Re-evaluating the necessity of routine laboratory monitoring during isotretinoin therapy for acne

In this letter,we discuss the topic of necessity of routine laboratory monitoring during isotretinoin treatment for acne.According to Park and colleagues,it is advisable to monitor the levels of triglycerides,alanine aminotransferase,and aspartate aminotransferase every 5 to 6 months.Additionally,the levels of total cholesterol and low-density lipoprotein should be checked within the first two months of treatment.Isotretinoin is a commonly prescribed agent mainly used to treat acne.Despite its high effectiveness,it necessitates regular monitoring of laboratory parameters due to its side effect profile.Currently,there remains a lack of consensus on the appropriate frequency for monitoring these parameters during treatment with isotretinoin.This letter will provide insight into this complex and controversial topic.Based on existing literature,we concluded that the incidence of changes in lipid and liver aminotransferase levels during isotretinoin treatment for acne was low and likely clinically insignificant.For generally healthy people,we recommend testing lipid and liver profiles once at baseline and a second time at the peak dosage.However,frequent testing might still be beneficial in certain populations of patients.

强脉冲光ACNE滤光片不同脉冲数治疗寻常痤疮临床观察

目的:探讨强脉冲光ACNE滤光片不同脉冲数治疗寻常痤疮的疗效及安全性对比分析。方法:纳入2023年8月-2023年10月在笔者医院医疗美容科门诊就诊的寻常痤疮患者,根据筛选标准最终入选30例。采用自身左右脸对照的试验设计,用随机数字表法将患者两侧面部随机分为三脉冲治疗侧和双脉冲治疗侧,首先使用ACNE滤光片对痤疮部位进行两遍治疗,两侧面部选择相同的能量密度、脉冲延迟及子脉宽,仅脉冲数有差别,三冲侧子脉宽为4 ms-4 ms-4 ms三脉冲,双冲侧子脉宽为4 ms-4 ms双脉冲,之后再用其他滤光片对全面部进行治疗,两侧参数一致。间隔4周治疗1次,共3次。每次治疗后4周评估对比双侧疗效,并在每次治疗中及治疗后记录随访期间不良反应。结果:治疗后三冲侧在痤疮总数目及其疗效指数、炎性痤疮数目及其疗效指数、有效率、显效率等指标评估上均优于双冲侧,差异有统计学意义;在非炎性痤疮数目及其疗效指数上,两侧对比差异无统计学意义。安全性上,双冲侧有1例患者在治疗后额部出现片状结痂、水疱,三冲侧未出现明显不良反应。结论:用强脉冲光ACNE滤光片治疗寻常痤疮,相比于4 ms-4 ms双脉冲,选择4 ms-4 ms-4 ms三脉冲可能是更优的参数。

Ocular surface changes in moderate-to-severe acne vulgaris

AIM:To investigate ocular surface disorders and tear function changes in patients with acne vulgaris and explore the potential relationship between acne vulgaris and dry eye.METHODS:This cross-sectional study included right eyes of 53 patients with acne vulgaris and 54 healthy controls.The participants completed the Ocular Surface Disease Index(OSDI)questionnaire.The following ocular surface-related parameters were measured:tear meniscus height(TMH),noninvasive tear breakup time(NIBUT),Schirmer I test(SIT),lipid layer thickness(LLT)score of the tear film,meibum score,meibomian gland orifice obstruction score,the ratio of meibomian gland loss,conjunctival hyperemia score,and corneal fluorescein staining(CFS)score.RESULTS:The stability of the tear film decreased in acne vulgaris patients.In the acne group,the TMH and NIBUT were lower,whereas the OSDI,meibum score,meibomian gland orifice obstruction score,ratio of meibomian gland loss,and conjunctival hyperemia score were higher compared with controls(P<0.05).There were no significant differences in the CFS score,SIT,or LLT score between the groups(P>0.05).In two dry eye groups,the TMH,NIBUT,and LLT score were lower in the acne with dry eye(acne-DE)group,and the meibum score,meibomian gland orifice obstruction score,ratio of meibomian gland loss and conjunctival hyperemia score in the acne-DE group were higher(P<0.05).There were no significant differences between OSDI,SIT,and CFS score(P>0.05).CONCLUSION:Patients with moderate-to-severe acne vulgaris are more likely to experience dry eye than those without acne vulgaris.Reduced tear film stability and meibomian gland structure dysfunction are more pronounced in patients with moderate-to-severe acne and dry eye.

Tamanu Oil in Acne Management: Potential Anti-Inflammatory and Wound-Healing Properties for Scar Reduction

Tamanu oil, derived from the nuts of Calophyllum inophyllum, has gained increasing attention for its potential in acne management due to its purported anti-inflammatory and wound-healing properties. This analysis evaluates the efficacy of tamanu oil in acne treatment with a specific focus on its impact on inflammation and scar reduction. The novelty of this research lies in its comprehensive analysis of tamanu oil’s dual mechanism of action: reducing acne-related inflammation and promoting the healing of acne scars. Clinical trials and laboratory analyses were conducted to assess the oil’s effectiveness in diminishing erythema, swelling, and post-acne scarring compared to conventional treatments. Preliminary findings demonstrate that tamanu oil significantly reduces inflammation and accelerates wound healing, potentially offering a promising adjunct or alternative to standard acne therapies. Future research should aim to optimize formulation and application protocols, long-term effects, and comparative therapeutic efficacy with other anti-inflammatory agents. Tamanu oil offers a novel and effective approach to acne management, with potential advantages that go beyond inflammation reduction to include enhanced scar reduction, making it a subject that warrants further investigation.

痤疮皮杆菌(Cutibacterium acnes)的研究进展

痤疮皮杆菌(Cutibacterium acnes)可以引起皮肤及其他组织或器官感染和疾病,是造成青春痘的主要细菌,所以研究较多,发展变化较快,尤其最近其分类学发生了较大的变化,使其研究和临床应用等方面不易追踪而造成混乱。本文从痤疮皮杆菌的分类进化、生理生态、保护机制及其利用、致病机制及其防御治疗等方面进行综述,以期了解痤疮皮杆菌系统进化关系,全面而系统地了解该类微生物,为其服务于后期的深入研究、治疗预防等应用提供参考。

Evaluation of Self-Treatment of Acne Using Silk’n Blue Phototherapy System

Background: At-home phototherapy devices for the treatment of acne have emerged as an appealing treatment option and as an effective adjunct treatment to existing modalities. The principal goal of the study was to determine the changes in the number of inflammatory lesions in acne patients. Methods: Patients received instruction for daily at-home use of Silk’n Blue device for 12 weeks. Follow-up visits were conducted at 1 and 3 months to collect data. Results: Fifteen subjects with mild to severe cases experienced improvement over the course of the trial. The decrease in mean inflammatory acne counts (from 41.26 to 24.46) and mean percent reduction (41.8%) were statistically significant (p < 0.001). Some participants experienced percent reductions as great as 67%. No adverse events were recorded. Conclusions: The Silk’n Blue device is a safe and effective modality for at-home treatment of mild, moderate, and severe inflammatory acne vulgaris with proper use.

Research on the Nursing Effect of Glycolipids on Acne Skin

Glycolipids are lipid compounds,which are a type of amphiphilic molecules containing glycosyl ligands.This experiment studied the efficacy of glycolipids on acne skin care from the aspects of antibacterial,anti-inflammatory,anti-allergic,oil-control,soothing and repair.Research results show that glycolipids have excellent antibacterial properties against P.acnes;when the dosage of glycolipids reaches 10μg/mL,the inhibition rate of glycolipids on lipid synthesis in SZ95 cells can reach 20%;glycolipids can induce LPS induction RAW264.7 cells have the inhibitory effect on the release of inflammatory factors IL-6 and NO;when the glycolipids concentration is 15 mg/mL,the inhibition rate of glycolipids on hyaluronidase reaches 45.8%;when the glycolipids concentration is 25μg/mL,the inhibition rate on calcium ion concentration reaches 45.3%;glycolipids have a significant promoting effect on wound healing.Furthermore,human efficacy evaluation shows that glycolipids products have comprehensive care effects on acne skin.This study will help further promote the application of glycolipids in cosmetic products,especially in skin care products for acne skin.

Balancing Dermatological and Gynecological Considerations: Evaluating the Necessity of Pelvic Exams in OCP Prescriptions for Acne Management

Routine pelvic examinations in women prescribed oral contraceptive pills (OCPs) for acne management are scrutinized to assess their impact on dermatological outcomes versus gynecological health. A synthesis of clinical trials, patient surveys, and medical guidelines reveals that these routine exams do not significantly enhance the effectiveness of acne treatment with OCPs but are linked to increased patient discomfort and false-positive results. Evidence suggests that routine pelvic examinations do not significantly impact the effectiveness of acne management with OCPs but are associated with increased patient discomfort and higher rates of false-positive results. The analysis indicates that a more personalized approach, focusing on selective pelvic examinations based on individual risk factors and clinical symptoms, may offer a more practical and patient-centered alternative. The review advocates for a reexamination of existing guidelines to better align with a model of individualized care, emphasizing the need for further research to optimize best practices at the intersection of dermatological and gynecological care. Adopting a personalized approach to pelvic examinations could substantially improve patient care by minimizing unnecessary interventions and discomfort while maintaining the efficacy of acne treatment with oral contraceptive pills.

Inhibition of Propionibacterium acnes by refined bamboo vinegar and preparation of the slow-release system with bamboo charcoal as the carrier

Background:Acne vulgaris is one of the most common skin diseases that can significantly impact a considerable proportion of individuals over their lifetime.Objective:This study focuses on the exploration of the application potential of bamboo vinegar in cosmetics.Materials and Methods:The stock solution of bamboo vinegar is subjected to reduced-pressure distillation at different temperatures to obtain refined bamboo vinegar.Then,inhibition of Propionibacterium acnes(P.acnes)by refined bamboo vinegar is observed.Moreover,the refined bamboo vinegar is adsorbed and released with activated bamboo charcoal as the carrier.In all,this study aims to probe into the mechanism of the controlledrelease system of bamboo vinegar.Results:The results shows that the harmful substances(tar)in bamboo vinegar distilled at 70℃decreased by 94.44%,which is a more notable decrease compared with that in the stock solution.The total organic acid content in bamboo vinegar after reduced-pressure distillation is 11.840%,reaching the national standard for refined bamboo vinegar(GB/T 31734–2015).Additionally,the minimum inhibitory concentration of refined bamboo vinegar against P.acnes using the punch method is 7.90 mg/mL.This indicates that refined bamboo vinegar has the potential as a prospective raw material for formulations in anti-acne cosmetic products.Furthermore,the release rate of bamboo charcoal/bamboo vinegar in water for 15 min reaches 70.57%,which then slows down to a plateau.The slow-release behavior is agreed with the Ritger-Peppas model and is beneficial to relieve the irritation of bamboo vinegar to the skin and lengthen its bacteriostatic duration.Conclusion:The foregoing conclusions can serve as the theoretical foundation for the application of bamboo vinegar in anti-acne cosmetics.

Topical 5-aminolevulinic acid photodynamic therapy improved refractory acne conglobata and perifolliculitis capitis abscedens et suffodiens rather than hidradenitis suppurativa

Acne conglobata(AC),perifolliculitis capitis abscedens et suffodiens(PCAS)and hidradenitis suppurativa(HS)are uncommon refractory chronic,inflammatory,scarring diseases but cause serious damage to the quality of life.These three diseases are associated with follicular occlusion.Several studies indicated topical 5-aminolevulinic acid photodynamic therapy(ALA-PDT)improved follicular occlusion besides acne treatment.So we attempted to apply ALA-PDT to medicine resistant AC,PCAS and HS.Topical ALA-PDT was applied to 10 patients with AC,seven patients with PCAS and three patients with HS for more than three sessions.All the patients completed the dermatology life quality index(DLQI)questionnaire and were assessed for the efficacy at the baseline and on two weeks after each treatment.Adverse effects were recorded at each visit.The results showed 25.5%(5/20,two cases of AC and three cases of PCAS)of patients achieved excellent improvement after three sessions of PDT and another 60.0%(12/20,eight cases of AC and four cases of PCAS)of patients achieved good improvement.15.0%(3/20,three cases of HS)got poor response(<20%lesions clearance).Anotherfive cases(three cases of AC and two cases of PCAS)also achieved excellent response after 5–7 sessions of PDT.We also found that papular/nodular,cyst/abscess showed higher clearance rate than sinus/¯stula(88.5%,86.1%versus 11.1%).DLQI was reduced after three sessions of PDT in AC and PCAS patients rather than HS patients.5-ALA-PDT could improve refractory AC and PCAS but could not lead to improvement in late stage of HS.The e±cacy increased with more treatment sessions.

Treatment of spinal cord injury with biomaterials and stem cell therapy in non-human primates and humans

Spinal cord injury results in the loss of sensory,motor,and autonomic functions,which almost always produces permanent physical disability.Thus,in the search for more effective treatments than those already applied for years,which are not entirely efficient,researches have been able to demonstrate the potential of biological strategies using biomaterials to tissue manufacturing through bioengineering and stem cell therapy as a neuroregenerative approach,seeking to promote neuronal recovery after spinal cord injury.Each of these strategies has been developed and meticulously evaluated in several animal models with the aim of analyzing the potential of interventions for neuronal repair and,consequently,boosting functional recovery.Although the majority of experimental research has been conducted in rodents,there is increasing recognition of the importance,and need,of evaluating the safety and efficacy of these interventions in non-human primates before moving to clinical trials involving therapies potentially promising in humans.This article is a literature review from databases(PubMed,Science Direct,Elsevier,Scielo,Redalyc,Cochrane,and NCBI)from 10 years ago to date,using keywords(spinal cord injury,cell therapy,non-human primates,humans,and bioengineering in spinal cord injury).From 110 retrieved articles,after two selection rounds based on inclusion and exclusion criteria,21 articles were analyzed.Thus,this review arises from the need to recognize the experimental therapeutic advances applied in non-human primates and even humans,aimed at deepening these strategies and identifying the advantages and influence of the results on extrapolation for clinical applicability in humans.

Comprehensive Sequential Successful Therapy Comprising Chemical Peeling, Iontophoresis and Topical Vitamin C for Postinflammatory Hyperpigmentation in Acne Vulgaris

A 20-year-old man presented with for 6-month history of facial acne. He had erythema and red papules on the face secondary to BPO-induced contact dermatitis. He was administered topical corticosteroid. Contact dermatitis improved with this treatment, and he had red papules, comedones, prominent postinflammatory hyperpigmentation (PIH), postinflammatory erythema (PIE), erosions and erythema associated with acne vulgaris. He was subsequently treated with oral minocycline 100 mg/d and topical adapalene and ozenoxacin lotion once daily for 3 months. The inflammatory lesions and comedo subsided;however, PIH, PIE, atrophic scar and erosion persisted. During 3 months, the patient underwent chemical peeling using 20% glycolic acid (GA) and subsequent vitamin C iontophoresis twice at 1-month intervals. He showed almost disappearance of red papules and comedones but persistent PIH, PIE and erosion after 3 months of treatment. He was thereafter prescribed topical glyceryl-octyl-ascorbic acid/ascorbyl 2-phosphate 6-palmitate/DL-a-tocopherol phosphate complex for local application twice daily for 3 months. After 7 months of treatment, PIH, PIE, erosion and atrophic scar faded significantly with only trace residual erosions, atrophic scar and PIH. Subsequently, he was prescribed local application of 2% isostearyl-L-ascorbic acid gel vitamin C gel twice daily for 3 months. After 15 months, PIH, PIE, erosion and atrophic scar disappeared completely with significant improvement. Comprehensive sequential therapy resulted in significant improvement. It is suggested that medical treatment using systemic and topical antimicrobials and topical adapalene reduces inflammatory lesions and comedones initially. Subsequent chemical peeling using GA and vitamin C iontophoresis could improve PIH. These synergistic effects might have contributed to the significant improvement observed in this case. Comprehensive sequential treatment using chemical peeling, vitamin C iontophoresis and topical vitamin C can be a useful treatment strategy for PIH in acne vulgaris.

Real-world evidence on the efficacy and safety of vonoprazanamoxicillin dual therapy for Helicobacter pylori treatment in elderly patients

BACKGROUND A dual therapy regimen containing amoxicillin is a common treatment option for the eradication of Helicobacter pylori(H.pylori).While substantial research supports the efficacy and safety of vonoprazan and amoxicillin(VA)dual therapy in the general population,there is still a lack of studies specifically focusing on its safety in elderly patients.AIM To evaluate efficacy and safety of VA dual therapy as first-line or rescue treatment for H.pylori in elderly patients.METHODS As a real-world retrospective study,data were collected from elderly patients aged 60 years and above who accepted VA dual therapy(vonoprazan 20 mg twice daily+amoxicillin 1000 mg thrice daily for 14 days)for H.pylori eradication in the Department of Gastroenterology at Peking University First Hospital between June 2020 and January 2024.H.pylori status was evaluated by^(13)C-urease breath test 6 weeks after treatment.All adverse events(AEs)during treatment were recorded.RESULTS In total,401 cases were screened.Twenty-one cases were excluded due to loss to follow-up,lack of re-examination,or unwillingness to take medication.The total of 380 included cases comprised 250 who received VA dual therapy as first-line treatment and 130 who received VA dual therapy as rescue treatment.H.pylori was successfully eradicated in 239 cases(95.6%)in the first-line treatment group and 116 cases(89.2%)in the rescue treatment group.The overall incidence of AEs was 9.5%for both groups.Specifically,9.2%of patients experienced an AE in the first-line treatment group and 10.0%in the rescue treatment group.Five patients discontinued treatment due to AE,with a discontinuation rate of 1.3%.No serious AE occurred.CONCLUSION The VA dual therapy regimen as a first-line treatment and a rescue therapy was effective and safe for elderly patients aged 60 and older.

Optimizing care for gastric cancer with overt bleeding:Is systemic therapy a valid option?

Gastric cancer(GC)and gastroesophageal junction cancer(GEJC)represent a significant burden globally,with complications such as overt bleeding(OB)further exacerbating patient outcomes.A recent study by Yao et al evaluated the effectiveness and safety of systematic treatment in GC/GEJC patients presenting with OB.Using propensity score matching,the study balanced the comparison groups to investigate overall survival and treatment-related adverse events.The study's findings emphasize that systematic therapy can be safe and effective and contribute to the ongoing debate about the management of advanced GC/GEJC with OB,highlighting the complexities of treatment decisions in these high-risk patients.

PHOTOTHERAPY FOR MILD TO MODERATE ACNE VULGARIS WITH PORTABLE BLUE AND RED LED

In this paper,we studied portable blue and red light-emitting-diode(LED)light sources in phototherapy for mild to moderate acne vulgaris to evaluate the efficacy and tolerance of patients.Patients,randomly divided into blue and red groups,received either blue or red LED phototherapy twice a week for four weeks.After complete treatment,the number of lesions reduced by 71.4% in the blue group,in contrast to 19.5% in the red group.No obvious side effects were observed during and one month after the treatment,except for some mild dryness mentioned by several patients.

Clinical Observation on the Common Acne Treated with the Five,ioint Therapy of the Traditional Medicine

Objective： The curative effect of the common acne treated by the five-joint therapy of traditional Chinese medicine was observed. Methods： 360 cases with the common acne were treated using five methods （embedding acupuncture point into traditional Chinese medicine soaked catgut; traditional Chinese medicine facial mask; taking traditional Chinese medicine orally; auricular point stimulation; discerning and cupping therapy） for 4-8 weeks, and then the improvements of the patients in clinical skin lesion were observed and also compared using the historical control method and the treatment method in the literature history. Results： The total effective rate was I00%, the cure rate was 56.39%, and the efficiency was 30.56%. Conclusion： The curative effect of the common ache treated by the five-joint therapy of traditional Chinese medicine is significant and also obviously better than that of the control method in this paper. Therefore, it is worthy of popularization and application.

Current status of drug therapy for chronic hepatitis B

In this editorial,we comment on the article by Meng et al.Chronic hepatitis B(CHB)is a significant global health problem,particularly in developing countries.Hepatitis B virus(HBV)infection is one of the most important risk factors for cirrhosis and hepatocellular carcinoma.Prevention and treatment of HBV are key measures to reduce complications.At present,drug therapy can effectively control virus replication and slow disease progression,but completely eliminating the virus remains a challenge.Anti-HBV treatment is a long-term process,and there are many kinds of antiviral drugs with different mechanisms of action,it is essential to evaluate the safety and efficacy of these drugs to reduce side effects and improve patients’compliance.We will summarize the current status of CHB drug treatment,hoping to provide a reference for the selection of clinical antiviral drugs.

Experience of Photopneumatic Therapy in Taiwan Residents Acne Patients

Acne is a disease of the pilosebaceous unit affecting both teenagers and adults. The treatment of acne is sometimes frustrating due to the emergence of antibiotic resistance, skin irritation and lack of novel therapy. Light and vacuum devices, also known as photopneumatic therapy, have been shown promising as a generally well-tolerated adjunctive treatment of acne vulgaris. We conducted a clinical study using such device to assess the efficacy and safety as an adjunctive treatment of acne in Taiwan Residents patients. Twenty patients received six sequential treatments every one to two weeks in the facial region. A 4 × 4 cm2 area on cheek was chosen as a control area and was not treated with photopneumatic device. Safety parameters and adverse events were recorded. VISIA Complexion Analysis System was used for image analysis on the improvement of four parameters, namely, pigmentation, pore reduction, redness and porphyrin levels. There was an overall improvement in pigmentation, pore size, redness and porphyrin levels on treatment areas. The treatment areas showed statistically significant improvement (p < 0.05) in pigmentation and pore sizes compared with the control areas using paired samples T-test. Mild and self-limiting localized adverse events, mostly focal petechiae or mild irritation, were reported. Our study has demonstrated that photopneumatic therapy is an effective, safe and relatively well-tolerated procedure in Taiwan Residents acne patients.

Antiviral therapy for hepatitis B virus infection is beneficial for the prognosis hepatocellular carcinoma

In this editorial,we comment on the article by Mu et al,published in the recent issue of the World Journal of Gastrointestinal Oncology.We pay special attention to the immune tolerance mechanism caused by hepatitis B virus(HBV)infection,the pathogenesis of hepatocellular carcinoma(HCC),and the role of antiviral therapy in treating HCC related to HBV infection.HBV infection leads to systemic innate immune tolerance by directly inhibiting pattern recognition receptor recognition and antiviral signaling pathways,as well as by inhibiting the immune functions of macrophages,natural killer cells and dendritic cells.In addition,HBV leads to an immunosuppressive cascade by expressing inhibitory molecules to induce exhaustion of HBV-specific cluster of differentiation 8+T cells,ultimately leading to long-term viral infection.The loss of immune cell function caused by HBV infection ultimately leads to HCC.Long-term antiviral therapy can improve the prognosis of patients with HCC and prevent tumor recurrence and metastasis.

Summary of the current guidelines for managing iatrogenic colorectal perforations and the evolving role of endoluminal vacuum therapy

Colonoscopy represents a safe procedure that is widely used in medical practice either to diagnose or treat various gastrointestinal diseases.During the last few years,the incidence rate of perforations in colonoscopic procedures has increased,especially in therapeutic colonoscopies.The recent advancements in endoscopic techniques and gastrointestinal tumoral resection procedures such as endoscopic mucosal resection,endoscopic full-thickness resection,and endoscopic submucosal dissection(ESD)could be a risk factor for this increased risk.The incidence rate of mortality of serious colonoscopic perforations is 7.1%.The management plan for these perforations starts with conservative treatment in mild cases,endoscopic closure,and surgical management in severe cases.Recently,endoluminal vacuum therapy was found to be effective in the management of colorectal perforations and this has been reported in multiple case reports.This editorial provides an overview of the current guidelines for the management of iatrogenic colorectal perforations.These insights are from the perspectives of endoscopists and gastroenterologists.We also present a management algorithm based on the guidelines of the European Society of Gastrointestinal Endoscopy,the American Gastroenterological Association,and the World Society of Emergency Surgery.We also discussed in brief the use of endoluminal vacuum therapy in colorectal perforations.