Acne Drug Research Articles

Topical Tretinoin in the Management of Thick-skinned Rhinoplasty Patients.

Despite the increasing popularity of cosmetic surgeries, some patients still experience skin problems, particularly those with thick nasal skin. Isotretinoin is a commonly used drug for severe acne, and its effects on rhinoplasty aesthetic results have recently been studied. This placebo-controlled clinical trial aimed to investigate the effects of topical tretinoin gel on the cosmetic outcomes of rhinoplasty in patients with thick nasal skin. Forty-nine individuals were randomly allocated to either the treatment group or the control group in Mashhad, Iran from 2019 to 2021. The treatment group received topical tretinoin gel (0.05%) beginning on the 31st postoperative day and continued for six months, while the control group received a usual dermatological recommendation as a placebo. Patients were assessed during the first, third, and sixth months after the intervention, and their cosmetic results were evaluated by an expert surgeon and dermatologist. There were no significant differences in baseline features between the two groups. The median score given by the surgeon was not significantly different between the groups. However, the median score given by the dermatologist was significantly higher in the treatment group during the first, third, and sixth months (P<0.001). Patient satisfaction scores were also significantly higher in the treatment group during the third and sixth months compared to the control group. (P=0.02 and 0.01, respectively). Topical tretinoin gel could effectively reduce acne in patients with thick nasal skin after rhinoplasty and increase patient satisfaction in the early months following surgery. However, it did not significantly affect final cosmetic outcomes.

Detection of Secondary Metabolites in Cucumber (Cucumis sativus) Leaves and Its Potential as Candidates for Acne Drug Using Histochemical Analysis and In Silico Study

&lt;p&gt;Acne is a facial skin problem that is generally experienced by 75-80% of adolescents as a result of excessive production of oil glands and sweat, inflammatory mediators. The acnecausing bacteria, Propionibacterium acnes, involves KAS III and JNK 1 proteins, so it is expected to be an effective anti-inflammatory and antibacterial strategy. Cucumber leaves are known to have biological activity as a candidate for acne medication. This study aims to detect secondary metabolites in cucumber leaves through histochemical and in silico analysis. Histochemical analysis was carried out by preparing fresh leaves through lower leaf incisions by dropping secondary metabolite detection reagents and then observing the color changes microscopically. The in silico test aims to determine the physicochemical properties, pharmacokinetic properties and interactions of the active compounds with KAS III and JNK1 as acne drug targets through molecular docking. Histochemical analysis showed that cucumber leaves positively contained secondary metabolites, namely terpenoids, flavonoids, alkaloids, tannins, and phenols. Meanwhile, it was known that isovitexin, cucurbitacin B &amp;amp; C had fairly good physicochemical properties, but only isovitexin and cucurbitacin C had the best pharmacokinetic properties. Based on the results of molecular docking, there are the same amino acid bonds between isovitexin and the control at the JNK1 receptor, namely the amino acids Ile:32, Val:40 and Leu:168 and the binding affinity value is low so it is predicted to be the most effective in inhibiting JNK1. Therefore, cucumber leaves open up a new potential as a candidate for natural acne preparations.&lt;/p&gt;&lt;p class="Abstract"&gt;&lt;em&gt;Keywords: acne&lt;/em&gt;&lt;em&gt;, cucumber&lt;/em&gt;&lt;em&gt;,&lt;/em&gt;&lt;em&gt; &lt;/em&gt;secondary metabolites,&lt;em&gt; histochemical, in silico&lt;/em&gt;&lt;/p&gt;

A population-based study on the common androgenic symptoms in PCOS and its management

The aim of this population-based study is to comprehensively investigate the prevalence, severity, and management of common androgenic symptoms in individuals with Polycystic Ovary Syndrome (PCOS). By analyzing a diverse population sample, this study aims to provide valuable insights into the understanding and effective management of androgenic symptoms associated with PCOS. In the endocrine disorder known a PCOS, the ovaries produce an excessive number of androgens, which are male sex hormones that are typically present in women in modest amounts. The disorder known as polycystic ovarian syndrome is characterized by an abundance of small cysts (fluid-filled sacs) produced by the ovaries. Google forms-based survey data was gathered to better understand recent trends among female patients. In order to understand the pattern of androgenic symptoms in PCOS patients, the obtained replies were examined and analyzed. According to this study, hirsutism, alopecia, and acne are the most typical androgenic symptoms experienced by women. Common treatments for these symptoms include taking biotin supplements, applying minoxidil topically for alopecia, and utilizing over-the-counter acne drugs such benzoyl peroxide and salicylic acid. Additionally, drugs that reduce testosterone are used to treat hirsutism. These results underline how crucial it is to identify and treat androgenic symptoms in women because they can significantly affect both physical appearance and general wellbeing.

Anti-acne activity of carnitine salicylate and magnolol through the regulation of exfoliation, lipogenesis, bacterial growth and inflammation.

Salicylic acid has been used as an anti-acne agent with its comedolytic property and antimicrobial activity. However, there is a limit to use for leave-on cosmetics because of the transient skin irritation and low efficacy at neutral pH condition. We prepared a salicylic acid-based ionic pair with L -carnitine (we named, IP-BHA) overcoming the limitation of salicylic acid. We examined the effect of IP-BHA as well as the combination effect with magnolol, a bioactive organic lignan, in order to clarify their efficacy as anti-acne agents. After verifying the structure of IP-BHA, we confirmed anti-acne activities including the regulation of exfoliation, lipogenesis, bacterial growth, and inflammation with IP-BHA and/or magnolol. The antibacterial activity of IP-BHA and magnolol was evaluated by determining the minimum antibacterial inhibitory concentration. Magnolol showed strong activity against Cutibacterium acnes, which was better than a medical antibiotic acne drug, clindamycin. The combined application with IP-BHA was more effective in antibacterial activity by 2.5 times. It was confirmed that testosterone-induced lipogenesis was significantly inhibited by treatment with IP-BHA and magnolol, while single treatment had no significant inhibitory effect. Interestingly, MMP-1 and VEGF were induced by C. acnes lysate in human keratinocytes. We found that these inflammatory molecules were completely inhibited by combined application of IP-BHA and magnolol. Through ex vivo test, the dose-dependent exfoliation effect of IP-BHA was confirmed at pH 5.5, and the synergic exfoliation effect was shown in the combined application of IP-BHA and magnolol. When topically applied, the emulsion containing IP-BHA and magnolol relieved the sodium dodecyl sulfate-induced erythema and improved inflamed acne with papule and pustule. Our data demonstrate that the ionic paired salicylic acid with L -carnitine can overcome the limitations of salicylic acid at low concentration and natural skin pH. Based on the dual administration effects, we suggest that IP-BHA and magnolol may be the potential agent for acne by improving inflammatory skin condition.

Prescribing Trends for Acne Vulgaris Visits in the United States.

Acne vulgaris is the most common reason for pediatric patients and third most common reason for adult patients to seek care from a dermatologist in the US. However, referring providers may be reluctant to initiate patients on acne treatment or certain prescriptions. We assessed over-the-counter (OTC) and prescription acne (antibiotic and non-antibiotic) treatment rates to characterize differences by patient demographics and provider specialty. The National Ambulatory Medical Care Survey (NAMCS) was analyzed for all acne therapies prescribed for at least 10 unweighted visits between 1993 and 2016 (most recent years available). Prescription rates varied by age, with younger patients more likely to receive a prescription; insurance status, with privately insured patients more likely to receive a prescription; and across and within specialties, with dermatologists more likely to recommend a prescription medication than family medicine and pediatric providers. Among all forms of antibiotics for acne vulgaris, oral minocycline was the most commonly prescribed antibiotic by dermatologists, followed by oral doxycycline. Oral minocycline was also the most common antibiotic prescribed by family physicians, followed by oral doxycycline and oral clindamycin, respectively. Pediatricians appeared to be less likely to prescribe oral antibiotics for acne. The OTC topical antimicrobial benzoyl peroxide was the most utilized drug for acne among pediatricians, and it was also the most commonly recommended OTC drug for acne among dermatologists, family physicians, and pediatricians.

13‑cis‑retinoic acid inhibits the self‑renewal, migration, invasion and adhesion of cholangiocarcinoma cells.

13‑cis‑retinoic acid (13CRA), a Food and Drug Administration‑approved drug for severe acne, is currently being investigated for its potential use in skin cancer prevention. 13CRA has been reported to exhibit antitumor effects against various types of cancer cells, both invitro and invivo. However, to the best of our knowledge, no information is yet available regarding the effects of 13CRA on cholangiocarcinoma (CCA), a malignancy of the bile duct epithelia. Currently, there are no reliably effective therapeutic options for metastatic CCA. The present study thus aimed to evaluate the effects of 13CRA on the self‑renewal, migration, invasion and adhesion of CCA cells, and also investigated the underlying mechanisms. The results revealed that 13CRA suppressed cell proliferation via the inhibition of the self‑renewal ability of CCA cells. 13CRA induced cell cycle arrest at the G2/M phase in KKU‑100 and KKU‑213B CCA cells through the regulation of cell cycle‑regulatory genes and proteins. 13CRA reduced the cell migratory ability of both cell lines via the modulation of the genes and proteins associated with epithelial‑mesenchymal transition. 13CRA also inhibited the invasive and adhesive abilities of CCA cells via the suppression of genes and proteins associated with the invasion and adhesion of CCA cells. On the whole, these results suggested that 13CRA exerts suppressive effects on CCA cell proliferation, migration, adhesion and invasion.

Acne vulgaris: navigating the National Institute for Health and Care Excellence recommendations for specialist referral, patient expectations and the isotretinoin product licence.

Oral isotretinoin is a highly effective drug for severe acne but with ongoing serious safety concerns and we are cautiously reminded by the Medicines and Healthcare products Regulatory Authority to prescribe this drug within licence. We review the National Institute for Health and Care Excellence recommendations for considering referral of acne to specialist care and propose some improvements. This may help manage patient expectations of treatment, ensure only appropriate patients are seen in secondary care and help prescribers remain within the isotretinoin product licence.

Long-Term Use of Silybum marianum fruit extract Contributes to Homeostasis in Acne-Prone Skin-A 12-Month Follow-Up International "Real Life" Cohort Study.

Homeostasis in the differentiation programme of sebaceous stem cells has been identified as a key step in comedogenesis and should be a target for acne-prone skin care. To report on a multicentre, year-long/real-life use study of a patented natural product containing S. marianum fruit extract proven to modulate molecular actors in the initial steps of comedogenesis. An open-label multicentric international study, with a 12 month follow-up, included 54 teenage and young adult subjects with mild to moderate facial acne. The study was aimed at reproducing a real-life use context. Total lesion count mean was 88.3 at inclusion. There was a sustained, highly significant decrease over the months of clinical lesion counts (45.6% improvement after 6 months and 59.6% at 12 months) and on other efficacy markers, associated with a significant decrease in global microcomedone quantity on cyanoacrylate superficial skin surface biopsies. Importantly, the study protocol allowed the dermatologist to prescribe, if needed as in real life, any of the acne drugs registered in the acne guidelines. The exposure to these acne drugs during the whole year was calculated as a percentage of S. marianum fruit extract/352 days of use and happened to be very limited at less than 4%, which indicates a marginal contribution to the sustained clinical improvement. (Oral and local acne treatments: Lymecycline 1.46%; Doxycycline 0.24%; Adapalene 0.16% or gel association with Benzoyl peroxide 1.17%; Clindamycin 0.04%; Benzoyl peroxide 1.5%; Erythromycin 0.75%). The tolerance with daily S. marianum fruit extract long-term use was good. The association with routine prescription acne drugs when needed, even if limited, does not allow a full evaluation of the intrinsic quantitative efficacy of S. marianum fruit extract in lesion reduction. This open, real-life, year-long multicentre study confirms a previous 48-week proof of concept study and qualifies the use of S. marianum fruit extract as a "field-dermo cosmetic" contributing to homeostasis of acne-prone skin in association with acne drugs.

694 DRUG INDUCED KIDNEY INFARCTION: A CASE REPORT

Abstract Isotretinoin (ISO) is a synthetic analog of vitamin A. Notwithstanding the well-known long-term efficacy in the treatment of severe resistant cystic acne, ISO induces several side effects too. Dyslipidemia, increased liver enzymes, as well as reduction of biotidinase have been already reported [1]. Homocysteine (HCY), a sulfur-containing amino acid, is recycled into methionine by a transmethylation reaction requiring folate and vitamin B12. Given that during ISO treatment elevated liver enzymes (SGOT, SGPT) are often observed, it has been hypothesized that iatrogenic liver dysfunction could affect cystathionine-b-synthase, an enzyme involved in HCY metabolism, [2]. Several studies have highlighted that elevated plasma HCY concentrations are associated with an increased risk of premature occlusive vascular disease. We hereby report a case of drug-induced kidney infarction after ISO therapy. A previously healthy 18-year-old male, on therapy with 40 mg/die isotretinoin for acne, was admitted to the Emergency Unit for abdominal pain, nausea and vomiting and dyspnea. A trans-thoracic echocardiogram showed dilated and hypocontractile left ventricle. During the hospitalization he had a total body CT that showed the presence of an ischemic lesion on left kidney without other pathological findings. He started therapy with 12 IU/kg UFH as soon as a surgical emergency was excluded. Subsequently, he underwent a coronary angiogram that resulted unremarkable. Cardiac MRI showed extensive delayed gadolinium late enhancement with intramural linear pattern. In the hypothesis of drug-induced vasculitis, an extensive serological testing was performed. Elevation of serum liver enzymes (SGOT, SGPT), CRP, LDH was found. Mutations on MTHFR gene and Leiden Factor were not detected, neither alteration in coagulation parameters. Finally the dosage of plasmatic HCY resulted over the range of normality and ISO was discontinued. The patient was discharged on optimized medical therapy for heart failure. He is currently managed as outpatient. HCY levels could be found elevated in patients with ischemic events during ISO treatment. Given the widespread use of this drug for acne, it could be reasonable to dose HCY in patients with suspected liver dysfunction. Physicians should be aware of this scenario and should act swiftly to avoid uneventful outcomes. [1] Schulpis KH et al. Elevated plasma homocysteine levels in patients on isotretinoin therapy for cystic acne. Int J Dermatol. 2001 Jan;40(1):33-6. [2] Polat M, et al. Plasma homocysteine level is elevated in patients on isotretinoin therapy for cystic acne: a prospective controlled study. J Dermatolog Treat. 2008;19(4):229-32.

Role of dermatocosmetics in treatment strategy for acne patients

In accordance with clinical recommendations for acne of any severity, gentle cleansing and moisturizing is recommended using specialized dermatocosmetics that restore the barrier properties of the skin, have an anti-inflammatory effect and do not contain skin-irritating components, as well as comedogenic substances. Gentle skin care should also accompany any topical and systemic acne drug therapy. At the same time, over-the-counter (OTC) skin care products, such as non-comedogenic cleansers and moisturizers, have been successful in both the monotherapy of mild acne and as maintenance therapy. The range of Normaderm dermatocosmetics (Vichy Laboratoires) is specially designed to meet the needs of oily acne prone skin. The composition of Normaderm products includes various active substances that allow solving certain problems with acne by influencing various links in the pathogenesis of the disease. In this article, we provide clinical examples of the use of specialized Vichy Normaderm cosmetics in patients with acne in various clinical situations.

Azadirachta indica Hexane Extract: Potent Antibacterial Activity Against Propionibacterium acne and Identification of its Chemicals Content

Background: Acne is a skin surface disease that appears when the excessive fat deposits clogged the skin pores, causes the growth of acne-causing bacteria and stimulates inflammation. Propionibacterium acnes is one of common acne-causing bacteria which usually manage by synthetic chemical-based drug. However, the presence of its long- used side effects pointed the urgent need of new anti P. acne drug discovery. Azadirachta indica is a medicinal plant which empirically used as antibacterial. A. indica leaves has been reported to exhibit activity against P. acne but limited to ethanol extract. Thus, the evaluation of other extract- and identification of active compound(s) against P. acne is needed to be explore. Methods: First, the microscopic morphology of A. indica leaves were observed using Scanning Electron Microscope. The leaves were then extracted sequentially by hexane, ethyl acetate, and methanol solvent using the ultrasonic assisted extraction method, followed by its in vitro anti- P. acne activity evaluation. The most active extract was further evaluated for its chemical(s) content by LC-MS. Results: Scanning Electron Microscope identified the presence of oxalate in the leaves of A. indica. Evaluation of the anti-P. acne activity showed that the hexane extract had highest anti-P. acne compared to others. Further chemical identification showed that hexane extract contains three steroids, one saturated acids and one phenolic compounds. Conclusions: A. indica hexane extract leaf is prospective to be developed as an acne antibacterial.

PCR83 Acne Drug Therapy and the Development of Major Depressive Disorder in Patients with Acne

Although patients with acne carry an increased risk of developing major depressive disorder (MDD), the association between acne treatments and depression remains unclear. In particular, no adequate evidence exists to support the relationship between isotretinoin and depression. The objective of this study is to examine the association between acne drugs, especially isotretinoin, and the development of MDD among acne patients.

Skin microbiome reconstruction and lipid metabolism profile alteration reveal the treatment mechanism of Cryptotanshinone in the acne rat

BackgroundAcne has become one of the most prevalent skin disorders, affecting mostly young people's physical and mental health globally. Cryptotanshinone (CPT) is a potential drug for acne, but its mechanism of acne treatment has not been thoroughly studied on the microbiota. Till date, only a few studies are directed to the impact of acne therapy on skin microbiota and lipid metabolites. PurposeThe action mechanism of CPT treatment of acne was investigated by the strategy of microbiome integration with lipidomics. MethodsThe 16Sr DNA sequencing was used to detect skin microbiota composition, and absolute quantitative lipidomics was utilized to identify lipid metabolites profiles levels. Four key proteins of the glycolysis pathway were detected with the immunochemistry method. Antibacterial analysis was used to evaluate CPT treatment of acne. ResultsCPT significantly inhibited Staphylococcus epidermidis and Staphylococcus aureus. Combination of the skin microbiome and lipidomics analysis, 29 types of differentially expressed flora (DEFs) and 782 differentially expressed lipid metabolites (DELMs) were significantly altered, especially Staphylococcus, Corynebacterium, Ralstonia, Enhydrobacter, Burkholderia, and Streptococcus. Cer was mainly regulated by Staphylococcus and Corynebacterium, whereas TG and DG were mainly regulated by Ralstonia, Enhydrobacter, Burkholderia, and Streptococcus. The glycolysis pathway was significantly regulated by Staphylococcus on CPT treatment of acne. The energy metabolism, lipid metabolism, immune system, glycan biosynthesis, and metabolism could be reversed by CPT. ConclusionCPT might help acne rats rebuild their skin microbiota and alter lipid metabolism signatures. Furthermore, since skin microbes and skin lipid metabolites have a close correlation and are both regulated by CPT, the findings potentially provide a research foundation for the discovery of biomarkers of skin microbiome imbalance and targeted treatment of acne development mechanisms.

Retinoids are not linked to risk of multiple sclerosis: A Danish nationwide cohort study.

Multiple sclerosis (MS) is a chronic immune-mediated disease of the central nervous system with an undetermined etiology. Retinoids may have immunomodulatory effects that favorably influence MS progression. We aimed to explore the yet unknown relationship between exposure to retinoids and the risk of acquiring MS. We performed a nationwide cohort study in the Danish population in the period 1998-2016, comparing MS incidence in three groups: users of systemic retinoids; users of topical retinoids (negative control group); and users of non-retinoid acne drugs (control group). We used data from the Danish Multiple Sclerosis Registry (DMSR), the Danish National Prescription Registry and the Danish National Patient Registry. Linkage was obtained through the personal identification number (CPR number). We addressed confounding by three-way propensity score (PS)-matching weights. Additionally, to evaluate a cumulative dose-response effect for systemic retinoids on MS incidence, we conducted a case-control study, nested within the cohort. A total of 257,193 users of non-retinoid acne drugs, 130,560 users of topical retinoids, and 75,610 users of systemic retinoids were included. Systemic retinoid use was not associated with a reduced risk of MS compared to non-retinoid acne drug use in crude (hazard ratio [HR] 0.80, 95% confidence interval [CI] 0.61 to 1.05]) and weighted analyses (HR 0.89, 95% CI 0.67 to 1.20). There was no evidence of a cumulative dose-response association between systemic retinoids and MS incidence. Use of systemic retinoids was not associated with a reduced incidence of MS compared to use of non-retinoid acne drugs in this study.

EFEKTIVITAS GEL EKSTRAK ETANOL BAWANG PUTIH (Allium sativum L.) TERHADAP BAKTERI Staphylococcus aureus

Garlic (Allium sativum L.) is one of the traditional medicines which has an antibacterial efficacy compound namely Allisin which is able to inhibit the growth of Staphylococcus aureus bacteria. This study aims to formulate the garlic bulb extract into a good gel preparation for use as an acne drug and to determine the antibacterial effectiveness of the ethanol extract of garlic gel against the bacterium Staphylococcus aureus using the wells method. The gel evaluation was carried out to meet the requirements with organoleptic test parameters, homogeneity, pH, spreadability, adhesion and irritation test. This study uses extracts of 10% and 20% concentrations, at each concentration being able to inhibit the growth of Staphylococcus aureus bacteria. In the formula, the concentration of 20% has a inhibition zone diameter of 1.59 cm and a concentration of 10% has a inhibition of 1.50 cm. Statistical test results using the One Way ANOVA test found that there was no significant difference between the average diameter of inhibition of garlic extract gel concentration of 10% with a concentration of 20%.

In vitro Antimicrobial Activity of Acne Drugs Against Skin-Associated Bacteria

Acne is a common skin affliction that involves excess sebum production and modified lipid composition, duct blockage, colonization by bacteria, and inflammation. Acne drugs target one or more of these steps, with antibiotics commonly used to treat the microbial infection for moderate to severe cases. Whilst a number of other acne therapies are purported to possess antimicrobial activity, this has been poorly documented in many cases. We conducted a comparative analysis of the activity of common topical acne drugs against the principal etiological agent associated with acne: the aerotolerant anaerobic Gram-positive organism Propionibacterium acnes (recently renamed as Cutibacterium acnes). We also assessed their impact on other bacteria that could also be affected by topical treatments, including both antibiotic-sensitive and antibiotic-resistant strains, using broth microdilution assay conditions. Drugs designated specifically as antibiotics had the greatest potency, but lost activity against resistant strains. The non-antibiotic acne agents did possess widespread antimicrobial activity, including against resistant strains, but at substantially higher concentrations. Hence, the antimicrobial activity of non-antibiotic acne agents may provide protection against a background of increased drug-resistant bacteria.

Evaluation of sequential effect of isotretinoin on the haematological parameters in patients with acne vulgaris

Purpose: Isotretinoin is the most effective drug for acne with some side effects. Few studies exist regarding the effects of isotretinoin on haematological parameters with different results. Mostly, baseline values with a single value during or at the end of the treatment were compared. In this study, we aimed to determine the differences in haematological parameters during isotretinoin treatment until reaching the cumulative dose of 120 mg/kg.Materials and methods: The study included 118 patients with moderate-to-severe acne vulgaris. Patients with preexisting liver disease, anaemia, iron deficiency, abnormal liver function tests, thrombocytopenia/thrombocytosis or hyperlipidaemia were excluded. Laboratory monitoring for haematological parameters was performed at baseline and monthly during treatment. Parameters at the baseline, at the first and second months and at the end of the therapy were taken into account.Results: According to general linear model analysis, platelets and plateletcrit increased at the first month of the treatment and then decreased to baseline. White blood cells and neutrophils decreased at the first month, then increased to baseline value at the second month, and were found to be decreased again at the end of the treatment. Mean corpuscle volume was found to be increased at the end of the treatment. Other parameters in CBC did not show statistically significant differences.Conclusions: Although some changes occur in haematological parameters during isotretinoin therapy, all of these changes remain within the normal range. Evaluating the spot values at any time during treatment may cause misinterpretations.

Acne Fulminans: Treatment Experience from 26 Patients

Background /Aim: Acne fulminans is a rare form of acne vulgaris with acute clinical deterioration including systemic signs. Etiopathogenesis and management remain largely unknown. Our aim is to assess the efficacy of a combined therapeutic regimen of systemic isotretinoin and prednisolone following the recent concepts of acne pathogenesis and drug kinetics. Methods: A prospective case series was recruited over 15 years. Isotretinoin 0.5 mg/kg bw/d (0.25-0-0.25) and prednisolone 30 mg/d (10-10-10) were administered concomitantly with prednisolone being tapered after that time. The overall efficacy was evaluated at month 1 and every month thereafter. Daily drug doses were split to reduce the risk for adverse effects. Results: 26 patients (20 male, 77%) at a mean age of 19 years and a history of acne vulgaris of 3.2 years presented acutely necrotic and ulcerating skin papules (100%), fever (45%), arthralgia (38.5%), leukocytosis (88.5%) and elevated erythrocyte sedimentation rate (100%). After one month of treatment resolution of systemic signs was achieved in all patients and a >50% skin lesion improvement in 17 patients (65%). Conclusion: The concomitant administration of isotretinoin (0.5 mg/kg bw/d, 0.25-0-0.25) and prednisolone 30 mg/d (10-10-10) is able to resolve systemic signs and markedly improve skin lesions in 65% of the patients at one month.

Psychiatric disorders, acne and systemic retinoids: comparison of risks

ABSTRACTBackground: The link between isotretinoin, treatment of a severe form of acne, and psychiatric disorders remains controversial, as acne itself could explain the occurrence of psychiatric disorders. This study aims at assessing the disproportionality of psychiatric adverse events reported with isotretinoin in the French National PharmacoVigilance Database, compared with other systemic acne treatments and systemic retinoids.Materials and methods: Data were extracted from the French National PharmacoVigilance Database for systemic acne treatments, systemic retinoids and drugs used as comparators. Each report was subjected to double-blind analysis by two psychiatric experts. A disproportionality analysis was performed, calculating the number of psychiatric ADRs divided by the total number of notifications for each drug of interest.Results: Concerning acne systemic treatments: all 71 reports of severe psychiatric disorders involved isotretinoin, the highest proportion of mild/moderate psychiatric adverse events was reported with isotretinoin (14.1%). Among systemic retinoids, the highest proportion of severe and mild/moderate psychiatric events occurred with isotretinoin and alitretinoin.Conclusion: Our study raises the hypothesis that psychiatric disorders associated with isotretinoin are related to a class effect of retinoids, as a signal emerges for alitretinoin. Complementary studies are necessary to estimate the risk and further determine at-risk populations.

Acne drug offers hope for relapsing-remitting multiple sclerosis

Acne drug offers hope for relapsing-remitting multiple sclerosis