmacopée Française (Xème Ed.) (concentration minimale antiseptique: 10% v/V, pour un temps de contact de 5 min à 32 degrees C entre les germes tests et la solution diluée en eau distillée), et posséde une activité bactéricide antiseptique spectre 5 conforme à la norme AFNOR NF T

  10. Delayed Propionibacterium acnes surgical site infections occur only in the presence of an implant.

    PubMed

    Shiono, Yuta; Ishii, Ken; Nagai, Shigenori; Kakinuma, Hiroaki; Sasaki, Aya; Funao, Haruki; Kuramoto, Tetsuya; Yoshioka, Kenji; Ishihama, Hiroko; Isogai, Norihiro; Takeshima, Kenichiro; Tsuji, Takashi; Okada, Yasunori; Koyasu, Shigeo; Nakamura, Masaya; Toyama, Yoshiaki; Aizawa, Mamoru; Matsumoto, Morio

    2016-01-01

    Whether Propionibacterium acnes (P. acnes) causes surgical-site infections (SSI) after orthopedic surgery is controversial. We previously reported that we frequently find P. acnes in intraoperative specimens, yet none of the patients have clinically apparent infections. Here, we tracked P. acnes for 6 months in a mouse osteomyelitis model. We inoculated P. acnes with an implant into the mouse femur in the implant group; the control group was treated with the bacteria but no implant. We then observed over a 6-month period using optical imaging system. During the first 2 weeks, bacterial signals were detected in the femur in the both groups. The bacterial signal completely disappeared in the control group within 28 days. Interestingly, in the implant group, bacterial signals were still present 6 months after inoculation. Histological and scanning electron-microscope analyses confirmed that P. acnes was absent from the control group 6 months after inoculation, but in the implant group, the bacteria had survived in a biofilm around the implant. PCR analysis also identified P. acnes in the purulent effusion from the infected femurs in the implant group. To our knowledge, this is the first report showing that P. acnes causes SSI only in the presence of an implant. PMID:27615686

  11. Delayed Propionibacterium acnes surgical site infections occur only in the presence of an implant

    PubMed Central

    Shiono, Yuta; Ishii, Ken; Nagai, Shigenori; Kakinuma, Hiroaki; Sasaki, Aya; Funao, Haruki; Kuramoto, Tetsuya; Yoshioka, Kenji; Ishihama, Hiroko; Isogai, Norihiro; Takeshima, Kenichiro; Tsuji, Takashi; Okada, Yasunori; Koyasu, Shigeo; Nakamura, Masaya; Toyama, Yoshiaki; Aizawa, Mamoru; Matsumoto, Morio

    2016-01-01

    Whether Propionibacterium acnes (P. acnes) causes surgical-site infections (SSI) after orthopedic surgery is controversial. We previously reported that we frequently find P. acnes in intraoperative specimens, yet none of the patients have clinically apparent infections. Here, we tracked P. acnes for 6 months in a mouse osteomyelitis model. We inoculated P. acnes with an implant into the mouse femur in the implant group; the control group was treated with the bacteria but no implant. We then observed over a 6-month period using optical imaging system. During the first 2 weeks, bacterial signals were detected in the femur in the both groups. The bacterial signal completely disappeared in the control group within 28 days. Interestingly, in the implant group, bacterial signals were still present 6 months after inoculation. Histological and scanning electron-microscope analyses confirmed that P. acnes was absent from the control group 6 months after inoculation, but in the implant group, the bacteria had survived in a biofilm around the implant. PCR analysis also identified P. acnes in the purulent effusion from the infected femurs in the implant group. To our knowledge, this is the first report showing that P. acnes causes SSI only in the presence of an implant. PMID:27615686

  12. Efficacy of mupirocin and rifampin used with standard treatment in the management of acne vulgaris.

    PubMed

    Khorvash, Farzin; Abdi, Fatemeh; H Kashani, Hessam; Fatemi Naeini, Farahnaz; Khorvash, Fariborz

    2013-01-01

    The multiple etiologic factors involved in acne make the use of various medications necessary to treat the condition. This study aimed to determine the efficacy of mupirocin and rifampin used with standard treatment in the management of acne vulgaris. In a multicentre, randomized controlled, triple-blinded study, a total of 105 acne patients, with a clinical diagnosis of moderate to severe acne,were randomizedly divided into three groups (35 per group), for treatment of acne. The first group was treated with standard treatment alone, the second group received mupirocin plus standard treatment and the third group received rifampin plus standard treatment.There were three study visits according to Global Acne Grading System (GAGS): at baseline and weeks 6 and 12. The absolute changes of GAGS score from baseline to week 6 and 12 demonstrated a reduction in the mean score of GAGS in the three treatment groups (p < 0.001). Due to the difference between GAGS score at the baseline of study, the data were adjusted using the general linear model. The findings showed that all of the treatments significantly improved acne lesions. Nevertheless, none of the treatments was shown to be more effective than the others (p = 0.9). The three treatments were well tolerated, and no serious adverse events were reported. These findings provide evidence on the efficacy of combining mupirocin and rifampin with standard treatment in the management of acne vulgaris, although none of the treatments had superior efficacy compared with the others. PMID:24250593

  13. The Formulation of Bacteriophage in a Semi Solid Preparation for Control of Propionibacterium acnes Growth

    PubMed Central

    Brown, Teagan L.; Petrovski, Steve; Dyson, Zoe A.; Seviour, Robert; Tucci, Joseph

    2016-01-01

    Aims To isolate and characterise phage which could lyse P. acnes and to formulate the phage into a delivery form for potential application in topical treatment of acne infection. Methods and Results Using standard phage isolation techniques, ten phage capable of lysing P. acnes were isolated from human skin microflora. Their genomes showed high homology to previously reported P. acnes phage. These phage were formulated into cetomacrogol cream aqueous at a concentration of 2.5x108 PFU per gram, and shown to lyse underlying P. acnes cells grown as lawn cultures. These phage formulations remained active for at least 90 days when stored at four degrees Celsius in a light protected container. Conclusions P. acnes phage formulated into cetomacrogol cream aqueous will lyse surrounding and underlying P. acnes bacteria, and are effective for at least 90 days if stored appropriately. Significance and Impact of the Study There are few reports of phage formulation into semi solid preparations for application as phage therapy. The formulation method described here could potentially be applied topically to treat human acne infections. The potential exists for this model to be extended to other phage applied to treat other bacterial skin infections. PMID:26964063

  14. Antimicrobial activities of ozenoxacin against isolates of propionibacteria and staphylococci from Japanese patients with acne vulgaris.

    PubMed

    Nakajima, Akiko; Ikeda, Fumiaki; Kanayama, Shoji; Okamoto, Kazuaki; Matsumoto, Tatsumi; Ishii, Ritsuko; Fujikawa, Akira; Takei, Katsuaki; Kawashima, Makoto

    2016-08-01

    Ozenoxacin, a novel non-fluorinated topical quinolone, was assessed for in vitro antimicrobial activity against clinical isolates of propionibacteria and staphylococci according to the broth microdilution method recommended by the Clinical and Laboratory Standards Institute. The isolates used in this study were collected from Japanese patients with acne vulgaris during a period from 2012 to 2013. The MIC90s of ozenoxacin against Propionibacterium acnes (n=266), Propionibacterium granulosum (n=10), Staphylococcus aureus (n=23), Staphylococcus epidermidis (n=229) and other coagulase-negative staphylococci (n=82) were ≤0.06, ≤0.06, ≤0.06, 0.125 and ≤0.06 µg ml-1, respectively. The antimicrobial activity of ozenoxacin against the clinical isolates of propionibacteria and staphylococci was greater than that of five reference antimicrobial agents which have been used for the treatment of acne vulgaris. The MICs of ozenoxacin were correlated with those of nadifloxacin in P. acnes and S. epidermidis isolates. However, the MICs of ozenoxacin were 0.25-0.5 µg ml-1 and 0.5-8 µg ml-1 against nadifloxacin-resistant P. acnes (MIC: ≥8 µg ml-1; n=8) and S. epidermidis (MIC: ≥64 µg ml-1; n=10), respectively. These results indicated the potent antimicrobial activity against P. acnes and S. epidermidis isolates resistant to nadifloxacin. Topical ozenoxacin could represent an alternative therapeutic drug for acne vulgaris based on its potent antimicrobial activity against the isolates of propionibacteria and staphylococci from acne patients.

  15. Management of acne vulgaris with hormonal therapies in adult female patients.

    PubMed

    Husein-ElAhmed, Husein

    2015-01-01

    Acne vulgaris is a very common condition affecting up of 93% of adolescents. Although rare, this disease may persist in adulthood. In adult women with acne (those older than 25 years old), this condition is particularly relevant because of the refractory to conventional therapies, which makes acne a challenge for dermatologists in this group of patients. In order to its potential risk for chronicity and the involvement of visible anatomical sites such as face and upper torso, acne has been associated with a wide spectrum of psychological and social dysfunction such as depression, anxiety, suicidal ideation, somatization, and social inhibition. In particular, adult women with acne have been shown to be adversely impacted by the effect of acne on their quality of life. For the last four decades, dermatologists have used hormonal therapies for the management of acne vulgaris in adult women, which are considered a rational choice given the severity and chronicity of this condition in this group of patients. The aim of this work is to review the hormonal drugs for management of acne.

  16. Clinical implications of lipid peroxidation in acne vulgaris: old wine in new bottles

    PubMed Central

    2010-01-01

    Acne vulgaris is a common dermatological disorder, one that is frequently associated with depression, anxiety and other psychological sequelae. In recent years there has been an increasing focus on the extent to which oxidative stress is involved in the pathophysiology of acne. Emerging studies have shown that patients with acne are under increased cutaneous and systemic oxidative stress. Indeed, there are indications that lipid peroxidation itself is a match that lights an inflammatory cascade in acne. The notion that lipid peroxidation is a 'starter gun' in acne is not a new one; here we review the nearly 50-year-old lipid peroxidation theory and provide a historical perspective to the contemporary investigations and clinical implications. In addition, we present a novel hypothesis in which lipid peroxidation may be priming an increased susceptibility to co-morbid depression and anxiety in those with acne. The emerging research on the systemic burden of oxidative stress in acne sheds further light on the brain-skin axis. The recent findings also suggest potential avenues of approach for the treatment of acne via specific nutrients, dietary modifications, oral and topical interventions. PMID:21143923

  17. Pentobra: A potent antibiotic with multiple layers of selective antimicrobial mechanisms against Propionibacterium acnes

    PubMed Central

    Schmidt, Nathan W.; Agak, George W.; Deshayes, Stephanie; Yu, Yang; Blacker, Alyssa; Champer, Jackson; Xian, Wujing; Kasko, Andrea M.; Kim, Jenny; Wong, Gerard C. L.

    2015-01-01

    Although antibiotics are a common treatment for acne, the difficulties inherent to effective antimicrobial penetration in sebum and selective antimicrobial action in skin are compounded by increasing resistance of Propionibacterium acnes clinical isolates. To address these problems, we engineered Pentobra, a peptide-aminoglycoside molecule which has multiple mechanisms of antibacterial action, and investigated whether it can be a potential candidate for the treatment of acne. Pentobra combines the potent ribosomal activity of aminoglycosides with the bacteria-selective membrane-permeabilizing abilities of antimicrobial peptides (AMPs). Pentobra demonstrated potent and selective killing of P. acnes, but not against human skin cells in vitro. In direct comparison, Pentobra demonstrated bactericidal activity and drastically outperformed free tobramycin (by 5–7 logs) against multiple P. acnes clinical strains. Moreover, EM studies showed that Pentobra had robust membrane activity, as treatment with Pentobra killed P. acnes cells and caused leakage of intracellular contents. Pentobra may also have potential anti-inflammatory effects as demonstrated by suppression of some P. acnes-induced chemokines. Importantly, the killing activity was maintained in sebaceous environments as Pentobra was bactericidal against clinical isolates in comedones extracts isolated from human donors. Our work demonstrates that equipping aminoglycosides with selective membrane activity is a viable approach for developing antibiotics against P. acnes that are effective in cutaneous environments. PMID:25668237

  18. Musculoskeletal features of acne, hidradenitis suppurativa, and dissecting cellulitis of the scalp.

    PubMed

    Olafsson, S; Khan, M A

    1992-02-01

    This article describes the various forms of acne and the clinical and radiographic features of the associated musculoskeletal manifestations. Occasionally, acne may occur together with hidradenitis suppurativa and dissecting cellulitis of the scalp, the so called "follicular occlusion triad." The current understanding of the etiology of these conditions and their treatment are also reviewed. PMID:1532858

  19. Acne isolated within a Becker nevus of a 14 year-old girl.

    PubMed

    Juhl, Mark; Pappo, Eden; Bain, Michelle

    2015-08-01

    Becker nevus (BN) is a common benign condition occurring most often in young men, much more often than in women. Acne isolated within a BN is a rare phenomenon hypothesized to occur, at least in part, due to increased androgen sensitivity within the nevus. We present a rare case of papular acne with in a BN of a 14 year-old girl.

  20. De Novo Meningitis Caused by Propionibacterium acnes in a Patient with Metastatic Melanoma

    PubMed Central

    Burnham, Jason P.; Trevino, Sergio E.; McElvania TeKippe, Erin; Burnham, Carey-Ann D.; Kuhlmann, F. Matthew

    2014-01-01

    Propionibacterium acnes is a known cause of postneurosurgical meningitis; however, it is rarely implicated in de novo meningitis. Herein we report a case of a 49-year-old male with de novo meningitis caused by P. acnes with metastatic melanoma as the only identified risk factor for his infection. PMID:24478417

  1. Antimicrobial activities of ozenoxacin against isolates of propionibacteria and staphylococci from Japanese patients with acne vulgaris.

    PubMed

    Nakajima, Akiko; Ikeda, Fumiaki; Kanayama, Shoji; Okamoto, Kazuaki; Matsumoto, Tatsumi; Ishii, Ritsuko; Fujikawa, Akira; Takei, Katsuaki; Kawashima, Makoto

    2016-08-01

    Ozenoxacin, a novel non-fluorinated topical quinolone, was assessed for in vitro antimicrobial activity against clinical isolates of propionibacteria and staphylococci according to the broth microdilution method recommended by the Clinical and Laboratory Standards Institute. The isolates used in this study were collected from Japanese patients with acne vulgaris during a period from 2012 to 2013. The MIC90s of ozenoxacin against Propionibacterium acnes (n=266), Propionibacterium granulosum (n=10), Staphylococcus aureus (n=23), Staphylococcus epidermidis (n=229) and other coagulase-negative staphylococci (n=82) were ≤0.06, ≤0.06, ≤0.06, 0.125 and ≤0.06 µg ml-1, respectively. The antimicrobial activity of ozenoxacin against the clinical isolates of propionibacteria and staphylococci was greater than that of five reference antimicrobial agents which have been used for the treatment of acne vulgaris. The MICs of ozenoxacin were correlated with those of nadifloxacin in P. acnes and S. epidermidis isolates. However, the MICs of ozenoxacin were 0.25-0.5 µg ml-1 and 0.5-8 µg ml-1 against nadifloxacin-resistant P. acnes (MIC: ≥8 µg ml-1; n=8) and S. epidermidis (MIC: ≥64 µg ml-1; n=10), respectively. These results indicated the potent antimicrobial activity against P. acnes and S. epidermidis isolates resistant to nadifloxacin. Topical ozenoxacin could represent an alternative therapeutic drug for acne vulgaris based on its potent antimicrobial activity against the isolates of propionibacteria and staphylococci from acne patients. PMID:27305898

  2. Effect of a Polyherbal Unani formulation in acne vulgaris: A preliminary study

    PubMed Central

    Lone, Azad Hussain; Habib, Shahida; Ahmad, Tanzeel; Anwar, Mohd

    2012-01-01

    Acne vulgaris is the most common disorder treated by dermatologists. Acne is a disease of pilosebaceous units characterized by the formation of the open and closed comedones, papules, pustules, nodules and cysts. A preliminary trial was conducted in the department of Medicine, National Institute of Unani Medicine, Bangalore, India, to assess the safety and efficacy of a Polyherbal Unani Formulation (PHUF) in the management of Acne Vulgaris on scientific parameters. Twenty five patients, diagnosed with acne, were included in the study after obtaining their informed consents. All the patients were clinically assessed and diagnosed on the basis of thorough history and dermatological examination. Then, PHUF was administered locally once at night for a period of 45 days. The severity of acne and efficacy of treatment was assessed by Cook′s acne grading scale. The results showed significant reduction in the Cook′s acne grading scores of post-treatment group (P<0.01) as compared to pre-treatment scores. Further, PHUF was found safe and fairly well accepted by the patients. It was therefore, concluded that PHUF can be used safely and effectively for the treatment of acne vulgaris. PMID:23326087

  3. Efficacy of Mupirocin and Rifampin Used with Standard Treatment in the Management of Acne Vulgaris

    PubMed Central

    Khorvash, Farzin; Abdi, Fatemeh; H.Kashani, Hessam; Fatemi Naeini, Farahnaz; Khorvash, Fariborz

    2013-01-01

    The multiple etiologic factors involved in acne make the use of various medications necessary to treat the condition. This study aimed to determine the efficacy of mupirocin and rifampin used with standard treatment in the management of acne vulgaris. In a multicentre, randomized controlled, triple-blinded study, a total of 105 acne patients, with a clinical diagnosis of moderate to severe acne,were randomizedly divided into three groups (35 per group), for treatment of acne. The first group was treated with standard treatment alone, the second group received mupirocin plus standard treatment and the third group received rifampin plus standard treatment.There were three study visits according to Global Acne Grading System (GAGS): at baseline and weeks 6 and 12. The absolute changes of GAGS score from baseline to week 6 and 12 demonstrated a reduction in the mean score of GAGS in the three treatment groups (p < 0.001). Due to the difference between GAGS score at the baseline of study, the data were adjusted using the general linear model. The findings showed that all of the treatments significantly improved acne lesions. Nevertheless, none of the treatments was shown to be more effective than the others (p = 0.9). The three treatments were well tolerated, and no serious adverse events were reported. These findings provide evidence on the efficacy of combining mupirocin and rifampin with standard treatment in the management of acne vulgaris, although none of the treatments had superior efficacy compared with the others. PMID:24250593

  4. Specific Humoral Immune Response Induced by Propionibacterium acnes Can Prevent Actinobacillus pleuropneumoniae Infection in Mice

    PubMed Central

    Yang, Feng; Ma, Qiuyue; Huang, Jing; Ji, Qun; Zhai, Ruidong; Wang, Lei; Wang, Yu; Li, Linxi; Sun, Changjiang; Feng, Xin; Han, Wenyu

    2014-01-01

    Porcine contagious pleuropneumonia, caused by Actinobacillus pleuropneumoniae, has a major impact on economics, ecology, and animal welfare in the pig-rearing industry. Propionibacterium acnes, a facultative anaerobic Gram-positive corynebacterium, exists widely in normal healthy adult animals. We have shown previously that P. acnes can prevent A. pleuropneumoniae infections in mice and pigs. To elucidate the mechanism of this effect and to identify novel A. pleuropneumoniae vaccines, the role of anti-P. acnes antibodies in preventing infection was analyzed by indirect immunofluorescence and opsonophagocytosis assays in vitro. The role of the specific humoral immune response induced by P. acnes was confirmed in a B cell depletion mouse model. The survival rates of mice challenged with A. pleuropneumoniae exhibited a highly significant positive rank correlation with the levels of anti-P. acnes antibodies. The specific antibodies induced by P. acnes had the ability to combine with A. pleuropneumoniae and increase opsonization of A. pleuropneumoniae for phagocytosis. Furthermore, analysis in the murine B cell depletion model confirmed that the humoral immune response induced by P. acnes played an important role in resistance to A. pleuropneumoniae infection. In this study, we further elucidated the reasons that P. acnes can prevent A. pleuropneumoniae infection, which provides useful evidence for the development of heterologous vaccines for the control of porcine contagious pleuropneumonia. PMID:24429068

  5. In vivo assessment of the efficacy of an innovative face care system in subjects with mild acne vulgaris.

    PubMed

    Scherdin, U; Presto, S; Rippke, F; Nielsen, J; Strassner, M; Imadojemun, A; Gärtner, E; Herpens, A; Korting, H C; Bielfeldt, S

    2004-10-01

    The purpose of our studies was to verify efficacy and skin compatibility of a medical face care system containing 2% lactic acid (LA) as active ingredient in a specially designed vehicle (Follicle Targeting System) in adult subjects with mild acne vulgaris. The first study (46 patients) demonstrated superiority of 2% LA in comparison to 2% salicylic acid with respect to number of comedones and inflammatory lesions. The second study evaluated 90 patients receiving distinct combinations of face care products (Eucerin) Impure Skin, Hamburg, Germany), i.e. cleansing gel, facial tonic (2% LA) and cream gel (2% LA). All treatments were performed twice daily over a 12 weeks period. Lesion counts, cyanoacrylate biopsies and determination of quality of life by questionnaires were performed at different timepoints. A reduction of comedones by 56% corresponding to an 46% increase of quality of life index was demonstrated in patients applying cleansing gel, facial tonic and cream gel. For the first time we were able to show a significant improvement concerning the quality of life after using a new face care line. Especially adults with mild forms of acne may benefit from this effective skin care regimen. PMID:18492134

  6. Potential role of FoxO1 and mTORC1 in the pathogenesis of Western diet-induced acne.

    PubMed

    Melnik, Bodo C; Zouboulis, Christos C

    2013-05-01

    Acne in adolescents of developed countries is an epidemic skin disease and has currently been linked to the Western diet (WD). It is the intention of this viewpoint to discuss the possible impact of WD-mediated nutrient signalling in the pathogenesis of acne. High glycaemic load and dairy protein consumption both increase insulin/insulin-like growth factor-1 (IGF-1) signalling (IIS) that is superimposed on elevated IGF-1 signalling of puberty. The cell's nutritional status is primarily sensed by the forkhead box transcription factor O1 (FoxO1) and the serine/threonine kinase mammalian target of rapamycin complex 1 (mTORC1). Increased IIS extrudes FoxO1 into the cytoplasm, whereas nuclear FoxO1 suppresses hepatic IGF-1 synthesis and thus impairs somatic growth. FoxO1 attenuates androgen signalling, interacts with regulatory proteins important for sebaceous lipogenesis, regulates the activity of innate and adaptive immunity, antagonizes oxidative stress and most importantly functions as a rheostat of mTORC1, the master regulator of cell growth, proliferation and metabolic homoeostasis. Thus, FoxO1 links nutrient availability to mTORC1-driven processes: increased protein and lipid synthesis, cell proliferation, cell differentiation including hyperproliferation of acroinfundibular keratinocytes, sebaceous gland hyperplasia, increased sebaceous lipogenesis, insulin resistance and increased body mass index. Enhanced androgen, TNF-α and IGF-1 signalling due to genetic polymorphisms promoting the risk of acne all converge in mTORC1 activation, which is further enhanced by nutrient signalling of WD. Deeper insights into the molecular interplay of FoxO1/mTORC1-mediated nutrient signalling are thus of critical importance to understand the impact of WD on the promotion of epidemic acne and more serious mTORC1-driven diseases of civilization. PMID:23614736

  7. Potential role of FoxO1 and mTORC1 in the pathogenesis of Western diet-induced acne

    PubMed Central

    Melnik, Bodo C; Zouboulis, Christos C

    2013-01-01

    Acne in adolescents of developed countries is an epidemic skin disease and has currently been linked to the Western diet (WD). It is the intention of this viewpoint to discuss the possible impact of WD-mediated nutrient signalling in the pathogenesis of acne. High glycaemic load and dairy protein consumption both increase insulin/insulin-like growth factor-1 (IGF-1) signalling (IIS) that is superimposed on elevated IGF-1 signalling of puberty. The cell's nutritional status is primarily sensed by the forkhead box transcription factor O1 (FoxO1) and the serine/threonine kinase mammalian target of rapamycin complex 1 (mTORC1). Increased IIS extrudes FoxO1 into the cytoplasm, whereas nuclear FoxO1 suppresses hepatic IGF-1 synthesis and thus impairs somatic growth. FoxO1 attenuates androgen signalling, interacts with regulatory proteins important for sebaceous lipogenesis, regulates the activity of innate and adaptive immunity, antagonizes oxidative stress and most importantly functions as a rheostat of mTORC1, the master regulator of cell growth, proliferation and metabolic homoeostasis. Thus, FoxO1 links nutrient availability to mTORC1-driven processes: increased protein and lipid synthesis, cell proliferation, cell differentiation including hyperproliferation of acroinfundibular keratinocytes, sebaceous gland hyperplasia, increased sebaceous lipogenesis, insulin resistance and increased body mass index. Enhanced androgen, TNF-α and IGF-1 signalling due to genetic polymorphisms promoting the risk of acne all converge in mTORC1 activation, which is further enhanced by nutrient signalling of WD. Deeper insights into the molecular interplay of FoxO1/mTORC1-mediated nutrient signalling are thus of critical importance to understand the impact of WD on the promotion of epidemic acne and more serious mTORC1-driven diseases of civilization. PMID:23614736

  8. Comparative activity of benzoyl peroxide and hexachlorophene. In vivo studies against propionibacterium acnes in humans.

    PubMed

    Nacht, S; Gans, E H; McGinley, K J; Kligman, A M

    1983-07-01

    The bactericidal effects of benzoyl peroxide (5% lotion) and hexachlorophene (3% colloidal suspension) against Propionibacterium acnes were compared in nine healthy college students who had the microbiological and skin lipid characteristics typical of acne vulgaris, but no active lesions. Each of the two medications was applied twice daily, to opposite sides of the face, for four consecutive weeks. Hexachlorophene was effective against surface aerobes but only slightly active against P acnes. It marginally reduced free fatty acid concentrations in surface lipids and in follicular porphyrin fluorescence. Conversely, benzoyl peroxide virtually eliminated P acnes and aerobes and induced substantially decreased free fatty acid concentrations and follicular fluorescence. We conclude that benzoyl peroxide exerts its antimicrobial action in the follicles and inhibits P acnes, while the antimicrobial effectiveness of hexachlorophene is limited to the skin surface.

  9. Re-evaluating treatment targets in acne vulgaris: adapting to a new understanding of pathophysiology.

    PubMed

    Kircik, Leon H

    2014-06-01

    Two primary factors are changing current approaches to the management of acne vulgaris (AV): the continuously evolving role of Propionibacterium acnes in the pathophysiology of AV and recent evidence of an inflammatory basis for AV via innate immunity. The developing concepts emphasize that acne is primarily an inflammatory disease. The emerging concept of subclinical inflammation and its effect on development and progression of acne lesions correlating with the sequence of the underlying inflammation process has been a major change in our understanding of acne pathogenesis. Thus, inflammation has become the major feature of the disease process from onset to resolution, including postinflammatory erythema, postinflammatory hyperpigmentation, and scarring. Our treatment targets may also need to be reconsidered, with more emphasis on anti-inflammatory treatments.

  10. Strain-Level Differences in Porphyrin Production and Regulation in Propionibacterium acnes Elucidate Disease Associations

    PubMed Central

    Johnson, Tremylla; Kang, Dezhi; Barnard, Emma

    2016-01-01

    ABSTRACT Propionibacterium acnes is an important skin commensal, but it is also considered a pathogenic factor in several diseases including acne vulgaris, the most common skin disease. While previous studies have revealed P. acnes strain-level differences in health and disease associations, the underlying molecular mechanisms remain unknown. Recently, we demonstrated that vitamin B12 supplementation increases P. acnes production of porphyrins, a group of proinflammatory metabolites important in acne development (D. Kang, B. Shi, M. C. Erfe, N. Craft, and H. Li, Sci. Transl. Med. 7:293ra103, 2015, doi:10.1126/scitranslmed.aab2009). In this study, we compared the porphyrin production and regulation of multiple P. acnes strains. We revealed that acne-associated type IA-2 strains inherently produced significantly higher levels of porphyrins, which were further enhanced by vitamin B12 supplementation. On the other hand, health-associated type II strains produced low levels of porphyrins and did not respond to vitamin B12. Using a small-molecule substrate and inhibitor, we demonstrated that porphyrin biosynthesis was modulated at the metabolic level. We identified a repressor gene (deoR) of porphyrin biosynthesis that was carried in all health-associated type II strains, but not in acne-associated type IA-2 strains. The expression of deoR suggests additional regulation of porphyrin production at the transcriptional level in health-associated strains. Our findings provide one potential molecular mechanism for the different contributions of P. acnes strains to skin health and disease and support the role of vitamin B12 in acne pathogenesis. Our study emphasizes the importance of understanding the role of the commensal microbial community in health and disease at the strain level and suggests potential utility of health-associated P. acnes strains in acne treatment. IMPORTANCE Propionibacterium acnes is a dominant bacterium residing on skin, and it has been thought

  11. Strain-Level Differences in Porphyrin Production and Regulation in Propionibacterium acnes Elucidate Disease Associations.

    PubMed

    Johnson, Tremylla; Kang, Dezhi; Barnard, Emma; Li, Huiying

    2016-01-01

    Propionibacterium acnes is an important skin commensal, but it is also considered a pathogenic factor in several diseases including acne vulgaris, the most common skin disease. While previous studies have revealed P. acnes strain-level differences in health and disease associations, the underlying molecular mechanisms remain unknown. Recently, we demonstrated that vitamin B12 supplementation increases P. acnes production of porphyrins, a group of proinflammatory metabolites important in acne development (D. Kang, B. Shi, M. C. Erfe, N. Craft, and H. Li, Sci. Transl. Med. 7:293ra103, 2015, doi:10.1126/scitranslmed.aab2009). In this study, we compared the porphyrin production and regulation of multiple P. acnes strains. We revealed that acne-associated type IA-2 strains inherently produced significantly higher levels of porphyrins, which were further enhanced by vitamin B12 supplementation. On the other hand, health-associated type II strains produced low levels of porphyrins and did not respond to vitamin B12. Using a small-molecule substrate and inhibitor, we demonstrated that porphyrin biosynthesis was modulated at the metabolic level. We identified a repressor gene (deoR) of porphyrin biosynthesis that was carried in all health-associated type II strains, but not in acne-associated type IA-2 strains. The expression of deoR suggests additional regulation of porphyrin production at the transcriptional level in health-associated strains. Our findings provide one potential molecular mechanism for the different contributions of P. acnes strains to skin health and disease and support the role of vitamin B12 in acne pathogenesis. Our study emphasizes the importance of understanding the role of the commensal microbial community in health and disease at the strain level and suggests potential utility of health-associated P. acnes strains in acne treatment. IMPORTANCE Propionibacterium acnes is a dominant bacterium residing on skin, and it has been thought to play a

  12. Status report from the American Acne & Rosacea Society on medical management of acne in adult women, part 1: overview, clinical characteristics, and laboratory evaluation.

    PubMed

    Del Rosso, James Q; Harper, Julie C; Graber, Emmy M; Thiboutot, Diane; Silverberg, Nanette B; Eichenfield, Dawn Zhang; Eichenfield, Lawrence F

    2015-10-01

    Acne presenting in adult women is commonly encountered in clinical practice. Many affected women have had acne during their teenaged years, have tried several therapies in the past, and are seeking effective treatment. Others are frustrated by the inexplicable emergence of acne as an adult when they never had it as a teenager. Both groups seek an explanation of why they have acne, are often psychosocially affected by its effects on appearance and self-esteem, and all are wanting effective and safe treatment. Clinicians are encouraged to connect favorably with each patient through careful history and physical examination and to consider underlying causes of androgen excess. Practical approaches to examination and laboratory evaluation are discussed.

  13. Status report from the American Acne & Rosacea Society on medical management of acne in adult women, part 1: overview, clinical characteristics, and laboratory evaluation.

    PubMed

    Del Rosso, James Q; Harper, Julie C; Graber, Emmy M; Thiboutot, Diane; Silverberg, Nanette B; Eichenfield, Dawn Zhang; Eichenfield, Lawrence F

    2015-10-01

    Acne presenting in adult women is commonly encountered in clinical practice. Many affected women have had acne during their teenaged years, have tried several therapies in the past, and are seeking effective treatment. Others are frustrated by the inexplicable emergence of acne as an adult when they never had it as a teenager. Both groups seek an explanation of why they have acne, are often psychosocially affected by its effects on appearance and self-esteem, and all are wanting effective and safe treatment. Clinicians are encouraged to connect favorably with each patient through careful history and physical examination and to consider underlying causes of androgen excess. Practical approaches to examination and laboratory evaluation are discussed. PMID:26682286

  14. Immunoproteomic Identification of In Vivo-Produced Propionibacterium acnes Proteins in a Rabbit Biofilm Infection Model

    PubMed Central

    Achermann, Yvonne; Tran, Bao; Kang, Misun; Harro, Janette M.

    2015-01-01

    Propionibacterium acnes is well-known as a human skin commensal but can also act as an invasive pathogen causing implant-associated infections. In order to resolve these types of P. acnes infections, the implants must be removed, due to the presence of an established biofilm that is recalcitrant to antibiotic therapy. In order to identify those P. acnes proteins produced in vivo during a biofilm infection, we established a rabbit model of implant-associated infection with this pathogen. P. acnes biofilms were anaerobically grown on dextran beads that were then inoculated into the left tibias of rabbits. At 4 weeks postinoculation, P. acnes infection was confirmed by radiograph, histology, culture, and PCR. In vivo-produced and immunogenic P. acnes proteins were detected on Western blot using serum samples from rabbits infected with P. acnes after these bacterial proteins were separated by two-dimensional gel electrophoresis. Those proteins that bound host antibodies were then isolated and identified by tandem mass spectrometry. Radiographs and histology demonstrated a disruption in the normal bone architecture and adherent biofilm communities in those animals with confirmed infections. A total of 24 immunogenic proteins were identified; 13 of these proteins were upregulated in both planktonic and biofilm modes, including an ABC transporter protein. We successfully adapted a rabbit model of implant-associated infection for P. acnes to identify P. acnes proteins produced during a chronic biofilm-mediated infection. Further studies are needed to evaluate the potential of these proteins for either a diagnostic test or a vaccine to prevent biofilm infections caused by P. acnes. PMID:25694647

  15. Mild insulin resistance during oral glucose tolerance test (OGTT) in women with acne.

    PubMed

    Aizawa, H; Niimura, M

    1996-08-01

    The purpose of this study was to evaluate serum levels of basal insulin and glucose-stimulated insulin, and to evaluate their correlations with androgen levels in women with acne. Serum levels of total testosterone (T), free testosterone (FT), dihydrotestosterone (DHT), dehydroepiandrosterone sulfate (DHEA-S), sex hormone binding globulin (SHBG), insulin-like growth factor-1 (IFG-1), and immunoreactive insulin (IRI) were measured and compared in thirty women with moderate or severe acne and thirteen healthy controls. Serum FT, DHT and DHEA-S levels in the acne group were significantly higher than those in the control group. In the acne group, there were no significant correlations between insulin or IGF-1 levels and T, FT, DHT and SHBG, despite the positive correlation between insulin and IGF-1. In order to determine the effects of insulin secretion as a dynamic response to an oral glucose tolerance test (OGTT) on serum androgen levels in acne patients, we examined the responses of serum insulin and androgen levels to a 75 g, 2 hour OGTT in the acne group and in the control group. Basal insulin levels were not significantly higher than those in the control group, but the summed insulin levels during the OGTT in the acne group were significantly higher than those in the control group. Serum T and FT levels in the acne group decreased during the OGTT, but these changes were not so significant when compared to normal controls. In conclusion, we tried to demonstrate mild insulin resistance during the OGTT in acne patients. However, postmeal transient hyperinsulinemia does not seem to play an important role in determining hyperandrogenemia in acne patients. PMID:8854583

  16. Adrenal androgen abnormalities in women with late onset and persistent acne.

    PubMed

    Aizawa, H; Niimura, M

    1993-01-01

    Androgens are an essential prerequisite for the development of acne. The present study was undertaken to characterize the androgen status of women with late onset and persistent acne only and, using the dexamethasone (dex) suppression test, to identify the source(s) of the androgen excess. We measured serum levels of total testosterone (T), free testosterone (FT), androstenedione (delta 4A), dihydrotestosterone (DHT), dehydroepiandrosterone sulphate (DHEA-S) and sex hormone binding globulin (SHBG) in 34 healthy control subjects, in 34 women with mild acne and in 29 women with moderate or severe acne. Serum FT, DHT and DHEA-S levels in patients of both acne groups were significantly higher than those in the control subjects. The other hormone levels showed no significant differences between patients and control subjects, and there were no significant differences between the two acne groups in any of the androgen levels. In order to evaluate the ovarian and adrenal contributions to serum androgens in the acne patients, the serum levels of delta 4A, T, DHT and DHEA-S were measured prior to and following 2 weeks of dex therapy. Following the dex test, the DHT and T of adrenal origin were significantly higher in the acne patients than in the control subjects. These results suggest that, in acne patients, hyperandrogenaemia is likely to develop as a result of adrenal androgen excess. In addition, since abnormally high androgen levels are frequently seen in late onset and persist acne, it seems that this condition is likely to be a sign of hyperandrogenism. PMID:8466282

  17. Immunoproteomic Identification of In Vivo-Produced Propionibacterium acnes Proteins in a Rabbit Biofilm Infection Model.

    PubMed

    Achermann, Yvonne; Tran, Bao; Kang, Misun; Harro, Janette M; Shirtliff, Mark E

    2015-05-01

    Propionibacterium acnes is well-known as a human skin commensal but can also act as an invasive pathogen causing implant-associated infections. In order to resolve these types of P. acnes infections, the implants must be removed, due to the presence of an established biofilm that is recalcitrant to antibiotic therapy. In order to identify those P. acnes proteins produced in vivo during a biofilm infection, we established a rabbit model of implant-associated infection with this pathogen. P. acnes biofilms were anaerobically grown on dextran beads that were then inoculated into the left tibias of rabbits. At 4 weeks postinoculation, P. acnes infection was confirmed by radiograph, histology, culture, and PCR. In vivo-produced and immunogenic P. acnes proteins were detected on Western blot using serum samples from rabbits infected with P. acnes after these bacterial proteins were separated by two-dimensional gel electrophoresis. Those proteins that bound host antibodies were then isolated and identified by tandem mass spectrometry. Radiographs and histology demonstrated a disruption in the normal bone architecture and adherent biofilm communities in those animals with confirmed infections. A total of 24 immunogenic proteins were identified; 13 of these proteins were upregulated in both planktonic and biofilm modes, including an ABC transporter protein. We successfully adapted a rabbit model of implant-associated infection for P. acnes to identify P. acnes proteins produced during a chronic biofilm-mediated infection. Further studies are needed to evaluate the potential of these proteins for either a diagnostic test or a vaccine to prevent biofilm infections caused by P. acnes. PMID:25694647

  18. Managing nonteratogenic adverse reactions to isotretinoin treatment for acne vulgaris.

    PubMed

    Reilly, Bridget K; Ritsema, Tamara S

    2015-07-01

    Isotretinoin is the strongest, most effective oral treatment for patients with severe acne vulgaris, with remission rates of 89% and higher. Because of its potency, isotretinoin causes many adverse reactions. This article reviews common and severe adverse reactions to isotretinoin and how providers can best manage these reactions. Because of inconclusive research on the correlation between isotretinoin and depression and irritable bowel syndrome, providers should ask patients about symptoms monthly. Prescribing micronized isotretinoin and starting at the lowest dose with gradual upward titration also can help reduce the incidence of adverse reactions.

  19. Are we underdosing acne patients with generic isotretinoin?

    PubMed

    Mutizwa, Misha M; Sheinbein, David M

    2013-01-15

    With Roche's withdrawl of Accutane from the U.S. market in 2009, isotretinoin has only been available in its generic form. Many clinicians fail to realize that for approval by the U.S. Food and Drug Administration, a generic medication must have a bioequivalence between 80 percent and 125 percent of that of the innovator product. This potential variability in bioavailability between branded and generic medications is important to keep in mind with isotretinoin, given the implications for achieving a sustained remission in acne patients.

  20. Acne vulgaris: treatment with topical benzoyl peroxide acetone gel.

    PubMed

    Montes, L F

    1977-05-01

    The topical effect on acne of a benzoyl peroxide acetone gel was studied over an eight week period and simultaneously compared with the effect of a benzoyl peroxide lotion and a vitamin A acid cream. The three formulations produced a significant reduction in the number of comedones. The two benzoyl peroxide formulations substantially reduced the number of papules, but this effect was not observed to a significant degree with the vitamin A acid. Burning sensation following application, a common problem with the benzoyl peroxide alcohol gels, was not reported by patients using the benzoyl peroxide acetone gel.

  1. Association of HSD17B3 and HSD3B1 polymorphisms with acne vulgaris in Southwestern Han Chinese.

    PubMed

    Yang, Xiao-Yan; Wu, Wen-Juan; Yang, Cheng; Yang, Ting; He, Jun-Dong; Yang, Zhi; He, Li

    2013-01-01

    Acne vulgaris is a very common skin disorder. Previous studies have indicated that genetic background factors play key roles in the onset of acne. Our previous investigation implicated several genes in the androgen metabolism pathway with acne vulgaris in the Han Chinese population. Thus, we further investigated genes and genetic variants that play important roles in this pathway for their relationship with the pathology of acne. In this study, a total of 610 subjects, including 403 acne patients and 207 healthy controls, were genotyped for 15 single-nucleotide polymorphisms in HSD3B1 and HSD17B3 genes. This study shows that rs6428829 in HSD3B1 was associated with acne vulgaris in Han patients from Southwest China, even after adjusting for age and sex. The GG genotype was associated with an increased risk of acne vulgaris (p < 0.05) and G allele carriers were associated with an increased risk of acne vulgaris (p < 0.05). In addition, the haplotype AAT in HSD3B1 significantly increased the risk of acne vulgaris in the case-control study (p < 0.05). Furthermore, for another gene in this pathway, HSD17B3, the haplotype H8 was significantly associated with an increased risk of acne vulgaris. Based on these analyses, our study indicates that the cutaneous androgen metabolism-regulated genes HSD3B1 and HSD17B3 increase the susceptibility to acne vulgaris in Han Chinese from Southwest China.

  2. Use of a Cutaneous Body Image (CBI) scale to evaluate self perception of body image in acne vulgaris.

    PubMed

    Amr, Mostafa; Kaliyadan, Feroze; Shams, Tarek

    2014-01-01

    Skin disorders such as acne, which have significant cosmetic implications, can affect the self-perception of cutaneous body image. There are many scales which measure self-perception of cutaneous body image. We evaluated the use of a simple Cutaneous Body Image (CBI) scale to assess self-perception of body image in a sample of young Arab patients affected with acne. A total of 70 patients with acne answered the CBI questionnaire. The CBI score was correlated with the severity of acne and acne scarring, gender, and history of retinoids use. There was no statistically significant correlation between CBI and the other parameters - gender, acne/acne scarring severity, and use of retinoids. Our study suggests that cutaneous body image perception in Arab patients with acne was not dependent on variables like gender and severity of acne or acne scarring. A simple CBI scale alone is not a sufficiently reliable tool to assess self-perception of body image in patients with acne vulgaris.

  3. Indexing Images.

    ERIC Educational Resources Information Center

    Rasmussen, Edie M.

    1997-01-01

    Focuses on access to digital image collections by means of manual and automatic indexing. Contains six sections: (1) Studies of Image Systems and their Use; (2) Approaches to Indexing Images; (3) Image Attributes; (4) Concept-Based Indexing; (5) Content-Based Indexing; and (6) Browsing in Image Retrieval. Contains 105 references. (AEF)

  4. with Disabilities

    ERIC Educational Resources Information Center

    Cote, Debra L.; Jones, Vita L.; Sparks, Shannon L.; Aldridge, Patricia A.

    2012-01-01

    Parents from culturally diverse backgrounds need to feel that they play a vital role in the future success of their sons or daughters with disabilities. Differences in culture and ethnicity can affect families' involvement in transition planning and the goals that they emphasize for their children. Families of diverse backgrounds were…

  5. Intellectual Disability

    MedlinePlus

    ... follows: _________________ Definition of “Intellectual Disability” under IDEA Until Rosa’s Law was signed into law by President Obama ... the term “mental retardation” instead of “intellectual disability.” Rosa’s Law changed the term to be used in ...

  6. Intellectual Disability

    MedlinePlus

    ... known causes of intellectual disability – like Down syndrome, fetal alcohol syndrome, fragile X syndrome, genetic conditions, birth defects, and infections – happen before birth. Others happen while a baby is being born or soon after ... fetal, el síndrome X frágil, afecciones genéticas, defectos congénitos ...

  7. Inequality in Disability in Bangladesh

    PubMed Central

    Tareque, Md. Ismail; Begum, Sharifa; Saito, Yasuhiko

    2014-01-01

    Objective To investigate inequality in disability in Bangladesh. Methods The study used both household level and individual level data from a large nationally representative data set, Bangladesh’s Household Income and Expenditure Survey - 2010. Principal component analysis was used to construct a wealth index based on household assets from household level data. Then, using data from 49,809 individuals aged 5 years and over, chi-square tests and logistic regression were performed to test the association between wealth level and disability. Findings Women and older people are significantly more likely to report having disabilities than men and younger people. For middle and rich families, respectively, there is a 14 percent lower likelihood of reporting disabilities than for poor families. Changes in the probability of having disabilities are linear with increasing wealth. In addition, the study identifies some significant factors affecting disability, namely, age, sex, education, marital status, and place of residence including divisional differences. Conclusion In Bangladesh, worse health among the poor argues for policies prioritizing this group while at the same time giving special attention to women and the elderly. PMID:25075513

  8. A Derivative of the Thiopeptide GE2270A Highly Selective against Propionibacterium acnes

    PubMed Central

    He, Cheng-Guang; Gaspari, Eleonora; Maffioli, Sonia; Brandi, Letizia; Spurio, Roberto; Sosio, Margherita; Jabes, Daniela

    2015-01-01

    A chemical derivative of the thiopeptide GE2270A, designated NAI003, was found to possess a substantially reduced antibacterial spectrum in comparison to the parent compound, being active against just a few Gram-positive bacteria. In particular, NAI003 retained low MICs against all tested isolates of Propionibacterium acnes and, to a lesser extent, against Enterococcus faecalis. Furthermore, NAI003 showed a time- and dose-dependent killing of both a clindamycin-resistant and a clindamycin-sensitive P. acnes isolate. Gel shift experiments indicated that, like the parent compound, NAI003 retained the ability to bind to elongation factors Tu (EF-Tus) derived from Escherichia coli, E. faecalis, or P. acnes, albeit with reduced efficiency. In contrast, EF-Tus derived from the NAI003-insensitive Staphylococcus aureus or Streptococcus pyogenes did not bind this compound. These results were confirmed by in vitro studies using a hybrid translation system, which indicated that NAI003 can inhibit most efficiently protein synthesis driven by the P. acnes EF-Tu. P. acnes mutants resistant to NAI003 were isolated by direct plating. With one exception, all analyzed strains carried mutations in the tuf gene, encoding EF-Tu. Because of its selective effect on P. acnes in comparison to resident skin flora, NAI003 represents a promising candidate for the topical treatment of acne, which has already completed a phase 1 clinical study. PMID:25987631

  9. A meta-analysis of association between acne vulgaris and Demodex infestation.

    PubMed

    Zhao, Ya-E; Hu, Li; Wu, Li-Ping; Ma, Jun-Xian

    2012-03-01

    Until now, etiology of acne vulgaris is still uncertain. Although clinicians usually deny the association between Demodex infestation and acne vulgaris, it has been proved in some clinical practices. To confirm the association between Demodex infestation and acne vulgaris, a meta-analysis was conducted. Predefined selection criteria were applied to search all published papers that analyzed the association between Demodex infestation and acne vulgaris (January 1950 to August 2011) in ISI Web of Knowledge, MEDLINE, and China National Knowledge Infrastructure (CNKI) databases. A meta-analysis was performed to calculate odds ratios (ORs) and 95% confidence intervals (CIs) based on fixed effects models or random effects models. We enrolled the 60 Chinese and 3 English papers in this meta-analysis, which covered Turkey and 25 different provinces/municipalities in China and 42130 participants including students and residents, aged from 1 to 78 years. The pooled OR in random effects models is 2.80 (95% CI, 2.34-3.36). Stability is robust according to sensitivity analysis. The fail-safe number is 18477, suggesting that at least 18477 articles with negative conclusions would be needed to reverse the conclusion that acne vulgaris was related to Demodex infestation. So the effect of publication bias was insignificant and could be ignored. It was concluded that acne vulgaris is associated with Demodex infestation. This indicates that when regular treatments for acne vulgaris are ineffective, examination of Demodex mites and necessary acaricidal therapies should be considered.

  10. The diversity and host interactions of Propionibacterium acnes bacteriophages on human skin.

    PubMed

    Liu, Jared; Yan, Riceley; Zhong, Qiao; Ngo, Sam; Bangayan, Nathanael J; Nguyen, Lin; Lui, Timothy; Liu, Minghsun; Erfe, Marie C; Craft, Noah; Tomida, Shuta; Li, Huiying

    2015-09-01

    The viral population, including bacteriophages, is an important component of the human microbiota, yet is poorly understood. We aim to determine whether bacteriophages modulate the composition of the bacterial populations, thus potentially playing a role in health or disease. We investigated the diversity and host interactions of the bacteriophages of Propionibacterium acnes, a major human skin commensal implicated in acne pathogenesis. By sequencing 48 P. acnes phages isolated from acne patients and healthy individuals and by analyzing the P. acnes phage populations in healthy skin metagenomes, we revealed that P. acnes phage populations in the skin microbial community are often dominated by one strain. We also found phage strains shared among both related and unrelated individuals, suggesting that a pool of common phages exists in the human population and that transmission of phages may occur between individuals. To better understand the bacterium-phage interactions in the skin microbiota, we determined the outcomes of 74 genetically defined Propionibacterium strains challenged by 15 sequenced phages. Depending on the Propionibacterium lineage, phage infection can result in lysis, pseudolysogeny, or resistance. In type II P. acnes strains, we found that encoding matching clustered regularly interspaced short palindromic repeat spacers is insufficient to confer phage resistance. Overall, our findings suggest that the prey-predator relationship between bacteria and phages may have a role in modulating the composition of the microbiota. Our study also suggests that the microbiome structure of an individual may be an important factor in the design of phage-based therapy. PMID:25848871

  11. A Derivative of the Thiopeptide GE2270A Highly Selective against Propionibacterium acnes.

    PubMed

    Fabbretti, Attilio; He, Cheng-Guang; Gaspari, Eleonora; Maffioli, Sonia; Brandi, Letizia; Spurio, Roberto; Sosio, Margherita; Jabes, Daniela; Donadio, Stefano

    2015-08-01

    A chemical derivative of the thiopeptide GE2270A, designated NAI003, was found to possess a substantially reduced antibacterial spectrum in comparison to the parent compound, being active against just a few Gram-positive bacteria. In particular, NAI003 retained low MICs against all tested isolates of Propionibacterium acnes and, to a lesser extent, against Enterococcus faecalis. Furthermore, NAI003 showed a time- and dose-dependent killing of both a clindamycin-resistant and a clindamycin-sensitive P. acnes isolate. Gel shift experiments indicated that, like the parent compound, NAI003 retained the ability to bind to elongation factors Tu (EF-Tus) derived from Escherichia coli, E. faecalis, or P. acnes, albeit with reduced efficiency. In contrast, EF-Tus derived from the NAI003-insensitive Staphylococcus aureus or Streptococcus pyogenes did not bind this compound. These results were confirmed by in vitro studies using a hybrid translation system, which indicated that NAI003 can inhibit most efficiently protein synthesis driven by the P. acnes EF-Tu. P. acnes mutants resistant to NAI003 were isolated by direct plating. With one exception, all analyzed strains carried mutations in the tuf gene, encoding EF-Tu. Because of its selective effect on P. acnes in comparison to resident skin flora, NAI003 represents a promising candidate for the topical treatment of acne, which has already completed a phase 1 clinical study. PMID:25987631

  12. Mutagenesis of Propionibacterium acnes and analysis of two CAMP factor knock-out mutants.

    PubMed

    Sörensen, Meike; Mak, Tim N; Hurwitz, Robert; Ogilvie, Lesley A; Mollenkopf, Hans J; Meyer, Thomas F; Brüggemann, Holger

    2010-11-01

    P. acnes is a skin commensal that is frequently associated with inflammatory diseases such as acne vulgaris. Despite the availability of the genome sequence functional studies on P. acnes are scarce due to a lack of methods for genetic manipulation of this bacterium. Here we present an insertional mutagenesis approach for the inactivation of specific P. acnes genes. The gene of interest can be disrupted and replaced with an erythromycin-resistance cassette by employing homologous recombination. We used this method to generate knock-out mutants of camp2 (PPA0687) and camp4 (PPA1231), encoding CAMP factor homologs with predicted co-hemolytic activities. The successful inactivation of the two genes was confirmed by PCR and Western blotting experiments using specific anti-CAMP2/CAMP4 sera. The Δcamp2 but not the Δcamp4 mutant exhibited reduced hemolytic activity in the CAMP reaction with sheep erythrocytes, indicating that CAMP2 is the major active co-hemolytic factor of P. acnes. The biological relevance of the CAMP factors remains unclear as disruption of camp2 or camp4 did not significantly alter the transcriptome response of HaCaT cells to P. acnes. The here presented insertional mutagenesis approach will facilitate future studies on P. acnes.

  13. The diversity and host interactions of Propionibacterium acnes bacteriophages on human skin

    PubMed Central

    Liu, Jared; Yan, Riceley; Zhong, Qiao; Ngo, Sam; Bangayan, Nathanael J; Nguyen, Lin; Lui, Timothy; Liu, Minghsun; Erfe, Marie C; Craft, Noah; Tomida, Shuta; Li, Huiying

    2015-01-01

    The viral population, including bacteriophages, is an important component of the human microbiota, yet is poorly understood. We aim to determine whether bacteriophages modulate the composition of the bacterial populations, thus potentially playing a role in health or disease. We investigated the diversity and host interactions of the bacteriophages of Propionibacterium acnes, a major human skin commensal implicated in acne pathogenesis. By sequencing 48 P. acnes phages isolated from acne patients and healthy individuals and by analyzing the P. acnes phage populations in healthy skin metagenomes, we revealed that P. acnes phage populations in the skin microbial community are often dominated by one strain. We also found phage strains shared among both related and unrelated individuals, suggesting that a pool of common phages exists in the human population and that transmission of phages may occur between individuals. To better understand the bacterium–phage interactions in the skin microbiota, we determined the outcomes of 74 genetically defined Propionibacterium strains challenged by 15 sequenced phages. Depending on the Propionibacterium lineage, phage infection can result in lysis, pseudolysogeny, or resistance. In type II P. acnes strains, we found that encoding matching clustered regularly interspaced short palindromic repeat spacers is insufficient to confer phage resistance. Overall, our findings suggest that the prey–predator relationship between bacteria and phages may have a role in modulating the composition of the microbiota. Our study also suggests that the microbiome structure of an individual may be an important factor in the design of phage-based therapy. PMID:25848871

  14. Medicinal Plants for the Treatment of Acne Vulgaris: A Review of Recent Evidences

    PubMed Central

    Nasri, Hamid; Bahmani, Mahmoud; Shahinfard, Najmeh; Moradi Nafchi, Atefeh; Saberianpour, Shirin; Rafieian Kopaei, Mahmoud

    2015-01-01

    Context: Acne vulgaris affects about 85% of teenagers and may continue to adulthood. There are about two million visits to physicians per year for teenagers and the direct cost of acne treatment in the US exceeds $1 billion per year. Evidence Acquisition: A wide variety of treatment regimens exist for acne vulgaris including benzoil peroxide, retinoids, isotretinoids, keratolytic soaps, alpha hydroxy acids, azelaic acid, salicilic acid as well as hormonal, anti-androgen or antiseborrheic treatments. However, none of these methods is free of side effects and their exact role in therapy is not clear. In this paper apart from presenting the possible causes of acne vulgaris and its available drugs, recently published papers about medicinal plants used in the treatment of acne vulgaris were reviewed. Results: Consumption of alternative and complementary medicine, including medicinal plants, is increasing and is common amongst patients affected by acne and infectious skin diseases. Medicinal plants have a long history of use and have been shown to possess low side effects. These plants are a reliable source for preparation of new drugs. Conclusions: Many plants seem to have inhibitory effects on the growth of bacteria, fungi and viruses in vitro. However, there are a few clinical evidences about the effectiveness and safety of these plants in the treatment of acne and other skin infections. PMID:26862380

  15. Elevated serum insulin-like growth factor-1 (IGF-1) levels in women with postadolescent acne.

    PubMed

    Aizawa, H; Niimura, M

    1995-04-01

    The purpose of this study was to measure the serum levels of IGF-1 in women with postadolescent acne compared to normal controls, and evaluate the relationship of these levels to the levels of androgens, in order to investigate the possible role of IGF-1 in the pathogenesis of acne. Eighty-two female patients with acne between 20 and 25 years of age and thirty-one age-matched control women were studied. We measured the serum levels of total testosterone (T), free testosterone (FT), dihydrotestosterone (DHT), dehydroepiandrosterone sulfate (DHEA-S), and insulin-like growth factor-1 (IGF-1). The levels of IGF-1 in patients with acne (1.26 +/- 0.52 U/ml) were significantly (p < 0.001) increased over those of controls (0.96 +/- 0.32 U/ml). Of 82 acne patients, six (7%) had IGF-1 levels which exceeded the normal range, but there were no significant correlations between IGF-1 and T, FT, DHT or DHEA-S levels or between IGF-1 and acne severity. Since the measurement of serum IGF-1 levels is a convenient indicator of GH secretion, the increase of serum IGF-1 levels seen in some acne patients might reflect an increase of GH. PMID:7608381

  16. The diversity and host interactions of Propionibacterium acnes bacteriophages on human skin.

    PubMed

    Liu, Jared; Yan, Riceley; Zhong, Qiao; Ngo, Sam; Bangayan, Nathanael J; Nguyen, Lin; Lui, Timothy; Liu, Minghsun; Erfe, Marie C; Craft, Noah; Tomida, Shuta; Li, Huiying

    2015-09-01

    The viral population, including bacteriophages, is an important component of the human microbiota, yet is poorly understood. We aim to determine whether bacteriophages modulate the composition of the bacterial populations, thus potentially playing a role in health or disease. We investigated the diversity and host interactions of the bacteriophages of Propionibacterium acnes, a major human skin commensal implicated in acne pathogenesis. By sequencing 48 P. acnes phages isolated from acne patients and healthy individuals and by analyzing the P. acnes phage populations in healthy skin metagenomes, we revealed that P. acnes phage populations in the skin microbial community are often dominated by one strain. We also found phage strains shared among both related and unrelated individuals, suggesting that a pool of common phages exists in the human population and that transmission of phages may occur between individuals. To better understand the bacterium-phage interactions in the skin microbiota, we determined the outcomes of 74 genetically defined Propionibacterium strains challenged by 15 sequenced phages. Depending on the Propionibacterium lineage, phage infection can result in lysis, pseudolysogeny, or resistance. In type II P. acnes strains, we found that encoding matching clustered regularly interspaced short palindromic repeat spacers is insufficient to confer phage resistance. Overall, our findings suggest that the prey-predator relationship between bacteria and phages may have a role in modulating the composition of the microbiota. Our study also suggests that the microbiome structure of an individual may be an important factor in the design of phage-based therapy.

  17. [Emotions and bodily experience in Hidradenitis Suppurative-Acne Inversa].

    PubMed

    Tugnoli, S; Bettoli, V; Agnoli, C; Caracciolo, S

    2016-01-01

    Hidradenitis Suppurative-Acne Inversa is one of the most debilitating chronic skin diseases. It seriously affects the emotional and relational life of the patient, it has a significant psychiatric comorbidity and it impairs the quality of life. We present the report of a clinical situation with onset of the illness in a young woman during pregnancy, a case characterized by particular evolution, severe systemic involvement, strong psycho-emotional impact on the patient and impairment of subjective well-being of the caregiver. The clinical evaluation highlights mainly the relevance of the bodily experience, that stands out as a central issue in the sufference of the patient. She feels an uncanny foreignness to herself and a lacerating wound of her identity, related to her desirability, her femininity and her motherhood. Specific personality factors, which are likely to have influenced and guided the experience of illness and the quality of the relationship with the treatment team, are also evaluated. This case exemplifies, at different levels, the clinical complexity of Hidradenitis Suppurative-Acne Inversa and its impact on individual subjectivity. This disease requires an integrated intervention by a multidisciplinary team, providing for the assessment, the treatment and the evaluation of outcomes. It is necessary an effective operational link between different competences, in order to promote the patient compliance and to activate and develop the best care and the right psychological support. PMID:27424511

  18. Oral isotretinoin. How can we treat difficult acne patients?

    PubMed

    Leyden, J J

    1997-01-01

    Isotretinoin (Roaccutane/Accutane) therapy (120 mg/kg) normally results in complete clearing of nodulocystic acne followed by prolonged remission, and many patients remain free of disease. Four groups of patients respond poorly or have a high rate of relapse. Preteens and young teenagers show a high rate of relapse and several courses of treatment are usually needed; 14 of 20 under the age of 12 years, 21 of 47 aged 12-14 and 23 of 66 aged 14-16 relapsed within 1 year. Individuals with linear lesions consisting of undermining tracks of follicular epithelium often show only a partial response. These individuals typically have a history of other 'sinus track' disease such as pilonidial sinus and hidradenitis, either themselves or other family members. Hemorrhagic or crusted lesions can be exacerbated by full doses of isotretinoin and patients develop pyrogenic-granuloma-type lesions and even acne-fulminans-like eruptions. Women with adrenal or ovarian syndrome associated with elevated androgens commonly relapse with 6-12 months after isotretinoin therapy.

  19. Oral isotretinoin. How can we treat difficult acne patients?

    PubMed

    Leyden, J J

    1997-01-01

    Isotretinoin (Roaccutane/Accutane) therapy (120 mg/kg) normally results in complete clearing of nodulocystic acne followed by prolonged remission, and many patients remain free of disease. Four groups of patients respond poorly or have a high rate of relapse. Preteens and young teenagers show a high rate of relapse and several courses of treatment are usually needed; 14 of 20 under the age of 12 years, 21 of 47 aged 12-14 and 23 of 66 aged 14-16 relapsed within 1 year. Individuals with linear lesions consisting of undermining tracks of follicular epithelium often show only a partial response. These individuals typically have a history of other 'sinus track' disease such as pilonidial sinus and hidradenitis, either themselves or other family members. Hemorrhagic or crusted lesions can be exacerbated by full doses of isotretinoin and patients develop pyrogenic-granuloma-type lesions and even acne-fulminans-like eruptions. Women with adrenal or ovarian syndrome associated with elevated androgens commonly relapse with 6-12 months after isotretinoin therapy. PMID:9310743

  20. [Emotions and bodily experience in Hidradenitis Suppurative-Acne Inversa].

    PubMed

    Tugnoli, S; Bettoli, V; Agnoli, C; Caracciolo, S

    2016-01-01

    Hidradenitis Suppurative-Acne Inversa is one of the most debilitating chronic skin diseases. It seriously affects the emotional and relational life of the patient, it has a significant psychiatric comorbidity and it impairs the quality of life. We present the report of a clinical situation with onset of the illness in a young woman during pregnancy, a case characterized by particular evolution, severe systemic involvement, strong psycho-emotional impact on the patient and impairment of subjective well-being of the caregiver. The clinical evaluation highlights mainly the relevance of the bodily experience, that stands out as a central issue in the sufference of the patient. She feels an uncanny foreignness to herself and a lacerating wound of her identity, related to her desirability, her femininity and her motherhood. Specific personality factors, which are likely to have influenced and guided the experience of illness and the quality of the relationship with the treatment team, are also evaluated. This case exemplifies, at different levels, the clinical complexity of Hidradenitis Suppurative-Acne Inversa and its impact on individual subjectivity. This disease requires an integrated intervention by a multidisciplinary team, providing for the assessment, the treatment and the evaluation of outcomes. It is necessary an effective operational link between different competences, in order to promote the patient compliance and to activate and develop the best care and the right psychological support.

  1. Chronic subdural hematoma infected by propionibacterium acnes: a case report.

    PubMed

    Yamamoto, Shusuke; Asahi, Takashi; Akioka, Naoki; Kashiwazaki, Daina; Kuwayama, Naoya; Kuroda, Satoshi

    2015-01-01

    We present a very rare case of a patient with an infected subdural hematoma due to Propionibacterium acnes. A 63-year-old male complained of dizziness and was admitted to our hospital. He had a history of left chronic subdural hematoma due to a traffic accident, which had been conservatively treated. Physical, neurological and laboratory examinations revealed no definite abnormality. Plain CT scan demonstrated a hypodense crescentic fluid collection over the surface of the left cerebral hemisphere. The patient was diagnosed with chronic subdural hematoma and underwent burr hole surgery three times and selective embolization of the middle meningeal artery, but the lesion easily recurred. Repeated culture examinations of white sedimentation detected P. acnes. Therefore, he underwent craniotomy surgery followed by intravenous administration of antibiotics. The infected subdural hematoma was covered with a thick, yellowish outer membrane, and the large volume of pus and hematoma was removed. However, the lesion recurred again and a low-density area developed in the left frontal lobe. Craniotomy surgery was performed a second time, and two Penrose drainages were put in both the epidural and subdural spaces. Subsequently, the lesions completely resolved and he was discharged without any neurological deficits. Infected subdural hematoma may be refractory to burr hole surgery or craniotomy alone, in which case aggressive treatment with craniotomy and continuous drainage should be indicated before the brain parenchyma suffers irreversible damage. PMID:25759659

  2. What's new in acne? An analysis of systematic reviews published in 2011-2012.

    PubMed

    Bhate, K; Williams, H C

    2014-04-01

    This review summarizes important clinical developments in acne vulgaris identified from 17 systematic reviews published between February 2011 and August 2012. Regarding causes, Demodex mites have been shown to be associated with both acne vulgaris and rosacea, although it is unclear if their eradication improves either disease. Some weak evidence has emerged that suggests a possible link between dairy produce and acne, which warrants further research. With reference to the effects of acne, there is good evidence that acne negatively affects quality of life, self-esteem and mood in adolescents. Acne is also associated with an increased risk of anxiety, depression and suicidal ideation, highlighting the importance of asking patients with acne directly about psychological issues in order to identify those who might benefit from early psychiatric support. Regarding treatment, there seems to be no additional benefit to using higher strengths of benzoyl peroxide, and lower strengths such as 2.5% have fewer side effects. Despite earlier concerns of increased mortality in those using topical tretinoin for skin cancer prevention, a systematic review on this topic has not found any convincing evidence of a link between such non-cutaneous events and once-daily application of 0.02-0.05% tretinoin. Combined oral contraceptives are of benefit in both inflammatory and non-inflammatory acne. Current surveys suggest that implementation of the pregnancy prevention programme for isotretinoin may not be stringent, and a high level of monitoring and audit is recommended. Ablative and non-ablative laser resurfacing for the treatment of acne scars may be beneficial, but further studies with a longer follow-up period are required.

  3. Stressful Events and Serum Concentration of Substance P in Acne Patients

    PubMed Central

    Rokowska-Waluch, Anita; Cybulski, Marcin; Żurawski, Jakub; Kaczmarek, Mariusz; Michalak, Michał; Mojs, Ewa

    2016-01-01

    Background Psychological stress is an important factor of acne pathogenesis. Stress related production of hormones, cytokines and neuropeptides may result in the chronic course and exacerbations of the disease. Objective The aim of the study was to evaluate the relationship between acne severity, intensity of emotional stress and serum concentration of substance P (scSP), to compare the intensity of adversities, psychological stress and scSP in acne patients with healthy controls and to compare coping techniques for stress. Methods The study consisted of 80 patients. Emotional stress was analyzed with the use of social readjustment rating scale, whereas the methods of coping with stress were assessed with the coping inventory for stressful situation questionnaire. The blood concentration of substance P was analyzed by enzyme-linked immunosorbent assay method in a group of 40 patients with acne vulgaris and in control subjects. Results There was no statistically significant difference between the severity of acne and the intensity of stress. Acne patients presented a higher average scSP than the controls. No statistically significant correlation was observed between the severity of acne and scSP; however, the intensity of stress correlated with scSP in the control group. The evaluation of methods of coping with stress showed significantly higher rate for the avoidance-oriented coping among acne patients. Conclusion The number of stressful events is not a factor that determines the severity of acne. The course of the disease may depend on tolerance to stress and methods of coping with stress. PMID:27489429

  4. Acne-Related Quality of Life Among Female Adults of Different Races/Ethnicities

    PubMed Central

    Gorelick, Joe; Daniels, Selena R.; Kawata, Ariane K.; Degboe, Arnold; Wilcox, Teresa K.; Burk, Caroline T.; Douse-Dean, Tracee

    2015-01-01

    ABSTRACT: Background Acne impairs quality of life, but its effect on different races/ethnicities is unclear. This study evaluated racial/ethnic differences in acne-related quality of life and psychological symptoms among female adults. Methods A Web-based survey was conducted with U.S. female adults (25–45 years old) with facial acne (≥25 visible lesions). Outcomes included sociodemographics, clinical characteristics, acne-related quality of life (Acne-Specific Quality of Life Questionnaire), psychological symptoms (Patient Health Questionnaire), and work/school productivity. Racial/ethnic differences were evaluated using descriptive statistics and analysis of variance/chi-square analyses. Results Three-hundred twelve subjects (Black = 30.8%, Hispanic = 17.6%, Asian/other = 17.3%, White = 34.3%) completed the survey (mean age = 35.3 ± 5.9 years). Acne negatively impacted quality of life for all subjects. Black subjects reported significantly less negative impact on self-perception versus Asian/other (Black = 12.6 ± 9.9, Asian/other = 8.4 ± 8.6; p = .05). Social functioning was less negatively impacted in White and Black subjects versus Asian/other (White = 12.7 ± 7.5, Asian/other = 8.4 ± 7.8, p < .05; Black = 12.1 ± 9.2, Asian/other = 8.4 ± 7.8, p = .06). Over one third (total sample = 40.7%, Black = 31.3%, Hispanic = 36.4%, Asian/other = 50.0%, White = 46.7%) reported moderate/severe anxiety/depression symptoms. Acne also impacted ability to concentrate on work/school. Conclusion Racial/ethnic differences were observed in acne-related quality of life and psychological symptoms in female adults; acne negatively impacted self-perceptions and social/emotional functioning. PMID:26097643

  5. Isotretinoin therapy changes the expression of antimicrobial peptides in acne vulgaris.

    PubMed

    Borovaya, Alena; Dombrowski, Yvonne; Zwicker, Stephanie; Olisova, Olga; Ruzicka, Thomas; Wolf, Ronald; Schauber, Jürgen; Sárdy, Miklós

    2014-10-01

    In acne vulgaris, antimicrobial peptides (AMPs) could play a dual role; i.e., protective by acting against Propionibacterium acnes, pro-inflammatory by acting as signalling molecules. The cutaneous expression of 15 different AMPs was investigated in acne patients; furthermore, the impact of isotretinoin therapy on AMP expression was analysed in skin biopsies from 13 patients with acne vulgaris taken before, during and after a 6-month treatment cycle with isotretinoin using quantitative real-time polymerase chain reaction. Cutaneous expression of the AMPs cathelicidin, human β-defensin-2 (HBD-2), lactoferrin, lysozyme, psoriasin (S100A7), koebnerisin (S100A15), and RNase 7 was upregulated in untreated acne vulgaris, whereas α-defensin-1 (HNP-1) was downregulated compared to controls. While relative expression levels of cathelicidin, HBD-2, lactoferrin, psoriasin (S100A7), and koebnerisin (S100A15) decreased during isotretinoin treatment, only those of cathelicidin and koebnerisin returned to normal after 6 months of isotretinoin therapy. The increased expression of lysozyme and RNase 7 remained unaffected by isotretinoin treatment. The levels of granulysin, RANTES (CCL5), perforin, CXCL9, substance P, chromogranin B, and dermcidin were not regulated in untreated acne patients and isotretinoin had no effect on these AMPs. In conclusion, the expression of various AMPs is altered in acne vulgaris. Isotretinoin therapy normalizes the cutaneous production of distinct AMPs while the expression of others is still increased in healing acne. Considering the antimicrobial and pro-inflammatory role of AMPs, these molecules could serve as specific targets for acne therapy and maintenance of clinical remission.

  6. Antimicrobial activity of enterocins from Enterococcus faecalis SL-5 against Propionibacterium acnes, the causative agent in acne vulgaris, and its therapeutic effect.

    PubMed

    Kang, Bong Seon; Seo, Jae-Gu; Lee, Gwa-Su; Kim, Jung-Hwa; Kim, Sei Yeon; Han, Ye Won; Kang, Hoon; Kim, Hyung Ok; Rhee, Ji Hwan; Chung, Myung-Jun; Park, Young Min

    2009-02-01

    A lactic acid bacterial strain was isolated from human fecal specimen and identified as Enterococcus faecalis SL-5. The isolated strain showed antimicrobial activity against Gram-positive pathogens assayed, especially the highest activity against Propionibacterium acnes. The antimicrobial substance was purified and verified as a bacteriocin (named ESL5) of E. faecalis SL-5 by activity-staining using P. acnes as an indicator. N-terminal sequence of ESL5 was determined (MGAIAKLVAK) and sequence analysis revealed that it is almost identical to the some of enterocins including L50A/B of E. faecium L50 and MR10A/B of E. faecalis MRR 10-3. From the sequencing data of L50A/B structural genes, the nucleotide sequence showed 100% identity with that of the MR10A/B structural genes, implying that ESL5 is an equivalent of enterocin MR10. Meanwhile, we also tested the therapeutic effect of anti-P. acnes activity in patients with mild to moderate acne because of its pathogenic role to acne vulgaris. For this purpose, a concentrated powder of CBT SL-5 was prepared using cell-free culture supernatant (CFCS) of E. faecalis SL-5 and included in a lotion for application in the patients. The study showed that CBT SL-5 lotion significantly reduced the inflammatory lesions like pustules compared to the placebo lotion. Therefore our results indicate that the anti-P. acnes activity produced by E. faecalis SL-5 has potential role to the treatment of acne as an alternative to topical antibiotics.

  7. Multicenter cross-sectional observational study of antibiotic resistance and the genotypes of Propionibacterium acnes isolated from Chinese patients with acne vulgaris.

    PubMed

    Fan, Yukun; Hao, Fei; Wang, Weizhen; Lu, Yonghong; He, Li; Wang, Gang; Chen, Wenchieh

    2016-04-01

    Antibiotics are widely applied in management of acne vulgaris, which raises the issue of antibiotic resistance. Due to improper application and supervision of antibiotics, antibiotic resistance has become a serious problem in China. So, the efficacy of antimicrobial therapy in acne is unclear without an objective monitor of antibiotic resistance of Propionibacterium acnes. This cross-sectional, multicenter observational study is aimed at understanding the status of antibiotic resistance in P. acnes, investigating the measures of acne management in China and analyzing the genotypes of antibiotic-resistant strains of P. acnes. Altogether, 312 strains of P. acnes were collected from patients in five medical centers across central China after reviewing the corresponding medical history in detail. The samples underwent antibiotic susceptibility assays by agar dilution method with a total of 11 classes of antibiotics being tested. The antibiotic-resistant strains were screened and further analyzed by investigation of the genotypes regarding 23S rRNA, 16S rRNA and erm(X). The predominant resistance occurred in macrolides and lincomycin with an overall resistance rate of 47.8%. The resistance to tetracyclines was scarce with only two cases identified. The emergence of minimum inhibitory concentration elevation for tetracyclines is associated with its application history (P < 0.005). The genotypes of the reported macrolide-lincosamide-streptogramin B resistance strains were also spotted in Chinese subjects while other resistance determinants may also exist. The tetracyclines have been proved to be vastly susceptible while macrolides and lincomycin face a serious resistance status in China.

  8. Microvascular changes during acne lesion initiation and scarring is revealed in vivo using optical microangiography

    NASA Astrophysics Data System (ADS)

    Baran, Utku; Li, Yuandong; Choi, Woo J.; Wang, Ruikang K.

    2015-02-01

    Acne is a common skin disease in society and often leads to scarring. In this paper, we demonstrate the capabilities of swept-source optical coherence tomography (SS-OCT) in detecting specific features of acne lesion initiation and scarring on human facial skin in vivo over 30 days. Optical microangiography (OMAG) technique made it possible to image 3D tissue microvasculature changes up to 1 mm depth in vivo without the need of exogenous contrast agents in ~10 seconds. The presented results show promise to facilitate clinical trials of treatment and prognosis of acne vulgaris by detecting cutaneous microvasculature and structural changes within human skin in vivo.

  9. Oral Spironolactone in Post-teenage Female Patients with Acne Vulgaris

    PubMed Central

    Kim, Grace K.

    2012-01-01

    Oral spironolactone has been used for over two decades in the dermatological setting. Although it is not generally considered a primary option in the management of female patients with acne vulgaris, the increase in office visits by post-teenage women with acne vulgaris has recently placed a spotlight on the use of this agent in this subgroup of patients. This article reviews the literature focusing on the use of oral spironolactone in this subset of women with acne vulgaris, including discussions of the recommended starting dose, expected response time, adjustments in therapy, potential adverse effects, and patient monitoring. PMID:22468178

  10. Acute infection with Propionibacterium acnes after a Latarjet coracoid transfer procedure: a case report.

    PubMed

    Erickson, Brandon J; Bhatia, Sanjeev; Biswas, Debdut; Verma, Nikhil N

    2016-06-01

    Coracoid transfer procedures are highly effective at improving glenohumeral stability in patients with recurrent shoulder instability; complication rates from this procedure are generally low. We present the first case in the literature of a Propionibacterium acnes (P. acnes) infection following a coracoid transfer. The case stresses the importance of proper antibiotic prophylaxis for patients undergoing Latarjet procedures, as well as the workup for a painful postoperative shoulder, and the need to maintain cultures from the shoulder for up to 21 days to isolate P. acnes.

  11. Perinuclear antineutrophilic cytoplasmic antibody-positive cutaneous polyarteritis nodosa associated with minocycline therapy for acne vulgaris.

    PubMed

    Schaffer, J V; Davidson, D M; McNiff, J M; Bolognia, J L

    2001-02-01

    Minocycline is an oral antibiotic widely used for the long-term treatment of acne vulgaris. Unusual side effects of this medication include two overlapping autoimmune syndromes: drug-induced lupus and autoimmune hepatitis. In addition, in a few patients livedo reticularis or subcutaneous nodules have developed in association with arthritis and serum perinuclear antineutrophil cytoplasmic antibodies (P-ANCA) during long-term minocycline therapy. We report the cases of two young women receiving long-term minocycline therapy (>3 years) in whom P-ANCA-positive cutaneous polyarteritis nodosa developed. Both patients presented with a violaceous reticulated pattern on the lower extremities. Histologic examination of biopsy specimens from a reticulated area and a subcutaneous nodule showed necrotizing vasculitis of medium-sized arteries in the deep dermis, consistent with the diagnosis of polyarteritis nodosa. The cutaneous lesions rapidly resolved on discontinuation of minocycline and initiation of prednisone therapy. A high index of suspicion and testing for antineutrophil cytoplasmic antibody in addition to the standard antinuclear antibody panel can facilitate diagnosis of minocycline-related autoimmune disorders.

  12. In vitro antimicrobial activity of benzoyl peroxide against Propionibacterium acnes assessed by a novel susceptibility testing method.

    PubMed

    Okamoto, Kazuaki; Ikeda, Fumiaki; Kanayama, Shoji; Nakajima, Akiko; Matsumoto, Tatsumi; Ishii, Ritsuko; Umehara, Masatoshi; Gotoh, Naomasa; Hayashi, Naoki; Iyoda, Takako; Matsuzaki, Kaoru; Matsumoto, Satoru; Kawashima, Makoto

    2016-06-01

    Benzoyl peroxide (BPO), a therapeutic agent for acne vulgaris, was assessed for in vitro antimicrobial activity against Propionibacterium acnes using a novel broth microdilution testing that improved BPO solubility. We searched for a suitable culture medium to measure the minimum inhibitory concentration (MIC) of BPO against P. acnes and finally found the Gifu anaerobic medium (GAM) broth supplemented with 0.1(v/v)% glycerol and 2(v/v)% Tween 80, in which BPO dissolved up to 1250 μg/mL and P. acnes grew well. The MICs and minimum bactericidal concentrations (MBCs) of BPO against 44 clinical isolates of P. acnes collected from Japanese patients with acne vulgaris were determined by our testing method using the supplemented GAM broth. The MICs of BPO were 128 or 256 μg/mL against all isolates of P. acnes regardless of susceptibility to nadifloxacin or clindamycin. The MBCs of BPO were also 128 or 256 μg/mL against the same isolates. Moreover, BPO at the MIC showed a rapid bactericidal activity against P. acnes ATCC11827 in time-kill assay. In conclusion, we could develop a novel assay for the MIC and MBC determinations of BPO against P. acnes, which is reliable and reproducible as a broth microdilution testing and the present results suggest that BPO has a potent bactericidal activity against P. acnes.

  13. Disability Experience and Measurement.

    PubMed

    Verbrugge, Lois M

    2016-10-01

    Top themes of international research on disability in the past three decades are discussed: disability dynamics, buffers and barriers for disability, disability trends, and disability among very old persons. Each theme is highlighted by research examples. Turning to measurement, I discuss traditional measures of disability, new longer and shorter ones, and composites like disability-free life expectancy, noting their merits. Contemporary models of disability are presented, ranging from visual images to formal theories. The article ends on how scientists can facilitate movement of disability science into health care practice and policy. PMID:27590795

  14. Inflammatory Acne Treatment: Review of Current and New Topical Therapeutic Options.

    PubMed

    Zeichner, Joshua A

    2016-01-01

    Acne vulgaris (AV) is an inflammatory skin disease characterized by the presence of comedones, papules, pustules, and nodules. Consensus guidelines recommend the use of combination therapy using different drugs with complementary mechanisms of action to best address as many acne pathogenic factors as possible at the same time. Topical acne medications exist as individual agents that may be combined in physician-recommended regimens or as pre-formulated fixed-dose combination products. In addition, there are several new and promising topical therapies currently being developed that work by different mechanisms of action from traditionally used acne therapies. The following review will cover commonly used drugs, newcomers to the market, and what the future holds for the topical treatment of AV. PMID:26741391

  15. A comparative study of isolutrol versus benzoyl peroxide in the treatment of acne.

    PubMed

    Dunlop, K J; Barnetson, R S

    1995-02-01

    Isolutrol is the active principle isolated from aqueous tissue extracts of deep sea shark liver and gall-bladder. A previous study has demonstrated the ability of isolutrol to reduce hyperseborrhoea, which provides a rationale for its use in the treatment of acne. We have performed a double-blind clinical trial on 70 patients to evaluate the efficacy and skin tolerance of isolutrol 0.15 g/100 mL (Ketsugo) in the treatment of mild to moderate acne when compared with 5% benzoyl peroxide lotion. The results from this study showed that both isolutrol and benzoyl peroxide significantly improved patients' acne by reducing the number of inflamed lesions. Isolutrol did not significantly reduce the numbers of non-inflamed lesions whereas benzoyl peroxide did. Fewer side effects were experienced by patients treated with isolutrol when compared with benzoyl peroxide. These results indicate that isolutrol may be a useful adjunct in the treatment of acne, particularly in patients with inflamed lesions.

  16. Acne vulgaris: an inflammatory disease even before the onset of clinical lesions.

    PubMed

    Rocha, Marco Alexandre; Costa, Caroline Sousa; Bagatin, Edileia

    2014-01-01

    Acne is a chronic self-limited disease, which affects mostly teenagers, without gender difference. In recent years, the incidence has increased in female adults. The factors involved in this epidemiological observation are still under discussion in the literature. Clinically, acne is characterized by different types of lesions. The disease affects the regions rich in sebaceous glands (face, chest and upper back). The clinical lesions are: open and closed comedones, erythematous papules, pustules, nodules and different types of scars. Taking into consideration the general concept of inflammation (redness, pain, heat and loss of function), acne is traditionally classified as non-inflammatory (open and closed comedones) and inflammatory (other primary lesions). With the knowledge advancement this concept seems to be wrong and therefore acne would be an inflammatory disease even before the onset of their clinical lesions.

  17. Contact dermatitis to topical acne drugs: a review of the literature.

    PubMed

    Foti, Caterina; Romita, Paolo; Borghi, Alessandro; Angelini, Gianni; Bonamonte, Domenico; Corazza, Monica

    2015-01-01

    Acne vulgaris is a chronic dermatological disorder that affects the majority of teenagers in the Western world. Topical therapy is widely used to treat mild-moderate acne and is known as well-tolerated thanks to its low systemic toxicity, although associated to skin adverse effects. Acne seems to be associated also to an intrinsic alteration of the epidermal barrier, regarding both the upper and the follicular stratum corneum that promotes the onset of such local side effects. The commonest one is irritant contact dermatitis, an event of frequent observation occurring with erythema, burning, dryness, scaling, and itching, usually characterized by low severity and limited duration. Among topical acne drugs, retinoids are the most irritating ones. Another side effect is allergic contact dermatitis: it is rare and mainly associated to benzoyl peroxide.

  18. Acne vulgaris, probiotics and the gut-brain-skin axis - back to the future?

    PubMed

    Bowe, Whitney P; Logan, Alan C

    2011-01-01

    Over 70 years have passed since dermatologists John H. Stokes and Donald M. Pillsbury first proposed a gastrointestinal mechanism for the overlap between depression, anxiety and skin conditions such as acne. Stokes and Pillsbury hypothesized that emotional states might alter the normal intestinal microflora, increase intestinal permeability and contribute to systemic inflammation. Among the remedies advocated by Stokes and Pillsbury were Lactobacillus acidophilus cultures. Many aspects of this gut-brain-skin unifying theory have recently been validated. The ability of the gut microbiota and oral probiotics to influence systemic inflammation, oxidative stress, glycemic control, tissue lipid content and even mood itself, may have important implications in acne. The intestinal microflora may also provide a twist to the developing diet and acne research. Here we provide a historical perspective to the contemporary investigations and clinical implications of the gut-brain-skin connection in acne. PMID:21281494

  19. Abuse of anabolic-androgenic steroids and bodybuilding acne: an underestimated health problem.

    PubMed

    Melnik, Bodo; Jansen, Thomas; Grabbe, Stephan

    2007-02-01

    Abuse of anabolic-androgenic steroids (AAS) by members of fitness centers and others in Germany has reached alarming dimensions. The health care system provides the illegal AAS to 48.1 % of abusers. Physicians are involved in illegal prescription of AAS and monitoring of 32.1 % of AAS abusers. Besides health-threatening cardiovascular, hepatotoxic and psychiatric long-term side effects of AAS, acne occurs in about 50 % of AAS abusers and is an important clinical indicator of AAS abuse, especially in young men 18-26 years of age. Both acne conglobata and acne fulminans can be induced by AAS abuse. The dermatologist should recognize bodybuilding acne, address the AAS abuse, and warn the patient about other potential hazards.

  20. Inflammatory Acne Treatment: Review of Current and New Topical Therapeutic Options.

    PubMed

    Zeichner, Joshua A

    2016-01-01

    Acne vulgaris (AV) is an inflammatory skin disease characterized by the presence of comedones, papules, pustules, and nodules. Consensus guidelines recommend the use of combination therapy using different drugs with complementary mechanisms of action to best address as many acne pathogenic factors as possible at the same time. Topical acne medications exist as individual agents that may be combined in physician-recommended regimens or as pre-formulated fixed-dose combination products. In addition, there are several new and promising topical therapies currently being developed that work by different mechanisms of action from traditionally used acne therapies. The following review will cover commonly used drugs, newcomers to the market, and what the future holds for the topical treatment of AV.

  1. Propionibacterium Acnes Brain Abscess in an Immunocompetent Man in the Absence of Prior Neurosurgery.

    PubMed

    Odunukan, Olufunso W; Masannat, Fares; Baka, J Jeff

    2016-02-01

    Propionibacterium acnes is a rare, but established, cause of intracranial abscesses. We describe a case of P. acnes brain abscess in an immunocompetent man without prior neurosurgery. A 49-year old man with mild psoriasis presented with a two-week history of gait changes, generalized weakness and a two-day history of headaches, aphasia and confusion. Imaging revealed a left thalamic mass and surgical biopsy suggested a pyogenic abscess. Cultures of biopsy samples of the abscess grew P. acnes alone. MRI and serial neurological exam showed marked clinical improvement with intravenous antibiotics. The significant reduction in the abscess was sustained on MRI obtained at six weeks after completion of antibiotic therapy. In conclusion, P. acnes must be considered as a differential diagnosis in individuals presenting with features suggestive of a brain abscess even in the absence of immunosuppression or previous neurosurgery. PMID:26999913

  2. Antibiotic resistance and acne: where we stand and what the future holds.

    PubMed

    Bowe, Whitney P

    2014-06-01

    Antibiotic resistance is described as "a global public health challenge" and a "major health security challenge of the 21st century" by global health authorities,1 and there is a growing need for dermatologists to counteract it in their treatments of acne.3,4 Antibiotic limiting regimens, such as a combination of topical retinoids and benzoyl peroxide, have shown effectiveness in the treatment of acne; and topical probiotics could also play a needed role.

  3. The In vitro anti-acne activity of two unani drugs

    PubMed Central

    Chaudhary, Shahid Shah; Tariq, Mohd.; Zaman, Roohi; Imtiyaz, Shaikh

    2013-01-01

    Background: Acne is the most common disorder treated by dermatologists. As many as 80-90% of all adolescents have some type of acne and 30% of them require medical treatment. It is an inflammatory disease of the pilosebaceous unit characterized by the formation of open and closed comedones, papules, pustules, nodules, and cysts. Aims: The present study was conducted to investigate the in vitro anti-acne activity of two Unani single drugs Darchini (Cinnamomum zeylanicum Bl.) and Tukhm Khashkhash (Papaver somniferum L. seeds). Materials and Methods: The antibacterial activity of aqueous, ethanolic and hydroalcoholic extracts of both drugs were investigated against two acne causing bacteria, i.e., Propionibacterium acne and Staphylococcus epidermidis using well diffusion method. Results: The result showed that both drugs were active against the two bacteria. Against P. acne aqueous and ethanolic extract of Darchini and Tukhm Khashkhash showed the zone of inhibition of 18 ± 1.02 mm and 18 ± 1.6 mm and 13 ± 1.04 mm and 14 ± 1.8 mm, respectively. Against S. epidermidis aqueous, hydroalcoholic and ethanolic extracts of Darchini showed 22 ± 1.7 mm, 22 ± 1.2 mm and 15 ± 1.8 mm zone of inhibition respectively. Hydroalcoholic and ethanolic extracts of Tukhm Khashkhash showed 15 ± 1.09 mm and 13 ± 1.6 mm zone of inhibition respectively. Conclusion: This suggests that C. zeylanicum and P. somniferum have potential against acne causing bacteria and hence they can be used in topical anti-acne preparations and may address the antibiotic resistance of the bacteria. PMID:25161328

  4. Rural People with Disabilities

    MedlinePlus

    ... with Disabilities in Rural Areas . What are the requirements of the Americans with Disabilities Act for small ... U.S. Equal Employment Opportunity Commission. What are the requirements of the Americans with Disabilities Act for local ...

  5. Facts about Developmental Disabilities

    MedlinePlus

    ... Children with kernicterus are more likely to have cerebral palsy, hearing and vision problems, and problems with their ... developmental disabilities, such as: ADHD , autism spectrum disorder , cerebral palsy , hearing loss , intellectual disability , learning disability, vision impairment , ...

  6. What Are Learning Disabilities?

    MedlinePlus

    ... Research Information Clinical Trials Resources and Publications Learning Disabilities: Condition Information Skip sharing on social media links Share this: Page Content What are learning disabilities? Learning disabilities are conditions that affect how a ...

  7. Sexuality and Intellectual Disability

    MedlinePlus

    ... Curiae Briefs Legislative Goals Consortium for Citizens with Disabilities National Goals 2015 SIS Product Information Benefits of ... SIS Use Order SIS-A Contact Us Intellectual Disability Historical Context Definition FAQs on Intellectual Disability Diagnostic ...

  8. Antibiotic resistance to Propionobacterium acnes: worldwide scenario, diagnosis and management.

    PubMed

    Sardana, Kabir; Gupta, Tanvi; Garg, Vijay K; Ghunawat, Sneha

    2015-07-01

    Antibiotic resistance in cutaneous Propionobacterium is a global problem. As a general rule, resistance levels are high to macrolides, trimethoprim/sulfamethoxazole and clindamycin, while tetracyclines and levofloxacin have low resistance potential. Newer preparations like doxycycline MR and doxycycline 20 mg are subantimicrobial and may not lead to resistance. Sampling techniques are crucial to determine resistance. Genomic evaluation using 16S ribosomal RNA gene sequencing can be useful in diagnosing mutations and mapping phylotypes of Propionobacterium acnes. Resistance may lead to slow response and relapses. Apart from benzoyl peroxide, azelaic acid, topical dapsone, oral zinc and retinoids, novel molecules with little resistance potential include octadecenedioic acid, phytosphingosine, lauric acid, retapamulin, resveratrol, T-3912 and NB-003. The use of oral retinoids and non-antibiotics like zinc can prevent resistance and help reduce the dependence on antibiotics.

  9. Pilot investigation of the hydrating effects of topical acne medications.

    PubMed

    Zhen, Yaxian; Stoudemayer, Marianne; Vamvakias, George; Kligman, Albert M

    2007-08-01

    Topical therapies are effective in managing acne vulgaris but are associated with local adverse effects such as irritation and dryness. This 4-week pilot study compared skin hydration in 36 healthy adult women randomized to treatment with 1 of 4 topical therapies: 2 different (jar and tube) clindamycin 1%/benzoyl peroxide 5% gels, sodium sulfacetamide 10% lotion, or over-the-counter (OTC) moisturizing cream. Subjects treated with OTC moisturizer or sodium sulfacetamide exhibited decreased water loss, increased water retention, similar or improved levels of skin hydration, and decreased desorption rates. In contrast, subjects treated with jar or tube clindamycin/benzoyl peroxide had increased water loss, decreased water retention, decreased hydration, and increased desorption rates. Skin dryness decreased slightly in the moisturizer group. No serious adverse events occurred. Overall, the OTC moisturizer had the best skin hydration profile. Sodium sulfacetamide demonstrated some moisturizing characteristics, and no clinically relevant differences were noted between jar and tube clindamycin/benzoyl peroxide gels.

  10. Antibiotic resistance to Propionobacterium acnes: worldwide scenario, diagnosis and management.

    PubMed

    Sardana, Kabir; Gupta, Tanvi; Garg, Vijay K; Ghunawat, Sneha

    2015-07-01

    Antibiotic resistance in cutaneous Propionobacterium is a global problem. As a general rule, resistance levels are high to macrolides, trimethoprim/sulfamethoxazole and clindamycin, while tetracyclines and levofloxacin have low resistance potential. Newer preparations like doxycycline MR and doxycycline 20 mg are subantimicrobial and may not lead to resistance. Sampling techniques are crucial to determine resistance. Genomic evaluation using 16S ribosomal RNA gene sequencing can be useful in diagnosing mutations and mapping phylotypes of Propionobacterium acnes. Resistance may lead to slow response and relapses. Apart from benzoyl peroxide, azelaic acid, topical dapsone, oral zinc and retinoids, novel molecules with little resistance potential include octadecenedioic acid, phytosphingosine, lauric acid, retapamulin, resveratrol, T-3912 and NB-003. The use of oral retinoids and non-antibiotics like zinc can prevent resistance and help reduce the dependence on antibiotics. PMID:26025191

  11. Gamma-secretase gene mutations in familial acne inversa.

    PubMed

    Wang, Baoxi; Yang, Wei; Wen, Wen; Sun, Jing; Su, Bin; Liu, Bo; Ma, Donglai; Lv, Dan; Wen, Yaran; Qu, Tao; Chen, Min; Sun, Miao; Shen, Yan; Zhang, Xue

    2010-11-19

    Acne inversa (AI), also known as hidradenitis suppurativa, is a chronic, recurrent, inflammatory disease of hair follicles that often runs in families. We studied six Chinese families with features of AI as well as additional skin lesions on back, face, nape, and waist and found independent loss-of-function mutations in PSENEN, PSEN1, or NCSTN, the genes encoding essential components of the γ-secretase multiprotein complex. Our results identify the γ-secretase component genes as the culprits for a subset of familial AI, implicate the γ-secretase-Notch pathway in the molecular pathogenesis of AI, and demonstrate that familial AI can be an allelic disorder of early-onset familial Alzheimer's disease.

  12. Oral trimethoprim as a third-line antibiotic in the management of acne vulgaris.

    PubMed

    Bottomley, W W; Cunliffe, W J

    1993-01-01

    Acne vulgaris usually improves with long-term oral antibiotic therapy; however, some patients fail or only partially respond to the commonly prescribed antibiotics. Only a proportion of these patients warrants treatment with isotretinoin suggesting a need for additional therapeutic options. We have therefore performed an open retrospective study of the efficacy of trimethoprim as a third-line antibiotic in the treatment of patients whose acne vulgaris failed to respond to at least 2 courses of antibiotics. A total of 56 patients were reviewed, who had all failed to respond adequately to a minimum of 2 courses of antibiotics. All patients received trimethoprim in a dosage of 300 mg twice daily for at least 4 months, unless it had been withdrawn due to side effects. Topically they were given 1% clindamycin lotion twice daily to the affected areas. The severity of the patient's acne was graded on the face, back and chest. The changes in acne grades were evaluated using non-parametric statistics (Wilcoxon matched pairs). At 4 months there were significant improvements from the grades at initiation in all three sites (p = 0.005 or less). Twenty-one patients remained on the treatment for 8 months, and a significant improvement in the changes of the acne grades remained (p = 0.02 or less). Two patients had the trimethoprim stopped due to side effects. We can therefore recommend this regime as a third-line treatment in the management of acne.

  13. Depositing α-mangostin nanoparticles to sebaceous gland area for acne treatment.

    PubMed

    Pan-In, Porntip; Wongsomboon, Atthakorn; Kokpol, Chayada; Chaichanawongsaroj, Nuntaree; Wanichwecharungruang, Supason

    2015-12-01

    Although entrapment of nanoparticles of appropriate sizes at hair follicles has been clarified, there is no report on specific clinical application of this finding. Since sebaceous gland is associated with hair follicle, we hypothesize that effective acne vulgaris treatment/prevention can be achieved by depositing anti-acne agent in nanoparticle form at the hair follicles. Challenge of this strategy, however, lies at the finding of effective anti-acne particles with minimal skin irritation. Here using cellulose-based nanoparticles as nano-reservoir and α-mangostin (an active component isolated from the edible Garcinia mangostana Linn. fruit) as anti-acne agent, we prepare nanoparticles highly loaded with α-mangostin. Ability of the obtained particles to sustained release α-mangostin into synthetic sebum is demonstrated. The obtained mangostin particles are verified for their insignificant skin irritation through the two-week, twice-daily open application test in 20 healthy human volunteers. Excellent entrapment and sustainment of the mangostin nanoparticles at the hair follicles are elucidated in six human volunteers by detecting the presence of α-mangostin at the roots of hairs pulled from the treated skin area. The 4-week-randomized, double-blind, placebo-controlled, split-face study in 10 acne patients indicates significant improvement in acne vulgaris condition on the side twice daily applied with mangostin nanoparticles.

  14. Intense pulsed light versus benzoyl peroxide 5% gel in treatment of acne vulgaris.

    PubMed

    El-Latif, Azmy Ahmed Abd; Hassan, Faisal Abdel Aziz; Elshahed, Ahmed Rashad; Mohamed, Amr Ghareeb; Elsaie, Mohamed L

    2014-05-01

    Acne is a common disorder affecting the pilosebaceous unit. Despite many advances in the treatments of acne vulgaris the best option is still controversial as the pathogenesis of acne is rather complex, necessitating various combination therapies. The objective of this study is to compare the clinical efficacy of intense pulsed light therapy (IPL) versus benzoyl peroxide 5% for the treatment of inflammatory acne. Fifty patients of both sexes, (15 males and 35 females) aged (18-27 years), with mild-to-severe acne and Fitzpatrick skin phototype IV were enrolled in this study. The patients were equally divided into two groups. The first group was treated by benzoyl peroxide while the second group was treated by IPL. For both therapies, patients experienced a significant reduction in the mean of the inflammatory lesion counts over the treatment period. Comparing the effects of both therapies, BP produced better results than IPL. The difference in the results was statistically significant at the midpoint of the study. However, this difference was insignificant at the end of study. Treatment with both benzoyl peroxide and IPL resulted in considerable improvement of the acne after 5 weeks of treatment. Comparing the effects of both therapies, BP produced better results than IPL. The difference in the results was statistically significant at the midpoint of the study. However, this difference was insignificant at the end of study.

  15. Mutants of Saccharomyces Cerevisiae with Defects in Acetate Metabolism: Isolation and Characterization of Acn(-) Mutants

    PubMed Central

    McCammon, M. T.

    1996-01-01

    The two carbon compounds, ethanol and acetate, can be oxidatively metabolized as well as assimilated into carbohydrate in the yeast Saccharomyces cerevisiae. The distribution of acetate metabolic enzymes among several cellular compartments, mitochondria, peroxisomes, and cytoplasm makes it an intriguing system to study complex metabolic interactions. To investigate the complex process of carbon catabolism and assimilation, mutants unable to grow on acetate were isolated. One hundred five Acn(-) (``ACetate Nonutilizing'') mutants were sorted into 21 complementation groups with an additional 20 single mutants. Five of the groups have defects in TCA cycle enzymes: MDH1, CIT1, ACO1, IDH1, and IDH2. A defect in RTG2, involved in the retrograde communication between the mitochondrion and the nucleus, was also identified. Four genes encode enzymes of the glyoxylate cycle and gluconeogenesis: ICL1, MLS1, MDH2, and PCK1. Five other genes appear to be defective in regulating metabolic activity since elevated levels of enzymes in several metabolic pathways, including the glyoxylate cycle, gluconeogenesis, and acetyl-CoA metabolism, were detected in these mutants: ACN8, ACN9, ACN17, ACN18, and ACN42. In summary, this analysis has identified at least 22 and as many as 41 different genes involved in acetate metabolism. PMID:8878673

  16. Depositing α-mangostin nanoparticles to sebaceous gland area for acne treatment.

    PubMed

    Pan-In, Porntip; Wongsomboon, Atthakorn; Kokpol, Chayada; Chaichanawongsaroj, Nuntaree; Wanichwecharungruang, Supason

    2015-12-01

    Although entrapment of nanoparticles of appropriate sizes at hair follicles has been clarified, there is no report on specific clinical application of this finding. Since sebaceous gland is associated with hair follicle, we hypothesize that effective acne vulgaris treatment/prevention can be achieved by depositing anti-acne agent in nanoparticle form at the hair follicles. Challenge of this strategy, however, lies at the finding of effective anti-acne particles with minimal skin irritation. Here using cellulose-based nanoparticles as nano-reservoir and α-mangostin (an active component isolated from the edible Garcinia mangostana Linn. fruit) as anti-acne agent, we prepare nanoparticles highly loaded with α-mangostin. Ability of the obtained particles to sustained release α-mangostin into synthetic sebum is demonstrated. The obtained mangostin particles are verified for their insignificant skin irritation through the two-week, twice-daily open application test in 20 healthy human volunteers. Excellent entrapment and sustainment of the mangostin nanoparticles at the hair follicles are elucidated in six human volunteers by detecting the presence of α-mangostin at the roots of hairs pulled from the treated skin area. The 4-week-randomized, double-blind, placebo-controlled, split-face study in 10 acne patients indicates significant improvement in acne vulgaris condition on the side twice daily applied with mangostin nanoparticles. PMID:26701606

  17. Consequences of acne on stress, fatigue, sleep disorders and sexual activity: a population-based study.

    PubMed

    Misery, Laurent; Wolkenstein, Pierre; Amici, Jean-Michel; Maghia, Rémi; Brenaut, Emilie; Cazeau, Christine; Voisard, Jean-Jacques; Taïeb, Charles

    2015-04-01

    Acne is a common disease among young people, which could have a serious impact on quality of life. Based on a survey using the quotas method on a large sample of the French population, we studied the impact of acne on feelings of stress, fatigue upon waking, sleep disorders and sexual activity. We did not establish any relationship to sleep disorders, but clearly ascertained that people with acne (n = 1,375) feel more stressed and have less sexual intercourse. Hence, 18% of people from acne group declared to be stressed every day (13.9% in control group) and 37.5% had no sexual intercourse (20.4% in control group; n = 891). To our knowledge, this is the first study to show that fatigue upon waking is strongly associated with the presence of acne (65.4% versus 58.4%). This study emphasises the fact that acne could have a deep resounding impact on the lives of people suffering from the disease.

  18. Acn9 is a novel protein of gluconeogenesis that is located in the mitochondrial intermembrane space.

    PubMed

    Dennis, R A; McCammon, M T

    1999-04-01

    Previous studies have indicated that the Acn9 protein is involved in gluconeogenesis. Yeast mutants defective in the ACN9 gene display phenotypes identical with mutants defective in metabolic enzymes required for carbon assimilation. These phenotypes include the inability to utilize acetate as a carbon and energy source, elevated levels of enzymes of the glyoxylate cycle, gluconeogenesis and acetyl-CoA mobilization, and a deficiency in de novo synthesis of glucose from ethanol. The ACN9 gene was isolated by functional complementation of the acetate growth defect of an acn9 mutant. The open reading frame corresponds to YDR511w, and encodes a protein of unknown function. Homologs have been identified in human, mouse, and nematode databases. Two mutant alleles were sequenced. The mutations altered amino acid residues that are conserved among members of the new gene family. ACN9 gene expression was slightly repressed by glucose, and the level of the transcript was approximately 100-fold lower than that of glyoxylate or tricarboxylic acid cycle enzymes. A functional epitope-tagged form of Acn9 was expressed to study expression and the subcellular localization of the protein. The tagged protein was localized to the mitochondrial intermembrane space.

  19. Mutants of Saccharomyces cerevisiae with defects in acetate metabolism: isolation and characterization of Acn- mutants.

    PubMed

    McCammon, M T

    1996-09-01

    The two carbon compounds, ethanol and acetate, can be oxidatively metabolized as well as assimilated into carbohydrate in the yeast Saccharomyces cerevisiae. The distribution of acetate metabolic enzymes among several cellular compartments, mitochondria, peroxisomes, and cytoplasm makes it an intriguing system to study complex metabolic interactions. To investigate the complex process of carbon catabolism and assimilation, mutants unable to grow on acetate were isolated. One hundred five Acn- ("ACetate Nonutilizing") mutants were sorted into 21 complementation groups with an additional 20 single mutants. Five of the groups have defects in TCA cycle enzymes: MDH1, CIT1, ACO1, IDH1, and IDH2. A defect in RTG2, involved in the retrograde communication between the mitochondrion and the nucleus, was also identified. Four genes encode enzymes of the glyoxylate cycle and gluconeogenesis: ICL1, MLS1, MDH2, and PCK1. Five other genes appear to be defective in regulating metabolic activity since elevated levels of enzymes in several metabolic pathways, including the glyoxylate cycle, gluconeogenesis, and acetyl-CoA metabolism, were detected in these mutants: ACN8, ACN9, ACN17, ACN18, and ACN42. In summary, this analysis has identified at least 22 and as many as 41 different genes involved in acetate metabolism.

  20. Distribution of rabies virus in infected mice, vaccinated and submitted to P. acnes as immunomodulator.

    PubMed

    Megid, J; Cremonini, D N; Leomil, H

    2002-07-01

    The lethality and distribution of rabies virus were evaluated in swiss mice experimentally infected with street rabies virus, vaccinated and submitted to immunomodulation by P .acnes (formerly Corynebacterium parvum). The animals were sacrificed at different times,when the different tissues were collected and submitted to fluorescent antibody test (FAT) and mouse inoculation test (MIT). The group submitted to vaccination and P. acnes treatment presented a percentage of survival superior to that observed in infected mice only treated with P. acnes. Control infected animals had the lowest survival rates. The distribution of rabies virus in spleen of infected mice, vaccinated and submitted to P. acnes was superior to that verified in infected mice not treated with P.acnes. The increased survival correlated with the distribution of rabies virus in lymphoid tissues, could be interpreted as the consequence of P. acnes activity on macrophages. The results suggest the role of macrophages against rabies virus infection in mice and the importance of vaccination in the post expositive treatment of rabies. PMID:12135238

  1. Treatment of acne with tea tree oil (melaleuca) products: a review of efficacy, tolerability and potential modes of action.

    PubMed

    Hammer, K A

    2015-02-01

    Over-the-counter acne treatments containing tea tree oil from the plant Melaleuca alternifolia are widely available, and evidence indicates that they are a common choice amongst those self-treating their acne. The aims of this review were to collate and evaluate the clinical evidence on the use of tea tree oil products for treating acne, to review safety and tolerability and to discuss the underlying modes of therapeutic action. PMID:25465857

  2. Current nanotechnological approaches for an effective delivery of bio-active drug molecules in the treatment of acne.

    PubMed

    Garg, Tarun

    2016-01-01

    Acne is a chronic inflammatory human skin disease, characterized by areas of skin with seborrhoea, comedones, papules, nodules, pimples, and possibly scarring with lesions occurring on face, neck, and back. Nanotechnological approaches such as particulate (solid lipid nanoparticles and microspheres), vesicular (liposomes and niosomes), colloidal drug delivery systems (micro-emulsion and nano-emulsion), and miscellaneous systems (aerosol foams and micro-sponges) have an important place in acne therapy. These approaches have an enormous opportunity for the designing of a novel, low-dose and effective treatment systems to control acne disease. In this review, we specially focus on the different nanotechnological approaches for an effective treatment of acne.

  3. Suppression of Propionibacterium acnes Infection and the Associated Inflammatory Response by the Antimicrobial Peptide P5 in Mice.

    PubMed

    Ryu, Sunhyo; Han, Hyo Mi; Song, Peter I; Armstrong, Cheryl A; Park, Yoonkyung

    2015-01-01

    The cutaneous inflammation associated with acne vulgaris is caused by the anaerobic bacterium Propionibacterium acnes through activation of the innate immune system in the skin. Current standard treatments for acne have limitations that include adverse effects and poor efficacy in many patients, making development of a more effective therapy highly desirable. In the present study, we demonstrate the protective effects of a novel customized α-helical cationic peptide, P5, against P. acnes-induced inflammatory responses in vitro and in vivo. Application of P5 significantly reduced expression of two inflammatory cytokines IL-8 and TNF-α in P. acnes-treated primary human keratinocytes, where P5 appeared to act in part by binding to bacterial lipoteichoic acid, thereby suppressing TLR2-to-NF-κB signaling. In addition, in a mouse model of acne vulgaris, P5 exerted both anti-inflammatory and antimicrobial effects against P. acnes, but exerted no cytotoxic effects against skin cells. These results demonstrate that P5, and perhaps other cationic antimicrobial peptides, offer the unique ability to reduce numbers P. acnes cells in the skin and to inhibit the inflammation they trigger. This suggests these peptides could potentially be used to effectively treat acne without adversely affecting the skin. PMID:26197393

  4. Pathogenesis, clinical course and neuro-radiological signs of Proprionibacterium acnes cerebritis: Case report and literature review.

    PubMed

    Yakhkind, Aleksandra; Yacoub, Hussam A; Grove, Jacqueline; Varrato, Jay D; Castaldo, John E

    2015-01-01

    The clinical and neuroimaging characteristics of brain infections related to Propionibacterium acnes are not well-characterized, making early diagnosis and treatment a challenge. More recently, life-threatening central nervous system infections with P. acnes are being reported with increasing frequency as complications of neurointerventional procedures. We present a rare case of P. acnes cerebritis that occurred as a sequela of bare platinum aneurysm coiling and a contaminant of percutaneous angiographic intervention. We include an extensive review of the literature describing the pathogenesis of P. acnes and neuro-radiological signs of brain infections related to this pathogen. PMID:25762004

  5. Pyoderma gangrenosum, acne conglobata, suppurative hidradenitis, and axial spondyloarthritis: efficacy of anti-tumor necrosis factor α therapy.

    PubMed

    Bruzzese, Vincenzo

    2012-12-01

    We report the case of a patient with a simultaneous presence of pyoderma gangrenosum, acne conglobata, suppurative hidradenitis, and axial spondyloarthritis. This condition differs from both the PASH (pyoderma gangrenosum, acne, and suppurative hidradenitis) syndrome, in which arthritis is absent, and the PAPA (pyogenic arthritis, pyoderma gangrenosum, and acne) syndrome, in which suppurative hidradenitis is lacking. Our patient failed to respond to etanercept therapy, whereas all dermatologic and rheumatic manifestations completely regressed following infliximab infusion. We therefore propose that simultaneous presence of pyoderma gangrenosum, acne conglobata, suppurative hidradenitis, and seronegative spondyloarthritis might represent a distinct syndrome that could be termed the PASS syndrome. Tumor necrosis factor α therapies seem to play selective roles.

  6. South-East Asia study alliance guidelines on the management of acne vulgaris in South-East Asian patients.

    PubMed

    Goh, Chee Leok; Abad-Casintahan, Flordeliz; Aw, Derrick Chen Wee; Baba, Roshidah; Chan, Lee Chin; Hung, Nguyen Thanh; Kulthanan, Kanokvalai; Leong, Hoe Nam; Medina-Oblepias, Marie Socouer; Noppakun, Nopadon; Sitohang, Irma Bernadette; Sugito, Titi Lestari; Wong, Su-Ni

    2015-10-01

    The management of acne in South-East Asia is unique, as Asian skin and local variables require a clinical approach unlike that utilized in other parts of the world. There are different treatment guidelines per country in the region, and a group of leading dermatologists from these countries convened to review these guidelines, discuss current practices and recent advances, and formulate consensus guidelines to harmonize the management of acne vulgaris in the region. Emphasis has been placed on formulating recommendations to impede the development of antibiotic resistance in Propionibacterium acnes. The group adopted the Acne Consensus Conference system for grading acne severity. The group recommends that patients may be treated with topical medications including retinoids, benzoyl peroxide (BPO), salicylic acid, a combination of retinoid and BPO, or a combination of retinoids and BPO with or without antibiotics for mild acne; topical retinoid with topical BPO and a oral antibiotic for moderate acne; and oral isotretinoin if the patient fails first-line treatment (a 6- or 8-week trial of combined oral antibiotics and topical retinoids with BPO) for severe acne. Maintenance acne treatment using topical retinoids with or without BPO is recommended. To prevent the development of antibiotic resistance, topical antibiotics should not be used as monotherapy or used simultaneously with oral antibiotics. Skin care, comprised of cleansing, moisturizing and sun protection, is likewise recommended. Patient education and good communication is recommended to improve adherence, and advice should be given about the characteristics of the skin care products patients should use.

  7. Suppression of Propionibacterium acnes Infection and the Associated Inflammatory Response by the Antimicrobial Peptide P5 in Mice

    PubMed Central

    Ryu, Sunhyo; Han, Hyo Mi; Song, Peter I.

    2015-01-01

    The cutaneous inflammation associated with acne vulgaris is caused by the anaerobic bacterium Propionibacterium acnes through activation of the innate immune system in the skin. Current standard treatments for acne have limitations that include adverse effects and poor efficacy in many patients, making development of a more effective therapy highly desirable. In the present study, we demonstrate the protective effects of a novel customized α-helical cationic peptide, P5, against P. acnes-induced inflammatory responses in vitro and in vivo. Application of P5 significantly reduced expression of two inflammatory cytokines IL-8 and TNF-α in P. acnes-treated primary human keratinocytes, where P5 appeared to act in part by binding to bacterial lipoteichoic acid, thereby suppressing TLR2-to-NF-κB signaling. In addition, in a mouse model of acne vulgaris, P5 exerted both anti-inflammatory and antimicrobial effects against P. acnes, but exerted no cytotoxic effects against skin cells. These results demonstrate that P5, and perhaps other cationic antimicrobial peptides, offer the unique ability to reduce numbers P. acnes cells in the skin and to inhibit the inflammation they trigger. This suggests these peptides could potentially be used to effectively treat acne without adversely affecting the skin. PMID:26197393

  8. Antimicrobial and anti-inflammatory properties of nostocionone isolated from Nostoc commune Vauch and its derivatives against Propionibacterium acnes.

    PubMed

    Itoh, Tomohiro; Tsuchida, Akihiro; Muramatsu, Yuji; Ninomiya, Masayuki; Ando, Masashi; Tsukamasa, Yasuyuki; Koketsu, Mamoru

    2014-06-01

    Propionibacterium acnes is the primary pathogenic agent responsible for acne vulgaris on the skin and hair follicles. Overgrowth of this bacterium inhibits growth and promotes follicular inflammation, with an associated increase in pro-inflammatory cytokine production. P. acnes has therefore been considered the main target for the prevention and medical treatment of acne vulgaris. The aim of this study was to evaluate the in vitro anti-P. acnes and anti-inflammatory properties of 6 compounds isolated from Nostoc commune. One of these compounds, nostocionone (Nost), and one of its derivatives, NostD3 [(1E,4E)-1-(3,4-dihydroxyphenyl)-5-(2,6,6-trimethylcyclohex-1-enyl)penta-1,4-dien-3-one], significantly inhibited P. acnes growth. Furthermore, we investigated the effects of Nost and NostD3 on heat-killed (hk) P. acnes-induced inflammation in macrophages. Both Nost and NostD3 suppressed hk P. acnes-induced nitric oxide (NO) production through the suppression of inducible NO synthase expression, following inactivation of nuclear factor kappa B. Taken together, our findings suggested that both Nost and NostD3 were promising agents for the treatment of acne vulgaris, and that NostD3 showed higher efficacy than Nost. PMID:24699048

  9. Zolav®: a new antibiotic for the treatment of acne

    PubMed Central

    Dinant, Alexa; Boulos, Ramiz A

    2016-01-01

    Background Acne is a prominent skin condition affecting >80% of teenagers and young adults and ~650 million people globally. Isotretinoin, a vitamin A derivative, is currently the standard of care for treatment. However, it has a well-established teratogenic activity, a reason for the development of novel and low-risk treatment options for acne. Objective To investigate the effectiveness of Zolav®, a novel antibiotic as a treatment for acne vulgaris. Materials and methods Minimum inhibitory concentration of Zolav® against Propionibacterium acnes was determined by following a standard protocol using Mueller-Hinton broth and serial dilutions in a 96-well plate. Cytotoxicity effects on human umbilical vein endothelial cells and lung cells in the presence of Zolav® were investigated by determining the growth inhibition (GI50) concentration, total growth inhibition concentration, and the lethal concentration of 50% (LC50). The tryptophan auxotrophic mutant of Escherichia coli strain, WP2 uvrA (ATCC 49979), was used for the AMES assay with the addition of Zolav® tested for its ability to reverse the mutation and induce bacterial growth. The in vivo effectiveness of Zolav® was tested in a P. acnes mouse intradermal model where the skin at the infection site was removed, homogenized, and subjected to colony-forming unit (CFU) counts. Results Susceptibility testing of Zolav® against P. acnes showed a minimum inhibitory concentration of 2 µg/mL against three strains with no cytotoxicity and no mutagenicity observed at the highest concentrations tested, 30 µM and 1,500 µg/plate, respectively. The use of Zolav® at a concentration of 50 µg/mL (q8h) elicited a two-log difference in CFU/g between the treatment group and the control. Conclusion This study demonstrates the potential of Zolav® as a novel treatment for acne vulgaris. PMID:27042015

  10. [Effective and safe pharmacotherapy of acne vulgaris and treatment of sun-damaged skin].

    PubMed

    Fendrich, Z; Jandová, E; Finsterlová, M

    2000-03-01

    An inevitable condition for the pharmacist is a basic knowledge of dermatological changes which are prominent in acne and solar impairment of the skin to be able to recommend in a qualified manner an effective and safe treatment to the patient. However, sufferers of the more serious forms of acne should always be referred to their general practitioner, or preferentially a dermatologist. Acne vulgaris is an androgen-induced disorder, but three major mechanisms for the development of the disease have been identified: hypertrophy of the sebaceous gland, hyperkatosis of the follicular epithelium, and proliferation of microbial flora, particularly Propionibacterium acnes. The basis of all lesions is the microcomedone which is developed into the ripe comedone. Inflammatory lesions are thought to be due to proliferation of P. acnes. In the selfmedication of common acne, benzoyl peroxide, which in a 5-10% lotion exerts antimicrobial and keratolytic properties, proved to be useful. Patients appreciate a lot its instant effect which is visible after just one day of treatment. Salicylic acid is another effective drug, which, when used on the long-term basis, has comedolytic properties; it reduces the number of microcomedones and counteracts plugging of the follicles. In addition, in healthy young women who take oral contraception, a triphasic combined oral preparations of contraceptives with newer progestins, notably with norgestimmate, which is practically free of androgenic effects, are recommended with advantage for the treatment of moderate acne vulgaris without any adverse effects. Solar impairment of the skin, the so-called solar ageing, is clinically indistinguishable from biological ageing. Changes connected with solar impairment appear mostly in the dermis, where solar elastosis develops, the skin gets drier and wrinkle formation appears. For the treatment, hydroxy acids are recommended, namely salicylic acid, which is very effective, because in combination with a

  11. Aqueous extract of dried fruit of Berberis vulgaris L. in acne vulgaris, a clinical trial.

    PubMed

    Fouladi, Rohollah F

    2012-12-01

    Berberis vulgaris L. (barberry) is a very well-known herb in traditional medicine. Apart from its anti-inflammatory and antibacterial properties, the antilipogenic effect of barberry on the sebaceous glands in animals may further suggest it could be employed as an anti-acne agent. This study examined the effect of oral aqueous extract of barberry on acne vulgaris. Adolescents aged 12-17 years with moderate to severe acne vulgaris were randomly given oral gelatin capsules containing either aqueous extract of dried barberry (600 mg daily for 4 weeks, n = 25) or placebo (n = 24). Counts of facial noninflamed, inflamed, and total acne lesions, as well as the Michaelson's acne severity score were documented at baseline and at weeks 2 and 4. Both groups were comparable in terms of the patients' characteristics and baseline variables. After 4 weeks, the mean number of noninflamed, inflamed, and total lesions as well as mean Michaelson's acne severity score declined significantly by 43.25 ± 10.88% (median: 42.11%), 44.53 ± 11.78% (median: 45.45%), 44.64 ± 8.46% (median: 46.15%), and 44.38 ± 8.25% (median: 44.07%), respectively, among the extract receivers (p <.001 for all the changes). Similar changes were not significant in the placebo group. No notable complication or side effect was reported in relation to barberry. In conclusion, oral aqueous extract of dried barberry is a safe, well-tolerated, and effective choice in teenagers with moderate to severe acne vulgaris.

  12. Propionibacterium acnes infected intervertebral discs cause vertebral bone marrow lesions consistent with Modic changes.

    PubMed

    Dudli, Stefan; Liebenberg, Ellen; Magnitsky, Sergey; Miller, Steve; Demir-Deviren, Sibel; Lotz, Jeffrey C

    2016-08-01

    Modic type I change (MC1) are vertebral bone marrow lesions adjacent to degenerated discs that are specific for discogenic low back pain. The etiopathogenesis is unknown, but occult discitis, in particular with Propionibacteria acnes (P. acnes), has been suggested as a possible etiology. If true, antibiotic therapy should be considered for patients with MC1. However, this hypothesis is controversial. While some studies report up to 40% infection rate in herniated discs, others fail to detect infected discs and attribute reports of positive cultures to contamination during sampling procedure. Irrespective of the clinical controversy, whether it is biologically plausible for P. acnes to cause MC1 has never been investigated. Therefore, the objective of this study was to test if P. acnes can proliferate within discs and cause reactive changes in the adjacent bone marrow. P. acnes was aseptically isolated from a symptomatic human L4/5 disc with MC1 and injected into rat tail discs. We demonstrate proliferation of P. acnes and up-regulation of IL-1 and IL-6 within three days of inoculation. At day-7, disc degeneration was apparent along with fibrotic endplate erosion. TNF-α immunoreactivity was enhanced within the effected endplates along with cellular infiltrates. The bone marrow appeared normal. At day-14, endplates and trabecular bone close to the disc were almost completely resorbed and fibrotic tissue extended into the bone marrow. T-cells and TNF-α immunoreactivity were identified at the disc/marrow junction. On MRI, bone marrow showed MC1-like changes. In conclusion, P. acnes proliferate within the disc, induce degeneration, and cause MC1-like changes in the adjacent bone marrow. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:1447-1455, 2016. PMID:27101067

  13. Serum levels of hypersensitive-C-reactive protein in moderate and severe acne

    PubMed Central

    Namazi, M. R.; Parhizkar, A. R.; Jowkar, F.

    2015-01-01

    Background: Elevation of C-reactive protein (CRP) has been reported to occur in psoriasis, urticaria, acne, rosacea and many other dermatological and nondermatological conditions. Chronic systemic inflammation has been implicated in the development of neuropsychiatric/degenerative disorders, atherosclerosis, coronary artery disease, diabetes mellitus and even carcinogenesis. The present study is designed to determine whether the level of inflammation created by acne vulgaris could be high enough to raise the serum levels of high-sensitive CRP. Materials and Methods: Forty-two patients with moderate and severe acne vulgaris were enrolled, along with 44 age and sex matched healthy blood donors as controls. Hypersensitive-CRP (Hs-CRP) was measured in both groups. Results: Hypersensitive-C-reactive protein levels in the case group varied between 0 and 28.1 μg/ml with an average of 2.24 ± 4.87 μg/ml (mean ± standard deviation) and a median of 0.6 μg/ml (interquartile range [IQR] =0.3, 1.4 μg/ml). Hs-CRP levels of the control group varied between 0 and 14 μg/ml with an average of 3.12 ± 3.67 μg/ml and a median of 1.5 μg/ml (IQR = 0.55, 5.0 μg/ml). No significant difference of Hs-CRP level between the two groups was seen (t = –0.961, 95% confidence interval: Lower = –2.6942, upper = 0.9377; P = 0.339). Additionally, no significant difference in the level of Hs-CRP was noted between the moderate and severe acne groups (95% confidence interval: Lower = –5.2495, upper = 1.6711; P = 0.165). Conclusion: Acne vulgaris, even in its severe grades (excluding acne fulminans and acne conglobata), does not induce significant inflammation at the systemic level. PMID:26225329

  14. Staphylococcal LTA-Induced miR-143 Inhibits Propionibacterium acnes-Mediated Inflammatory Response in Skin.

    PubMed

    Xia, Xiaoli; Li, Zhiheng; Liu, Kewei; Wu, Yelin; Jiang, Deming; Lai, Yuping

    2016-03-01

    Staphylococcus epidermidis (S. epidermidis) plays a critical role in modulating cutaneous inflammatory responses in skin. Although S. epidermidis has been shown to co-colonize with Propionibacterium acnes (P. acnes) in acne lesions, it is unclear whether S. epidermidis is involved in the regulation of P. acnes-induced inflammatory responses. In this study, we demonstrated that S. epidermidis inhibited P. acnes-induced inflammation in skin. P. acnes induced the expression of interleukin-6 and tumor necrosis factor-α via the activation of toll-like receptor (TLR) 2 in both keratinocytes and mouse ears. Staphylococcal lipoteichoic acid activated TLR2 to induce miR-143 in keratinocytes, and miR-143, in turn, directly targeted 3' UTR of TLR2 to decrease the stability of TLR2 mRNA and then decreased TLR2 protein, thus inhibiting P. acnes-induced proinflammatory cytokines. The inhibitory effect of miR-143 was further confirmed in vivo as the administration of miR-143 antagomir into mouse ears abrogated the inhibitory effect of lipoteichoic acid on P. acnes-induced inflammation in skin. Taken together, these observations demonstrate that staphylococcal lipoteichoic acid inhibits P. acnes-induced inflammation via the induction of miR-143, and suggest that local modulation of inflammatory responses by S. epidermidis at the site of acne vulgaris might be a beneficial therapeutic strategy for management of P. acnes-induced inflammation.

  15. Staphylococcal LTA-Induced miR-143 Inhibits Propionibacterium acnes-Mediated Inflammatory Response in Skin.

    PubMed

    Xia, Xiaoli; Li, Zhiheng; Liu, Kewei; Wu, Yelin; Jiang, Deming; Lai, Yuping

    2016-03-01

    Staphylococcus epidermidis (S. epidermidis) plays a critical role in modulating cutaneous inflammatory responses in skin. Although S. epidermidis has been shown to co-colonize with Propionibacterium acnes (P. acnes) in acne lesions, it is unclear whether S. epidermidis is involved in the regulation of P. acnes-induced inflammatory responses. In this study, we demonstrated that S. epidermidis inhibited P. acnes-induced inflammation in skin. P. acnes induced the expression of interleukin-6 and tumor necrosis factor-α via the activation of toll-like receptor (TLR) 2 in both keratinocytes and mouse ears. Staphylococcal lipoteichoic acid activated TLR2 to induce miR-143 in keratinocytes, and miR-143, in turn, directly targeted 3' UTR of TLR2 to decrease the stability of TLR2 mRNA and then decreased TLR2 protein, thus inhibiting P. acnes-induced proinflammatory cytokines. The inhibitory effect of miR-143 was further confirmed in vivo as the administration of miR-143 antagomir into mouse ears abrogated the inhibitory effect of lipoteichoic acid on P. acnes-induced inflammation in skin. Taken together, these observations demonstrate that staphylococcal lipoteichoic acid inhibits P. acnes-induced inflammation via the induction of miR-143, and suggest that local modulation of inflammatory responses by S. epidermidis at the site of acne vulgaris might be a beneficial therapeutic strategy for management of P. acnes-induced inflammation. PMID:26739093

  16. Glycemic index, glycemic load, wellness and beauty: the state of the art.

    PubMed

    Berra, Bruno; Rizzo, Angela Maria

    2009-01-01

    The glycemic index (GI) is a ranking system for carbohydrates' effect on blood glucose levels. It compares available carbohydrates gram for gram in individual foods, providing a numerical, evidence-based index of postprandial glycemia. The glycemic load (GL) is a ranking system for carbohydrate content in food portions based on their GI and the portion size. These two markers increasingly are being used to prevent typical diseases of the Western world, including type 2 diabetes mellitus, cardiovascular disease, obesity, metabolic syndrome, and acne. Data on the efficacy of GI and GL in the treatment of Western population diseases are discussed and critically evaluated, with a particular focus on acne and other skin disorders. PMID:19168005

  17. European S1 guideline for the treatment of hidradenitis suppurativa/acne inversa.

    PubMed

    Zouboulis, C C; Desai, N; Emtestam, L; Hunger, R E; Ioannides, D; Juhász, I; Lapins, J; Matusiak, L; Prens, E P; Revuz, J; Schneider-Burrus, S; Szepietowski, J C; van der Zee, H H; Jemec, G B E

    2015-04-01

    Hidradenitis suppurativa/acne inversa (HS) is a chronic, inflammatory, recurrent, debilitating skin disease of the hair follicle that usually presents after puberty with painful, deep-seated, inflamed lesions in the apocrine gland-bearing areas of the body, most commonly the axillae, inguinal and anogenital regions. A mean disease incidence of 6.0 per 100,000 person-years and an average prevalence of 1% has been reported in Europe. HS has the highest impact on patients' quality of life among all assessed dermatological diseases. HS is associated with a variety of concomitant and secondary diseases, such as obesity, metabolic syndrome, inflammatory bowel disease, e.g. Crohn's disease, spondyloarthropathy, follicular occlusion syndrome and other hyperergic diseases. The central pathogenic event in HS is believed to be the occlusion of the upper part of the hair follicle leading to a perifollicular lympho-histiocytic inflammation. A highly significant association between the prevalence of HS and current smoking (Odds ratio 12.55) and overweight (Odds ratio 1.1 for each body mass index unit) has been documented. The European S1 HS guideline suggests that the disease should be treated based on its individual subjective impact and objective severity. Locally recurring lesions can be treated by classical surgery or LASER techniques, whereas medical treatment either as monotherapy or in combination with radical surgery is more appropriate for widely spread lesions. Medical therapy may include antibiotics (clindamycin plus rifampicine, tetracyclines), acitretin and biologics (adalimumab, infliximab). A Hurley severity grade-relevant treatment of HS is recommended by the expert group following a treatment algorithm. Adjuvant measurements, such as pain management, treatment of superinfections, weight loss and tobacco abstinence have to be considered.

  18. Racial Differences in Clinical Characteristics, Perceptions and Behaviors, and Psychosocial Impact of Adult Female Acne

    PubMed Central

    Alexis, Andrew F.; Daniels, Selena R.; Kawata, Ariane K.; Burk, Caroline T.; Wilcox, Teresa K.; Taylor, Susan C.

    2014-01-01

    Objective: Limited data are available on racial differences in clinical characteristics and burden in adult female acne. The objective was to describe racial differences in clinical characteristics, psychosocial impact, perceptions, behaviors, and treatment satisfaction in facial adult female acne. Design: Cross-sectional, web-based survey. Setting: Diverse sample of United States women. Participants: Women between the ages of 25 and 45 years with facial acne (≥25 visible lesions). Measurements: Outcomes included sociodemographic characteristics, psychosocial impacts, perceptions, behaviors, and treatment satisfaction. Racial differences were evaluated using descriptive statistics and t-test/chi-square analyses. Results: 208 females participated (mean age 35±6 years); 51.4 percent were White/Caucasian and 48.6 percent were non-White/Caucasian women [Black/African American (n=51); Hispanic/Latina (n=23); Asian (n=16); Other (n=ll)]. Age of acne onset (mean 14.8±5 vs. 17.0±8 years, p<0.05) and acne concern occurred earlier (16.6±7 vs. 19.3±9 years, p<0.05) in White/Caucasian than non-White/Caucasian subjects. Facial acne primarily presented on chin (28.0%) and cheeks (30.8%) for White/Caucasian women versus cheeks (58.4%) for non-White/Caucasian women. Non-White/Caucasian women experienced more postinflammatory hyperpigmentation than White/Caucasian women (p<0.0001). Facial acne negatively affected quality of life (QoL) in both groups, and most participants (>70%) reported some depression/anxiety symptoms. More White/Caucasian than non-White/Caucasian women were troubled by facial acne (88.8% vs. 76.2%, p<0.05). Lesion clearance was most important to White/Caucasian women (57.9 vs. non-White/Caucasian 31.7%, p<0.001); non-White/Caucasian females focused on postinflammatory hyperpigmentation clearance (41.6% vs. Caucasian 8.4%, p<0.0001). Conclusion: Results highlight racial differences in participant-reported clinical characteristics, attitudes, behaviors, and

  19. Cigarette Smoke-Induced Interleukin-1 Alpha May Be Involved in the Pathogenesis of Adult Acne

    PubMed Central

    Yang, Yun Seok; Lim, Hee Kyeong; Hong, Kyung Kook; Shin, Min Kyung; Lee, Jin Woo; Lee, Sung Won

    2014-01-01

    Background Lipid peroxide (LPO) in comedones, which are produced as a result of sebum oxidation, might potentially induce interleukin-1α (IL-1α) and exacerbate comedogenesis and inflammatory changes in comedones. Objective To investigate the relationship of proinflammatory cytokines and LPO levels in the extracts of comedones with the acne of clinical difference between smokers and non-smokers, and with the severity and distribution of the acne lesions. Methods Twenty-two non-smoking and 21 smoking adult acne patients were evaluated by comedone extraction and measurement of proinflammatory cytokines and LPO levels. Acne severity and distribution of the lesions were also analyzed. Results Relative to the non-smoking group, smokers had significantly higher levels of IL-1α and LPO in comedones. Their levels showed a positive correlation. However, there were no statistically significant difference between the severity or distribution of the disease and the levels of LPO and IL-1α in comedones. Conclusion Smoking may be involved in the pathogenesis of adult acne by increasing the oxidative stress that results in subsequent accumulation of LPO in comedones. PMID:24648681

  20. Efficacy and safety of combined ethinyl estradiol/drospirenone oral contraceptives in the treatment of acne

    PubMed Central

    Tan, Jerry KL; Ediriweera, Chemanthi

    2010-01-01

    Acne is a common disorder affecting the majority of adolescents and often extends into adulthood. The central pathophysiological feature of acne is increased androgenic stimulation and/or end-organ sensitivity of pilosebaceous units leading to sebum hypersecretion and infundibular hyperkeratinization. These events lead to Propionibacterium acnes proliferation and subsequent inflammation. Hormonal therapy, including combined oral contraceptives (OCs), can attenuate the proximate androgenic trigger of this sequence. For many women, hormonal therapy is a rational option for acne treatment as it may be useful across the spectrum of severity. Drospirenone (DRSP) is a unique progestin structurally related to spironolactone with progestogenic, antimineralocorticoid, and antiandrogenic properties. It is available in 2 combined OC preparations (30 μg EE/3 mg DRSP; Yasmin® in a 21/7 regimen; and 20 μg EE/3 mg DRSP; Yaz® in a 24/4 regimen). These preparations are bereft of the fluid retentional side effects typical of other progestins and their safety has been demonstrated in large epidemiological studies in which no increased risk of vascular thromboembolic disease or arrhythmias was observed. In acne, the efficacy of DRSP-containing OCs has been shown in placebo-controlled superiority trials and in active-comparator non-inferiority trials. PMID:21072290

  1. Systematic review of antibiotic resistance in acne: an increasing topical and oral threat.

    PubMed

    Walsh, Timothy R; Efthimiou, John; Dréno, Brigitte

    2016-03-01

    Topical and oral antibiotics are routinely used to treat acne. However, antibiotic resistance is increasing, with many countries reporting that more than 50% of Propionibacterium acnes strains are resistant to topical macrolides, making them less effective. We reviewed the current scientific literature to enable proposal of recommendations for antibiotic use in acne treatment. References were identified through PubMed searches for articles published from January, 1954, to March 7, 2015, using four multiword searches. Ideally, benzoyl peroxide in combination with a topical retinoid should be used instead of a topical antibiotic to minimise the impact of resistance. Oral antibiotics still have a role in the treatment of moderate-to-severe acne, but only with a topical retinoid, benzoyl peroxide, or their combination, and ideally for no longer than 3 months. To limit resistance, it is recommended that benzoyl peroxide should always be added when long-term oral antibiotic use is deemed necessary. The benefit-to-risk ratio of long-term antibiotic use should be carefully considered and, in particular, use alone avoided where possible. There is a need to treat acne with effective alternatives to antibiotics to reduce the likelihood of resistance.

  2. Genome-wide association study identifies three novel susceptibility loci for severe Acne vulgaris.

    PubMed

    Navarini, Alexander A; Simpson, Michael A; Weale, Michael; Knight, Jo; Carlavan, Isabelle; Reiniche, Pascale; Burden, David A; Layton, Alison; Bataille, Veronique; Allen, Michael; Pleass, Robert; Pink, Andrew; Creamer, Daniel; English, John; Munn, Stephanie; Walton, Shernaz; Willis, Carolyn; Déret, Sophie; Voegel, Johannes J; Spector, Tim; Smith, Catherine H; Trembath, Richard C; Barker, Jonathan N

    2014-01-01

    Acne vulgaris (acne) is a common inflammatory disorder of the cutaneous pilo-sebaceous unit. Here we perform a genome-wide association analysis in the United Kingdom, comparing severe cases of acne (n=1,893) with controls (n=5,132). In a second stage, we genotype putative-associated loci in a further 2,063 acne cases and 1,970 controls. We identify three genome-wide significant associations: 11q13.1 (rs478304, Pcombined=3.23 × 10(-11), odds ratio (OR) = 1.20), 5q11.2 (rs38055, P(combined) = 4.58 × 10(-9), OR = 1.17) and 1q41 (rs1159268, P(combined) = 4.08 × 10(-8), OR = 1.17). All three loci contain genes linked to the TGFβ cell signalling pathway, namely OVOL1, FST and TGFB2. Transcripts of OVOL1 and TFGB2 have decreased expression in affected compared with normal skin. Collectively, these data support a key role for dysregulation of TGFβ-mediated signalling in susceptibility to acne.

  3. Clinical practice guidelines for treatment of acne vulgaris: a critical appraisal using the AGREE II instrument.

    PubMed

    Sanclemente, Gloria; Acosta, Jorge-Luis; Tamayo, Maria-Eulalia; Bonfill, Xavier; Alonso-Coello, Pablo

    2014-04-01

    A significant number of clinical practice guidelines (CPGs) about the treatment of acne vulgaris in adolescents and adults have been published worldwide. However, little is known about the quality of CPGs in this field. The aim of this study was to appraise the methodological quality of published acne vulgaris CPGs. We performed a systematic review of published CPGs on acne vulgaris therapy from July 2002 to July 2012. Three reviewers independently assessed each CPG using the AGREE II instrument. A standardized score was calculated for each of the six domains. Our search strategy identified 103 citations but just six met our inclusion criteria. Agreement among reviewers was very good: 0.981. The domains that scored better were: "scope and purpose" and "clarity and presentation". Those that scored worse were "stakeholder involvement", "rigor of development", and "applicability". The European and the Malaysian CPGs were the only recommended with no further modifications. In addition, the Mexican, Colombian and the United States guidelines were recommended with provisos, with lower scores regarding stakeholder involvement, rigor of development and applicability. Only two guidelines clearly reported outcome measures for evaluating efficacy or included quality of life outcomes. CPGs varied regarding the consideration of light/laser therapy or consideration of complementary/alternative medicines. None of them included cost considerations of drugs such as systemic isotretinoin. In conclusion, published acne vulgaris CPGs for acne therapy vary in quality with a clear need to improve their methodological rigor. This could be achieved with the adherence to current CPGs development standards.

  4. Acne treatment by methyl aminolevulinate photodynamic therapy with red light vs. intense pulsed light.

    PubMed

    Hong, Jong Soo; Jung, Jae Yoon; Yoon, Ji Young; Suh, Dae Hun

    2013-05-01

    Various methods of photodynamic therapy (PDT) for acne have been introduced. However, comparative studies among them are still needed. We performed this study to compare the effect of methyl aminolevulinate (MAL) PDT for acne between red light and intense pulsed light (IPL). Twenty patients were enrolled in this eight-week, prospective, split-face study. We applied MAL cream over the whole face with a three-hour incubation time. Then patients were irradiated with 22 J/cm(2) of red light on one-half of the face and 8-10 J/cm(2) of IPL on the other half during each treatment session. We performed three treatment sessions at two-week intervals and followed-up patients until four weeks after the last session. Inflammatory and non-inflammatory acne lesions were reduced significantly on both sides. The red light side showed a better response than the IPL side after the first treatment. Serious adverse effects after treatment were not observed. MAL-PDT with red light and IPL are both an effective and safe modality in acne treatment. Red light showed a faster response time than IPL. After multiple sessions, both light sources demonstrated satisfactory results. We suggest that reducing the total dose of red light is desirable when performing MAL-PDT in Asian patients with acne compared with Caucasians.

  5. Propionibacterium acnes and Staphylococcus lugdunensis cause pyogenic osteomyelitis in an intramedullary nail model in rabbits.

    PubMed

    Gahukamble, Abhay Deodas; McDowell, Andrew; Post, Virginia; Salavarrieta Varela, Julian; Rochford, Edward Thomas James; Richards, Robert Geoff; Patrick, Sheila; Moriarty, Thomas Fintan

    2014-05-01

    Propionibacterium acnes and coagulase-negative staphylococci (CoNS) are opportunistic pathogens implicated in prosthetic joint and fracture fixation device-related infections. The purpose of this study was to determine whether P. acnes and the CoNS species Staphylococcus lugdunensis, isolated from an "aseptically failed" prosthetic hip joint and a united intramedullary nail-fixed tibial fracture, respectively, could cause osteomyelitis in an established implant-related osteomyelitis model in rabbits in the absence of wear debris from the implant material. The histological features of P. acnes infection in the in vivo rabbit model were consistent with localized pyogenic osteomyelitis, and a biofilm was present on all explanted intramedullary (IM) nails. The animals displayed no outward signs of infection, such as swelling, lameness, weight loss, or elevated white blood cell count. In contrast, infection with S. lugdunensis resulted in histological features consistent with both pyogenic osteomyelitis and septic arthritis, and all S. lugdunensis-infected animals displayed weight loss and an elevated white blood cell count despite biofilm detection in only two out of six rabbits. The differences in the histological and bacteriological profiles of the two species in this rabbit model of infection are reflective of their different clinical presentations: low-grade infection in the case of P. acnes and acute infection for S. lugdunensis. These results are especially important in light of the growing recognition of chronic P. acnes biofilm infections in prosthetic joint failure and nonunion of fracture fixations, which may be currently reported as "aseptic" failure.

  6. Comparison of clinical efficacies of sodium ascorbyl phosphate, retinol and their combination in acne treatment.

    PubMed

    Ruamrak, C; Lourith, N; Natakankitkul, S

    2009-02-01

    Acne vulgaris impairs the appearance of an individual and causes psychological irritation. Inflammatory acne lesion is caused by multifactor incorporates in each step of acne pathogenesis. In an attempt to archive inflammatory lesion treatment with the promise of prevention of acne vulgaris, randomized and double-blind studies on the comparison of the efficacies of topical formulations containing 5% sodium ascorbyl phosphate (SAP) and 0.2% retinol, separately as well as in combination application, were conducted. The resulting data showed that SAP reduced the inflammatory lesion by 20.14% and 48.82% within 4 and 8 weeks respectively. Application of the formulation containing retinol slightly improved the treatment efficacy as the lesion reduced by 21.79% and 49.50% after 4 and 8 weeks respectively. The combination treatment significantly reduced the inflammatory lesion by 29.28% after 4 weeks and 63.10% after 8 weeks of application. The most effective treatment was by using the combination of 5% SAP and 0.2% retinol, which incorporated the synergistic effects on lipid peroxidation and sebaceous gland function in addition to the enhancement of SAP permeability by the desquamation of stratum corneum influenced by retinol, keratin plug removal and anti-inflammatory effect of retinol. This study promises for the development of cosmetic products to overcome aesthetic and psychological problems caused by acne vulgaris. PMID:19134126

  7. Evidence for acne-promoting effects of milk and other insulinotropic dairy products.

    PubMed

    Melnik, Bodo C

    2011-01-01

    Acne vulgaris, the most common skin disease of western civilization, has evolved to an epidemic affecting more than 85% of adolescents. Acne can be regarded as an indicator disease of exaggerated insulinotropic western nutrition. Especially milk and whey protein-based products contribute to elevations of postprandial insulin and basal insulin-like growth factor-I (IGF-I) plasma levels. It is the evolutional principle of mammalian milk to promote growth and support anabolic conditions for the neonate during the nursing period. Whey proteins are most potent inducers of glucose-dependent insulinotropic polypeptide secreted by enteroendocrine K cells which in concert with hydrolyzed whey protein-derived essential amino acids stimulate insulin secretion of pancreatic β-cells. Increased insulin/IGF-I signaling activates the phosphoinositide-3 kinase/Akt pathway, thereby reducing the nuclear content of the transcription factor FoxO1, the key nutrigenomic regulator of acne target genes. Nuclear FoxO1 deficiency has been linked to all major factors of acne pathogenesis, i.e. androgen receptor transactivation, comedogenesis, increased sebaceous lipogenesis, and follicular inflammation. The elimination of the whey protein-based insulinotropic mechanisms of milk will be the most important future challenge for nutrition research. Both, restriction of milk consumption or generation of less insulinotropic milk will have an enormous impact on the prevention of epidemic western diseases like obesity, diabetes mellitus, cancer, neurodegenerative diseases and acne.

  8. Systematic review of antibiotic resistance in acne: an increasing topical and oral threat.

    PubMed

    Walsh, Timothy R; Efthimiou, John; Dréno, Brigitte

    2016-03-01

    Topical and oral antibiotics are routinely used to treat acne. However, antibiotic resistance is increasing, with many countries reporting that more than 50% of Propionibacterium acnes strains are resistant to topical macrolides, making them less effective. We reviewed the current scientific literature to enable proposal of recommendations for antibiotic use in acne treatment. References were identified through PubMed searches for articles published from January, 1954, to March 7, 2015, using four multiword searches. Ideally, benzoyl peroxide in combination with a topical retinoid should be used instead of a topical antibiotic to minimise the impact of resistance. Oral antibiotics still have a role in the treatment of moderate-to-severe acne, but only with a topical retinoid, benzoyl peroxide, or their combination, and ideally for no longer than 3 months. To limit resistance, it is recommended that benzoyl peroxide should always be added when long-term oral antibiotic use is deemed necessary. The benefit-to-risk ratio of long-term antibiotic use should be carefully considered and, in particular, use alone avoided where possible. There is a need to treat acne with effective alternatives to antibiotics to reduce the likelihood of resistance. PMID:26852728

  9. Propionibacterium acnes: from Commensal to Opportunistic Biofilm-Associated Implant Pathogen

    PubMed Central

    Achermann, Yvonne; Goldstein, Ellie J. C.; Coenye, Tom

    2014-01-01

    SUMMARY Propionibacterium acnes is known primarily as a skin commensal. However, it can present as an opportunistic pathogen via bacterial seeding to cause invasive infections such as implant-associated infections. These infections have gained more attention due to improved diagnostic procedures, such as sonication of explanted foreign materials and prolonged cultivation time of up to 14 days for periprosthetic biopsy specimens, and improved molecular methods, such as broad-range 16S rRNA gene PCR. Implantassociated infections caused by P. acnes are most often described for shoulder prosthetic joint infections as well as cerebrovascular shunt infections, fibrosis of breast implants, and infections of cardiovascular devices. P. acnes causes disease through a number of virulence factors, such as biofilm formation. P. acnes is highly susceptible to a wide range of antibiotics, including beta-lactams, quinolones, clindamycin, and rifampin, although resistance to clindamycin is increasing. Treatment requires a combination of surgery and a prolonged antibiotic treatment regimen to successfully eliminate the remaining bacteria. Most authors suggest a course of 3 to 6 months of antibiotic treatment, including 2 to 6 weeks of intravenous treatment with a beta-lactam. While recently reported data showed a good efficacy of rifampin against P. acnes biofilms, prospective, randomized, controlled studies are needed to confirm evidence for combination treatment with rifampin, as has been performed for staphylococcal implant-associated infections. PMID:24982315

  10. New developments in acne treatment: role of combination adapalene–benzoylperoxide

    PubMed Central

    Kim, Su Youn; Ochsendorf, Falk R

    2016-01-01

    The fixed-dose combination adapalene 0.1%/benzoylperoxide 2.5% (A/BPO) was introduced as an acne vulgaris therapeutic in 2007. It combines anti-inflammatory, keratolytic, comedolytic, and antibacterial properties. Thus, it addresses several pathophysiological factors involved in the pathophysiology of acne. This review highlights the rationale for the use of this fixed-dose combination product, its therapeutic efficacy including effects on adherence and quality of life, its use for different forms of acne, and the side-effect profile. In summary, the fixed-dose combination of A/BPO gel can be regarded as a highly effective and safe formulation. It is not associated with antibiotic resistance. It reduces factors that cause nonadherence and has positive effects on the quality of life of affected patients. The tolerance is good. The initial mild irritation potential can be addressed by adequate counseling. A/BPO can be used for all forms of inflammatory acne, including severe forms, as part of a combination with systemic antibiotics. Finally, it can also be used for the long-term treatment of chronic acne. Thus, it is a very valuable therapeutic option in daily practice, which is reflected by its strong recommendation in the “European S3-guidelines”. PMID:27757036

  11. A systematic review and meta-analysis on Staphylococcus aureus carriage in psoriasis, acne and rosacea.

    PubMed

    Totté, J E E; van der Feltz, W T; Bode, L G M; van Belkum, A; van Zuuren, E J; Pasmans, S G M A

    2016-07-01

    Staphylococcus aureus might amplify symptoms in chronic inflammatory skin diseases. This study evaluates skin and mucosal colonization with S. aureus in patients with psoriasis, acne and rosacea. A systematic literature search was conducted. Both odds ratios (OR) for colonization in patients versus controls and the prevalence of colonization in patients are reported. Fifteen articles about psoriasis and 13 about acne (12 having a control group) were included. No study in rosacea met our inclusion criteria. For psoriasis, one study out of three controlled studies showed increased skin colonization (OR 18.86; 95 % confidence interval [CI] 2.20-161.99). Three out of the five studies that reported on nasal colonization showed significant ORs varying from 1.73 (95 % CI 1.16-2.58) to 14.64 (95 % CI 2.82-75.95). For acne one of the three studies that evaluated skin colonization reported a significant OR of 4.16 (95 % CI 1.74-9.94). A relation between nasal colonization and acne was not found. Limitations in study design and low sample sizes should be taken into consideration when interpreting the results. Colonisation with S. aureus seems to be increased in patients with psoriasis. This bacterial species, known for its potential to induce long-lasting inflammation, might be involved in psoriasis pathogenesis. Information on acne is limited. Prospective controlled studies should further investigate the role of S. aureus in chronic inflammatory skin diseases. PMID:27151386

  12. The Performance of Mouse Pointing and Selecting for Pupils with and without Intellectual Disabilities

    ERIC Educational Resources Information Center

    Lin, Yun-Lung; Chen, Ming-Chung; Chang, Yun-Ting; Yeh, Chih-Ching; Meng, Ling-Fu

    2009-01-01

    The purpose of this study was to compare the performance of mouse pointing and selecting in the tasks with different index of difficulty between 20 pupils with intellectual disabilities and 21 pupils without disabilities. A mouse proficiency assessment software was utilized to collect data. Pupils with intellectual disabilities executed tasks more…

  13. Propionibacterium acnes: Disease-Causing Agent or Common Contaminant? Detection in Diverse Patient Samples by Next-Generation Sequencing

    PubMed Central

    Friis-Nielsen, Jens; Vinner, Lasse; Hansen, Thomas Arn; Richter, Stine Raith; Fridholm, Helena; Herrera, Jose Alejandro Romero; Lund, Ole; Brunak, Søren; Izarzugaza, Jose M. G.; Mourier, Tobias; Nielsen, Lars Peter

    2016-01-01

    Propionibacterium acnes is the most abundant bacterium on human skin, particularly in sebaceous areas. P. acnes is suggested to be an opportunistic pathogen involved in the development of diverse medical conditions but is also a proven contaminant of human clinical samples and surgical wounds. Its significance as a pathogen is consequently a matter of debate. In the present study, we investigated the presence of P. acnes DNA in 250 next-generation sequencing data sets generated from 180 samples of 20 different sample types, mostly of cancerous origin. The samples were subjected to either microbial enrichment, involving nuclease treatment to reduce the amount of host nucleic acids, or shotgun sequencing. We detected high proportions of P. acnes DNA in enriched samples, particularly skin tissue-derived and other tissue samples, with the levels being higher in enriched samples than in shotgun-sequenced samples. P. acnes reads were detected in most samples analyzed, though the proportions in most shotgun-sequenced samples were low. Our results show that P. acnes can be detected in practically all sample types when molecular methods, such as next-generation sequencing, are employed. The possibility of contamination from the patient or other sources, including laboratory reagents or environment, should therefore always be considered carefully when P. acnes is detected in clinical samples. We advocate that detection of P. acnes always be accompanied by experiments validating the association between this bacterium and any clinical condition. PMID:26818667

  14. Epidemiologic Study of Malassezia Yeasts in Acne Patients by Analysis of 26S rDNA PCR-RFLP

    PubMed Central

    Song, Young Chan; Hahn, Hyung Jin; Kim, Ji Young; Ko, Jong Hyun; Choe, Yong Beom; Ahn, Kyu Joong

    2011-01-01

    Background Although acne is a common follicular inflammatory dermatosis, studies of the relationship between Malassezia yeasts and acne have rarely been conducted. Objective We sought to identify Malassezia yeasts from acne patients and establish a relationship between specific types of species of Malassezia and acne. Methods Sixty acne patients were enrolled. Each strain obtained was identified as one of eleven species by 26S rDNA PCR-RFLP. We then compared these data with those of age- and sex-matched healthy subjects. Results Growth of Malassezia was evident in fewer patients with acne (50%) in comparison to controls (70.6%). M. restricta was dominant in patients with acne (23.9%), whereas M. globosa was most common (26.7%) in healthy controls. In the patients group, the rate was the highest (71.7%) in the twenties and, in terms of body site, the rate was the highest (60%) in the chest. In the control group, the rate was the highest (75.0%) in the thirties and in the forehead (85.0%). Conclusion The detection rate of Malassezia yeasts was conspicuously low in the acne patients group. Statistically significant differences were observed between the patient and the control groups in the twenties and thirties, and in terms of body site, in the forehead and chest. PMID:21909202

  15. Concurrent hidradenitis suppurativa, inflammatory acne, dissecting cellulitis of the scalp, and pyoderma gangrenosum in a 16-year-old boy.

    PubMed

    Koshelev, Misha V; Garrison, Paige A; Wright, Teresa S

    2014-01-01

    We report the case of a 16-year-old boy who presented to our clinic with concomitant hidradenitis suppurativa, inflammatory acne, dissecting cellulitis of the scalp, and pyoderma gangrenosum. Recent reports describe the co-occurrence of pyoderma gangrenosum, acne, and hidradenitis suppurativa. This case further expands the spectrum of concomitant pyoderma gangrenosum and dissecting cellulitis of the scalp. PMID:24118007

  16. Hidradenitis suppurrativa (acne inversa) as a systemic disease.

    PubMed

    Dessinioti, Clio; Katsambas, Andreas; Antoniou, Christina

    2014-01-01

    Hidradenitis suppurativa (HS), also known as acne inversa, is a chronic follicular occlusive skin disorder characterized by recurrent abscesses, draining sinuses, and scarring, with a multifactorial pathogenesis. The answer to the question whether HS may be considered a systemic disease relies on the presence of accompanying systemic manifestations, on the proof of association with other diseases or conditions, and on the occurrence of systemic implications. We address these questions based on a systemic review of the existing literature. There are several reports in the literature of the coexistence of HS with other diseases, including pyoderma gangrenosum, PASH syndrome, Adamantiades-Behcet's disease, spondylarthropathy, Crohn's disease, SAPHO, pachyonychia congenita, Dowling-Degos disease, and the keratitis-ichthyosis-deafness (KID) syndrome. Case series exist only for Crohn's disease, while most other reports are anecdotal, thus, not providing high-quality scientific evidence. Based on well-designed studies, HS has been associated with the metabolic syndrome and with excess body weight or obesity. The link between HS and systemic associations may be attributed to common genetic or environmental factors or shared inflammatory pathways. PMID:24767187

  17. Topical treatment of acne rosacea with benzoyl peroxide acetone gel.

    PubMed

    Montes, L F; Cordero, A A; Kriner, J; Loder, J; Flanagan, A D

    1983-08-01

    A group of patients with acne rosacea was treated with 5 percent benzoyl peroxide acetone gel for four weeks and then with 10 percent benzoyl peroxide acetone gel for an additional four weeks. A parallel group of patients was treated with a matching placebo (acetone gel vehicle). At the end of the first four weeks of treatment the dropout rate due to lack of improvement was 23 and 63 percent for benzoyl peroxide acetone gel and placebo, respectively. Benzoyl peroxide acetone gel was superior to placebo with respect to improvement in the overall severity of the lesions when judged by photographs, and by reduction of erythema, papules, and pustules. Results after treatment with benzoyl peroxide acetone gel were better during weeks five to eight than during weeks one to four for all lesions except telangiectasia. Benzoyl peroxide acetone gel was superior to placebo when the overall responses were compared. In addition, the benzoyl peroxide acetone gel-treated group, but not the placebo-treated group, showed a significantly better response during weeks five to eight compared to weeks one to four.

  18. Psychosocial judgements and perceptions of adolescents with acne vulgaris: A blinded, controlled comparison of adult and peer evaluations

    PubMed Central

    2011-01-01

    Background The purpose of the current survey was to evaluate how teenagers and adults view teens with acne as compared to those with smooth, clear skin. We also surveyed teens and adults about their experiences with acne. Methods We hypothesized that teens with acne would be perceived in a more negative fashion as compared to teens with smooth, clear skin. We presented digitally altered photographs to our responders and asked how they perceived the two groups. No mention was made of acne. In the first survey (n = 1,002), both adults and teens provided their impressions on photo images of teenagers with either clear skin or acne. In the second survey (n = 1,006), the adults and teens also answered questions about their own experiences with acne. Results Survey 1. With respect to impressions of photo images, the first thing teens and adults noticed about a person with acne was their skin (65% and 75%, respectively). Teenagers with acne were perceived most often by other teens and adults (teen responder %, adult responder %) as being shy (39%, 43%), nerdy (31%, 21%), stressed (24%, 20%), lonely (23%, 22%), boring (15%, 6%), unkempt (13%, 7%), unhealthy (12%, 8%), introverted (9%, 23%), and rebellious (7%, 5%). Survey 2. Most teenagers with acne (64%) felt embarrassed by it and thought that getting acne was the most difficult aspect of puberty (55%). Teenagers with acne reported lower self-confidence or shyness (71%); difficulty finding dates (43%), problems making friends (24%), challenges with school (21%), and trouble getting a job (7%). Conclusions Teens with smooth, clear skin were rated higher on every favorable characteristic and lower on every unfavorable characteristic by both teens and adults. In most cases, the first thing that respondents noticed was the skin of teens with acne. Teenagers and adults alike perceived other teens with acne as generally being shy, less socially active, more likely to be bullied, and less successful in terms of finding a job

  19. The emotional impact of chronic and disabling skin disease: a psychoanalytic perspective.

    PubMed

    Koblenzer, Caroline S

    2005-10-01

    This article discusses some major early factors that influence the evolving psychologic development, which in turn helps determine the emotional impact that chronic or disabling skin disease may have on patients' lives. If the emotional environment, encompassed by the infant-caretaker relationship, is less than optimal, the stability of the body image may be compromised, self-esteem diminished, and affect less well handled and the somatic expression of emotional content may ensue. Each of these is important in dermatology, as is the nature of the disease and the capacity of families and of society to adapt. Psoriasis, atopic dermatitis, and acne are used as examples.

  20. Evaluating the Efficacy of Photodynamic Therapy with 20% Aminolevulinic Acid and Microdermabrasion as a Combination Treatment Regimen for Acne Scarring

    PubMed Central

    Jim On, Shelbi; Haddican, Madelaine; Singer, Giselle; Shim-Chang, Helen

    2014-01-01

    Acne scarring is a consequence of abnormal resolution of wound healing after damage that occurs in the sebaceous follicle during acne inflammation. No trial to date has evaluated the efficacy of the combination of microdermabrasion and photodynamic therapy for acne scarring. This single-center, double-blinded pilot study enrolled subjects with moderate-to-severe acne scarring who were randomly assigned in a blinded fashion to use aminolevulinic acid and vehicle in a split-face fashion after full-face treatment with microdermabrasion. On average, 80 percent of the patients displayed more improvement in scarring on the aminolevulinic acid split face versus the vehicle split face after five treatments. Using two different noninvasive mechanisms of targeting acne scarring provided for a safe treatment regimen characterized by more efficacious results with respect to higher rates of scarring improvement. PMID:24847407

  1. How does our increased understanding of the role of inflammation and innate immunity in acne impact treatment approaches?

    PubMed

    Leyden, James

    2016-01-01

    A supplement article recently published in the Journal of the European Academy of Dermatology and Venereology by Dréno et al., members of the Global Alliance to Improve Outcomes in Acne group, summarized the data for the emerging concept that inflammation in general and the innate immune system specifically play a central role in the pathogenesis of acne. This review, entitled "Understanding innate immunity and inflammation in acne: implications for management", also discusses the impact of different treatment options on the innate immune response and inflammation. The aim of the present summary is to provide a synopsis of the key points made in the paper, from the members of the Global Alliance, as relevant to the main article within this supplement: "Recent advances in the use of adapalene 0.1%/benzoyl peroxide 2.5% to treat acne patients with moderate to severe acne".

  2. Topical treatment of acne with a tetracycline preparations: results of a multi-group study.

    PubMed

    Frank, S B

    1976-03-01

    This report presents the results of a 13-week study done on 300 patients with acne vulgaris treated with a tetracycline topical lotion alone. The vehicle used was an aqueous-ethanol solution containing the penetration enhancer, n-decyl methyl sulfoxide. On a 0-8 grading scale, 81% of the patients improved by one or more grade points, 57% by two or more points and 31% by three or more points. Analysis indicated that concomitant variables such as severity, age, type of acne, sex and season of the year did not alter the conclusion as to efficacy. Detailed statistical analysis indicates that the conclusion is valid that the tetracycline preparation is beneficial in the treatment of acne vulgaris. No adverse reactions were observed in the patients treated. Hemograms, blood studies and urinalyses were completed on 37 patients. No disturbing trends were uncovered.

  3. A comparative study of gluconolactone versus benzoyl peroxide in the treatment of acne.

    PubMed

    Hunt, M J; Barnetson, R S

    1992-01-01

    Alpha hydroxy acids (AHA's) or "fruit acids" are a special group of organic acids found in many natural foods. They have been described in the literature for the treatment of a number of conditions in which abnormal keratinization consistently contributes to pathogenesis. These include the icthyoses, warts, psoriasis, eczema and acne. We have performed a double-blind clinical trial on 150 patients to evaluate the efficacy and skin tolerance of the alpha hydroxy acid gluconolactone 14% in solution (Nuvoderm lotion) in the treatment of mild to moderate acne when compared with its vehicle (placebo) and 5% benzoyl peroxide lotion. The results of this study showed that both gluconolactone and benzoyl peroxide had a significant effect in improving patients' acne by reducing the number of lesions (inflamed and non-inflamed). Furthermore, fewer side-effects were experienced by patients treated with gluconolactone when compared with benzoyl peroxide.

  4. Topical, Biological and Clinical Challenges in the Management of Patients with Acne Vulgaris.

    PubMed

    Al-Hammadi, Anwar; Al-Ismaily, Abla; Al-Ali, Sameer; Ramadurai, Rajesh; Jain, Rishi; McKinley-Grant, Lynn; Mughal, Tariq I

    2016-05-01

    Acne vulgaris is one of the most common chronic inflammatory skin disorders among adolescents and young adults. It is associated with substantial morbidity and, rarely, with mortality. The exact worldwide incidence and prevalence are currently unknown. Current challenges involve improving understanding of the underlying pathophysiology of acne vulgaris and developing a practical treatment consensus. Expert panel discussions were held in 2013 and 2014 among a group of scientists and clinicians from the Omani and United Arab Emirate Dermatology Societies to ascertain the current optimal management of acne vulgaris, identify clinically relevant end-points and construct suitable methodology for future clinical trial designs. This article reviews the discussions of these sessions and recent literature on this topic.

  5. Topical, Biological and Clinical Challenges in the Management of Patients with Acne Vulgaris

    PubMed Central

    Al-Hammadi, Anwar; Al-Ismaily, Abla; Al-Ali, Sameer; Ramadurai, Rajesh; Jain, Rishi; McKinley-Grant, Lynn; Mughal, Tariq I.

    2016-01-01

    Acne vulgaris is one of the most common chronic inflammatory skin disorders among adolescents and young adults. It is associated with substantial morbidity and, rarely, with mortality. The exact worldwide incidence and prevalence are currently unknown. Current challenges involve improving understanding of the underlying pathophysiology of acne vulgaris and developing a practical treatment consensus. Expert panel discussions were held in 2013 and 2014 among a group of scientists and clinicians from the Omani and United Arab Emirate Dermatology Societies to ascertain the current optimal management of acne vulgaris, identify clinically relevant end-points and construct suitable methodology for future clinical trial designs. This article reviews the discussions of these sessions and recent literature on this topic. PMID:27226905

  6. The interleukin-6 and interleukin-1A gene promoter polymorphism is associated with the pathogenesis of acne vulgaris.

    PubMed

    Younis, S; Javed, Q

    2015-05-01

    Acne vulgaris is a skin disorder with a complex pathogenesis. Better treatment strategies require comprehensive knowledge of molecular factors contributing to the acne pathophysiology. Recent studies are focused on investigating the influence of inflammatory cytokines on the disease. This case-control study investigated the association of IL-6-572 G/C and IL-1A-889 C/T gene polymorphisms with acne in a Pakistani population. Pakistani subjects (380 healthy controls and 430 acne patients) were enrolled in this study. Polymorphism in the promoter region of IL-6-572 and IL-1A-889 was determined by polymerase chain reaction and restriction fragment length polymorphism. The IL-6-572 and IL-1A-889 variant genotypes were significantly associated with the acne pathogenesis. The IL-6-572C and the IL-1A-889T alleles were significantly high in the patient vs. control group (p < 0.0001 for both loci). The IL-6-572 G/C and IL-1A-889 C/T variant allele haplotypes showed significantly high prevalence in patients with acne; G-T (P = 0.0014), C-C (P < 0.0001), and C-T (P < 0.0001). This is the first report on the association between the IL-6-572 G/C polymorphism and acne among any population. The IL-1A-889 C/T polymorphism is also significantly linked with acne in the study population; the -889 C/T association with acne has been reported in one ethnic group previously. Our findings suggest that the IL-6-572C and IL-1A-889T alleles may contribute to the pathogenesis of acne in a Pakistani population. Further studies are required to verify these findings in other populations.

  7. Antimicrobial and anti-inflammatory activities of endophytic fungi Talaromyces wortmannii extracts against acne-inducing bacteria.

    PubMed

    Pretsch, Alexander; Nagl, Michael; Schwendinger, Katja; Kreiseder, Birgit; Wiederstein, Martina; Pretsch, Dagmar; Genov, Miroslav; Hollaus, Ralph; Zinssmeister, Daniela; Debbab, Abdesamad; Hundsberger, Harald; Eger, Andreas; Proksch, Peter; Wiesner, Christoph

    2014-01-01

    Acne vulgaris is the most common skin disease, causing significant psychosocial problems such as anxiety and depression similar to a chronic illness for those afflicted. Currently, obtainable agents for acne treatment have limited use. Thus, development of novel agents to treat this disease is a high medical need. The anaerobic bacterium Propionibacterium acnes has been implicated in the inflammatory phase of acne vulgaris by activating pro-inflammatory mediators such as the interleukin-8 (IL-8) via the NF-κB and MAPK pathways. Talaromyces wortmannii is an endophytic fungus, which is known to produce high bioactive natural compounds. We hypothesize that compound C but also the crude extract from T. wortmannii may possess both antibacterial activity especially against P. acnes and also anti-inflammatory properties by inhibiting TNF-α-induced ICAM-1 expression and P. acnes-induced IL-8 release. Treatment of keratinocytes (HaCaT) with P. acnes significantly increased NF-κB and activator protein-1 (AP-1) activation, as well as IL-8 release. Compound C inhibited P. acnes-mediated activation of NF-κB and AP-1 by inhibiting IκB degradation and the phosphorylation of ERK and JNK MAP kinases, and IL-8 release in a dose-dependent manner. Based on these results, compound C has effective antimicrobial activity against P. acnes and anti-inflammatory activity, and we suggest that this substance or the crude extract are alternative treatments for antibiotic/anti-inflammatory therapy for acne vulgaris. PMID:24887557

  8. Problems in the reporting of acne clinical trials: a spot check from the 2009 Annual Evidence Update on Acne Vulgaris.

    PubMed

    Ingram, John R; Grindlay, Douglas J C; Williams, Hywel C

    2010-07-12

    In the course of producing the 2009 NHS Evidence--skin disorders Annual Evidence Update on Acne Vulgaris, 25 randomised controlled trials were examined. From these, at least 12 potentially serious problems of trial reporting were identified. Several trials concluded no effect of a treatment yet they were insufficiently powered to exclude potentially useful benefits. There were examples of duplicate publication and "salami publication", as well as two trials being combined and reported as one. In some cases, an incorrect "within-groups" statistical comparison was made and one trial report omitted original efficacy data and included only P values. Both of the non-inferiority studies examined failed to pre-specify a non-inferiority margin. Trials reported as "double-blind" compared treatments that were dissimilar in appearance or had differing adverse effect profiles. In one case an intention-to-treat analysis was not performed and there was a failure to account for all of the randomized participants. Trial results were made to sound more impressive by selective outcome reporting, emphasizing the statistical significance of treatment effects that were clinically insignificant, and by the use of larger-sounding odds ratios rather than rate ratios for common events. Most of the reporting problems could have been avoided by use of the CONSORT guidelines and prospective trial registration on a public clinical trials database.

  9. A study on the characterization of Propionibacterium acnes isolated from ocular clinical specimens

    PubMed Central

    Sowmiya, Murali; Malathi, Jambulingam; Swarnali, Sen; Priya, Jeyavel Padma; Therese, Kulandai Lily; Madhavan, Hajib N.

    2015-01-01

    Background & objectives: There are only a few reports available on characterization of Propionibacterium acnes isolated from various ocular clinical specimens. We undertook this study to evaluate the role of P. acnes in ocular infections and biofilm production, and also do the phylogenetic analysis of the bacilli. Methods: One hundred isolates of P. acnes collected prospectively from ocular clinical specimens at a tertiary care eye hospital between January 2010 and December 2011, were studied for their association with various ocular disease conditions. The isolates were also subjected to genotyping and phylogenetic analysis, and were also tested for their ability to produce biofilms. Results: Among preoperative conjunctival swabs, P. acnes was a probably significant pathogen in one case; a possibly significant pathogen in two cases. In other clinical conditions, 13 per cent isolates were probably significant pathogens and 38 per cent as possibly significant pathogens. The analysis of 16S rRNA gene revealed four different phylogenies whereas analysis of recA gene showed two phylogenies confirming that recA gene was more reliable than 16S rRNA with less sequence variation. Results of polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) had 100 per cent concordance with phylogenetic results. No association was seen between P. acnes subtypes and biofilm production. Interpretation & conclusions: RecA gene phylogenetic studies revealed two different phylogenies. RFLP technique was found to be cost-effective with high sensitivity and specificity in phylogenetic analysis. No association between P. acnes subtypes and pathogenetic ability was observed. Biofilm producing isolates showed increased antibiotic resistance compared with non-biofilm producing isolates. PMID:26609036

  10. Benzoyl peroxide, adapalene, and their combination in the treatment of acne vulgaris.

    PubMed

    Korkut, Caner; Piskin, Suleyman

    2005-03-01

    Benzoyl peroxide and adapalene are among the most effective topical agents used in the treatment of acne. We planned an open-labeled, prospective study to compare the effects and side effects of these two drugs alone and in combination in the treatment of acne vulgaris. One hundred and five consecutive patients (30 men and 75 women) with acne vulgaris were included in this study. The patients were randomly divided into three groups with 35 patients in each. The groups were randomly assigned to 0.1% adapalene gel, 5% benzoyl peroxide lotion, or combination of 0.1% adapalene gel +5% benzoyl peroxide treatment. Acne lesions were classified as noninflammatory (open and closed comedones) and inflammatory (papule, pustule, nodule, cyst), and the lesions on the face were counted before the therapy, during the control visits, and after the treatment. Erythema, dryness, burning, and other side effects were recorded during the treatment. The mean age of the patients was 18.44 +/- 3.75 years. Eight patients were excluded because of noncompliance with the treatment regimen or the follow-up schedule, and four patients were excluded due to allergic contact dermatitis. The study revealed that all three therapy protocols were effective in treating noninflammatory and inflammatory lesions in acne vulgaris (p<0.05) and that there was no significant difference between the groups in efficacy or side effects (p>0.05). Adapalene and benzoyl peroxide are effective and well tolerated agents for acne vulgaris; combination therapy has no superiority over adapalene or benzoyl peroxide alone.

  11. Evaluation of nasal and oropharyngeal flora in patients with acne vulgaris according to treatment options.

    PubMed

    Ozuguz, Pınar; Callioglu, Elif E; Tulaci, Kamil G; Kacar, Seval D; Balta, Ilknur; Asik, Gulsah; Karatas, Serap; Karaca, Semsettin

    2014-11-01

    The aim of this study was to evaluate changes in nasal and oropharyngeal flora in patients with acne during treatments with tetracycline and isotretinoin. Swab specimens were taken from the right and left nasal cavities and oropharynx of 55 patients with acne and 20 healthy volunteers who were admitted to the dermatology department (Etlik Educational and Research Hospital, Ankara, Turkey) before the administration of treatment and in the third month of treatment. Study participants were divided into four groups as follows: patients with acne on topical treatment only, systemic isotretinoin, and systemic tetracycline, and the control group. Of 55 patients with acne, 18 were male and 37 were female. The mean age of the patients and the control group was 22.21 ± 4.22 and 21.95 ± 7.64, respectively. Staphylococcus aureus was isolated from the nasal flora of five patients, normal flora was suppressed in the oropharyngeal cultures of seven patients, and normal flora grew in the cultures of the other 20 patients who were on tetracycline treatment. On the other hand, normal flora grew in the nasal and oropharyngeal cultures of all the patients who were on isotretinoin treatment. Treatment options and follow-up procedures for acne vulgaris may lead to the development of bacterial resistance and damage to flora. In particular, systemic tetracycline treatment leads to changes in flora of the nose and throat in patients with acne with an increased carriage of S. aureus. Therefore, careful attention should be paid to the duration of tetracycline treatment in order to not increase the risk of disturbance of microbial flora.

  12. A Comprehensive Critique and Review of Published Measures of Acne Severity

    PubMed Central

    Furber, Gareth; Leach, Matthew; Segal, Leonie

    2016-01-01

    Objective: Acne vulgaris is a dynamic, complex condition that is notoriously difficult to evaluate. The authors set out to critically evaluate currently available measures of acne severity, particularly in terms of suitability for use in clinical trials. Design: A systematic review was conducted to identify methods used to measure acne severity, using MEDLINE, CINAHL, Scopus, and Wiley Online. Each method was critically reviewed and given a score out of 13 based on eight quality criteria under two broad groupings of psychometric testing and suitability for research and evaluation. Results: Twenty-four methods for assessing acne severity were identified. Four scales received a quality score of zero, and 11 scored ≤3. The highest rated scales achieved a total score of 6. Six scales reported strong inter-rater reliability (ICC>0.75), and four reported strong intra-rater reliability (ICC>0.75). The poor overall performance of most scales, largely characterized by the absence of reliability testing or evidence for independent assessment and validation indicates that generally, their application in clinical trials is not supported. Conclusion: This review and appraisal of instruments for measuring acne severity supports previously identified concerns regarding the quality of published measures. It highlights the need for a valid and reliable acne severity scale, especially for use in research and evaluation. The ideal scale would demonstrate adequate validation and reliability and be easily implemented for third-party analysis. The development of such a scale is critical to interpreting results of trials and facilitating the pooling of results for systematic reviews and meta-analyses. PMID:27672410

  13. Randomised controlled trial of topical kanuka honey for the treatment of acne

    PubMed Central

    Semprini, Alex; Corin, Andrew; Sheahan, Davitt; Tofield, Christopher; Helm, Colin; Montgomery, Barney; Fingleton, James; Weatherall, Mark; Beasley, Richard

    2016-01-01

    Objective To investigate the efficacy of Honevo, a topical 90% medical-grade kanuka honey, and 10% glycerine (honey product) as a treatment for facial acne. Design Randomised controlled trial with single blind assessment of primary outcome variable. Setting Outpatient primary care from 3 New Zealand localities. Participants Of 136 participants aged between 16 and 40 years with a diagnosis of acne and baseline Investigator's Global Assessment (IGA) for acne score of ≥2.68, participants were randomised to each treatment arm. Interventions All participants applied Protex, a triclocarban-based antibacterial soap twice daily for 12 weeks. Participants randomised to the honey product treatment arm applied this directly after washing off the antibacterial soap, twice daily for 12 weeks. Outcome measures The primary outcome was ≥2 point decrease in IGA score from baseline at 12 weeks. Secondary outcomes included mean lesion counts and changes in subject-rated acne improvement and severity at weeks 4 and 12, and withdrawals for worsening acne. Results 4/53 (7.6%) participants in the honey product group and 1/53 (1.9%) of participants in the control group had a ≥ 2 improvement in IGA score at week 12, compared with baseline, OR (95% CI) for improvement 4.2 (0.5 to 39.3), p=0.17. There were 15 and 14 participants who withdrew from the honey product group and control group, respectively. Conclusions This randomised controlled trial did not find evidence that addition of medical-grade kanuka honey in combination with 10% glycerine to standard antibacterial soap treatment is more effective than the use of antibacterial soap alone in the treatment of acne. Trial registration number ACTRN12614000003673; Results. PMID:26832428

  14. A Comprehensive Critique and Review of Published Measures of Acne Severity

    PubMed Central

    Furber, Gareth; Leach, Matthew; Segal, Leonie

    2016-01-01

    Objective: Acne vulgaris is a dynamic, complex condition that is notoriously difficult to evaluate. The authors set out to critically evaluate currently available measures of acne severity, particularly in terms of suitability for use in clinical trials. Design: A systematic review was conducted to identify methods used to measure acne severity, using MEDLINE, CINAHL, Scopus, and Wiley Online. Each method was critically reviewed and given a score out of 13 based on eight quality criteria under two broad groupings of psychometric testing and suitability for research and evaluation. Results: Twenty-four methods for assessing acne severity were identified. Four scales received a quality score of zero, and 11 scored ≤3. The highest rated scales achieved a total score of 6. Six scales reported strong inter-rater reliability (ICC>0.75), and four reported strong intra-rater reliability (ICC>0.75). The poor overall performance of most scales, largely characterized by the absence of reliability testing or evidence for independent assessment and validation indicates that generally, their application in clinical trials is not supported. Conclusion: This review and appraisal of instruments for measuring acne severity supports previously identified concerns regarding the quality of published measures. It highlights the need for a valid and reliable acne severity scale, especially for use in research and evaluation. The ideal scale would demonstrate adequate validation and reliability and be easily implemented for third-party analysis. The development of such a scale is critical to interpreting results of trials and facilitating the pooling of results for systematic reviews and meta-analyses.

  15. The mode of action of ethyl lactate as a treatment for acne.

    PubMed

    Prottey, C; George, D; Leech, R W; Black, J G; Howes, D; Vickers, C F

    1984-04-01

    We have shown that an alcoholic lotion containing ethyl lactate when applied topically to rat skin under occlusion became localized in the follicles and sebaceous glands. When applied to human facial skin the ethyl lactate was hydrolysed to ethanol and lactic acid, and thereby lowered the skin pH. Under such conditions the growth of recoverable skin bacteria, in particular the anaerobe Propionibacterium acnes, was inhibited, and the hydrolysis of sebum to free fatty acids by lipase derived from the bacteria was greatly impaired. These effects of ethyl lactate would account for its observed clinical efficacy in acne vulgaris.

  16. Benzoyl peroxide versus topical erythromycin in the treatment of acne vulgaris.

    PubMed

    Burke, B; Eady, E A; Cunliffe, W J

    1983-02-01

    In a double-blind clinical study in ninety-four subjects a 1.5% (w/v) erythromycin lotion was as effective as 5% (w/v) benzoyl peroxide gel in significantly reducing the number of small inflamed lesions and the overall acne severity. However, benzoyl peroxide also significantly reduced the number of non-inflamed lesions whereas erythromycin had no effect on these lesions. This study supports the view that, although topical erythromycin is of value in the treatment of mild or moderate acne vulgaris, long established, safe and effective remedies should not be replaced by topical antibiotics until more comparative studies and investigations on bacterial resistance have been completed.

  17. Acne treatment patterns, expectations, and satisfaction among adult females of different races/ethnicities

    PubMed Central

    Rendon, Marta I; Rodriguez, David A; Kawata, Ariane K; Degboe, Arnold N; Wilcox, Teresa K; Burk, Caroline T; Daniels, Selena R; Roberts, Wendy E

    2015-01-01

    Background Limited data are available on acne treatment patterns, expectations, and satisfaction in the adult female subpopulation, particularly among different racial and ethnic groups. Objective Describe acne treatment patterns and expectations in adult females of different racial/ethnic groups and analyze and explore their potential effects on medication compliance and treatment satisfaction. Methods A cross-sectional, Web-based survey was administered to US females (25–45 years) with facial acne (≥25 visible lesions). Data collected included sociodemographics, self-reported clinical characteristics, acne treatment use, and treatment expectations and satisfaction. Results Three hundred twelve subjects completed the survey (mean age, 35.3±5.9 years), comprising black (30.8%), Hispanic (17.6%), Asian/other (17.3%), and white (34.3%). More than half of the subjects in each racial group recently used an acne treatment or procedure (black, 63.5%; Hispanic, 54.5%; Asian/other, 66.7%; white, 66.4%). Treatment use was predominantly over-the-counter (OTC) (47.4%) versus prescription medications (16.6%). OTC use was highest in white subjects (black, 42.7%; Hispanic, 34.5%; Asian/other, 44.4%; white, 59.8%; P<0.05). The most frequently used OTC treatments in all racial/ethnic groups were salicylic acid (SA) (34.3%) and benzoyl peroxide (BP) (32.1%). Overall, compliance with acne medications was highest in white versus black (57.0±32.4 vs 42.7±33.5 days, P>0.05), Hispanic (57.0±32.4 vs 43.2±32.9 days, P>0.05), and Asian/other (57.0±32.4 vs 46.9±37.2 days, P>0.05) subjects. Most subjects expected OTC (73.7%) and prescription (74.7%) treatments to work quickly. Fewer than half of the subjects were satisfied with OTC treatment (BP, 47.0%; SA, 43.0%), often due to skin dryness (BP, 26.3%; SA, 44.3%) and flakiness (BP, 12.3%; SA, 31.1%). No statistically significant differences were observed among racial/ethnic groups in their level of satisfaction with OTC or

  18. What is an Intellectual Disability?

    MedlinePlus

    ... White House Lunch Recipes What Is an Intellectual Disability? KidsHealth > For Kids > What Is an Intellectual Disability? ... becoming an independent person. continue What Causes Intellectual Disabilities? Intellectual disabilities happen because the brain gets injured ...

  19. INDEXING MECHANISM

    DOEpatents

    Kock, L.J.

    1959-09-22

    A device is presented for loading and unloading fuel elements containing material fissionable by neutrons of thermal energy. The device comprises a combination of mechanical features Including a base, a lever pivotally attached to the base, an Indexing plate on the base parallel to the plane of lever rotation and having a plurality of apertures, the apertures being disposed In rows, each aperture having a keyway, an Index pin movably disposed to the plane of lever rotation and having a plurality of apertures, the apertures being disposed in rows, each aperture having a keyway, an index pin movably disposed on the lever normal to the plane rotation, a key on the pin, a sleeve on the lever spaced from and parallel to the index pin, a pair of pulleys and a cable disposed between them, an open collar rotatably attached to the sleeve and linked to one of the pulleys, a pin extending from the collar, and a bearing movably mounted in the sleeve and having at least two longitudinal grooves in the outside surface.

  20. Fatty acid compositions of triglycerides and free fatty acids in sebum depend on amount of triglycerides, and do not differ in presence or absence of acne vulgaris.

    PubMed

    Akaza, Narifumi; Akamatsu, Hirohiko; Numata, Shigeki; Matsusue, Miyuki; Mashima, Yasuo; Miyawaki, Masaaki; Yamada, Shunji; Yagami, Akiko; Nakata, Satoru; Matsunaga, Kayoko

    2014-12-01

    To clarify the influence of the fatty acid composition of sebum in acne vulgaris, we investigated the amounts and fatty acid compositions of triglycerides (TG) and free fatty acids (FFA), and the amounts of cutaneous superficial Propionibacterium acnes in acne patients and healthy subjects. The foreheads of 18 female patients, 10 male patients, 10 healthy females and 10 healthy males were studied in a Japanese population. There were significant differences in the amounts of sebum, TG and cutaneous superficial P. acnes, as well as the fatty acid compositions of TG and FFA between acne patients and healthy subjects in females. Their fatty acid compositions were correlated with the amount of TG with or without acne. It was clarified that the fatty acid compositions of TG and FFA depended on the amount of TG, and there were no differences in the fatty acid composition in the presence and absence of acne.