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...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.展开更多
Background:Acne vulgaris(AV)is a common inflammatory skin disease.Although various mechanisms have been indicated in the etiopathogenesis of AV,the exact pathophysiology remains unknown.Various lasers have been used t...Background:Acne vulgaris(AV)is a common inflammatory skin disease.Although various mechanisms have been indicated in the etiopathogenesis of AV,the exact pathophysiology remains unknown.Various lasers have been used to treat AV;however,the serum level changes of inflammatory cytokines after laser therapy have not been elucidated.We aimed to investigate the relationship between inflammatory changes and remission on the opposite side in patients with moderate to severe AV after treating half of the face with 595-and 1064-nm dualwavelength laser.Methods:In total,18 patients(9 male and 9 female)between 16 and 35 years of age with moderate to severe AV were evaluated in the study.Disease severity was classified according to the Pillsbury grading system of acne.Patients were randomized to receive a series of two treatment sessions at intervals of 2 weeks and followed up at 2 weeks after the final treatment.A 3 mL blood sample was drawn from every subject each time,and serum levels of inflammatory cytokines such as interleukin(IL)-6,IL-8,and IL-22 were determined using enzyme-linked immunosorbent assay at baseline and 2 weeks after each treatment.Improvement was determined by a blinded assessment of photographs taken before and after the final evaluation.Results:Inflammation was significantly reduced on both the treated and untreated sides,and symptoms of AV lesions were alleviated.All patients showed a significant increase in serum IL-22 levels after the first laser therapy,with no significant difference in serum IL-6 and IL-8 levels.After the second laser therapy,serum IL-6,IL-8,and IL-22 levels were significantly decreased.No significant side effects such as bruising,edema,hyperpigmentation,hypopigmentation,or scarring were reported.Conclusion:Half-face treatment with 595-and 1064-nm dual-wavelength laser for moderate and severe AV showed a significant effect of full-face remission,which was associated with a gradual decrease in IL-6,IL-8,and IL-22 levels after half-face topical treatment.This suggests that reducing inflammatory cytokine levels in the serum can relieve inflammation in non-therapeutic sites.This laser treatment is effective,economical,and painless.展开更多
BACKGROUND Isotretinoin is a widely prescribed drug for various dermatological conditions,especially acne.Blood tests are routinely performed to monitor its side effects.However,the optimal testing schedule remains co...BACKGROUND Isotretinoin is a widely prescribed drug for various dermatological conditions,especially acne.Blood tests are routinely performed to monitor its side effects.However,the optimal testing schedule remains controversial.AIM To evaluate the laboratory monitoring tests and schedules of patients with acne taking isotretinoin to determine the most efficient testing regimen.METHODS We retrospectively reviewed electronic medical records from the Dermatology Department of Dongguk University Ilsan Hospital from 2005 to 2020 for patients prescribed isotretinoin for acne who underwent monthly blood tests.RESULTS Aspartate aminotransferase(AST),alanine aminotransferase(ALT),and trigly-ceride(TG)levels significantly changed between 5 and 6 mo when the total prescription period and dose variables were considered altogether.The high-density lipoprotein level also significantly changed between 5 and 6 mo.However,low-density lipoprotein(LDL)and total cholesterol levels significantly changed between 1 and 2 mo.CONCLUSION We recommend testing AST,ALT,and TG levels once every 5 to 6 mo.We also suggest testing LDL and total cholesterol levels during the first and second months.展开更多
Prior to his initial diagnosis, a 21-year-old male had been experiencing facial acne for two years and had been treated by a doctor in private practice. The patient visited our department because the clinical manifest...Prior to his initial diagnosis, a 21-year-old male had been experiencing facial acne for two years and had been treated by a doctor in private practice. The patient visited our department because the clinical manifestations of mandibular acne did not improve. At the time of initial examination, telangiectasia (TE), post-inflammatory erythema (PIE), post-inflammatory hyperpigmentation (PIH), atrophic scars (ASs), and a hypertrophic scar (HS) with induration were observed on the right neck. We diagnosed this as an acne vulgaris complication. HS lesions were topically treated by injecting triamcinolone acetonide, and the patient was prescribed 8.1 g/day of oral Saireito (Japanese herb). Adapalene benzoyl peroxide gel and topical tacrolimus hydrate ointment were used to treat PIE and TE. Both HSs and PIE improved;however, TE and AS did not improve. Currently, the patient is under observation. We consider this to be a very rare concurrent occurrence of diverse complications of acne vulgaris, and present the following case study.展开更多
With the introduction of new drugs, the treatment of acne vulgaris has improved dramatically;however, there remains a considerable gap between treatment outcomes and patients’ treatment goals. This study aimed to det...With the introduction of new drugs, the treatment of acne vulgaris has improved dramatically;however, there remains a considerable gap between treatment outcomes and patients’ treatment goals. This study aimed to determine whether dermatologists’ guidance on appropriate skincare for skin symptoms such as post-inflammatory erythema and post-inflammatory hyperpigmentation (PIH), which are not covered by acne treatment, leads to an improvement in patients’ skin condition and patient satisfaction. Japanese women who had completed standard treatment for acne vulgaris and those with mild symptoms not requiring treatment were included in the study. The participants received instructions about skin care at the beginning of the study, which they continued to apply for 6 weeks. At the start and end of the study, participants were examined by a dermatologist;afterward, skin measurements, including skin color, skin surface lipid content, and image analysis by VISIA<sup>®</sup> Evolution, analysis of stratum corneum obtained from the skin surface, and Skindex-16 questionnaire for assessing quality of life (QOL), were performed. The following showed significant improvements: PIH score, number of inflammatory acne lesions, and number of non-inflammatory acne lesions observed via skin examination;skin surface lipid content and values of L* and a* obtained via instrumental measurement;n number of pore, texture, red spot, and pigmented spot obtained via by image analysis;and degree of multilayer exfoliation and interleukin-1α determined by analysis of epidermal stratum corneum. QOL measurement using Skindex-16 also improved significantly. Appropriate skin care guidance following standard acne vulgaris treatment is helpful in achieving patients’ treatment goals. .展开更多
Acne is a chronic inflammatory skin disease involving hair follicle sebaceous glands,which is characterized by acne,papules,pustules,nodules,cysts and so on.The disorder of immune inflammation is the key link.A variet...Acne is a chronic inflammatory skin disease involving hair follicle sebaceous glands,which is characterized by acne,papules,pustules,nodules,cysts and so on.The disorder of immune inflammation is the key link.A variety of factors participate in the immune inflammatory response of acne and interact with each other,leading to the occurrence and development of acne inflammation.Acupuncture can regulate the immune and inflammatory response through many links and improve the skin lesions.This study explains potential mechanisms of acupuncture in the treatment of acne by regulating the body's immune inflammatory response,in order to provide new ideas.展开更多
Acne vulgaris is a chronic dermatologic problem with multiple factors involved in its pathogenesis. Alternative solutions to acne treatment were instigated by antibiotic resistance despite of its extensive use. Purifi...Acne vulgaris is a chronic dermatologic problem with multiple factors involved in its pathogenesis. Alternative solutions to acne treatment were instigated by antibiotic resistance despite of its extensive use. Purified bee venom （PBV） has been proposed as a promising candidate for that purpose. The present study was designed to confirm the antibacterial effect of PBV and access the efficacy of cosmetics containing PBV in subjects with acne vulgaris. METHODS： The skin bacterium Propionibacterium acnes was incubated with PBV at various concentrations and bacterial growth was evaluated using the colony forming unit （CFU） assay. The mechanism of PBV employed in killing P. acnes was examined by scanning electron microscopy （SEM） and transmission electron microscopy （TEM）. In addition, a total of 12 subjects were randomized in a double-blind, controlled trial to receive either cosmetics containing PBV or cosmetics without PBV for two weeks. Evaluations included lesion counts and skin microorganism. RESULTS： PBV exhibited antimicrobial activity in a concentration-dependent manner, reducing the number of P. acnes CFU by approximately 6 logs at a concentration of 0.5 mg. When PBV concentration was higher than 1.0 mg, no P. acnes colonies were spotted on an agar. TEM and SEM of untreated P. acnes illustrated the normal pleomorphic structure, whereas the PBV- treated bacterium lost the integrity of surface architecture. Significant difference （P=0.027） in the grading levels based on numbers of lesion counts for inflammatory and noninflammatory was observed in favour of the PBV group compared with the control group. In terms of average decrement of skin microorganism, subjects receiving cosmetics containing PBV experienced a significant 57.5% decrease of adenosine triphosphate levels, whereas participants receiving cosmetics without PBV experienced a nonsignificant decrease of 4.7%. CONCLUSION： These results show that the in vitro actions of antimicrobial activity of PBV were translated in vivo. Cosmetics containing PBV provided a certain degree of efficacy in terms of lesion counts and skin microorganism concentration compared with cosmetics without PBV in subjects with acne vulgaris. PBV may be a good candidate compound for developing therapeutic drua for the treatment of acne vulaaris.展开更多
Background:Acne vulgaris,a common skin disease,affects up to 80% of the population.Moderate to severe acne requires treatment with a combination of topical and oral drugs such as antibiotics,hormones and retinoids.Ret...Background:Acne vulgaris,a common skin disease,affects up to 80% of the population.Moderate to severe acne requires treatment with a combination of topical and oral drugs such as antibiotics,hormones and retinoids.Retinoids have many contraindications and adverse effects requiring close monitoring.The study's objectives were to describe prescribing trends in acne medication over time in a military setting,and assess physician adherence to guidelines for acne treatment,including drug precautions,clinical monitoring,and treatment progression.Methods:We conducted a descriptive,serial cross-sectional study of acne drugs prescribed in the Israel Defense Forces(IDF) in the years 2002–2007,analyzing the classes of drugs prescribed and patient characteristics.In addition,the clinical quality of the medical encounter was assessed by examining physician adherence to IDF guidelines.Results:Between 2002 and 2007,64,281 patients were treated for acne.Treatment courses generally persisted for 1–2 months.Over 70% of female patients receiving oral retinoids were not concomitantly receiving oral contraceptives.Conclusions:This study provides a unique perspective of acne treatment in a military setting,overall displaying good adherence to general guidelines.The common prescription of oral retinoids to young females without concomitant contraception is alarming.展开更多
Background: The microneedle fractional RF handpiece used in our study (Intensif Handpiece, EndyMed Medical, Caesarea, Israel) is a novel handpiece that uses a tip with 25 non-insulated, gold plated microneedle electro...Background: The microneedle fractional RF handpiece used in our study (Intensif Handpiece, EndyMed Medical, Caesarea, Israel) is a novel handpiece that uses a tip with 25 non-insulated, gold plated microneedle electrodes. The needles are inserted into the skin by a specially designed electronically controlled, smooth motion motor minimizing patient discomfort. RF emission delivered over the whole dermal portion of the needle allows effective coagulation resulting in minimal or no bleeding, together with bulk volumetric heating. Study Design/Materials and Methods: The study included 20 patients, treated for depressed acne scars using the IntensifTM?Microneedles handpiece (EndyMed PRO Platform System, EndyMed Medical, Caesarea, Israel). The degree of clinical improvement was assessed by the global aesthetic improvement scale (GAIS) and subjects satisfaction by post treatment questionnaires. Results: The number of treatments per patient varied between 1 and 6 (average 3.3 treatments per patient). Eleven patients (55%) reported none to minimal pain, six (30%) moderate discomfort and only three (15%) reported significant pain. Objective evaluation of the improvement by a board certified dermatologist showed improvement in 95% of patients. 25% showed excellent improvement, 50% experienced good improvement, and the 20% showed minimal improvement. One patient showed no improvement. Conclusions: The presented results show that the tested electronically controlled motorized insertion, non-insulated microneedle treatment technology provides a minimal discomfort, minimal downtime, effective and safe treatment for depressed acne scars.展开更多
Objective:Propionibacterium acnes(P.acnes)plays an important role in the development of acne,an inflammatory skin disease with a high-incidence.In this study,we used high-throughput RNA sequencing(RNA-seq)to reveal th...Objective:Propionibacterium acnes(P.acnes)plays an important role in the development of acne,an inflammatory skin disease with a high-incidence.In this study,we used high-throughput RNA sequencing(RNA-seq)to reveal the anti-inflammatory mechanism of baicalin on P.acnes-induced acne in rabbits.Methods:The Kligman method was used to induce acne in the ears of New Zealand rabbits.The effect of baicalin on the acne model was evaluated by the number of acne lesions and hematoxylin and eosin(H&E)staining of acne tissues.Enzyme-linked immunoabsorbent assay was used to measure the protein expression levels of tumor necrosis factor a(TNFA),interleukin-1 b(IL1B),IL6,and IL8 in the serum of rabbits.RNA-seq was performed to investigate the mechanism of anti-inflammatory activities of baicalin on acne.Immunohistochemical analysis and Western blot were used to validate the expression levels of related proteins in acne tissues.Results:Baicalin treatment significantly reduced the number of acne lesions and lesions of the ear as well as levels of serum inflammatory cytokines.RNA-seq data showed that baicalin treatment globally suppressed inflammation,especially the TNF signaling pathway and Staphylococcus aureus infection pathway,in the rabbit acne model.Conclusion: Baicalin effectively ameliorates P. acnes-induced acne in rabbits by suppressingthe inflammatory response in rabbits.展开更多
Acne vulgaris is among the most frequent chronic skin disorders in adolescents, characterized by inflammation of the pilosebaceous unit. The psychological distress due to the disfiguring is the main problem that affec...Acne vulgaris is among the most frequent chronic skin disorders in adolescents, characterized by inflammation of the pilosebaceous unit. The psychological distress due to the disfiguring is the main problem that affects the quality of life for patients suffering from acne. Drugs for the treatment of acne are one of the main contents of drug research on common skin diseases. Acne treatment has remained relatively unaltered over the last years. Still, in conjunction with the increase of bacterial resistance to antibiotics throughout the world, there is a global trend away from antibiotic monotherapy treatment. This review discussed the currently used treatment options and evaluated the issues and evidence supporting their usage for patients with acne, including drug therapy with topical, oral, hormonal therapy, and so on. Drug therapy is the most common method in the clinic. Due to the multifactorial etiology of acne vulgaris, most drugs cannot meet the treatment requirements. Therefore, the screening and development of excellent drugs are one of the key targets for treating acne in the future.展开更多
BACKGROUND Synovitis,acne,pustulosis,hyperostosis,and osteitis(SAPHO)syndrome is a rare autoinflammatory disease for which clinical treatment has not been standardized.Janus kinase(JAK)inhibitors represent a novel the...BACKGROUND Synovitis,acne,pustulosis,hyperostosis,and osteitis(SAPHO)syndrome is a rare autoinflammatory disease for which clinical treatment has not been standardized.Janus kinase(JAK)inhibitors represent a novel therapeutic option for rheumatoid arthritis,psoriatic arthritis,and some other autoinflammatory diseases.However,the clinical utility of JAK inhibitors in treating SAPHO syndrome has not been thoroughly investigated.In this study,we describe a patient with SAPHO syndrome who failed to respond to conventional treatment but demonstrated a remarkable and rapid response to the JAK inhibitor tofacitinib.CASE SUMMARY A 62-year-old female patient presented with swelling and pain at the sternoclavicular joints,back pain that limited her activities,arthralgia in the right knee,and cutaneous lesions.Her symptoms were unresponsive to nonsteroidal anti-inflammatory drugs,disease-modifying antirheumatic drugs,Tripterygium wilfordii hook f,and bisphosphonates.SAPHO syndrome was diagnosed in accordance with dermatological and osteoarticular manifestations and abnormal inflammatory factors.Multiple image studies have illustrated bone lesions and pathological fractures of vertebral bodies.Oral treatment with tofacitinib at 5 mg twice daily with methotrexate and bisphosphonates was initiated.The patient reported that her pain symptoms were relieved after 3 d and her cutaneous lesions were reduced after 4 wk of treatment.Vertebral lesions were improved after 6 mo on tofacitinib.No serious adverse effects were noted.CONCLUSION JAK inhibitor therapy may be a promising strategy to treat SAPHO syndrome.展开更多
Background and Objectives: Effective treatment for atrophic (depressed) and icepick acne scars requires treatment of both epidermis—for roughness, texture and hyperpigmentation, and the dermis—for collagen remodelin...Background and Objectives: Effective treatment for atrophic (depressed) and icepick acne scars requires treatment of both epidermis—for roughness, texture and hyperpigmentation, and the dermis—for collagen remodeling. All first generation radiofrequency systems allow nonablative RF treatment while a few others allow simple bipolar Fractional RF skin resurfacing. The FDA cleared multisource radiofrequency therapy system (EndyMed PRO, EndyMed Ltd., Cesarea, Israel) allows, for the first time, phase controlled multisource RF for both deep (up to 11 mm) non ablative RF and fractional RF skin resurfacing on the same treatment device. Study Design/Materials and Methods: Ten subjects with atrophic acne scars were enrolled in the study. Patients were photographed using standardized methods. In each treatment session, each patient received a full face 3DEEP non ablative skin tightening treatment followed by a Fractional skin resurfacing treatment. The treatment sessions were repeated once a month to a total of up to 4 treatments. Results: All subjects experienced mild-moderate edema and erythema as an immediate response to treatment. Edema resolved after up to three hours post treatment and erythema lasted up to 2 days. Micro ablative crusts were formed 1 - 2 days post treatments and lasted up to 5 days on facial areas. Patients' photographs—before each treatment session and 1 and 3 months after the last session—were graded according to the accepted Cosmetic Improvement Scale. All patients obtained significant skin improvement. Seventy percent of patients had 50% - 75% improvement one month after the third treatment session while the other thirty percent experienced a 25% - 50%. Discussion and Conclusions: The presented results describe for the first time a new treatment system (EndyMed PROTM) that allows both deep non ablative RF delivery and Fractional skin resurfacing on the same treatment platform. This work shows the synergy of combining these two applications for the improvement of acne scars, as well as for some secondary possible pigmentation and vascular improvement.展开更多
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 det...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.展开更多
Background: There are many effective topical and systemic therapies for acne rosacea. Topical zinc sulfate and tea lotion have been used in treatment of acne vulgaris. Objectives: To evaluate effectiveness of 2% tea l...Background: There are many effective topical and systemic therapies for acne rosacea. Topical zinc sulfate and tea lotion have been used in treatment of acne vulgaris. Objectives: To evaluate effectiveness of 2% tea lotion in comparison with 5% zinc sulfate solution in the treatment of acne rosacea. Patients and Methods: This single, blinded, comparative therapeutic clinical trial was carried out in the Department of Dermatology—Baghdad Teaching Hospital from June 2006-December 2007. Twenty two patients with acne rosacea were divided into two groups and were instructed to apply the following lotions for two months, Group A used 2% tea lotion twice daily while Group B used 5% zinc sulfate solution twice daily. Patient with severe acne rosacea were excluded from the study. Clinical improvement was evaluated every 2 weeks by determination of the disease severity score (Sharquie’s score) before and after treatment. Results: Eighteen patients with acne rosacea completed the study with their ages ranging from 26 - 70 (40.5 ± 10.9) years. For Group A and Group B were 39.7 ± 8.2, 41.2 ± 13.1 years respectively, with eight patients in Group A, ten patients in Group B. Five percent zinc sulfate solution was statistically significant in reducing the disease severity score in acne rosacea, while 2% tea lotion was beneficial but did not reach statistically significant level as zinc sulfate solution. Conclusion: Five percent zinc sulfate solution was a good alternative remedy to be used in patients with acnerosacea.展开更多
基金Supported by the National Natural Science Foundation of China(No.81260145No.82060175)Priority Union Foundation of Yunnan Provincial Science and Technology Department and Kunming Medical University(No.202001AY070001-050).
文摘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.
基金the Interdisciplinary Program of Shanghai Jiao Tong University(grant nos.YG2019QNB10 and YG2021QN67)Shanghai Municipal Key Clinical Specialty(grant no.shslczdzk00901)Shanghai Municipal Commission of Health and Family Planning(grant no.202240150)。
文摘Background:Acne vulgaris(AV)is a common inflammatory skin disease.Although various mechanisms have been indicated in the etiopathogenesis of AV,the exact pathophysiology remains unknown.Various lasers have been used to treat AV;however,the serum level changes of inflammatory cytokines after laser therapy have not been elucidated.We aimed to investigate the relationship between inflammatory changes and remission on the opposite side in patients with moderate to severe AV after treating half of the face with 595-and 1064-nm dualwavelength laser.Methods:In total,18 patients(9 male and 9 female)between 16 and 35 years of age with moderate to severe AV were evaluated in the study.Disease severity was classified according to the Pillsbury grading system of acne.Patients were randomized to receive a series of two treatment sessions at intervals of 2 weeks and followed up at 2 weeks after the final treatment.A 3 mL blood sample was drawn from every subject each time,and serum levels of inflammatory cytokines such as interleukin(IL)-6,IL-8,and IL-22 were determined using enzyme-linked immunosorbent assay at baseline and 2 weeks after each treatment.Improvement was determined by a blinded assessment of photographs taken before and after the final evaluation.Results:Inflammation was significantly reduced on both the treated and untreated sides,and symptoms of AV lesions were alleviated.All patients showed a significant increase in serum IL-22 levels after the first laser therapy,with no significant difference in serum IL-6 and IL-8 levels.After the second laser therapy,serum IL-6,IL-8,and IL-22 levels were significantly decreased.No significant side effects such as bruising,edema,hyperpigmentation,hypopigmentation,or scarring were reported.Conclusion:Half-face treatment with 595-and 1064-nm dual-wavelength laser for moderate and severe AV showed a significant effect of full-face remission,which was associated with a gradual decrease in IL-6,IL-8,and IL-22 levels after half-face topical treatment.This suggests that reducing inflammatory cytokine levels in the serum can relieve inflammation in non-therapeutic sites.This laser treatment is effective,economical,and painless.
基金Supported by the Dongguk University Research Program(2021).
文摘BACKGROUND Isotretinoin is a widely prescribed drug for various dermatological conditions,especially acne.Blood tests are routinely performed to monitor its side effects.However,the optimal testing schedule remains controversial.AIM To evaluate the laboratory monitoring tests and schedules of patients with acne taking isotretinoin to determine the most efficient testing regimen.METHODS We retrospectively reviewed electronic medical records from the Dermatology Department of Dongguk University Ilsan Hospital from 2005 to 2020 for patients prescribed isotretinoin for acne who underwent monthly blood tests.RESULTS Aspartate aminotransferase(AST),alanine aminotransferase(ALT),and trigly-ceride(TG)levels significantly changed between 5 and 6 mo when the total prescription period and dose variables were considered altogether.The high-density lipoprotein level also significantly changed between 5 and 6 mo.However,low-density lipoprotein(LDL)and total cholesterol levels significantly changed between 1 and 2 mo.CONCLUSION We recommend testing AST,ALT,and TG levels once every 5 to 6 mo.We also suggest testing LDL and total cholesterol levels during the first and second months.
文摘Prior to his initial diagnosis, a 21-year-old male had been experiencing facial acne for two years and had been treated by a doctor in private practice. The patient visited our department because the clinical manifestations of mandibular acne did not improve. At the time of initial examination, telangiectasia (TE), post-inflammatory erythema (PIE), post-inflammatory hyperpigmentation (PIH), atrophic scars (ASs), and a hypertrophic scar (HS) with induration were observed on the right neck. We diagnosed this as an acne vulgaris complication. HS lesions were topically treated by injecting triamcinolone acetonide, and the patient was prescribed 8.1 g/day of oral Saireito (Japanese herb). Adapalene benzoyl peroxide gel and topical tacrolimus hydrate ointment were used to treat PIE and TE. Both HSs and PIE improved;however, TE and AS did not improve. Currently, the patient is under observation. We consider this to be a very rare concurrent occurrence of diverse complications of acne vulgaris, and present the following case study.
文摘With the introduction of new drugs, the treatment of acne vulgaris has improved dramatically;however, there remains a considerable gap between treatment outcomes and patients’ treatment goals. This study aimed to determine whether dermatologists’ guidance on appropriate skincare for skin symptoms such as post-inflammatory erythema and post-inflammatory hyperpigmentation (PIH), which are not covered by acne treatment, leads to an improvement in patients’ skin condition and patient satisfaction. Japanese women who had completed standard treatment for acne vulgaris and those with mild symptoms not requiring treatment were included in the study. The participants received instructions about skin care at the beginning of the study, which they continued to apply for 6 weeks. At the start and end of the study, participants were examined by a dermatologist;afterward, skin measurements, including skin color, skin surface lipid content, and image analysis by VISIA<sup>®</sup> Evolution, analysis of stratum corneum obtained from the skin surface, and Skindex-16 questionnaire for assessing quality of life (QOL), were performed. The following showed significant improvements: PIH score, number of inflammatory acne lesions, and number of non-inflammatory acne lesions observed via skin examination;skin surface lipid content and values of L* and a* obtained via instrumental measurement;n number of pore, texture, red spot, and pigmented spot obtained via by image analysis;and degree of multilayer exfoliation and interleukin-1α determined by analysis of epidermal stratum corneum. QOL measurement using Skindex-16 also improved significantly. Appropriate skin care guidance following standard acne vulgaris treatment is helpful in achieving patients’ treatment goals. .
基金Tianjin Administration of Traditional Chinese Medicine Research Project of Integrated Traditional Chinese and Western Medicine(No.2021147).
文摘Acne is a chronic inflammatory skin disease involving hair follicle sebaceous glands,which is characterized by acne,papules,pustules,nodules,cysts and so on.The disorder of immune inflammation is the key link.A variety of factors participate in the immune inflammatory response of acne and interact with each other,leading to the occurrence and development of acne inflammation.Acupuncture can regulate the immune and inflammatory response through many links and improve the skin lesions.This study explains potential mechanisms of acupuncture in the treatment of acne by regulating the body's immune inflammatory response,in order to provide new ideas.
基金supported by a grant from BioGreen21 Program, Rural Development Administration (Code#:PJ009519), Republic of Korea
文摘Acne vulgaris is a chronic dermatologic problem with multiple factors involved in its pathogenesis. Alternative solutions to acne treatment were instigated by antibiotic resistance despite of its extensive use. Purified bee venom （PBV） has been proposed as a promising candidate for that purpose. The present study was designed to confirm the antibacterial effect of PBV and access the efficacy of cosmetics containing PBV in subjects with acne vulgaris. METHODS： The skin bacterium Propionibacterium acnes was incubated with PBV at various concentrations and bacterial growth was evaluated using the colony forming unit （CFU） assay. The mechanism of PBV employed in killing P. acnes was examined by scanning electron microscopy （SEM） and transmission electron microscopy （TEM）. In addition, a total of 12 subjects were randomized in a double-blind, controlled trial to receive either cosmetics containing PBV or cosmetics without PBV for two weeks. Evaluations included lesion counts and skin microorganism. RESULTS： PBV exhibited antimicrobial activity in a concentration-dependent manner, reducing the number of P. acnes CFU by approximately 6 logs at a concentration of 0.5 mg. When PBV concentration was higher than 1.0 mg, no P. acnes colonies were spotted on an agar. TEM and SEM of untreated P. acnes illustrated the normal pleomorphic structure, whereas the PBV- treated bacterium lost the integrity of surface architecture. Significant difference （P=0.027） in the grading levels based on numbers of lesion counts for inflammatory and noninflammatory was observed in favour of the PBV group compared with the control group. In terms of average decrement of skin microorganism, subjects receiving cosmetics containing PBV experienced a significant 57.5% decrease of adenosine triphosphate levels, whereas participants receiving cosmetics without PBV experienced a nonsignificant decrease of 4.7%. CONCLUSION： These results show that the in vitro actions of antimicrobial activity of PBV were translated in vivo. Cosmetics containing PBV provided a certain degree of efficacy in terms of lesion counts and skin microorganism concentration compared with cosmetics without PBV in subjects with acne vulgaris. PBV may be a good candidate compound for developing therapeutic drua for the treatment of acne vulaaris.
文摘Background:Acne vulgaris,a common skin disease,affects up to 80% of the population.Moderate to severe acne requires treatment with a combination of topical and oral drugs such as antibiotics,hormones and retinoids.Retinoids have many contraindications and adverse effects requiring close monitoring.The study's objectives were to describe prescribing trends in acne medication over time in a military setting,and assess physician adherence to guidelines for acne treatment,including drug precautions,clinical monitoring,and treatment progression.Methods:We conducted a descriptive,serial cross-sectional study of acne drugs prescribed in the Israel Defense Forces(IDF) in the years 2002–2007,analyzing the classes of drugs prescribed and patient characteristics.In addition,the clinical quality of the medical encounter was assessed by examining physician adherence to IDF guidelines.Results:Between 2002 and 2007,64,281 patients were treated for acne.Treatment courses generally persisted for 1–2 months.Over 70% of female patients receiving oral retinoids were not concomitantly receiving oral contraceptives.Conclusions:This study provides a unique perspective of acne treatment in a military setting,overall displaying good adherence to general guidelines.The common prescription of oral retinoids to young females without concomitant contraception is alarming.
文摘Background: The microneedle fractional RF handpiece used in our study (Intensif Handpiece, EndyMed Medical, Caesarea, Israel) is a novel handpiece that uses a tip with 25 non-insulated, gold plated microneedle electrodes. The needles are inserted into the skin by a specially designed electronically controlled, smooth motion motor minimizing patient discomfort. RF emission delivered over the whole dermal portion of the needle allows effective coagulation resulting in minimal or no bleeding, together with bulk volumetric heating. Study Design/Materials and Methods: The study included 20 patients, treated for depressed acne scars using the IntensifTM?Microneedles handpiece (EndyMed PRO Platform System, EndyMed Medical, Caesarea, Israel). The degree of clinical improvement was assessed by the global aesthetic improvement scale (GAIS) and subjects satisfaction by post treatment questionnaires. Results: The number of treatments per patient varied between 1 and 6 (average 3.3 treatments per patient). Eleven patients (55%) reported none to minimal pain, six (30%) moderate discomfort and only three (15%) reported significant pain. Objective evaluation of the improvement by a board certified dermatologist showed improvement in 95% of patients. 25% showed excellent improvement, 50% experienced good improvement, and the 20% showed minimal improvement. One patient showed no improvement. Conclusions: The presented results show that the tested electronically controlled motorized insertion, non-insulated microneedle treatment technology provides a minimal discomfort, minimal downtime, effective and safe treatment for depressed acne scars.
基金This work was supported by the National Natural Science Foundation of China(81430099)International S&T Cooperation Program of China(2014DFA32950).
文摘Objective:Propionibacterium acnes(P.acnes)plays an important role in the development of acne,an inflammatory skin disease with a high-incidence.In this study,we used high-throughput RNA sequencing(RNA-seq)to reveal the anti-inflammatory mechanism of baicalin on P.acnes-induced acne in rabbits.Methods:The Kligman method was used to induce acne in the ears of New Zealand rabbits.The effect of baicalin on the acne model was evaluated by the number of acne lesions and hematoxylin and eosin(H&E)staining of acne tissues.Enzyme-linked immunoabsorbent assay was used to measure the protein expression levels of tumor necrosis factor a(TNFA),interleukin-1 b(IL1B),IL6,and IL8 in the serum of rabbits.RNA-seq was performed to investigate the mechanism of anti-inflammatory activities of baicalin on acne.Immunohistochemical analysis and Western blot were used to validate the expression levels of related proteins in acne tissues.Results:Baicalin treatment significantly reduced the number of acne lesions and lesions of the ear as well as levels of serum inflammatory cytokines.RNA-seq data showed that baicalin treatment globally suppressed inflammation,especially the TNF signaling pathway and Staphylococcus aureus infection pathway,in the rabbit acne model.Conclusion: Baicalin effectively ameliorates P. acnes-induced acne in rabbits by suppressingthe inflammatory response in rabbits.
文摘Acne vulgaris is among the most frequent chronic skin disorders in adolescents, characterized by inflammation of the pilosebaceous unit. The psychological distress due to the disfiguring is the main problem that affects the quality of life for patients suffering from acne. Drugs for the treatment of acne are one of the main contents of drug research on common skin diseases. Acne treatment has remained relatively unaltered over the last years. Still, in conjunction with the increase of bacterial resistance to antibiotics throughout the world, there is a global trend away from antibiotic monotherapy treatment. This review discussed the currently used treatment options and evaluated the issues and evidence supporting their usage for patients with acne, including drug therapy with topical, oral, hormonal therapy, and so on. Drug therapy is the most common method in the clinic. Due to the multifactorial etiology of acne vulgaris, most drugs cannot meet the treatment requirements. Therefore, the screening and development of excellent drugs are one of the key targets for treating acne in the future.
文摘BACKGROUND Synovitis,acne,pustulosis,hyperostosis,and osteitis(SAPHO)syndrome is a rare autoinflammatory disease for which clinical treatment has not been standardized.Janus kinase(JAK)inhibitors represent a novel therapeutic option for rheumatoid arthritis,psoriatic arthritis,and some other autoinflammatory diseases.However,the clinical utility of JAK inhibitors in treating SAPHO syndrome has not been thoroughly investigated.In this study,we describe a patient with SAPHO syndrome who failed to respond to conventional treatment but demonstrated a remarkable and rapid response to the JAK inhibitor tofacitinib.CASE SUMMARY A 62-year-old female patient presented with swelling and pain at the sternoclavicular joints,back pain that limited her activities,arthralgia in the right knee,and cutaneous lesions.Her symptoms were unresponsive to nonsteroidal anti-inflammatory drugs,disease-modifying antirheumatic drugs,Tripterygium wilfordii hook f,and bisphosphonates.SAPHO syndrome was diagnosed in accordance with dermatological and osteoarticular manifestations and abnormal inflammatory factors.Multiple image studies have illustrated bone lesions and pathological fractures of vertebral bodies.Oral treatment with tofacitinib at 5 mg twice daily with methotrexate and bisphosphonates was initiated.The patient reported that her pain symptoms were relieved after 3 d and her cutaneous lesions were reduced after 4 wk of treatment.Vertebral lesions were improved after 6 mo on tofacitinib.No serious adverse effects were noted.CONCLUSION JAK inhibitor therapy may be a promising strategy to treat SAPHO syndrome.
文摘Background and Objectives: Effective treatment for atrophic (depressed) and icepick acne scars requires treatment of both epidermis—for roughness, texture and hyperpigmentation, and the dermis—for collagen remodeling. All first generation radiofrequency systems allow nonablative RF treatment while a few others allow simple bipolar Fractional RF skin resurfacing. The FDA cleared multisource radiofrequency therapy system (EndyMed PRO, EndyMed Ltd., Cesarea, Israel) allows, for the first time, phase controlled multisource RF for both deep (up to 11 mm) non ablative RF and fractional RF skin resurfacing on the same treatment device. Study Design/Materials and Methods: Ten subjects with atrophic acne scars were enrolled in the study. Patients were photographed using standardized methods. In each treatment session, each patient received a full face 3DEEP non ablative skin tightening treatment followed by a Fractional skin resurfacing treatment. The treatment sessions were repeated once a month to a total of up to 4 treatments. Results: All subjects experienced mild-moderate edema and erythema as an immediate response to treatment. Edema resolved after up to three hours post treatment and erythema lasted up to 2 days. Micro ablative crusts were formed 1 - 2 days post treatments and lasted up to 5 days on facial areas. Patients' photographs—before each treatment session and 1 and 3 months after the last session—were graded according to the accepted Cosmetic Improvement Scale. All patients obtained significant skin improvement. Seventy percent of patients had 50% - 75% improvement one month after the third treatment session while the other thirty percent experienced a 25% - 50%. Discussion and Conclusions: The presented results describe for the first time a new treatment system (EndyMed PROTM) that allows both deep non ablative RF delivery and Fractional skin resurfacing on the same treatment platform. This work shows the synergy of combining these two applications for the improvement of acne scars, as well as for some secondary possible pigmentation and vascular improvement.
文摘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.
文摘Background: There are many effective topical and systemic therapies for acne rosacea. Topical zinc sulfate and tea lotion have been used in treatment of acne vulgaris. Objectives: To evaluate effectiveness of 2% tea lotion in comparison with 5% zinc sulfate solution in the treatment of acne rosacea. Patients and Methods: This single, blinded, comparative therapeutic clinical trial was carried out in the Department of Dermatology—Baghdad Teaching Hospital from June 2006-December 2007. Twenty two patients with acne rosacea were divided into two groups and were instructed to apply the following lotions for two months, Group A used 2% tea lotion twice daily while Group B used 5% zinc sulfate solution twice daily. Patient with severe acne rosacea were excluded from the study. Clinical improvement was evaluated every 2 weeks by determination of the disease severity score (Sharquie’s score) before and after treatment. Results: Eighteen patients with acne rosacea completed the study with their ages ranging from 26 - 70 (40.5 ± 10.9) years. For Group A and Group B were 39.7 ± 8.2, 41.2 ± 13.1 years respectively, with eight patients in Group A, ten patients in Group B. Five percent zinc sulfate solution was statistically significant in reducing the disease severity score in acne rosacea, while 2% tea lotion was beneficial but did not reach statistically significant level as zinc sulfate solution. Conclusion: Five percent zinc sulfate solution was a good alternative remedy to be used in patients with acnerosacea.
