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2.
Pediatrics ; 145(Suppl 2): S225-S230, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32358215

RESUMO

Acne vulgaris is an extraordinarily common skin condition in adolescents. The mainstays of acne treatment have remained largely unchanged over recent years. In the context of increasing antibiotic resistance worldwide, there is a global movement away from antibiotic monotherapy toward their more restrictive use. Classically reserved for nodulocystic acne, isotretinoin has become the drug of choice by dermatologists for moderate to severe acne. Given the virtually ubiquitous nature of acne in teenagers, there remains an appreciable need for novel therapies. In this article, we will cover the currently used acne treatments, evaluate the issues and data supporting their use, explore the issues of compliance and the mental health implications of acne care, and recommend directions for the field of acne management in adolescents in the years ahead.


Assuntos
Acne Vulgar/terapia , Acne Vulgar/epidemiologia , Acne Vulgar/psicologia , Adolescente , Antibacterianos/uso terapêutico , Feminino , Humanos , Isotretinoína/uso terapêutico , Masculino , Saúde Mental , Cooperação do Paciente/psicologia , Pediatria , Resultado do Tratamento
3.
Medicine (Baltimore) ; 99(18): e19764, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32358349

RESUMO

INTRODUCTION: Acne vulgaris is a chronic inflammatory disease of the sebaceous glands that occurs in adolescent men and women. In recent years, the incidence of acne has increased year by year, so it is of great significance to find a precise and effective treatment and further explore its possible mechanism of action. The purpose of this study will be to explore a treatment method that has both traditional Chinese medicine characteristics and significant effects, and provides a higher level of evidence for acupuncture for acne vulgaris. It also provides patients with more treatment options. METHODS/DESIGN: The study will be a randomized controlled trial divided into 2 parallel groups. This pragmatic randomized controlled trial will recruit 66 patients who are diagnosed with acne vulgaris. 30-minutes acupuncture sessions will be provided to patients assigned to the intervention group. All participants will continue to receive conventional treatment. The selection of outcomes will be evaluated by the skin lesions score scale. DISCUSSION: This trial may provide evidence regarding the clinical effectiveness, safety, and cost-effectiveness of acupuncture for patients with acne vulgaris. TRIAL REGISTRATION NUMBER: CTR2000030427.


Assuntos
Acne Vulgar/terapia , Terapia por Acupuntura/métodos , Medicina Tradicional Chinesa/métodos , Creme para a Pele/administração & dosagem , Vitamina A/administração & dosagem , Administração Tópica , Adolescente , Adulto , Terapia Combinada , Feminino , Humanos , Masculino , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento , Adulto Jovem
5.
Pediatr Ann ; 49(3): e109-e115, 2020 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-32155276

RESUMO

Acne is the most common skin condition observed in adolescent and preadolescent patients. Pediatric providers are on the forefront of managing the disease, often as a secondary concern in a busy practice. Therefore, every provider needs to have an acne treatment plan that is effective, easy to communicate, and simple to follow. This article provides treatment rationale and guidelines-based recommendations for the initial treatment of acne, tips for troubleshooting any side effects, and a plan for subsequent follow-up to maintain good control. [Pediatr Ann. 2020;49(3):e109-e115.].


Assuntos
Acne Vulgar , Acne Vulgar/diagnóstico , Acne Vulgar/terapia , Adolescente , Criança , Humanos , Pediatria , Médicos de Atenção Primária , Guias de Prática Clínica como Assunto
7.
Facial Plast Surg Clin North Am ; 28(1): 1-7, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31779933

RESUMO

The use of microneedling with or without radiofrequency continues to expand in aesthetics. There are now many different devices available that have multiple indications, unique protocols, and low side effect profiles.


Assuntos
Acne Vulgar/terapia , Cicatriz/terapia , Técnicas Cosméticas , Agulhas , Terapia por Radiofrequência , Envelhecimento da Pele , Humanos , Rejuvenescimento
8.
Facial Plast Surg Clin North Am ; 28(1): 135-148, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31779937

RESUMO

Photodynamic therapy is the combination of the initial application of a photosensitive chemical on the skin and then using typically a blue filter light of varying spectrums. This treatment protocol has been more useful and functional than other chemical peels and lasers for a variety of conditions. There has been efficacy in antiviral treatments, such as herpetic lesions; malignant cancers of the head and neck; and lung, bladder, and skin cancers. It has been tested for prostate cancers, cervical cancer, colorectal cancer, lung cancer, breast cancer, esophageal cancer, stomach cancer, pancreatic cancer, vaginal cancer, gliomas, and erythroplasia of Queyrat.


Assuntos
Acne Vulgar/terapia , Técnicas Cosméticas , Ceratose Actínica/terapia , Fotoquimioterapia , Envelhecimento da Pele , Humanos
9.
Dermatol Surg ; 46(1): 86-92, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31356435

RESUMO

BACKGROUND: Microneedling is a popular, minimally invasive skin rejuvenation modality for acne scarring. Recent reports have evaluated the efficacy and safety of microneedling monotherapy and combination treatment for scarring. OBJECTIVE: This review aims to systematically analyze the current literature on microneedling techniques used for acne scarring. METHODS: A PubMed search (2009-current) was used to identify literature on microneedling treatment for acne. All randomized and nonrandomized clinical trials, case cohorts, case reports, and case series were included with the exception of 2 studies, which were excluded due to unavailability. RESULTS: All 33 articles evaluated showed improvement of acne scar appearance after microneedling treatment. Evidence was inconsistent when comparing microneedling monotherapy to dual therapy or to fractional laser treatment. CONCLUSION: Microneedling improves acne scarring, and further studies are needed to compare microneedling with other minimally invasive treatments.


Assuntos
Acne Vulgar/complicações , Acne Vulgar/terapia , Cicatriz/etiologia , Cicatriz/terapia , Técnicas Cosméticas , Humanos , Agulhas , Resultado do Tratamento
10.
J Drugs Dermatol ; 18(12): 1268-1272, 2019 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-31860216

RESUMO

INTRODUCTION: Acne vulgaris (AV) is a common skin disorder that may result in long-lasting acne scars. Techniques such as delivering fractional radiofrequency (RF) energy through miniature pins or needles have been utilized to manage active acne and acne scars. Skin restoration through dermal remodeling, neo-collagenesis, neo-elastogenesis, and epidermal re-newal are typical results of such treatments. METHODS: 15 subjects suffering from acne received 3 sessions of facial treatments, 3-4 weeks apart, using a fractional RF device with 24 pins tip of 2500µm in length. The treatment's safety and efficacy were evaluated up to 6 months after the last treatment. RESULTS: Facial photos and classifications of active acne, acne scars, and overall skin appearance demonstrated improve-ments in follow-up visits compared to baseline. No significant or unexpected adverse events were detected. CONCLUSION: The current study supports the safety and efficacy of the fractional RF treatment modality for acne condition. J Drugs Dermatol. 2019;18(12):1268-1272.


Assuntos
Acne Vulgar/terapia , Cicatriz/terapia , Técnicas Cosméticas , Terapia por Radiofrequência/métodos , Acne Vulgar/complicações , Adolescente , Adulto , Cicatriz/etiologia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Terapia por Radiofrequência/efeitos adversos , Resultado do Tratamento , Adulto Jovem
11.
J Drugs Dermatol ; 18(12): 221, 2019 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-31860223

RESUMO

Acne vulgaris is the most common dermatological disorder globally.1,2 Psychological and emotional distress due to acne, including poor self-esteem, social anxiety, depression, and suicidal ideation have been reported in various studies.3,4, Acne is a complex multifactorial disease with its pathophysiology incompletely elucidated.


Assuntos
Acne Vulgar/fisiopatologia , Higiene da Pele/métodos , Fenômenos Fisiológicos da Pele , Acne Vulgar/psicologia , Acne Vulgar/terapia , Humanos , Concentração de Íons de Hidrogênio , Pele/metabolismo , Pele/fisiopatologia
12.
J Wound Care ; 28(11): 780-783, 2019 Nov 02.
Artigo em Inglês | MEDLINE | ID: mdl-31721661

RESUMO

OBJECTIVE: Acne vulgaris (acne) presents with increased oil-sebum secretion and subsequent formation of comedones, papules, pustules and nodules. Skin cleansing is part of the daily routine to improve skin condition. A monofilament debridement pad has shown to be effective when used for wound debridement and skin cleansing in dermatological conditions. The pad may offer benefits when used for acne affected skin. METHODS: The in vitro cleansing capacity of the monofilament fibre pad was analysed and compared with commercially available cosmetic pads. For this purpose, a sebum model consisting of glass plates coated with an oil-red-stained layer of artificial sebum was used. To gain clinical experience a case series evaluated cleansing efficacy of the monofilament debridement pad in combination with polyhexanide and sodium-hypochlorite based solutions. Over a period of four months, seven individuals suffering from retentive moderate facial acne who visited the dermatology clinic for their acne used the pad as necessary, ranging from twice weekly to daily, dependent on the sensitivity of the patient's skin condition. RESULTS: The in vitro study exhibited a significantly better cleansing efficacy of the monofilament debridement pad compared with the cosmetic pads. After single use of the pad subject scores on sebum reduction revealed excellent/very good in 42.9% and acceptable in 57.1% of cases. After repeated use of the monofilament pads scores on sebum reduction of excellent/very good were given in 85.7% and acceptable in 14.3% of cases. Subject scored handling of the pad and comfort during use also received favourable ratings. CONCLUSION: These initial results show the potential of the monofilament debridement pad for cleansing of acne-prone and acne affected skin. More robust studies are needed to confirm these results.


Assuntos
Acne Vulgar/terapia , Desbridamento/instrumentação , Face , Adolescente , Biguanidas/uso terapêutico , Desenho de Equipamento , Feminino , Humanos , Masculino , Índice de Gravidade de Doença , Hipoclorito de Sódio/uso terapêutico , Adulto Jovem
13.
Cutis ; 104(3): 164-168, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31675392

RESUMO

Atopic dermatitis (AD) is a common chronic inflammatory dermatosis of childhood that typically improves during adolescence but can be lifelong. Black children are at 6-times greater risk for severe AD than white children, and AD may lead to a greater negative impact on quality of life (QOL) in patients with skin of color. For these reasons, it is important for dermatologists to consider the various issues associated with AD that adolescents with skin of color may face. We present management strategies for AD in this patient population.


Assuntos
Afro-Americanos , Dermatite Atópica , Pigmentação da Pele , Acne Vulgar/diagnóstico , Acne Vulgar/terapia , Adolescente , Doença Crônica , Cosméticos/uso terapêutico , Dermatite Atópica/diagnóstico , Dermatite Atópica/etnologia , Dermatite Atópica/etiologia , Dermatite Atópica/terapia , Progressão da Doença , Grupo com Ancestrais do Continente Europeu , Humanos , Qualidade de Vida , Proteínas S100/genética , Índice de Gravidade de Doença
14.
Dermatol Online J ; 25(10)2019 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-31735002

RESUMO

BACKGROUND: Mobile medical applications (apps) for clinical management of medical conditions are increasing in prevalence. Our aim was to identify features and overall quality of acne apps that could facilitate clinical management. METHODS: We established 10 pertinent features (6 essential and 4 desirable) for an acne app through literature search and nominal group discussion. Searches were then conducted in the Apple App Store and Google Play Store. Apps which assisted with clinical management of acne were assessed for functionality and quality. Overall quality was evaluated by grading against pre-established criteria for medical apps. RESULTS: A total of 358 Apple apps and 256 Google apps were found. After removing apps which did not assist with the clinical management of acne, 12 Apple and 13 Google apps remained. Apps were classified as interactive, informational, or teledermatology apps. Mean Masud scores were 12.8±3.7 for the Apple apps and 12.2±3.7 for the Google apps. CONCLUSIONS: Mobile acne apps can be effective in the self-management and collaborative management of acne. The current acne apps are of variable quality and none contained all 10 features crucial for effective clinical management. The shortcomings identified in this paper can guide future acne app development.


Assuntos
Acne Vulgar/terapia , Aplicativos Móveis/normas , Dermatologia , Humanos
15.
J Drugs Dermatol ; 18(11): 1109-1114, 2019 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-31741353

RESUMO

Objective: To assess the effectiveness of microfocused ultrasound with visualization (MFU-V) for treating moderate to severe atrophic acne scars. Design: Healthy subjects (N=20) seeking correction of moderate to severe atrophic acne scars on the cheeks and/or temples were enrolled. Scars were predominantly rolling- and boxcar-type, affecting an area ≥5.0cm2. Eighteen subjects completed the study. Intervention: The treatment area was marked with 14mm2 and 25mm2 squares and treated with four transducers: 7 MHz (3.0mm focal depth) and 10 MHz (1.5mm focal depth), each in 14mm and 25mm widths. During each session, MFU-V treatment lines were applied 2-3mm apart, within each treatment area, with a maximum length of 25mm. Each square received 30 treatment lines at two transducer depths (60 total lines). Subjects received three total treatments, with 30 days between each session. The primary outcome measure was improvement in baseline appearance of scars at 90 and 180 days after the final treatment. Secondary outcome measures included changes in severity using an Acne Scar Improvement Scale (ASIS) and Global Aesthetic Improvement Scale (GAIS) at 60-, 90-, and 180-days post-treatment, and a satisfaction questionnaire at 90-days post-treatment. Results: Among the 90-day images available for assessments (n=11), 100% were rated as improved by blinded reviewers, and 64% of pre- and post-treatment images were correctly selected. Among 180-day images (n=15), 100% were rated as improved, and 40% of pre- and post-treatment images were correctly selected. Most subjects were determined to have 25-50% improvement in investigator ASIS scores at 60-, 90-, and 180-days post-treatment. All subjects noted some improvement in severity at the 60-day assessment when measured using ASIS. Based on investigator GAIS scores, 100% of subjects were "Improved" or "Much Improved" at 60-, 90-, and 180-days post-treatment. Based on subject GAIS scores, all subjects noted improvement at the 60-day assessment, and 83% and 89% at the 90- and 180-day assessments, respectively. Overall, 17 subjects (94.4%) expressed some degree of satisfaction at 90-days post-treatment. Conclusions: The results of this study demonstrated that MFU-V therapy is beneficial and well tolerated for the treatment of rolling- and boxcar-type acne scars. J Drugs Dermatol. 2019;18(11):1109-1114.


Assuntos
Acne Vulgar/terapia , Cicatriz/patologia , Terapia por Ultrassom , Acne Vulgar/patologia , Adolescente , Adulto , Idoso , Atrofia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Índice de Gravidade de Doença , Resultado do Tratamento , Adulto Jovem
16.
J Drugs Dermatol ; 18(11): 1116-1122, 2019 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-31741354

RESUMO

Background and Objective: Laser and light-based therapies are relatively new treatment options for acne vulgaris patients. Intense pulsed light (IPL) is believed to exploit the photosensitivity of P. acnes residing in the pilosebaceous units at lower wavelengths and induce anti-inflammatory effects by influencing cytokine release at higher wavelengths. Our study aimed to assess the clinical safety and efficacy of a novel dual-band "notch" acne filter (400-600nm and 800-1200nm) in improving inflammatory and non-inflammatory lesions in patients presenting with mild-to-moderate acne. Materials and Methods: The study was designed as a single-site, prospective study of 10 patients with Fitzpatrick skin types II-V presenting with mild to moderate inflammatory facial acne vulgaris. A total of five whole-face light treatments were conducted at 1-2-week intervals with an IPL system (Lumenis M22 System, Lumenis Ltd.) equipped with a dual-band "notch" acne filter (400-600nm and 800-1200nm). Follow-up visits were performed at 1 and 4 weeks following the last treatment session. Acne mean change from baseline was assessed using the 4-point Investigator Global Assessment (IGA) scale. Comprehensive facial photographs were taken, and lesions were counted at screening, treatment 4, and both 1- and 4-week follow-up visits. The investigator and the patients assessed overall improvements in appearance, using the 5-point Likert scale. Subjects also completed the Cardiff Acne Disability Index (CADI) questionnaire and rated their satisfaction from treatment. Subject-reported pain, using the visual analog scale (VAS), and downtime were also recorded. Results: Treatment impact on overall lesion clearance was most substantial at 4 weeks follow-up, at which 50% of patients showed at least a 50% reduction from baseline of lesion counts (P<0.0001). IGA scores improved throughout the course of the study, and significant improvements in the overall skin condition was noted, with mean 1.63-point and 1.50-point increases from baseline in the acne improvement ratings, at 1- and 4-weeks follow-up, respectively (P=0.0074, 0.0063). Patient-assessed CADI improved throughout the treatment and follow-up visits, peaking at a 3.22-point and 4.9-point average reductions from baseline at 1-week follow-up (P=0.0001) and 1-month follow-up (P<0.0001), respectively. The majority of the patients (80%) rated their acne lesions as improved, much improved, or very much improved at 4-weeks follow-up (P=0.0004). Significant enhancements were also noted for skin texture. Eighty percent of the patients reported overall satisfaction with treatment outcomes, while 60% rated their satisfaction as "good" or "very good" at 4-weeks follow-up (P<0.0001). Treatments were well tolerated, with mean per-session VAS scores being ≤3.77, while the mean downtime was negligible (a few hours). Conclusion: The use of an IPL device equipped with a proprietary "notch" acne filter elicited a significant effect on acne vulgaris. No severe pain, erythema, edema, folliculitis, crusting or exfoliation was noted, emphasizing the safety of our technique. J Drugs Dermatol. 2019;18(11):1116-1122.


Assuntos
Acne Vulgar/terapia , Dermatoses Faciais/terapia , Fototerapia , Acne Vulgar/patologia , Adolescente , Adulto , Dermatoses Faciais/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Índice de Gravidade de Doença , Inquéritos e Questionários , Resultado do Tratamento , Adulto Jovem
17.
J Drugs Dermatol ; 18(11): 1140-1145, 2019 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-31741359

RESUMO

Introduction: Acne vulgaris is a highly prevalent skin condition that can adversely affect the quality of life. Acne-predisposed skin is in a state of subclinical inflammation leading to skin barrier dysfunction. A multi-center cohort study was designed to evaluate clinical efficacy and safety of twice daily facial cleansing using an oscillatory sonic brush, acne brush head, and cleansing gel for 4 weeks. Methods: Subjects with mild-to-moderate acne and acne-prone skin used the cleansing regime after which they applied the skin care products they routinely used. Physician-assessed skin condition comparing baseline versus week 4 using the FDA/IGA scale and subject satisfaction with cleansing efficacy and handling properties of the regime were scored during the last visit. Results: Forty-six subjects completed the study. Physician-scored skin condition showed a statistically significant improvement in FDA/IGA scores and a significant reduction of inflammatory and non-inflammatory lesions comparing baseline versus 4 weeks. Thirty-five (76.0%) subjects had cleared or almost cleared. Subjects similarly assessed their skin to be improved. Conclusion: Both the physician and subject scores revealed the gentle cleansing routine using the sonic brush to be effective reducing the number of acne lesions, improving skin condition. No adverse events were reported during the study period. The cleansing regime may offer an attractive, safe option for maintenance and treatment of subjects with mild-to-moderate acne and acne-prone skin. J Drugs Dermatol. 2019;18(11):1140-1145.


Assuntos
Acne Vulgar/terapia , Detergentes/administração & dosagem , Dermatoses Faciais/terapia , Higiene da Pele/instrumentação , Adulto , Estudos de Coortes , Feminino , Géis , Humanos , Masculino , Resultado do Tratamento , Estados Unidos
18.
Am Fam Physician ; 100(8): 475-484, 2019 10 15.
Artigo em Inglês | MEDLINE | ID: mdl-31613567

RESUMO

Acne vulgaris is the most prevalent chronic skin disease in the United States, affecting nearly 50 million people per year, mostly adolescents and young adults. Potential sequelae of acne, such as scarring, dyspigmentation, and low self-esteem, may result in significant morbidity. Typical acne lesions involve the pilosebaceous follicles and the interrelated processes of sebum production, Cutibacterium acnes (previously called Propionibacterium acnes) colonization, and inflammation. Acne may be classified as mild, moderate, or severe based on the number and type of skin lesions. Multiple treatment agents and formulations are available, with each agent targeting a specific area within acne pathogenesis. Treatment selection is based on disease severity, patient preference, and tolerability. Topical retinoids are indicated for acne of any severity and for maintenance therapy. Systemic and topical antibiotics should be used only in combination with benzoyl peroxide and retinoids and for a maximum of 12 weeks. Isotretinoin is used for severe, recalcitrant acne. Because of the risk of teratogenicity, patients, pharmacists, and prescribers must register with the U.S. Food and Drug Administration-mandated risk management program, iPledge, before implementing isotretinoin therapy. There is limited evidence for physical modalities (e.g., laser therapy, light therapy, chemical peels) and complementary therapies (e.g., purified bee venom, low-glycemic-load diet, tea tree oil); therefore, further study is required.


Assuntos
Acne Vulgar/diagnóstico , Acne Vulgar/terapia , Antibacterianos/uso terapêutico , Peróxido de Benzoíla/uso terapêutico , Doença Crônica/terapia , Fármacos Dermatológicos/uso terapêutico , Isotretinoína/uso terapêutico , Adolescente , Adulto , Terapias Complementares/métodos , Currículo , Educação Médica Continuada , Feminino , Humanos , Terapia a Laser/métodos , Masculino , Fototerapia/métodos , Estados Unidos , Adulto Jovem
19.
J Dermatol ; 46(12): 1210-1214, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31642108

RESUMO

Medicolegal disputes are increasing in practical medicine. Medications or procedures related to acne could lead to medical malpractice. This study analyzed medical litigation associated with acne in South Korea. Acne-related judgments were searched using the Supreme Court of Korea's Written Judgment Management System based on the keyword "acne". Eleven cases were selected; eight cases were related to acne scar and three cases were related to acne. Treatment modalities such as peeling, laser treatment, photodynamic therapy and antibiotics resulted in lawsuits. Claimed sequelae of the treatments were hyperpigmentation, scar worsening, erythema, skin bumps and liver transplant. Eight cases were awarded to the plaintiff, and the others were dismissed. This study shows that various treatments for acne can cause medical disputes.


Assuntos
Acne Vulgar/terapia , Dermatologia/legislação & jurisprudência , Imperícia/estatística & dados numéricos , Adolescente , Adulto , Feminino , Humanos , Masculino
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