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PubMed2006

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

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

Acne Vulgaris↗
PubMed1989

Analysis of Propionibacterium acnes-induced non-specific immunity to Trypanosoma brucei in mice.

Mice treated with dead Propionibacterium acnes (previously called Corynebacterium parvum), up to 30 days before infection with any of three strains of Trypanosoma brucei, were more able to limit the level of first-wave parasitaemia than untreated controls. Reduced parasitaemia was not due to enhanced phagocytosis of input parasites and was associated with a dramatic reduction in the proportion of multiplying T. brucei in the blood of treated as compared to control mice. For 4 days after P. acnes treatment, T. brucei growth-inhibitory molecules, assayed by their effect on T. brucei multiplication under axenic culture conditions, were detected in the serum of recipient mice. The molecules were released by macrophages collected from the peritoneal cavity of P. acnes-treated mice, and similar molecules were produced in vitro by macrophages from normal mice after incubation with P. acnes. Accessory studies suggested that the molecules were breakdown products of P. acnes and were unlikely to be responsible for the long-term in-vivo effects of the P. acnes treatment. It was also shown that monokines and lymphokines which are likely to be induced by in-vivo P. acnes treatment, i.e. IL-1, IL-2, TNF alpha, INF alpha, INF beta, INF gamma, PGE1, PGE2, PGF2 alpha and biological mediators present in Con-A and LPS-induced spleen cell supernatants (collected 20, 40, 60 or 80 h after mitogen stimulation) had no influence on T. brucei growth under axenic culture conditions over a wide range of concentrations. The studies suggest that the P. acnes effect was not due to a direct interaction of these biological mediators with the T. brucei. We suggest that the reduction in T. brucei parasitaemia in P. acnes-treated mice reflects secondary physiological effects of one or more unidentified biological mediators.

Animals↗
PubMed1979

Immune response modulation by colonization of germfree rats with Propionibacterium acnes.

Propionibacterium acnes (oral and/or parenteral administration) had a modulating effect on antibody-and cell-mediated immune responses of germfree (GF) and monoassociated (MA) rats. In conventionally reared rodents, parenteral injection of killed P. acnes stimulated the splenic plaque-forming cell response to sheep erythrocytes. However, in GF rats and in rats monoassociated with viable P. acnes, parenteral injection of killed P. acnes antigen inhibited the plaque-forming cell response to sheep erythrocytes. When compared with the responses of GF control rats, splenocytes from GF rats parenterally injected with P. acnes antigen had a decreased in vitro blastogenic response to phytohemagglutinin and concanavalin A and an increased blastogenic response to homologous bacterial antigens. Conversely, a parenteral injection of P. acnes antigen into P. acnes MA rats resulted in an increased splenocyte blastogenic response to phytohemagglutinin and concanavalin A but not to homologous (P. acnes) antigens. Thus the presence or absence of intestinal antigenic stimuli (in MA and GF rats) had a modulating effect on the immune response to a parenteral injection of P. acnes antigen.

Administration, Oral↗
PubMed1998

Oral contraceptives and cyproterone acetate in female acne treatment.

The sebaceous gland is a target of androgens, and hormonal influences play an important role in the multifactorial pathogenesis of acne. In both men and women, acne may be related to an excessive hypersensitivity of the sebaceous end organ to androgens. However, in women, the ovarian and adrenal production and the plasma transport of androgens may be implicated, particularly in late-onset or persistent acne or with associated hirsutism. Many reports have shown that females with acne frequently have abnormal levels of circulating androgens. Hormonal treatment is not usually the first line in female acne. But in relation to the possibilities, particularly the tetracyclines, this may be a choice when one prescribes a pill like Dianette to a young woman presenting a mild acne and who requests contraception. However, antiandrogen treatment is sometimes mandatory, especially in resistant acne in adult women and/or in female acne which is resistant or relapsing rapidly after treatment with Roaccutane and which is often related to hyperandrogenism. Finally, in severe prepubertal acne, the possible cause is an adrenal enzymatic block of which the only treatment is hormonal.

Acne Vulgaris↗
PubMedDate not supplied

Olanzapine may be an effective adjunctive therapy in the management of acne excoriée: a case report.

BACKGROUND: The self-inflicted dermatoses such as acne excorieé and neurotic excoriations are often chronic, recurring, and resistant to standard dermatologic therapies. OBJECTIVE: We present a 28-year-old woman with longstanding acne excorieé, whose acne started at age 14 years and was followed by acne excorieé at age 16 years. The patient reported that her acne and self-excoriative behavior were exacerbated by psychological stress. The previously treatment-resistant acne excorieé responded favorably to treatment with the atypical antipsychotic agent olanzapine. METHODS: The patient was started on olanzapine 2.5 mg at bedtime. RESULTS: After 4 weeks of therapy with olanzapine she reported a significant decline in her self-excoriative behavior which was associated with an improvement in her acne excorieé. The patient used the olanzapine 2.5 mg for 6 months, during which time she also entered psychotherapy in order to deal with some psychosocial stressors that were exacerbating her self-excoriative behavior. The patient has not experienced a recurrence in her self-excoriative behavior or acne excorieé for 4 months after discontinuing the olanzapine. CONCLUSION: Olanzapine may prove to be a useful adjunctive therapy in some self-induced dermatoses including acne excorieé.

Acne Vulgaris↗
PubMed2004

Phototherapy in the treatment of acne vulgaris: what is its role?

Acne vulgaris is a common dermatosis affecting 80% of the population. To date, different treatments have been used to manage this condition. Antibacterials and retinoids are currently the mainstay of treatment for acne, but their success rate varies. Phototherapy is emerging as an alternative option to treat acne vulgaris. Studies examining the role of different wavelengths and methods of light treatment have shown that phototherapy with visible light, specifically blue light, has a marked effect on inflammatory acne lesions and seems sufficient for the treatment of acne. In addition, the combination of blue-red light radiation seems to be superior to blue light alone, with minimal adverse effects. Photodynamic therapy has also been used, even in nodular and cystic acne, and had excellent therapeutic outcomes, although with significant adverse effects. Recently, low energy pulsed dye laser therapy has been used, and seems to be a promising alternative that would allow the simultaneous treatment of active acne and acne scarring. Further studies are needed to clarify the role of phototherapy as a monotherapy or an adjuvant treatment in the current management of acne vulgaris.

Acne Vulgaris↗
PubMed2004

Acne and its management beyond the age of 35 years.

Although acne is not usually considered to be a disorder that affects the elderly, the disorder occurs sufficiently often in mature individuals to be noteworthy. The variety known as 'persisting acne' is, as its name suggests, ordinary acne that continues into adult life. 'Chin acne' is a curious type that occurs premenstrually in mature women, while 'sporadic acne' describes the sudden development of significant acne in later life for no apparent reason. When acne develops in an individual outside the usual susceptible age group precipitating causes such as exposure to comedogenic substances or drugs must be excluded. Similarly, endocrine causes such as androgen-secreting tumors and the administration of anabolic steroids need to be considered. All inflammatory processes are decreased in the elderly and this may be one reason for the persistence and intransigence of acne lesions in older age groups. The principles of treatment of acne in the elderly do not differ from those in other age groups, although the emphasis during counseling needs to focus on explanation and reassurance rather than prognosis. Topical retinoids and benzoyl peroxide easily irritate elderly skin, so azelaic acid and even sulfur preparations are preferable. Low-dose systemic isotretinoin is reported to be helpful to patients in this age group and is certainly worth a trial.

Acne Vulgaris↗
PubMed1994

Efficacy of dry cow therapy and a Propionibacterium acnes product in herds with low somatic cell count.

Dry cow therapy and a Propionibaterium acnes product were evaluated in four commercial herds with low SCC. Cows were randomly assigned within herds to treatment groups of approximately 90 cows receiving dry cow therapy, P. acnes, dry cow therapy plus P. acnes, or no treatment in a factorial arrangement. Each lactating quarter of cows that received dry cow therapy was infused via the teat duct with 300 mg of cephaprin at drying off. Cows that received P. acnes were infused intravenously with .4 mg of killed P. acnes at drying off, 7 to 10 d prepartum, and within 7 d after calving. A second prepartum injection of P. acnes immunostimulator was administered to cows that did not calve within 10 d after the first prepartum injection. Dry cow therapy enhanced bacteriological cures of IMI by Staphylococcus aureus and Corynebacterium bovis at drying off. Dry cow therapy reduced incidence of new IMI by environmental streptococci and C. bovis that originated during the dry period. Cows treated with P. acnes alone had a greater incidence of new IMI by Gram-negative bacilli originating during the dry period than did cows in the other treatment groups. Incidence of clinical mastitis at calving was greater for cows receiving no treatment than for cows receiving dry cow therapy, P. acnes, or dry cow therapy plus P. acnes.

Adjuvants, Immunologic↗
PubMedDate not supplied

Beliefs, perceptions and psychological impact of acne vulgaris among patients in the Assir region of Saudi Arabia.

BACKGROUND: There is a paucity of reports in the literature detailing the assessment of the beliefs, perception and psychological impact of acne patients. This is the first study from Saudi Arabia designed to address this issue. MATERIALS AND METHODS: A voluntary self-completed questionnaire was used to collect data from acne patients visiting a community-based hospital in Assir region of Saudi Arabia. DATA COLLECTED, INCLUDED: patients biodata, duration and severity of the disease before the presentation, source of knowledge, psychological impact, and medication preference. The findings were compared to those of developed countries. RESULTS: 130 patients completed the questionnaires. Females were more affected than males (71.5%, 28.5% respectively). The M:F ratio was 1:2.5. Males tend to present with more severe form of the disease. Most patients had the disease for more than 1 year at presentation. Most patients sought medical advice as a self-made decision. Doctors were the most common source of information to patients. Most patients believe that hormonal imbalance and dirt were the major cause of acne while most of them believed that stress and diet were the major exacerbating factors. The most significant psychological impact in acne patients was on their self image which was severe in 49% of the patients, while the most bothering symptom was the spot of acne lesion. Most patients had used skin cleansers and creams before seeking medical advice (46.1%, 31.5% respectively). Retinoids and antibiotics were the most known prescribed medications to acne patients. Most acne patients expressed no preference of medication, but most of those who did so preferred topical medication. CONCLUSIONS: No major differences were found in the beliefs, perception and psychological impact of acne patients from a developing society compared to more developed societies. More community-based and developmental programmes are needed to upgrade the knowledge and common beliefs of acne patients.

Acne Vulgaris↗
PubMed1999

Glycolic acid peeling in the treatment of acne.

BACKGROUND: Glycolic acid chemical peels have been widely accepted as a useful modality in many cutaneous conditions characterized by abnormalities of keratinization. OBJECTIVE: The aim of this study is to evaluate the use of glycolic peels in the main clinical forms of acne. METHODS: Between January 1995 and December 1996, 80 women, aged 13-40 years, were visited for acne and selected for the study at the Cagliari University Dermatology Department (Italy). The type and severity of acne in each patient was assessed following the Leeds technique. The chemical peels were performed with a 70% glycolic acid solution, for times that varied in a range between 2 and 8 minutes. The number and frequency of the applications depended on the intensity of the clinical response. RESULTS: The main clinical forms were comedonic acne in 32 cases, papulo-pustular acne in 40 cases and nodule-cystic acne in the remaining eight cases. The most rapid improvement was observed in comedonic acne. In the papulo-pustular forms an average of six applications was necessary. Although nodular-cystic forms required eight to ten applications, a significant improvement of the coexisting post-acne superficial scarring was noted. The procedure was well tolerated and patient compliance was excellent. CONCLUSION: Glycolic acid chemical peels are an effective treatment for all types of acne, inducing rapid improvement and restoration to normal looking skin.

Acne Vulgaris↗
PubMed2002

[Induced acne].

Induced acne belongs to the clinical forms of acne. Some dermatoses present with acne-like patterns. They can be induced or perpetuated by non physiological factors. Among these factors, medicines must always be considered, taken either topically (dermocorticoids, sulfur, anti-acneic topics) or generally (androgens, oral corticoids, ACTH, anti-epileptics, anti-depressive drugs, anti-tuberculosis medications). Halogens (iodine, bromine) found in inhaled or orally taken pharmaceutical products, or associated with occupational contact, can also induce acne. Acne of exogenous origin has been described in some specific occupations, and are induced by exposure to chlorine, industrial oils, tar. Sun exposure, PUVA therapy and ionizing radiation are potentially acneigenous. Finally acne caused by cosmetics includes acne cosmetica, brilliantine and oily creams acne and detergent acne.

Acne Vulgaris↗
PubMed2003

Overall results of the BEST study following treatment of patients with mild to moderate acne.

In patients with acne, assurance of satisfaction with therapy is a significant factor in helping patients cope with their condition. Therefore, the BenzaClin (benzoyl peroxide/clindamycin topical gel) Efficacy and Satisfaction Trial (BEST) was developed to evaluate patient satisfaction following 8 weeks of treatment with benzoyl peroxide/clindamycin topical gel in patients with mild to moderate acne who were dissatisfied with their current acne therapy. Additional evaluations included efficacy, evaluated with the Global Acne Grading System (GAGS), and the impact of therapy on the social aspects of living with acne, measured with the Acne Quality of Life (AQOL) scale. Results demonstrated significant improvements for all study variables. Patient satisfaction, which was rated from 0 (not satisfied) to 10 (very satisfied) increased almost 3-fold from baseline to week 8 (P < or = .0001). The mean overall AQOL score also improved significantly by a mean of 2.2 points (P < .0001). Acne severity was reduced to almost half of its baseline value (measured using the GAGS score), indicating a significant treatment effect of benzoyl peroxide/clindamycin topical gel (P < or = .0001). Furthermore, as indicated by the Physician Global Assessment (PGA) performed at week 8, acne improved in 94% of patients. Improved patient satisfaction was most likely related to the significant improvements in both efficacy and quality of life (QOL). Overall results of the study suggest that benzoyl peroxide/ clindamycin topical gel is effective for the treatment of acne in patients who are dissatisfied with their current therapy.

Acne Vulgaris↗
PubMed2003

The effective treatment of acne vulgaris by a high-intensity, narrow band 405-420 nm light source.

BACKGROUND: Available topical treatments are slow and frequently irritating. Oral therapies may be associated with increased bacterial resistance (antibiotics) or possible severe side effects (oral isotretinoin). In vitro and in vivo exposure of acne bacteria to 405-420 nm ultraviolet (UV) free blue light results in the photo-destruction of these bacteria through the effects on the porphyrins produced naturally by Propionibacterium acnes. A novel, high-intensity, narrow band 420 nm UV free blue light has been shown to decrease inflammatory acne lesions after eight bi-weekly treatments. OBJECTIVES: To examine the effects of high-intensity, narrow band 420 nm UV free blue light (ClearLight) on inflammatory acne lesions. METHODS: Three studies were carried out to examine the clinical effects of high-intensity, narrow band blue light on papulo-pustular acne: the split-face dose-response study, the full-face open trial and the split-face, double-blind controlled study. The studies enrolled 10, 13 and 23 patients respectively. RESULTS: The data show more than an 80% response to 420 nm acne phototherapy with a significant reduction of 59-67% of inflammatory acne lesions after only eight treatments of 8-15 minutes. The reduction in lesions was steady in the follow-ups at 2, 4 and 8 weeks after the end of therapy. Prolonged remission was evident in the 8 weeks after the end of therapy. No adverse effects or patient discomfort were noted in any of the patients. CONCLUSIONS: Acne phototherapy by high intensity, narrow band 405-420 nm light is proven to be an attractive, fast, effective, non-invasive alternative to current topical and parenteral anti-acne remedies.

Acne Vulgaris↗
PubMed2003

Presentation and management of acne in primary care: a retrospective cohort study.

BACKGROUND: Acne is the most common skin disorder in young people, affecting up to 80% of teenagers. AIMS: To ascertain the incidence, prevalence, demographic distribution and severity of acne in primary care and to document the management of these patients for a two-year period after presentation. DESIGN OF STUDY: Retrospective cohort study using data from the medical records of 798 patients who had been treated for acne during a one-year identification period. SETTING: Fourteen general practices in a mixed urban area in north-east England. METHOD: Patients aged 13 to 25 years who had acne were identified from computerised practice medical records using diagnostic codes and medication records. The medical records of these patients were then hand-searched for data for two years after presentation. RESULTS: Data were collected for 798 patients from 14 practices. The prevalence of acne in 13- to 25-year-olds was 3.1%, and the incidence was 1.6%. The ratio of male to female patients with acne was 1:1.02. Median age at presentation was 15 years for male subjects and 16 years for female subjects. Recording of site and severity was rare (18.3%). In total, 55% of patients had two or more different prescriptions for acne, 21% of patients had six or more consultations during the two-year follow-up period, and 8.5% were referred to a dermatologist. CONCLUSION: Given previous estimates of community prevalence, it is clear that the majority of young people with acne do not present to primary care. These findings have implications for the provision of effective and appropriate health care for young people with acne.

Acne Vulgaris↗
PubMed2003

Pulmonary granulomas caused experimentally in mice by a recombinant trigger-factor protein of Propionibacterium acnes.

Etiology of sarcoidosis remains unknown. A trigger factor from Propionibacterium acnes causes a cellular immune response in some sarcoid patients but not in nonsarcoid subjects. We examined whether experimentally induced hypersensitivity to the trigger factor gives rise to granulomas. Female C57BL/6 mice primed intravenously with P. acnes or not were sensitized with recombinant-protein RP35, a fragment of P. acnes trigger factor, and complete Freund's adjuvant. In controls, RP35 was replaced with P. acnes or one of two control proteins. In primed and unprimed mice, pulmonary granulomas were found in some of the mice sensitized with RP35 or P. acnes but in no control-protein-sensitized mice. Detection of pulmonary granulomas (25-57%) did not differ significantly between mice sensitized with RP35 or P. acnes, primed or not. No difference in popliteal lymph-node-cell reactivity and serum antibodies to these two antigens was found between mice with and without pulmonary granulomas. P. acnes was cultured from the lungs of 8 (33%) of 24 untreated mice. The recombinant trigger-factor protein of P. acnes caused pulmonary granulomas in primed and unprimed mice sensitized with the protein and adjuvant. Sarcoid granulomas may form during hypersensitivity to antigens of P. acnes indigenous to the affected organ.

Animals↗
PubMed2005

Propionibacterium acnes is the most common bacterium commensal in peripheral lung tissue and mediastinal lymph nodes from subjects without sarcoidosis.

BACKGROUND: In studies of the unknown etiology of sarcoidosis, Propionibacterium acnes (a possible agent) was found in the lungs and lymph nodes of many sarcoidosis patients and some control subjects. P. acnes might be commensal not only to the skin, conjunctivae, and intestine, but also to the lungs and lymph nodes of individuals without sarcoidosis. METHODS: We cultured peripheral lung tissue and various lymph nodes obtained from patients with diseases other than sarcoidosis. DNA of 45 isolates of P. acnes from these patients, 67 isolates from normal skin, conjunctiva, and intestine, and 39 isolates from sarcoid lymph nodes were compared by random amplified polymorphic DNA analysis. RESULTS: P. acnes was isolated from half of 43 lungs and 8 of 11 mediastinal lymph nodes, mostly in pure culture. P. acnes was isolated from half of 20 gastric and 3 of 12 intestinal lymph nodes; intestinal bacteria were also numerous. In general, fewer than 500 colony-forming units of P. acnes per gram tissue were isolated, but 4 lung tissue specimens, 2 of which had a few granulomas, had many more. P. acnes strains from a particular site (lung, lymph node, skin or conjunctivae, and intestine) were genetically similar, more than isolates obtained from different sites. Lymph-node isolates from subjects with and without sarcoidosis differed little. CONCLUSION: These results suggest that P. acnes normally resides in peripheral lung tissue and mediastinal lymph nodes and that the strains of P. acnes isolated from sarcoid lymph nodes were not specific to sarcoidosis.

Adult↗
PubMed2006

Effects of biphasic oral contraceptives containing desogestrel (Oilezz) on cycle control facial acne and seborrhea in healthy Thai women.

OBJECTIVE: To demonstrate the effects of a new biphasic oral contraceptive (Oilezz) on cycle control as well as mild to moderate acne and facial seborrhea of healthy fertile Thai women. MATERIAL AND METHOD: The trial is a prospective, open, non-comparative, single center study. Fifty healthy, fertile Thai women with mild to moderate facial acne were recruited to study a specific drug (Oilezz) for 6 months. RESULTS: At the beginning, 66% of the subjects had mild acne and 34% had moderate acne. Significant improvements in facial seborrhea grades (as indicated by Sebutape assessments) were found after the first cycle. These improvements increased steadily and were much larger after the sixth cycle. There were no statistically significant changes in body weight or blood pressure during the study. No serious adverse events were reported. There were no mood changes, migraine, rash, abdominal discomfort, malaise, nausea and decrease in libido during the study period The premenstrual symptoms at initiation were 21 cases (42%). The symptoms were 4 (8%) with headache, 8 (16%) with breast tenderness, 5 (10%) with dysmenorrhea and one (2%) with bleeding irregularity. These symptoms were improved in the third and the sixth cycles. The percentage of women with spotting or bleeding increased after first cycle, compared with baseline and gradually decreased during subsequent cycles. After the sixth cycle of treatment, all subjects had improvement of acne. 80% of cases recovered from acne and there were only 20% had mild acne. CONCLUSION: Facial seborrhea and acne improved significantly with Oilezz. It is good to control cycle without change in body weight and blood pressure. Therefore, Oilezz can be used for treatment of seborrhea and acne and as a contraceptive.

Acne Vulgaris↗
PubMed2006

The effect of a daily facial cleanser for normal to oily skin on the skin barrier of subjects with acne.

Acne vulgaris is a common skin disorder that affects many people every year, especially the teenaged population. People with acne find the condition especially difficult to manage because of the disease's chronicity and variability in response to treatment. Acne is the result of pores clogged with shed skin cells combined with sebum in the hair follicle. Successful treatment of acne is important because acne has the potential to result in lasting physical and emotional scarring. For many years, physicians have agreed that although cleansing is not effective on its own, effective cleansing is an important part of any acne treatment regimen. However, patients have not been satisfied with the types of cleansers available. In addition to containing dyes and perfumes that can irritate and exacerbate acne, these cleansers often are too harsh and can result in excessive drying of the skin, which leads to overcompensation by the oil glands and ultimately to more oil on the surface of the skin. This study examined the use of a daily facial cleanser formulated for normal to oily skin in subjects with mild facial acne. The cleanser was studied for 2 weeks in the absence of additional treatments to eliminate the confounding effects of various treatments. Subjects were monitored for skin barrier function through transepidermal water loss (TEWL) and corneometry, sebum level, and lesion counts. The results of the study indicate that the facial cleanser is gentle and does not damage the skin barrier or result in sebum overcompensation; additionally, the cleanser is effective at deep-pore cleansing, which may help to manage some acne-associated symptoms.

Acne Vulgaris↗