Teenage Acne Research Articles

Melanoma of Non-Sun Exposed Skin in a Man with Previous Prostate Cancer: Recognition of a Recently Confirmed Association

BackgroundThe association of an increased risk to develop melanoma in patients with prostate cancer has recently been confirmed.PurposeThe postulated etiologic relationship between prostate cancer and the subsequent occurrence of melanoma is discussed.MethodsA man with previous prostate cancer who developed melanoma on the plantar surface of his left great toe is described and the possibility of high levels of endogenous androgens promoting not only prostate cancer, but also increased risk of melanoma are reviewed.ResultsModification of the host immune response, alteration of chromosome telomere length, and/or imbalance of androgen level (presenting as severe teenage acne) are potential mechanisms whereby high levels of endogenous androgens may contribute to the association between prostate cancer and risk of melanoma.ConclusionsAn increased surveillance for melanoma should be considered in prostate cancer patients. Complete skin examination in men who have had prostate cancer—especially in those individuals diagnosed with prostate cancer prior to age 68 years—should regularly be performed.Electronic supplementary materialThe online version of this article (doi:10.1007/s13555-014-0045-2) contains supplementary material, which is available to authorized users.

Personal History of Prostate Cancer and Increased Risk of Incident Melanoma in the United States

Steroid hormones, particularly androgens, play a major role in prostatic carcinogenesis. Personal history of severe acne, a surrogate for higher androgen activity, has been associated with an increased risk of prostate cancer (PCa), and one recent study indicated that severe teenage acne was a novel risk factor for melanoma. These findings suggest a possible relationship between PCa and risk of melanoma. We prospectively evaluated this association among US men. A total of 42,372 participants in the Health Professionals' Follow-Up Study (HPFS; 1986 to 2010) were included. Biennially self-reported PCa diagnosis was confirmed using pathology reports. Diagnosis of melanoma and nonmelanoma skin cancer (NMSC) was self-reported biennially, and diagnosis of melanoma was pathologically confirmed. We sought to confirm the association in 18,603 participants from the Physicians' Health Study (PHS; 1982 to 1998). We identified 539 melanomas in the HPFS. Personal history of PCa was associated with an increased risk of melanoma (multivariate-adjusted hazard ratio [HR], 1.83; 95% CI, 1.32 to 2.54). Although we also detected a marginally increased risk of NMSC associated with PCa (HR, 1.08; 95% CI, 0.995 to 1.16), the difference in the magnitude of the association between melanoma and NMSC was significant (P for heterogeneity = .002). We did not find an altered risk of melanoma associated with personal history of other cancers. The association between PCa and risk of incident melanoma was confirmed in the PHS (HR, 2.17; 95% CI, 1.12 to 4.21). Personal history of PCa is associated with an increased risk of melanoma, which may not be entirely a result of greater medical scrutiny.

A genome-wide association study of severe teenage acne in European Americans.

Despite the family aggregation of severe teenage acne, the genetic basis of this common skin condition remains unclear. We conducted a genome-wide association study (GWAS) on severe teenage acne in 928 European Americans. The SNP rs4133274 on chromosome 8q24 (72 kb upstream of MYC) revealed the most significant association with severe teenage acne (p value = 1.7 × 10(-6)). The variant allele of this SNP (G allele) was associated with an increased risk of severe teenage acne with odds ratio of 4.01 (95 % confidence interval = 2.37-6.82). Upon further replication, our findings suggest new genetic basis of acne and may explain the association between acne and cancer risk observed in the epidemiological studies.

Practical aspects of administering Acnecutan for the treatment of acne in teenagers

Goal of the study: to study the efficacy and tolerance of Acnecutan for the treatment of acne in teenager patients. Materials and methods. The study involved 43 patients aged 12-18 with moderate to severe acne, who received Acnecutan* as a monotherapy. The skin process dynamics was assessed visually based on the Basic Acne Severity Index (BASI). Results. Clinical recovery was achieved in 39 patients (90.7% of all cases), and clinical improvement was observed in 4 patients (9.3%). Conclusion. The results of Acnecutan administration demonstrate a high level of its efficacy and tolerance in teenagers. To assess the stability of the results achieved and to draw final conclusions, the patients will be followed up within a year after the end of the therapy. Therefore, the drug can be recommended as a monotherapy for acne of different clinical forms in teenager patients.

Systemic therapy of acne in teenagers

The goal was to determine clinical and anamnestic features of acne patients aged up to 18 years needing systemic isotretinoin treatment, and to assess the treatment dynamics. Materials and methods. The authors conducted a study of 27 patients with moderate to severe acne (with the mean age of 16.2 ± 1.2 years) receiving isotretinoin in the form of LIDOSE (Acnecutan) in the dose of 0.33 ± 0.06 mg/kg. Results. A steady improvement of the skin condition was observed when the dose of isotretinoin in the form of LIDOSE of 60.3 ± 2.8 mg/kg was used. Clinical recovery was observed in all of the patients (the cumulative dose amounted to 100 mg/kg). Teenagers demonstrated good tolerance to the drug and had no systemic adverse effects.

Abstract 2865: The significance of Vitamin D deficiency and low grade pathogens in etiology of prostate cancer.

Abstract Introduction. Estimations of sun exposure (but less so spot serum Vitamin D levels) correlate with risk of prostate cancer occurrence. This suggests that it is due to long term Vitamin D deficiency over 10-40 years as a possible explanation. This, via diminished macrophage function, could allow persistence of low grade pathogens to set up chronic inflammation that could lead to Proliferative Inflammatory Atrophy (PIA) of the prostate, now thought to be an important precursor of cancer. Despite multiple investigations of sexually transmitted infections, there has been no consistently associated organism. However recently infection with two low grade pathogenic organisms, teenage acne associated anaerobic bacterium Propionibacterium.acnes (PA) and protozoan Trichomonas vaginalis (TA), have shown a more consistent association with prostate cancer. This abstract reports the results of a systematic review of publications investigating the association of sun exposure and prostate cancer and of PA and T V with prostate cancer and considers how these observations could lead to improved specificity of PSA screening Methods. Pubmed searches using terms prostate or prostatic, sunshine or UVB or Vitamin D and acne or PA or TA were performed and the abstracts reviewed and appropriate papers selected for review and data extraction Results . Amongst 1134 abstracts investigating PC and Vitamin D were two systematic reviews that failed to produce a consistent association. In contrast four of four studies of an index of sun exposure involving 1568 patients (OR 0.75, 0.75, 0.59 & 0.89) and 6 of 7 geographic studies (0.32, 0.38, 0.44, 0.16, 0.52, 1.63 & 0.64) demonstrated an association of high UVB exposure with reduced PC risk. Four of five publications on PA and PC (1.7, 1.67, 2.17 & 0.67) and 2 of 3 publications on TV and PC (1.23, 1.43 & 0.83) from 205 papers reviewed showed consistent increase risk of PC associated with infection. Conclusion. Lack of association with spot Vitamin D but clear association with index of sun exposure suggest that the association is due to reduced long term Vitamin D mediated non-specific macrophage surveillance that is involved against lowly pathogenic agents of which PA and TV could be lead organisms. Impact on PSA of elimination of these organisms could become an important strategy in future efforts of to improve the specificity of PSA screening and chemoprevention of PC Citation Format: Tim R T D Oliver. The significance of Vitamin D deficiency and low grade pathogens in etiology of prostate cancer. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 2865. doi:10.1158/1538-7445.AM2013-2865

Medication Adherence, Healthcare Costs and Utilization Associated with Acne Drugs in Medicaid Enrollees with Acne Vulgaris

Acne vulgaris is a common chronic disease that may require long-term treatment. Medication adherence is critical to acne management; non-adherence is a common reason for treatment failure and can lead to poor quality of life. The aim of the study was to examine medication adherence, healthcare costs, and utilization associated with acne drugs among acne patients in the USA. This was a retrospective cohort study from January 2004 to December 2007 using the Marketscan Medicaid Database, a national healthcare claims database. The study followed acne patients aged 0-64 years for 90 days after the first acne drug prescription to measure acne medication adherence, acne-related outpatient visits, and total acne-related healthcare costs. Adherence was measured among different acne drug classes using medication possession ratio (MPR). Multivariate regression analyses were conducted to assess the outcomes. The study included 24,438 eligible patients, of whom 89.39 % were under 18 years old. The average adherence rate to acne drugs (MPR) was 0.34, and only 11.74 % of the patients were adherent (MPR ≥0.80). Patients with drug refills had a higher adherence rate (MPR = 0.74) than who those without refills (MPR = 0.27). Factors significantly associated with adherence were age, comorbidity, gender, number of drug refills and number of drug classes used. Patients were more adherent to oral retinoids than any other acne drug classes (MPR = 0.78, 57 % adherent). Patients were less adherent to oral antibiotics (MPR = 0.21) and topical retinoids (MPR = 0.31). After controlling for medication use behavior, the use of oral antibiotics decreased the number of acne-related outpatient visits by 50.9 % (p < 0.001) and lowered acne-related total costs by 51.7 % (p < 0.001). Medication non-adherence is generally prevalent among young acne patients enrolled in Medicaid. The combination of a topical retinoid and an antibiotic agent may be a good choice given their associated healthcare outcomes and costs. However, adherence to these agents is not satisfactory. Therefore, developing specific strategies to improve adherence to these drugs among teenage acne patients is warranted.

Complementary, Holistic, and Integrative Medicine

Complementary, Holistic, and Integrative Medicine

Complementary, Holistic, and Integrative Medicine: Acne

1. Anju Sawni, MD* 2. Amritpal Singh, MD† 1. *Pediatric Education, Hurley Children’s Hospital/Hurley Medical Center, Flint, MI. 2. †Department of Dravyaguna (Medicinal Plants), Sri Dhanwantry Ayurvedic College, Chandigarh, India. * Abbreviations: EFAs: : essential fatty acid LTB4: : leukotriene B4 Acne vulgaris is a common skin disorder that affects ∼70% to 87% of adolescents and young adults. (1) The pathogenesis of acne is multifactorial and complex, and is thought to be due to androgen-stimulated sebum production. This production leads to follicular occlusion and hyperkeratinization, with comedo formation, as well as microbial colonization of pilosebaceous follicles by Propionibacterium acnes , leading to inflammatory papules and pustules. Conventional treatments for acne include salicylic acid, benzoyl peroxide, retinoids, and antibiotics (topical and systemic). However, symptoms may not always improve, and patients may have adverse reactions to conventional treatments and thus seek alternative treatments. Antibiotic resistance in P acnes also has been rising, thus promoting the need to look at alternative therapies. (2) The influence of diet on acne has been debated for decades. One review of the literature looking at the evidence for diet, face washing, and sunlight exposure in acne management concluded that the evidence is incomplete at best. (3) Another review did not support any link between acne and foods such as dairy products, chocolate, and fatty foods. (4) However, with more recent focus on diet and nutritional supplements, emerging research suggests that diet may be a factor, particularly in mediating the inflammation and oxidative stress of the acne process. (5)(6)(7) Western diets, with characteristically high glycemic indices, can elevate insulin and insulin-like growth factor 1 levels acutely and chronically. (5) These hormones stimulate adrenal and gonadal androgen production, leading to increased sebum production and acne. Frequent consumption of high-glycemic-index carbohydrates may repeatedly expose adolescents to acute hyperinsulinemia. Therefore, a low-glycemic-load diet may have a beneficial effect on acne. (6) A review …

Fixed-dose combination gel clindamycin 1.2%/tretinoin 0.025% for the treatment of acne vulgaris: a review

Topical fixed-dose combinations are recommended as a first-line treatment for mild-to-moderate inflammatory (papulopustular) acne, as they target multiple acne pathogenetic factors, are associated with a favorable efficacy and tolerability profile, are easy to apply and may increase patient compliance, especially in teenage acne patients. The combination of a topical antibiotic with a retinoid combines the antibiotic-associated effects of improving inflammatory and noninflammatory acne lesions, with the retinoid-associated effects of normalizing desquamation and reducing comedogenesis, while aiming at reducing the risk of bacterial resistance. In this article, data regarding the efficacy, safety and tolerability of topical clindamycin 1.2%/tretinoin 0.025% gel for acne treatment will be presented. The effects of topical clindamycin 1.2%/tretinoin 0.025% gel therapy in children and young teenagers, as well as different skin types, will be addressed.

Diet in Acne: Further Evidence for the Role of Nutrient Signalling in Acne Pathogenesis – A Commentary

Recent evidence underlines the role of Western diet in the pathogenesis of acne. Acne is absent in populations consuming Palaeolithic diets with low glycaemic load and no consumption of milk or dairy products. Two randomized controlled studies, one of which is presented in this issue of Acta Dermato-Venereologica, have provided evidence for the beneficial therapeutic effects of low glycaemic load diets in acne. Epidemiological evidence confirms that milk consumption has an acne-promoting or acne-aggravating effect. Recent progress in understanding the nutrient-sensitive kinase mammalian target of rapamycin complex 1 (mTORC1) allows a new view of nutrient signalling in acne by both high glycaemic load and increased insulin-, IGF-1-, and leucine signalling due to milk protein consumption. Acne should be regarded as an mTORC1-driven disease of civilization, like obesity, type 2 diabetes and cancer induced by Western diet. Early dietary counselling of teenage acne patients is thus a great opportunity for dermatology, which will not only help to improve acne but may reduce the long-term adverse effects of Western diet on more serious mTORC1-driven diseases of civilization.

The psychological effects of acne in teenagers

Diane Joseph and Anne Sterling discuss the importance of understanding the psychological effects that acne can have on adolescents.

The psychological effects of acne in teenagers

Diane Joseph and Anne Sterling discuss the importance of understanding the psychological effects that acne can have on adolescents

Diet and acne: a review of the evidence

Pharmaceutical acne treatments are costly and have potentially severe side-effects. Adolescent acne is typically the result of clogged, infected, pilosebaceous follicles. Adults may experience fewer comedones and more inflammatory lesions. 1 Normally, sebum travels up the follicle to the skin surface. Hormones may increase sebum production and cause follicular cells to hyperproliferate and block the follicular opening, forming a comedo. 4 Complete follicle blockage results in closed comedones (i.e. “whiteheads”), whereas incomplete blockage results in open comedones (“blackheads”). Comedo formation typically occurs over the course of 2–3 weeks. Acne may manifest in the form of noninflammatory comedones, superficial inflammatory lesions (papules, pustules), and/or deeper inflammatory lesions (nodules, cysts). Inflammatory lesion formation occurs most commonly when Propionibacterium acnes colonizes the pilosebaceous unit, triggering follicular rupture and a neutrophil cascade. 5

New insights into adolescent acne

Acne vulgaris remains one of the most common conditions affecting adolescents. The pediatric practitioner is the first to evaluate adolescent acne, making familiarity with the condition and its management essential. This review covers some of the recent literature regarding acne to help practitioners stay current on the issues regarding this topic. The pathogenesis of acne is multifactorial and complex, but recent advances in molecular genetics have provided additional information on the actions of Proprionibacterium acnes. Nutritional studies have reevaluated a possible role for diet and lifestyle factors in acne development. Many therapies are available to control acne and to limit associated scarring. Their appropriate use requires an understanding of not only the benefits but also the possible risks and adverse effects involved. Recent concerns regarding the use of antibiotics and isotretinoin will be addressed. This study reviews the recent literature regarding teenage acne, focusing on pathogenesis, associations, and controversies and considerations in therapy.

Acne

In the Clinic1 July 2008AcneChristine Laine, MD, MPH, David R. Goldman, MD, and Susan V. Bershad, MDChristine Laine, MD, MPHSearch for more papers by this author, David R. Goldman, MDSearch for more papers by this author, and Susan V. Bershad, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-149-1-200807010-01001 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail PreventionWho is at risk for acne?Acne (also known as acne vulgaris, true acne, or teenage acne) affects 85% of U.S. adolescents but also occurs in up to 78% of preadolescents, 12% of adult women, and 3% of adult men. In addition to cosmetic effects, which can include permanent scarring, acne can have detrimental effects on self-image and social interactions. The annual cost of acne care in the United States, including over-the-counter products, outpatient visits, and prescription drugs, exceeds $2.2 billion. Despite its ubiquity, acne is poorly understood and often suboptimally treated.Those at greatest risk for acne are adolescents whose ...

Community-based study of acne vulgaris in adolescents in Singapore

There are few studies on the prevalence of acne vulgaris among Asian teenagers. To determine the epidemiology of acne in teenagers in Singapore. A community-based cross-sectional study in 1045 adolescents aged 13-19 years. Of these respondents, 88% identified themselves as having acne. Eight hundred and six of these respondents were examined by a dermatologist, and 51.4% were classified as having mild acne, 40% moderate acne and 8.6% severe acne. Isolation of Propionibacterium acnes was attempted in 262 subjects. Cultures were positive in 174 subjects, giving an isolation rate of 66.4%. Antibiotic-resistant strains of P. acnes were detected in 26 isolates (14.9%). Eleven of these 26 subjects (42%) had previously been treated or were presently on antibiotic treatment for acne, but the other 58% of students who had antibiotic-resistant strains of P. acnes did not give a history of prior antibiotic therapy. Teenagers expressed psychological distress over acne, and believed that hormonal factors, diet and hygiene were important factors in causing acne. There is a need for accessible, accurate education on acne and its appropriate treatment.

Acne, anxiety, depression and suicide in teenagers: A cross‐sectional survey of New Zealand secondary school students

To examine the associations between acne and depressive symptoms, anxiety and suicidal behaviours. This was a secondary analysis of a cross-sectional survey -'Youth2000' (New Zealand national survey of youth health). A total of 9567 secondary school students aged 12-18 years participated in the survey. The main outcome measures were self-reported acne, depressive symptoms (Reynolds Adolescent Depression Scale > 77), anxiety (Anxiety Disorder Index from Multidimensional Anxiety Scale for Children) and self-reported suicide attempts. 'Problem acne' was associated with an increased probability of depressive symptoms, odds ratio 2.04 (95% confidence interval 1.70-2.45); anxiety, odds ratio 2.3 (1.74-3.00); and suicide attempts, odds ratio 1.83 (1.51-2.22) in a logistic model that included age, gender, ethnicity, school decile and socio-economic status. The association of acne with suicide attempts remained after controlling for depressive symptoms and anxiety, odds ratio 1.50 (1.21-1.86). Young people presenting with acne are at increased risk of depression, anxiety and suicide attempts. Attention should be paid to their mental health, and the importance of asking directly regarding suicide is emphasised.

High School Dietary Dairy Intake and Teenage Acne

High School Dietary Dairy Intake and Teenage Acne

Milk consumption and acne in adolescent girls

There has been a remarkable paucity of evidence for an association between diet and acne. Our previous studies suggest that there is an association between milk intake and teenage acne. This is a prospective cohort study to evaluate that relationship. We studied 6,094 girls, aged 9-15 years in 1996, who reported dietary intake on up to three food frequency questionnaires from 1996 to 1998. Presence and severity of acne was assessed by questionnaire in 1999. We computed multivariate prevalence ratios (PR) and 95 percent confidence intervals for acne. After accounting for age at baseline, height and energy intake, the multivariate PRs (95 % CI; p-value for test of trend) for acne comparing highest (2 or more servings per day) to lowest (<1 per week) intake categories in 1996, were 1.20 (1.09, 1.31; <0.001) for total milk, 1.19 (1.06, 1.32; <0.001) for whole milk, 1.17 (1.04, 1.31; 0.002) for low fat milk and 1.19 (1.08, 1.31; <0.001) for skim milk. This result did not change appreciably when we excluded girls who reported use of contraceptives and when we restricted our analysis to those younger than 11 years of age at baseline. We found a positive association between intake of milk and acne. This finding supports earlier studies and suggests that the metabolic effects of milk are sufficient to elicit biological responses in consumers.