ABSTRACT
BACKGROUND: Acne scar (AS) is a frequent sequela in patients with acne. In addition to advanced treatment methods, microneedling (MN) is still used as an effective option in the treatment of AS. However, similar to most diseases in dermatology, there is no objective tool to determine the severity of AS and to evaluate the treatment outcome. OBJECTIVES: In the current study, we aimed to evaluate skin elasticity in AS patients who have undergone MN therapy. Furthermore, other purposes were to determine the relationships between the history of isotretinoin use, demographic data, and changes in skin elasticity. METHODS: In order to evaluate the skin elasticity of 20 patients with AS, shear wave elastography (SWE) was performed before and after MN treatment. The physician's clinical assessment was evaluated with quantitative AS severity scale. In order to show that SWE is a consistent method, three repeated measurements were performed on 24 healthy participants. RESULTS: A significant increase was found between the shear-wave velocity (SWV) values that were measured baseline and after treatment in the patient group (P = 0.033). In the control group, there was no significant difference between the three repeated measurements (P > 0.05). A statistically significant decrease was also detected in the AS severity scores (P < 0.005). CONCLUSIONS: In AS patients who underwent MN treatment, a significant increase was found in skin elasticity compared to the baseline. We argued that SWE is a method that can be useful to evaluate skin elasticity before and after similar cosmetic procedures and dermatological diseases.
Subject(s)
Acne Vulgaris , Elasticity Imaging Techniques , Humans , Elasticity Imaging Techniques/methods , Cicatrix/diagnostic imaging , Cicatrix/etiology , Percutaneous Collagen Induction , Isotretinoin , Acne Vulgaris/complications , Acne Vulgaris/diagnostic imaging , Acne Vulgaris/therapyABSTRACT
Polycystic ovarian syndrome manifests acne and alopecia in teenagers and young adult females. To evaluate ovarian morphology and the prevalence of polycystic ovarian morphology (PCOM) in females between the ages of 21 and 45 who are in the reproductive stage and have isolated acne and/or androgenic alopecia. And their association. The present study was done with patients in the age group of 21 to 45 years with acne and/or androgenic alopecia. Modified Ferriman-Gallwey score was used to assess the degree of hirsutism (with score of more or equal to 8 as significant). Grading of acne vulgaris and androgenic alopecia was done by a single observer. Subjects were then evaluated for biochemical investigations of Hormonal assays on day 2 to 7. Transabdominal ultrasonography was performed in the follicular phase to demonstrate the ovarian morphology. In our study isolated androgenic alopecia was present in 28 patients (24.34%). In our study 54 (46.95%) patients out of 115 had combined acne and androgenic alopecia. In our study out of 33 patients with isolated acne 17 (51.5%) had PCO Morphology with grade I, grade II, grade III having prevalence of 46.2%, 53.8% and 57.1% respectively. In our study of the 28 patients with isolated androgenic alopecia 16 (57.1%) had PCOM with grade I, II and III respectively having prevalence of 56.3%, 55.6%, 66.7% with P value of 0.939. Patients with normal ovarian morphology were 12 in number (42.9%). Of the 54 patients with combined acne and androgenic alopecia 32 (59.3%) had PCOM and 22 patients had normal ovarian morphology. Higher overall prevalence was found in patients with combined acne and alopecia (59.3%) than in isolated groups; acne (51.5%), alopecia (57.1%). In our study it was to found that women with dermatological manifestations like acne and androgenic alopecia with regular menstruation. In our study it was found that these women with have high prevalence of PCOS.
Subject(s)
Acne Vulgaris , Polycystic Ovary Syndrome , Young Adult , Adolescent , Humans , Female , Adult , Middle Aged , Polycystic Ovary Syndrome/complications , Polycystic Ovary Syndrome/diagnostic imaging , Polycystic Ovary Syndrome/epidemiology , Hirsutism/epidemiology , Alopecia/diagnostic imaging , Alopecia/epidemiology , Acne Vulgaris/diagnostic imaging , Acne Vulgaris/epidemiology , Acne Vulgaris/pathologyABSTRACT
Acne diagnosis, severity assessment and treatment follow-up rely primarily on clinical examination. In vivo reflectance confocal microscopy (RCM) provides non-invasively, real-time images of skin lesions with a level of detail close to histopathology. This systematic literature review aims to provide an overview of RCM utility in acne and a summary of specific features with clinical application that may increase objectivity in evaluating this condition. We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for reporting our results. We systematically searched three databases: PubMed, Clarivate and Google Scholar (January 2022). All included studies used RCM to investigate acne in human patients and reported the investigated skin area and type (acne lesions or clinically uninvolved skin), the substance used in the case of treatment. Our search identified 2184 records in the three databases investigated. After duplicate removal, 1608 records were screened, 35 were selected for full-text assessment, and 14 were included in this review. We used the QUADAS-2 tool to evaluate the risk of bias and applicability concerns. RCM was selected as the index test and clinical examination as the reference standard. The total number of patients from all studies was 291, with 216 acne patients and 60 healthy participants aged between 13 and 45 years. The 14 considered studies analysed 456 follicles from healthy participants, 1445 follicles from uninvolved skin in acne patients and 1472 acne lesions. Consistent RCM findings concerning follicles of acne patients reported across studies were increased follicular infundibulum size, thick, bright border, intrafollicular content and inflammation. Our analysis indicates that RCM is a promising tool for acne evaluation. Nevertheless, standardization, a unified terminology, consistent research methods and unitary reporting of RCM findings are necessary. PROSPERO registration number CRD42021266547.
Subject(s)
Acne Vulgaris , Skin Diseases , Skin Neoplasms , Humans , Adolescent , Young Adult , Adult , Middle Aged , Skin/pathology , Acne Vulgaris/diagnostic imaging , Acne Vulgaris/pathology , Skin Diseases/pathology , Intravital Microscopy , Microscopy, Confocal/methods , Skin Neoplasms/pathologyABSTRACT
BACKGROUND: Acne is a skin lesion type widely existing in adolescents, and poses computational challenges for automatic diagnosis. Computer vision algorithms are utilized to detect and determine different subtypes of acne. Most of the existing acne detection algorithms are based on the facial natural images, which carry noisy factors like illuminations. OBJECTIVE: In order to tackle this issue, this study collected a dataset ACNEDer of dermoscopic acne images with annotations. Deep learning methods have demonstrated powerful capabilities in automatic acne diagnosis, and they usually release the training epoch with the best performance as the delivered model. METHODS: This study proposes a novel self-ensemble and stacking-based framework AcneTyper for diagnosing the acne subtypes. Instead of delivering the best epoch, AcneTyper consolidates the prediction results of all training epochs as the latent features and stacks the best subset of these latent features for distinguishing different acne subtypes. RESULTS: The proposed AcneTyper framework achieves a promising detection performance of acne subtypes and even outperforms a clinical dermatologist with two-year experiences by 6.8% in accuracy. CONCLUSION: The method we proposed is used to determine different subtypes of acne and outperforms inexperienced dermatologists and contributes to reducing the probability of misdiagnosis.
Subject(s)
Acne Vulgaris , Algorithms , Adolescent , Humans , Acne Vulgaris/diagnostic imaging , Acne Vulgaris/pathology , Image Interpretation, Computer-Assisted/methods , Dermoscopy/methodsABSTRACT
PURPOSE: To investigate ocular surface and meibomian glands in patients with treatment-naive acne vulgaris. METHODS: The Ocular Surface Disease Index (OSDI) questionnaire, invasive tear film breakup time, fluorescein staining of the ocular surface, and Schirmer II test were performed for all subjects. Total eyelid and meibomian gland secretion scores were assessed. Non-contact meibography was performed with the Sirius corneal topographic device. RESULTS: The right eyes of 35 patients with acne vulgaris and 35 healthy volunteers were included the study. While the OSDI and staining scores were significantly higher in the acne group than in the control group (p=0.01 and p=0.003, respectively), the invasive tear film breakup time and Schirmer measurements were significantly lower in the acne group (p=0.000 and p=0.003, respectively). The total eyelid and meibomian gland secretion scores were also higher in the acne group than in the control group (p=0.003 and p=0.000, respectively). On the morphological evaluation of the meibomian glands, the thickening, thinning, tortuosity, and presence of ghost areas were statistically significantly more common in the acne vulgaris group than in the control group (p=0.000, p=0.001, p=0.05, and p=0.006, respectively). The percentage of the meibomian gland loss area was significantly high in the acne vulgaris group on both upper and lower meibography. The meibomian gland loss area positively correlated with total eyelid and meibomian gland secretion scores. CONCLUSION: Acne vulgaris may have a predisposition to meibomian gland dysfunction and ocular surface damage. Early recognition of meibomian gland and ocular surface alterations seems important, especially in acne vulgaris cases for which oral isotretinoin treatment is planned.
Subject(s)
Acne Vulgaris , Dry Eye Syndromes , Eyelid Diseases , Meibomian Gland Dysfunction , Humans , Meibomian Glands/diagnostic imaging , Tears , Acne Vulgaris/diagnostic imaging , Acne Vulgaris/drug therapy , Eyelid Diseases/diagnostic imagingABSTRACT
In order to explore the clinical treatment of severe acne, this paper proposed the effect of CT technology combined with modified qinfan decoction on improving sores and promoting angiogenesis. From October 2016 to November 2017, 69 patients with severe acne treated in the first traditional Chinese medicine hospital of a city were selected for retrospective analysis. The 69 patients were randomly divided into control group and treatment group. There were 34 patients in the control group and 35 patients in the treatment group. Patients in the control group were treated with VSD. Patients in the treatment group were treated with qinfan decoction combined with VSD. Then, the total effective rate, the time of clinical symptom improvement, the time when the new granulation began to grow, and the time when the sore surface area was reduced by 1/2 were compared between the two groups. The results showed that after treatment, the total effective rate of the treatment group was higher than that of the control group. The time for the improvement of clinical symptoms, the time for the growth of new granulation, and the time for the reduction of the sore surface area by 1/2 were shorter than those of the control group, and the healing rate of the sore surface was higher than that of the control group (P < 0.05). Qinfan decoction combined with negative pressure sealing drainage technology has a significant effect on the treatment of severe acne and can promote its rehabilitation.
Subject(s)
Acne Vulgaris , Acne Vulgaris/diagnostic imaging , Acne Vulgaris/drug therapy , Humans , Retrospective Studies , Tomography, X-Ray ComputedABSTRACT
INTRODUCTION: Patient compliance with care recommendations is closely related to the role of cosmetics in delaying or preventing the side effects of medications used to treat acne. METHODS: A total of 33 volunteers with symptoms of acne vulgaris were qualified for the study. The skin parameters were measured before the experiment, after the 4 and at the 8 weeks of use. The measurements were subject to moisturizing the skin and secretion of sebum and skin color. A skin acoustic parameters using high-frequency ultrasound (33 MHz) was also performed. The recorded images were used to determine the epidermal entrance echo thickness and echo density of dermis. RESULTS: The results show a change in the value of skin parameters during the 8-week application of a specific skin care procedure. The secretion of sebum did not change significantly, there was a decrease in hydration, and the level of melanin and hemoglobin remained at the same level. The thickness of the epidermis entrance echo in the ultrasound image was thinned. CONCLUSION: For many mild/moderate acne patients, cosmetics proven to be effective and well tested in clinical trials can offer a real benefit in reducing both inflammation, sebum production, melanin, and irritation, but should also be moisturizing.
Subject(s)
Acne Vulgaris , Cosmetics , Humans , Melanins , Skin/diagnostic imaging , Acne Vulgaris/diagnostic imaging , Acne Vulgaris/drug therapy , Cosmetics/adverse effects , Epidermis , SebumABSTRACT
BACKGROUND: Acne is one of the most common skin lesions in adolescents. Some severe or inflammatory acne leads to scars, which may have major impacts on patients' quality of life or even job prospects. Grading acne plays an important role in diagnosis, and the diagnosis is made by counting the number of acne. It is a labor-intensive job and it is easy for dermatologists to make mistakes, so it is very important to develop automatic diagnosis methods. Ensemble learning may improve the prediction results of the base models, but its time complexity is relatively high. The ensemble pruning strategy may solve this computational challenge by removing the redundant base models. MATERIALS AND METHODS: This study proposed a novel ensemble pruning framework of deep learning models to accurately detect and grade acne using images. First, we train multi-base models and prune the redundancy models according to the performance and diversity of the models. Then, we construct the new features of the training data by the base models we select in the previous step. Next, we remove the redundancy models further by a feature selection algorithm. Finally, we integrate all the base models by classifiers. The ensemble pruning algorithm was proposed to prune the deep learning base models. RESULTS: The experimental data showed that the ensemble pruned framework achieved a prediction accuracy of 85.82% on the acne dataset, better than the existing studies. To verify our method's effectiveness, we test our method in a skin cancer dataset and greatly outperform the state-of-the-art methods. CONCLUSION: The method we proposed is used to grade acne. Our method's performance outperforms state-of-the-art methods on two datasets, and it can also remove redundancy models to reduce computational complexity.
Subject(s)
Acne Vulgaris , Deep Learning , Acne Vulgaris/diagnostic imaging , Adolescent , Algorithms , Humans , Quality of LifeABSTRACT
BACKGROUND AND OBJECTIVE: Grading the severity level is an extremely important procedure for correct diagnoses and personalized treatment schemes for acne. However, the acne grading criteria are not unified in the medical field. This work aims to develop an acne diagnosis system that can be generalized to various criteria. METHODS: A unified acne grading framework that can be generalized to apply referring to different grading criteria is developed. It imitates the global estimation of the dermatologist diagnosis in two steps. First, an adaptive image preprocessing method effectively filters meaningless information and enhances key information. Next, an innovative network structure fuses global deep features with local features to simulate the dermatologists' comparison of local skin and global observation. In addition, a transfer fine-tuning strategy is proposed to transfer prior knowledge on one criterion to another criterion, which effectively improves the framework performance in case of insufficient data. RESULTS: The Preprocessing method effectively filters meaningless areas and improves the performance of downstream models.The framework reaches accuracies of 84.52% and 59.35% on two datasets separately. CONCLUSIONS: The application of the framework on acne grading exceeds the state-of-the-art method by 1.71%, reaches the diagnostic level of a professional dermatologist and the transfer fine-tuning strategy improves the accuracy of 6.5% on the small data.
Subject(s)
Acne Vulgaris , Acne Vulgaris/diagnostic imaging , Data Collection , Humans , Research Design , Skin/diagnostic imagingABSTRACT
OBJECTIVES: To assess acne vulgaris quantitatively using high-frequency ultrasonography (HF-USG) and power Doppler (PD), and investigate the feasibility and application value of HF-USG and PD in acne vulgaris. METHODS: A total of 105 patients with the diagnosis of acne vulgaris in the face referred by a dermatologist were studied prospectively. All the acne patients enrolled were clinically classified by two attending dermatologists independently using three degrees with four levels of classification evaluating only the severest lesion. Gray-scale ultrasound was used to assess the thickness of the lesion, and the thickness ratio was calculated. PD equipped with Qpack semi-quantitative analysis software was used to assess blood signals of the lesion, and Qpack ratio, Qpack peak were calculated. Ten level-4 acne patients were re-evaluated after 2 weeks' treatment, and the results were compared with those before treatment. RESULTS: A total of 105 patients were categorized into four groups by dermatologists, 23 cases were comedones, 33 were papules, 26 were pustules, and 23 were nodules/cysts. There were significant differences in thickness ratio (P < .001), Qpack ratio (P < .001), and Qpack peak (P < .001) among the four groups. For the 10 level-4 acne patients treated 2 weeks by the dermatologist, the difference in thickness ratio between pre-treatment and post-treatment showed no significance (P = .06). However, Qpack ratio and Qpack peak were significantly decreased between pre-treatment and post-treatment (both P = .01). CONCLUSIONS: HF-USG and PD equipped with semi-quantitative analysis software can assess acne vulgaris quantitatively, which provides a good basis for the classification and treatment of acne. Their features include thickness ratio, Qpack ratio, and Qpack peak, with Qpack ratio and Qpack peak being the sensitive features for the early efficacy evaluation.
Subject(s)
Acne Vulgaris , Acne Vulgaris/diagnostic imaging , Acne Vulgaris/pathology , Humans , UltrasonographyABSTRACT
BACKGROUND: Many ingredients used in cosmetics evoke a comedogenic response. The concept of ''acne cosmetica'' was developed to link the use of certain ingredients to comedone formation. Various clinical research methods have been suggested for the effective screening of an ingredient that can worsen acne or acneiform eruption and confirm its clinical relevance as to whether it is used as a non-comedogenic claim. Although comedogenicity assessment has not yet been established, attempts have been made to evaluate the comedogenicity of cosmetic ingredients and find the most appropriate method to evaluate comedogenicity in human skin. MATERIALS AND METHODS: Total 6 participants were included in the study. Each participant received patches on the upper back containing cocoa butter. We used reflectance confocal microscopy (RCM) to count the number of microcomedones and follicles induced by cocoa butter. RESULTS: The mean value change of microcomedone/follicle by the comedogenic substance was significantly higher than that of the non-applied site for 2 weeks (p = 0.0419). The mean value changes of the microcomedone diameter caused by the comedogenic substance were significantly larger than those found at the non-applied site at 2 and 4 weeks (p = 0.0026 and p = 0.0038, respectively). CONCLUSIONS: We recommend RCM as a non-invasive real-time method that is useful for evaluating comedogenicity and early detection of a microcomedone.
Subject(s)
Acne Vulgaris , Cosmetics , Acne Vulgaris/diagnostic imaging , Cosmetics/adverse effects , Dietary Fats , Humans , Microscopy, Confocal/methods , SkinABSTRACT
BACKGROUND: Current approaches for assessment of acne scars are subjective, including counting scar subtypes, subjective self-assessment, or scoring global acne scar severity. AIMS: We aimed to validate accuracy and present initial data of a new, simple, non-contact, high-resolution 3D stereoscopic optical imaging system in the setting of acne scarring. PATIENTS/METHODS: Ten patients treated for acne scars in the dermo-esthetic outpatient clinics in our institution from July to December 2019 were recruited from medical files and completed by telephone interview. Each patient was assessed by the 3D imaging system, the Qualitative Scarring Grading Score (QSGS), and the patient's questionnaire for Self-assessment of Clinical Acne-Related Scars (SCARS) before and 4 weeks after a single intervention. RESULTS: Scar depth measured by the imaging system correlated significantly with the actual depth of printed surface depressions and the 3D optical imaging assessments. The changes in SCARS and 3D optical imaging assessments correlated significantly, but there were no correlations between changes in QSGS and 3D optical assessment measures, or between the QSGS and SCARS results. CONCLUSION: The new stereoscopic optical system is a reliable and practical objective method for assessing the cumulative depth of atrophic acne scars and monitoring treatment response. It is more sensitive, accurate, and informative than subjective scales.
Subject(s)
Acne Vulgaris , Optical Devices , Acne Vulgaris/complications , Acne Vulgaris/diagnostic imaging , Acne Vulgaris/drug therapy , Atrophy , Cicatrix/diagnostic imaging , Cicatrix/etiology , Humans , Imaging, Three-Dimensional , Treatment OutcomeABSTRACT
BACKGROUND: Efficacy and safety of ablative fractional laser used for treatment of acne scars have been described in several studies. Recently, microneedling radiofrequency treatment has been showing promising results with low risk of side effects and rapid healing time. OBJECTIVE: To study efficacy and safety of ablative fractional Er:YAG laser 2940 nm and microneedling radiofrequency for facial atrophic acne scar. METHODS: 21 patients with atrophic postacne scars were randomized to MRF for one half of the face and laser for the other half. Four sessions were performed monthly. For evaluation, the validated scale "Quantitative Global Grading System for Postacne Scarring" and patient's satisfaction were used before and 3 months after treatment. Optical coherence tomography imaging of the skin was used as an objective tool for assessment. RESULTS: Both sides showed significant improvement on clinical evaluation with no significant difference. Optical coherence tomography assessment showed significant increase of both epidermal and dermal thickness compared to baseline. CONCLUSION: Both MRF and ablative fractional Er. YAG laser 2940 nm are effective in the treatment of post acne scars. Microneedling radiofrequency is better tolerated, with lower downtime and fewer side effects.
Subject(s)
Acne Vulgaris/therapy , Cicatrix/therapy , Lasers, Solid-State , Radiofrequency Therapy , Acne Vulgaris/complications , Acne Vulgaris/diagnostic imaging , Cicatrix/diagnostic imaging , Cicatrix/etiology , Humans , Tomography, Optical Coherence , Treatment OutcomeABSTRACT
AIM: This case-controlled study aimed at evaluating whether enthesitis is possibly associated with acne vulgaris. METHODS: This study was carried out on 90 patients with acne vulgaris and 30 normal individuals who were subjected to full history talking, acne scoring system, general, dermatological, musculoskeletal examination, and musculoskeletal ultrasonography with Doppler flow. RESULTS: A significant relation (P < 0.05) was discovered between left femoral condyle tenderness, which increased left femoral condyle hypoechogenicity on ultrasound. Moreover, a highly significant relation (P < 0.001) was established between tenderness on clinical examination and hypoechogenicity on ultrasound at three sites (right humerus epicondyle, right femoral condyle, and left humerus epicondyle). An association between tenderness and ultrasound increased thickness was significantly reported in the left femoral condyle (P < 0.05). Hypoechogenicity on ultrasound examination was more statistically evident with increased acne severity at the left Achilles tendon (LA), while enthesis calcifications (enthesophytes) were significantly associated with increased acne severity in the left humerus epicondyle (LA) and the right Achilles tendon (RA) (P < 0.05). CONCLUSION: There is a solid possibility acne is a systemic disease triggering other co-morbidities beyond skin which needs to be fully elucidated by further research evidence.
Subject(s)
Achilles Tendon , Acne Vulgaris , Enthesopathy , Achilles Tendon/diagnostic imaging , Acne Vulgaris/complications , Acne Vulgaris/diagnostic imaging , Enthesopathy/diagnostic imaging , Enthesopathy/etiology , Humans , Ultrasonography , Ultrasonography, DopplerABSTRACT
BACKGROUND: Adapalene-benzoyl peroxide (A-BPO) is a first-line topical treatment for acne vulgaris. In vivo reflectance confocal microscopy (RCM) and optical coherence tomography (OCT) detect micromorphological changes over time and visualize transfollicular delivery. OBJECTIVES: To visualize temporal, subclinical effects of A-BPO on acne micromorphology using RCM and OCT, and evaluate their impact on transfollicular delivery of microparticulate carrier systems. METHODS: Fifteen patients with mild to moderate acne received a 6-week course of A-BPO. Micromorphological changes were evaluated at time 0, 3 and 6 weeks with RCM (n = 1190 images) and OCT (n = 210 scans). Transfollicular delivery of microparticles was assessed at baseline and week 6. RESULTS: In vivo imaging visualized steady normalization of skin micromorphology in response to A-BPO over 6 weeks, including decreased hyperkeratinization of follicular borders (RCM median decrease -71.2%, P < 0.05), reduced intrafollicular keratinous content (RCM median decrease -47.7%, P < 0.05) and increased epidermal thickness (OCT median increase of 25.25%, P < 0.05). Imaging visualized microparticles in the follicular unit. Despite a visible reduction in keratin and sebum, transfollicular microparticle delivery appeared unaffected. CONCLUSIONS: Reflectance confocal microscopy and OCT detect A-BPO-induced changes in micromorphology and visualize transfollicular microparticle delivery. Keratolysis and sebolysis did not have a measurable effect on transfollicular delivery of microparticles.
Subject(s)
Acne Vulgaris , Dermatologic Agents , Acne Vulgaris/diagnostic imaging , Acne Vulgaris/drug therapy , Adapalene , Benzoyl Peroxide , Dermatologic Agents/therapeutic use , Drug Combinations , Gels , Humans , Prospective Studies , Treatment OutcomeABSTRACT
BACKGROUND: The use of high-frequency ultrasound for noninvasive assessment of skin during chemical peeling therapies may be a useful tool. AIMS: To determine whether high-frequency ultrasound is a useful tool to noninvasive assessment of skin and evaluation therapy progress. PATIENTS/METHODS: The 14 women underwent four treatments with chemical peelings at 2-week intervals. Before, after 4 weeks and after 9 weeks, photographic documentation and scans were recorded using a high-resolution ultrasound system. RESULTS: As a result of applying pyruvic acid peeling, the thickness of the entrance echo on the forehead, cheek, and chin was reduced. After applying the peeling consisting of a mixture of glycolic and salicylic acids, the thickness of the entrance echo of the epidermis decreased on the forehead, cheek, and chin. As a result of applying a 50% pyruvic acid peeling, the density of dermis on the forehead, cheeks, and chin increased. A similar increase in the density of dermis was observed on the forehead, cheeks, and chin after applying a mixture of glycolic and salicylic acid. CONCLUSION: High-frequency ultrasound is a useful tool for monitoring the progress in the treatment of acne vulgaris using chemical peelings.
Subject(s)
Acne Vulgaris , Chemexfoliation , Acne Vulgaris/diagnostic imaging , Acne Vulgaris/drug therapy , Female , Humans , Salicylic Acid/therapeutic use , Treatment Outcome , UltrasonographyABSTRACT
PURPOSE: To investigate the impact of oral isotretinoin therapy in choroidal thickness, central macular thickness (CMT), and retinal nerve fibre layer (RNFL) thickness using optical coherence tomography (OCT). PATIENTS AND METHODS: Choroidal thicknesses, CMT, and RNFL thickness of 64 eyes were evaluated at baseline and the end of the third month of isotretinoin therapy by spectral-domain OCT. For assessment of choroidal thickness, OCT measurements were obtained at the fovea with 6 additional measurements at adjacent locations (at 500-1000-1500 µm temporal to the fovea and 500-1000-1500 µm nasal to the fovea). RESULTS: There was not a statistically significant difference between the baseline and third-month follow-up measurements of choroidal thicknesses at seven distinct locations (p > 0.05). Similarly, RNFL thickness and CMT did not change with a mean dose of 30 (±6) mg per day isotretinoin therapy during follow-up (101.82 vs 102.24, p = 0.079; 217.77 vs 217.25, p = 0.731, respectively). CONCLUSION: After the use of oral isotretinoin for 3 months, no significant side effects have been observed in choroidal thickness, CMT, and RNFL thickness by OCT.
Subject(s)
Choroid/drug effects , Dermatologic Agents/therapeutic use , Isotretinoin/therapeutic use , Nerve Fibers/drug effects , Retina/drug effects , Acne Vulgaris/diagnostic imaging , Acne Vulgaris/drug therapy , Administration, Oral , Adolescent , Adult , Choroid/anatomy & histology , Choroid/diagnostic imaging , Female , Humans , Male , Retina/anatomy & histology , Retina/diagnostic imaging , Tomography, Optical Coherence , Young AdultABSTRACT
BACKGROUND: Acne vulgaris is one of the most common human pathologies worldwide. Its prevalence causes a high healthcare expenditure. Acne healthcare costs and effects on individuals' quality of life lead to the need of analysing current acne evaluation, treatment and monitoring methods. One of the most common ones is manual lesion counting by a dermatologist. However, this technique has several limitations, such as time spent. That is the reason why the development of new computer-assisted techniques is needed in order to automatically count the acne lesions. MATERIALS AND METHODS: Using the fluorescence images, a segmentation algorithm is implemented in MATLAB. RESULTS: A new counting tool has been obtained that provides a form of objective evaluation of acne vulgaris disease. The effectiveness of the application of the segmentation method is more than 90%, being valid for the follow-up and diagnosis of injuries. CONCLUSION: Automated counting of acne lesions has been proposed to solve current limitations of evaluation and monitoring methods for acne vulgaris. It is clear that the use of machine learning algorithms such as k-means enables clinicians to objectively and quickly evaluate the severity of acne.
Subject(s)
Acne Vulgaris , Acne Vulgaris/diagnostic imaging , Algorithms , Fluorescence , Humans , Machine LearningABSTRACT
Cutaneous chrysiasis is gold deposition in the dermis, described after parenteral administration of gold salts or after topical exposure to gold-containing materials. Gold microparticles (GMPs) have versatile therapeutic effects and are increasingly used in medicine. This case report describes the development of a blue-gray macule following the facial application of GMPs and laser treatment of acne vulgaris. Dermoscopy showed a nonspecific homogenous blue-gray pattern, gradually fading over an 8-month-period. Reflectance confocal microscopy (RCM) detected hyperreflective, subcellular particles in the papillary dermis, localized around hair follicles, eccrine glands, and inside macrophages. Histopathological evaluation, darkfield illumination with hyperspectral imaging, and neutron activation analysis confirmed the presence of GMPs in the dermis. RCM allowed non-invasive fast visualization of aggregates of hyperreflective particles in the dermis and can potentially be used for monitoring localized cutaneous chrysiasis and other metal deposition conditions over time. Lasers Surg. Med. © 2019 Wiley Periodicals, Inc.