Acne Group Research Articles

DEMODEX INFESTATION IN ACNE VULGARIS

Introduction: Acne is a very common skin disease in adolescents and young adults, but it also affects adults. However, its aetiology is not yet fully understood. Demodex mites are found on the skin of healthy people and patients with skin disorders Some reports indicate the association between acne vulgaris and demodicosis.
 Objectives: To investigate the Demodex infestation rate in acne patients and to analyze the relationship between Demodex infestation with some characteristics of the disease: age, gender, duration time of disease, clinical types of acne, severity of acne and GAGS score. 
 Material and methods: Case control study on an acne group of 40 acne patients and an age-sex matched healthy control group comprising 31 individuals at HCMC Hospital of Dermato - venereology. Dermatological examinations were performed and a direct microscopic examination was used to determine the presence of Demodex mites.
 Results: The median age was 22.5 (inter-quartile range 20.25 – 25), acne affected women than men (72.5% versus 22.5%). The median age of onset was 19,5 (inter-quartile range 16-23). Demodex infestation was seen in 7 (17.5%) patients in the acne group and 0 (0%) in the control group; this difference was statistically significant (p < 0.05) (OR =1.212; 95% CI: 1.051- 1.398) (p=0.015). Pain was related to Demodex positivity (OR=8.333 95% CI=1.906- 36.44), (p=0.003).
 Conclusions: The findings of our study emphasize that acne vulgaris is significantly associated with Demodex infestation. Demodex infestation should be considered when the classical therapies are ineffective especially in cases of post adolescent acne.

Incretin serum level as a biomarker of insulin resistance in acne vulgaris patients.

To investigate the relationship between serum Incretin and acne vulgaris (AV) and insulin resistance (IR), and to find the biological indicators of acne vulgaris with insulin resistance. 60 patients diagnosed with acne vulgaris in the dermatology department of Zagazig University and 56 healthy people in the health examination center of this hospital were collected, respectively, as the control group; all the included people were drawn fasting blood to test serum Incretin, blood lipids, sex hormones and INS release test to explore the role of serum Incretin in acne vulgaris and insulin resistance. The average level of Incretin in the acne group was lower than that in the control group, and the difference was statistically significant (t=7.189, p<0.001). The average level of Incretin in the acne group with insulin resistance was lower than that in the acne without insulin resistance group, the difference was statistically significant (t=22.328, p<0.001). In the acne group, the insulin resistance index decreased with the increase of Incretin level, and the two showed a negative correlation. (R=-0.711, p<0.001). Patients with acne vulgaris are prone to have insulin resistance. Insulin resistance in patients with acne vulgaris is negatively correlated with Incretin. Serum Incretin may be expected to be a biomarker for diagnosing acne vulgaris patients with insulin resistance. The severity of acne vulgaris may have no obvious correlation with insulin resistance and serum incretin.

Comparison of macro and micronutrients intake in an Indian subpopulation with acne vulgaris versus controls: an observational study

&lt;p&gt;&lt;strong&gt;Background:&lt;/strong&gt; Diet plays an important role in the development and severity of acne, a debilitating and psychologically distressing skin condition attributable to chronic inflammation. The diverse food cultures, influence of globalisation and confounding genetic and environmental factors have prompted studies of specific diet on acne. However, diet being a controllable factor, it would be useful to discern the beneficial and harmful effects of certain foods on acne. The aim of the study was to compare macro and micronutrient intakes in persons with acne vulgaris versus controls in an Indian subpopulation in Mumbai city. Current case-controlled, prospective, observational survey was conducted during September to December 2017 with 210 participants aged 18 to 40 years.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods:&lt;/strong&gt; We used semi-quantitative Food frequency questionnaire and 24-hour recall tests to identify the pattern of food consumption between acne and non-acne individuals. Statistical analysis was performed using “t” test and ANOVA.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results:&lt;/strong&gt; Our analysis revealed that the individuals with acne consume a higher portion of dairy products, refined cereals and relatively smaller portions of whole cereals. Acne group had a significant lower (p&amp;lt;0.05) intake of pulses, omega-3 and 6 fatty acids, α-linolenic acid than the non-acne group. Significant difference indicated a lower consumption of micronutrients including zinc (p=0.012), thiamine (p&amp;lt;0.05), and niacin (p=0.01) among acne individuals.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Study findings suggest an increased consumption of inflammation triggering foods and lower consumption of foods with anti-inflammatory and antioxidant property in the acne group of individuals.&lt;/p&gt;

Assessment of serum testosterone, estradiol, and progesterone levels in female patients with acne vulgaris

Introduction: Acne is a chronic inflammatory disorder of the pilosebaceous unit with differential pathogenesis. To elucidate the roles of hormones in acne pathogenesis, we conducted a study to evaluate the serum testosterone, estradiol, and progesterone levels in women with acne vulgaris. Methods: We conducted a cross-sectional descriptive study, and 175 women with acne vulgaris were examined; their serum estradiol, progesterone, and testosterone were analyzed by chemiluminescence technique and compared with the healthy control group. Results: Increased serum hormone levels in women with acne vulgaris accounted for 29.7%, and hyperandrogenism accounted for 16.0% of cases. We found significant differences in testosterone levels (mean value, 55.67±25.56 versus 38.37±10.16 ng/dL, p&lt;0.05) respectively, in the acne group and the control group. However, the estradiol level of the acne group (323.15±93.31 pmol/L) was lower than the control group (370.94±58.88 pmol/L), with p-value under 0.05. No statistically significant differences were found for progesterone (0.60±0.38 versus 0.50±0.15 ng/mL, p&gt;0.05) levels. Moreover, we did not find the relationship between serum hormone levels and the severity of acne vulgaris. Conclusion: This study showed that female acne vulgaris patients may have high serum testosterone levels and low serum estradiol levels compared with those of female controls. However, hormone alterations had no correlation with acne severity.

Assessment of serum testosterone, estradiol, and progesterone levels in female patients with acne vulgaris

Introduction: Acne is a chronic inflammatory disorder of the pilosebaceous unit with differential pathogenesis. To elucidate the roles of hormones in acne pathogenesis, we conducted a study to evaluate the serum testosterone, estradiol, progesterone levels in women with acne vulgaris. Methods: We conducted a cross-sectional descriptive study, and 175 women with acne vulgaris were examined; their serum estradiol, progesterone, testosterone were analyzed by chemiluminescence technique and compared with the healthy control group. Results: Increased serum hormone levels in women with acne vulgaris were accounted for 29.7%, and hyperandrogenism was accounted for 16.0% of cases. We found significant differences in testosterone levels (mean value, 55.67±25.56 versus 38.37±10.16 ng/dL, p&lt;0.05) respectively in the acne group and the control group. However, the estradiol level of the acne group (323.15±93.31 pmol/L) was lower than the control group (370.94±58.88 pmol/L) with p&lt;0.05). No statistically significant differences were found for progesterone (0.60±0.38 versus 0.50±0.15 ng/mL, p&gt;0.05) levels. Moreover, we did not find the relationship between serum hormone levels and the severity of acne vulgaris. Conclusion: This study showed that the female acne vulgaris patients may have high serum testosterone levels and low serum estradiol levels compared with those of female controls. However, hormone alterations had no correlation with the acne grades.

Severity of Acne and Use of Cosmetics in Adult Men

Purpose: This study aimed to collect basic data to educate adult men about the importance of skincare and to direct product research and development by identifying the use patterns of acne-only cosmetics in adult men based on the severity of their acne.Method: A nationwide online survey of 300 adult men in their 20s to 40s with acne-prone skin was conducted. The questionnaire had 36 questions in total, and questions related to acne occurrence and recognition level were evaluated using photos representing grades 1 to 6 of the Korean acne severity system listed in the Skin Science Journal, and data analysis was performed using the statistical package SPSS/WIN 23.0.Results: The longer the acne progression period, the higher the acne level. The skincare regimen involved acne-only cosmetics although studies have shown that the effectiveness of cosmetics is inadequate. Furthermore, in the acne group with low acne level, participants did not use dedicated cosmetics or take care of their skin because the cost was prohibitive and the problem was likely to worsen.Conclusion: This study provided insights on adult men's perceptions of acne-prone skin care and use of acne-only cosmetics based on the severity of acne. Further research by experts is required to confirm these findings.

Yin and Yang of skin microbiota in "swimmer acne".

Cutibacterium acnes (C.acnes) is an organism implicated in the pathogenesis of acne. Despite regular immersion in antimicrobial chlorine, adolescent swimmers suffer from acne and tend to be resistant to standard therapies. Given the presence of Pseudomonas within swimming facilities, we hypothesized that "swimmer acne" is potentially driven by a different microbial mechanism. In this study, we aimed to examine the microbial dynamics of C.acnes and Pseudomonadaceae, a family of gram-negative bacteria (includes Pseudomonas aeruginosa), in swimmers and its potential contribution to the pathogenesis of acne in this population. Using fluorescence photography that measures the Coproporphyrin III (CPIII), we quantitated an absolute abundance of C.acnes present on the face of each participant pre- and post-swimming. In addition, 16S rRNA gene sequencing was utilized to assess relative abundance of the skin microbiota on each participant pre- and post-swimming. 16swimmers (8girls and 8 boys) completed the study. Seven had acne on the face. The CPIII fluorescence levels decreased for all swimmers after 1h of swimming (p-value <0.001). In contrast, the relative abundance of C.acnes remained unchanged, while that of Pseudomonadaceae increased after swimming (p-value =0.027). Comparing the relative abundances of Pseudomonadaceae before swimming, there was a significant increase in variance from the mean in acne group as compared to no acne group (p-value <0.001). Taken together, we conclude that the skin dysbiosis resulting from repeated decolonization and colonization of C.acnes and Pseudomonadaceae, respectively, can potentially be associated with the pathogenesis of acne in swimmers.

Assessment of serum testosterone, estradiol, and progesterone levels in female patients with acne vulgaris

Introduction: Acne is a chronic inflammatory disorder of the pilosebaceous unit with differential pathogenesis. To elucidate the roles of hormones in acne pathogenesis, we conducted a study to evaluate the serum testosterone, estradiol, progesterone levels in women with acne vulgaris. Methods: We conducted a cross-sectional descriptive study, and 175 women with acne vulgaris were examined; their serum estradiol, progesterone, testosterone were analyzed by chemiluminescence technique and compared with the healthy control group. Results: Increased serum hormone levels in women with acne vulgaris were accounted for 29.7%, and hyperandrogenism was accounted for 16.0% of cases. We found significant differences in testosterone levels (mean value, 55.67±25.56 versus 38.37±10.16 ng/dL, p&lt;0.05) respectively in the acne group and the control group. However, the estradiol level of the acne group (323.15±93.31 pmol/L) was lower than the control group (370.94±58.88 pmol/L) with p&lt;0.05). No statistically significant differences were found for progesterone (0.60±0.38 versus 0.50±0.15 ng/mL, p&gt;0.05) levels. Moreover, we did not find the relationship between serum hormone levels and the severity of acne vulgaris. Conclusion: This study showed that the female acne vulgaris patients may have high serum testosterone levels and low serum estradiol levels compared with those of female controls. However, hormone alterations had no correlation with the acne grades.

Assessment of serum hormone levels in female patients with acne vulgaris

Introduction: Acne is a chronic inflammatory disorder of the pilosebaceous unit with differential pathogenesis. To elucidate the roles of hormones in acne pathogenesis, we conducted a study to evaluate the serum testosterone, estradiol, progesterone levels in women with acne vulgaris. Methods: We conducted a cross-sectional descriptive study, and 175 women with acne vulgaris were examined; their serum estradiol, progesterone, testosterone were analyzed by chemiluminescence technique and compared with the healthy control group. Results: Increased serum hormone levels in women with acne vulgaris were accounted for 29.7%, and hyperandrogenism was accounted for 16.0% of cases. We found significant differences in testosterone levels (mean value, 55.67±25.56 versus 38.37±10.16 ng/dL, p&lt;0.05) respectively in the acne group and the control group. However, the estradiol level of the acne group (323.15±93.31 pmol/L) was lower than the control group (370.94±58.88 pmol/L) with p&lt;0.05). No statistically significant differences were found for progesterone (0.60±0.38 versus 0.50±0.15 ng/mL, p&gt;0.05) levels. Moreover, we did not find the relationship between serum hormone levels and the severity of acne vulgaris. Conclusion: This study showed that the female acne vulgaris patients may have high serum testosterone levels and low serum estradiol levels compared with those of female controls. However, hormone alterations had no correlation with the acne grades.

Assessments of the ocular surface and meibomian gland morphology in patients with treatment-naive acne vulgaris.

To investigate ocular surface and meibomian glands in patients with treatment-naive acne vulgaris. 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. 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. 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.

Instability of tear film and loss of meibomian glands in patients with acne vulgaris.

In this prospective study, we compared ocular clinical variables in patients with acne vulgaris with those of healthy controls. These variables included tear film break-up time, meibomian gland dropout rate, and anterior chamber parameters. Our sample comprised 73 eyes from 73 patients with acne vulgaris and 67 eyes from 67 healthy controls. All participants underwent a non-invasive first tear film break-up time test and the average tear film break-up time was evaluated. Meibography was used to identify any meibomian gland dropout. The parameters of the cornea and anterior chamber were measured using Scheimpflug topography imaging. Finally, the ocular surface disease index questionnaire was administered to score each participant on their subjective experience of ocular complaints. The noninvasive first tear film break-up time values of the acne vulgaris Group and the control Group were 4.7 ± 2.8 and 6.4 ± 3.5 sec, respectively. There was a significant difference between the groups (p=0.016). The number of eyes with tear break-up at any time during the measurement period was also significantly higher in the acne Group (p=0.018). In the acne vulgaris Group, the mean meibomian gland dropout rates were 33.21 ± 15.5% in the upper lids and 45.4 ± 14.5% in the lower lids. In the control group, these rates were 15.7 ± 6.9% and 21 ± 9.7% respectively. Dropout was significantly higher in the acne group for both the upper and lower lids (p=0.000). We found impaired tear stability in patients with acne vulgaris and a high rate of meibomian gland dropout. These glands play a key role in tear stability and their dropout is likely to result in evaporative dry eye. Measurement of the variables in this study allows objective diagnosis of this condition using a non-invasive, dye-free methodology, with minimum contact.

Isotretinoin, Acne and Depression: A Prospective Controlled Study

Introduction: Acne and isotretinoin, one of its treatment, have been linked to the occurrence of depression. Our aim was to study if isotretinoin is associated with depression in a sample of acne patients followed for 6 months comparing them with acne patients under other treatment modalities and control patients without acne.&#x0D; Methods: One hundred individuals were included: 50 controls and 50 with acne (24 using and 26 not using isotretinoin). Patients and controls answered the Beck Depression Inventory (BDI) and the 12 Item-Short Form Health Survey for quality of life (SF-12). Acne patients repeated this evaluation in 90 and 180 days.&#x0D; Results: No differences were found between controls and acne patients regarding BDI results but controls performed worse in the SF-12 mental domain (p=0.004). No differences were found within the acne group between those treated and not treated with isotretinoin in the comparison of the BDI and SF-12 (mental and physical domains) in days 0. 90 and 180 (all with p&gt;0.05).&#x0D; Conclusion: In this small sample isotretinoin treatment showed to be safe regarding the occurrence of depression.

Could endocrine disruptors be a new player for acne pathogenesis? The effect of bisphenol A on the formation and severity of acne vulgaris: A prospective, case-controlled study.

Acne is one of the most common skin diseases in the adolescent period. Bisphenol A (BPA) is the most frequently observed endocrine-disrupting chemicals that we are exposed to in daily life. BPA can affect acne pathogenesis with similar biological activity on androgenic receptors. To investigate whether BPA levels play a role in the development and severity of acne in adults. Fifty-one adults with acne and 50healthy controls, whose ages varied between 18 and 25years and applied to our dermatology outpatient clinic, were evaluated. A questionnaire containing dietary and lifestyle habits for BPA exposure was filled. BPA and BPA glucuronides were analyzed in the LC-MS/MS system in the first-morning urine samples of the patients. Statistical significance was set at p<0.05. The median levels of total BPA were significantly higher in the acne group compared with the control group (7.94 (4.69-20.32) vs. 5.62 (1.52-21.05) µg/g creatinine, respectively; p=0.04)). The acne severity was positively associated with the BPA values (p=0.00 rs=0.534). Higher BPA level was noticed in younger acne onset age (p=0.012 r=-0.349) When the inquiry questions were evaluated, no difference was found between the study groups regarding BPA exposure risk (p>0.05). BPA could be a factor in acne development and its severity. Therefore, it may be beneficial to prevent BPA exposure and raise awareness in the adolescence and post-adolescence period, in which industrial products such as junk food and plastic bottled water are used more frequently.

Assessment of Anxiety and Depression in Patients with Acne Vulgaris in Medina: A Case-Control Study.

PurposeAcne vulgaris is a common dermatological disease in adolescents that show high prevalence rates of anxiety and depression that may lead to consequences that affect quality of life. This study aimed to assess and compare anxiety and depression in patients with acne and a control group and to determine their correlation with other demographic data.Patients and MethodsThis was a case-control study conducted in 2019 for 3 months at the derma-tology department of Ohud Hospital and two other private clinics in the Medina region of Saudi Arabia. For this study, 296 consecutive patients in the age group of 12 to 60 years who were diagnosed as having acne vulgaris were enrolled and matched with a control group. Data were collected through a self-administered questionnaire, including sociodemographic data and Hospital Anxiety and Depression Scale scores.ResultsWe found no significant differences between the two groups regarding sex, age group, nationality, and educational level, but found a significant difference in marital status (p < 0.001). Most (62.5%) of the acne cases were moderate in severity. The overall anxiety score in the acne group was 7.68 ± 4.90, with a significant difference with the control group (p = 0.031), whereas the anxiety level and depression score showed no significant difference (p = 0.082 and p = 0.656, respectively). Moreover, a strong correlation was found between anxiety and depression in the acne group (r = 0.732, p < 0.001).ConclusionA positive correlation was found between the anxiety and depression scores in the patients with acne, which was not related to age group or educational level. However, the anxiety scores of the patients with acne showed a significant relationship with sex.

Evaluation of serum insulin-like growth factor-1, insulin, glucose levels in patients with adolescent and post-adolescent acne.

There are many endogenous and exogenous factors that cause acne formation. This study aimed to determine whether the acne severity in patients with various age ranges is associated with serum insulin-like growth factor, insulin, and glucose and to identify how much they affect the acne severity. In this case-control prospective study, 44 patients withacne vulgarisand 44 age- and gender-matched control subjects withoutacnewere evaluated. Patients and the control group were divided into two age-groups as adolescence and post-adolescence. According to the Global Acne Scoring System (GASS) of the acne group, the acne score grades between 0 and 44 were calculated. The correlations between the IGF-1, insulin, glucose levels, and acne grades were calculated in each group. In our study, the acne scores and serum IGF-1levels were found to be significantly higher in patients under the age of 21 than patients over the age of 21. There was a statistically significant difference in acne score between the two groups. However, there was no statistically significant difference between the serum IGF-1, insulin, and glucose levels of the acne group and the control group. In this study, it has been revealed that IGF-1 is effective at the pathogenesis of acne in adolescence.

Social Support and Appearance Satisfaction Can Predict Changes in the Psychopathology Levels of Patients with Acne, Psoriasis and Eczema, before Dermatological Treatment and in a Six-Month Follow-up Phase

This was a cross-sectional study which assessed the factors that predicted changes in the levels of psychopathological symptomatology of patients with acne, psoriasis and eczema both before dermatological treatment and in a six-month follow-up phase. One hundred and eight dermatological patients (18–35 years) participated in the study; 54 with visible facial cystic acne (Group A), and 54 with non-visible psoriasis/eczema (Group B). A battery of self-report questionnaires were administered to all patients before their dermatological treatment and in a six-month follow-up phase and included: the Symptom Checklist-90 Revised (SCL-90-R), the Interpersonal Support Evaluation List (ISEL-40), the Multidimensional Body–Self Relations Questionnaire (MBSRQ–AS) and the Rosenberg Self-Esteem Scale. Multiple regression analyses revealed that patients’ overall perceived social support and overall appearance satisfaction appeared to be strong predictors of the maintenance of patients’ psychopathology levels, even six months after they began their dermatological treatment. Psychosocial factors such as patients’ social support and appearance satisfaction could influence their psychopathology levels and the way they experienced their skin condition, before treatment and after a six-month period of time. The psychological assessment of the aforementioned factors could detect patients who would benefit from psychotherapeutic interventions in order to help them adapt to the extra burden which accompanies dermatological disorders.

Assessment of ICAM-1 gene polymorphism in Acne Vulgaris

Background: Considering the recognized roles of ICAM-1 in inflammation and rising an evidence that inflammation is evident at all stages of AV. The current study aimed to investigate the incidence of ICAM-1 gene expression and polymorphism with special reference to amino acids at position 469 and 241 with acne vulgaris and its possible correlation with the lesion severity. Patient and methods: The present case control study included 60 participants of matched age, sex and of Egyptian origin where there were 45 acne patients assigned into three groups according to acne severity (mild, moderate and severe), 15 patients in each group, and there were 15 participants as control.All studied participants were tested for the genotypes of ICAM-1 gene polymorphism by PCR where four primers have been used to detect all possible polymorphism at codon 241 and 469 Results: There was statistically significant difference among four studied groups as regard ICAM (496) and ICAM (241) polymorphism where the highest percentage of GG were among severe acne group and none of controls had GG genotype. There was significant association between ICAM (496) polymorphism and patients’ BMI where the highest BMI Conclusion: ICAM-1 496 and 241 polymorphism might be associated with AV. Further understanding of functional significance of the ICAM-1 polymorphism will help delineate immunopathogenesis in certain subgroups of AV obese patients

Prepubertal acne: A retrospective study.

BackgroundAcne vulgaris is a common skin disorder, but studies on the epidemiologic features of prepubertal acne are limited.ObjectivesThe aim of this study was to determine the prevalence and severity of prepubertal acne and to identify factors influencing acne severity and poor response to treatment.MethodsA retrospective study was conducted on 683 patients with acne from our database who visited the dermatology department of Nantes University hospital between October 2014 and May 2018. Patients of prepubertal acne (7-12 years) were included in this study.ResultsOf the 683 patients with acne, 24 (3.5%) had prepubertal acne. Prepubertal acne was more common in female patients (75%). Acne severity assessment showed that severe acne (Groupe Expert Acné global acne severity scale 4) was the most common form (33%), and mild and moderate forms (Global Evaluation Acne Group, global acne severity scales 2 and 3) accounted for 25% each. There was a high predominance of phylotype IA1 of Cutibacterium acnes (belonging to CC18 subgroup). The analysis of patients’ lifestyle and acne features identified three factors associated with an increased risk of poor response or resistance to acne treatment. Initially severe acne grading (grade 4) was the most strongly associated parameter (p < .028), followed by regular milk consumption and taking other medications in addition to acne treatment (p < .049 for each).ConclusionThis study reported on prepubertal acne features and identified three factors associated with a high risk of treatment failure or relapse. Adequate and prompt treatment is needed in this subgroup of patients to minimize disease burden and prevent subsequent disease worsening.

Choroidal vascular changes in acne patients under isotretinoin treatment

Purpose The aim of this study was to evaluate the potential changes in choroidal vasculature in nodulocystic acne patients under isotretinoin treatment by using choroidal thickness (CT), choroidal vascularity index (CVI), and choriocapillaris (CC) flow area. Materials and methods This prospective study included nodulocystic acne patients under isotretinoin treatment and healthy controls. All patients underwent enhanced depth imaging–optical coherence tomography (EDI–OCT) imaging to assess the subfoveal CT and submacular CVI, and optical coherence tomography angiography (OCTA) imaging to evaluate the CC flow area. Results A total of 25 patients with acne and 23 controls were included. The mean duration of the treatment was 7.20 ± 0.79 months and the mean daily isotretinoin dose was 38.7 ± 2.8 mg in the acne group. The mean CT and CVI values were significantly higher in the acne group compared to the control group (p = 0.005 and p = 0.027, respectively). The cumulative isotretinoin dose was positively correlated with subfoveal CT and submacular CVI (r = 0.434, p = 0.015 and r = 0.385, p = 0.033, respectively). Regarding the CC flow area, the values for area with a radius of 1 mm, 2 mm and 3 mm were lower in the acne group than in the control group; however, the difference was not significant (p > 0.05, all values). Conclusion After a mean 7-month course of isotretinoin treatment, subfoveal CT and submacular CVI values were significantly higher in the nodulocyctic acne patients. Whether the choroidal changes are permanent or not should be investigated in future studies.

Anxiety and Depression in Egyptian Patients with Acne Vulgaris

Background: Acne vulgaris is a prevalent skin condition that may affect the perception of body image and adversely affect social and psychological states. This disease has been associated with rates of depression, anxiety, failure to thrive at school and in social environments, suicidal ideation, and suicidal attempts that are higher than in individuals without this disease. Objective: To estimate the frequency of anxiety and depression in patients with acne vulgaris and determine the association between acne severity and anxiety and depression in those patients Methods: A comparative cross-sectional study was conducted in Zagazig University Hospital on 92 subjects (46 patients with acne and 46 individuals without acne); they were interviewed. The researcher used the Global Acne Grading System (GAGS) to classify acne and the Hospital Anxiety and Depression Scale (HADS) to determine anxiety and depression. Results: In the acne group, 23.9% had anxiety and 13.1% had depression. In the control group, 6.5% had anxiety and 4.3% had depression; the difference was statistically significant. Of the acne group patients with severe acne, 66.7% had anxiety and 44.4% had depression. There was a significant correlation between the severity of acne evaluated by GAGS and HADS for anxiety (r = 0.712, p < 0.001) and GAGS and HADS for depression (r = 0.584, p < 0.001). Conclusion: Acne vulgaris may be associated with depression and anxiety, with a linear relationship between its severity and the presence of depression and anxiety. Patients with acne vulgaris should undergo a continually psychiatric evaluation by their primary care physician to avoid the negative effects on their mental and social health.