Acne Infections Research Articles

Eutectogel based on multi-functional deep eutectic solvent for acne infection treatment

Deep eutectic solvents (DESs), as a new type of green and easily designable solvent, showed great potential applications in various fields. In this work, a novel deep eutectic solvent based on active pharmaceutical ingredient matrine and lauric acid was developed. The structure, thermal stability, and cytotoxicity were investigated by various technologies. The prepared DES displayed excellent ability on enhancing the solubility of curcumin, and the curcuim showed high stability in DES. Moreover, DES as well as curcumin-contained DES possessed good antioxidant and anti-P. acne activity. More importantly, the prepared DES can act as a gelator to form eutectogel in water, which was confirmed from the rheological behavior and scanning electron microscope (SEM) measurement. The curcumin-contained eutectogel displayed good injectable and permeation ability. Therefore, the prepared multi-functional DES (i.e. antioxidant, antibacterial agent, solvent and stabilizer of curcumin, and gelator) provides a new strategy to construct transdermal delivery system that displays potential application on treatment of acne infection.

Expanding Prospects for Dermal Health with Bioactive Phytochemicals

The largest and most defensive organ in the human body is the skin. Skin health significantly affects the quality of life due to its crucial function in aesthetic appearance. The onset of numerous skin illnesses is frequently accompanied by chronic skin inflammation. Immune-mediated reactions defend the body against external harm and need to be quickly controlled. If unregulated, they can result in long-term cellular damage and a variety of skin diseases. Dermatological illnesses encompass a wide range of skin conditions, including but not limited to acne, eczema, psoriasis, vitiligo, dermatitis, skin cancer, and fungal infections. Phytochemicals are produced by plants as a defense mechanism against pathogens that have various biological activities and can be harnessed for therapeutic purposes. Through the quenching of free radicals and the suppression of nuclear factor-κB, phytochemicals shield the skin from damage. Phytochemicals also offer a safe topical delivery system for improving the skin and regenerative treatment. Some phytochemicals' direct molecular targets have been identified, and their underlying mechanisms of action are being researched. In this review, we summarise current studies on phytochemicals' impacts on dermal illnesses and their underlying mechanisms of action.

Characterization of four peptides from milk fermented with kombucha cultures and their metal complexes-in search of new biotherapeutics.

The most common skin diseases include eczema, psoriasis, acne, and fungal infections. There is often no effective cure for them. Increasing antimicrobial drug resistance prompts us to search for new, safe, and effective therapeutics. Among such interesting candidates are peptides derived from milk fermented with specific lactic acid bacteria or with kombucha cultures, which are a potential treasure trove of bioactive peptides. Four of them are discussed in this article. Their interactions with zinc and copper ions, which are known to improve the well-being of the skin, were characterized by potentiometry, MS, ITC, and spectroscopic methods, and their cytostatic potential was analyzed. The results suggest that they are safe for human cells and can be used alone or in complexes with copper for further testing as potential therapeutics for skin diseases.

Resistome, mobilome, and virulome explored in clinical isolates derived from acne patients in Egypt: unveiling unique traits of an emerging coagulase-negative Staphylococcus pathogen.

Coagulase-negative staphylococci (CoNS) are a group of gram-positive staphylococcal species that naturally inhabit the healthy human skin and mucosa. The clinical impact of CoNS-associated infections has recently been regarded as a challenge for diagnosis and therapeutic options. CoNS-associated infections are primarily caused by bacterial resistance to antibiotics and biofilm formation. As antibiotics are still the most used treatment, this problem will likely persist in the future. The present study aimed to investigate the resistance and virulence of CoNS recovered from various acne lesions and explore their genetic basis. Skin swab samples were collected from participants with acne and healthy skin. All samples underwent conventional culture for the isolation of CoNS, MALDI-TOF confirmation, antibiotic susceptibility, and biofilm formation testing. A total of 85 CoNS isolates were recovered from the samples and preliminarily identified as Staphylococcus epidermidis. Isolates from the acne group (n = 60) showed the highest rates of resistance to penicillin (73%), cefoxitin (63%), clindamycin (53.3%), and erythromycin (48%), followed by levofloxacin (36.7%) and gentamycin (31.7%). The lowest rates of resistance were observed against tetracycline (28.3%), doxycycline (11.7%), and minocycline (8.3%). CoNS isolated from mild, moderate acne and healthy isolates did not show strong biofilm formation, whereas the isolates from the severe cases of the acne group showed strong biofilm formation (76.6%). Four extensively drug-resistant and strong biofilm-forming staphylococcal isolates recovered from patients with severe acne were selected for whole-genome sequencing (WGS), and their genomes were investigated using bioinformatics tools. Three of the sequenced genomes were identified as S. epidermidis; however, isolate 29AM was identified as Staphylococcus warneri, which is a newly emerging pathogen that is not commonly associated with acne and was not detected by MALDI-TOF. All the sequenced strains were multidrug-resistant and carried multiple resistance genes, including blaZ, mecA, tet(K), erm(C), lnuA, vgaA, dfrC, fusB, fosBx1, norA, and vanT, which were found to be located on plasmids and chromosomes. Virulence features were detected in all genomes in the presence of genes involved in adherence and biofilm formation (icaA, icaB, icaC, sdrG, sdrH, atl, ebh, and ebp). Only the S. warneri isolate 29AM contained immune evasion genes (capB, capC, acpXL, and manA), an anti-phagocytosis gene (cdsA), and other unique features. As a result of their potential pathogenicity and antibiotic resistance, CoNS must be monitored as an emerging pathogen associated with acne infections. To the best of our knowledge, this is the first report to isolate, identify, and correlate S. warneri with severe acne infections among Egyptian patients using WGS and bioinformatic analysis.

Novel Arena of Nanocosmetics: Applications and their Remarkable Contribution in the Management of Dermal Disorders, Topical Delivery, Future Trends and Challenges.

Nanocosmetics have attracted a considerable audience towards natural care due to their low cost, target-specific delivery, and reduced toxicity compared to chemical-based cosmetics. Nanofomulations, including nanoemulsions, nanotubes, and polymeric carriers, have become next-generation products explored for the multifaced applications of nanotechnology in skin care. The rise in the cosmetic industry demands innovative and personalized products designed using nanocarriers for better targeting and improving patient compliance. Furthermore, nanocosmetics increase the efficiency of skin permeation active ingredient entrapment, providing better UV protection. Moreover, it offers controlled drug release, targeting active sites and enhancing physical stability. Further, overcoming the drawback of penetration problems makes them sustainable formulations for precision medicine. Skincare nourishment with nanocosmetics using Indian spices helps to maintain, beautify, and rejuvenate human skin. Nanophytopharmaceuticals extracted from plants, including alkaloids, flavonoids, antioxidants, and volatile oils, are essential phyto-products for skin care. Nano herbals and nanocosmetics are a growing market and gift of nature that nourishes and cures skin ailments like acne, pemphigus, anti-aging, albinism, psoriasis, and fungal infections. The emerging concern is highlighted in the investigation of nanoformulation toxicity and safety concerns in skin care. Further, it helps to manifest research, development, and innovation in expanding the scope of herbal industries.

Whole genome sequencing distinguishes skin colonizing from infection-associated Cutibacterium acnes isolates.

Cutibacterium acnes can both be a helpful colonizer of the human skin as well as the causative agent of acne and purulent infections. Until today, it is a moot point whether there are C. acnes strains exclusively devoted to be part of the skin microbiome and others, that carry special features enabling them to cause disease. So far, the search for the molecular background of such diverse behavior has led to inconsistent results. In the present study, we prospectively collected C. acnes strains from 27 infected persons and 18 healthy controls employing rigid selection criteria to ensure their role as infectious agent or colonizer. The genome sequences from these strains were obtained and carefully controlled for quality. Deduced traditional phylotyping assigned almost all superficial isolates to type IA1, while the clinical strains were evenly distributed between types IA1, IB, and II. Single locus sequence typing (SLST) showed a predominance of A1 type for the control strains, whereas 56% of the clinical isolates belonged to types A1, H1 and K8. Pangenome analysis from all the present strains and 30 published genomes indicated the presence of an open pangenome. Except for three isolates, the colonizing strains clustered in clades separate from the majority of clinical strains, while 4 clinical strains clustered with the control strains. Identical results were obtained by a single nucleotide polymorphism (SNP) analysis. However, there were no significant differences in virulence gene contents in both groups. Genome-wide association studies (GWAS) from both the pangenome and SNP data consistently showed genomic differences between both groups located in metabolic pathway and DNA repair genes. Thus, the different behavior of colonizing and infectious C. acnes strains could be due to special metabolic capacities or flexibilities rather than specific virulence traits.

A new method for improved topical drug delivery, Emulgel

Emulgel is used to treat injuries and diseases such as arthritis, headaches, muscle aches, backaches, and those brought on by colds. Patient compliance with topical formulations is crucial in the treatment of chronic dermatosis such psoriasis, acne, and fungal infections. Emulgel, a more recent NDDS technology used topically, combines the characteristics of an emulsion with a gel to provide a dual control release. Emulgels have emerged as one of the most exciting topical delivery methods because of their dual release control mechanism, which combines a gel with an emulsion. Gels have many benefits, but one significant drawback is that hydrophobic medication delivery is hampered. An emulsion-based approach is being developed to circumvent this limitation and enable even a hydrophobic medicinal component to take use of the unique properties of gels. Emulgel is the name given to the dosage form created by combining gel with emulsion. Emulgels can be added to analgesics and antifungal medications. In several aspects, these emulgels are superior to both cutting-edge vesicular systems and traditional systems.

Preparation and evaluation of different herbal gels synthesized from Chinese medicinal plants as an antimicrobial agents

BackgroundThe aim of the present study was to formulate and evaluate the herbal gels containing Chinese onion or Allium cepa (A. cepa), Yin Lian Ye or Azadirachta indica (A. indica) and Chinese peppermint or Menthe piperita (M. piperita) extracts and their antimicrobial effects against different microorganisms. All selected three plants have a good medicinal value in the Chinese medicine system. MethodsA topical gel formulation was designed by using mentioned plants, as well as all three in combination with Carbopol-940 as a gelling agent with different excipients. Microbial species, such as Staphylococcus aureus (S. aureus), Bacillus subtilis (B. subtilis), Escherichia coli (E. coli), Pseudomonas aeruginosa (P. aeruginosa), Aspergillus tubingensis (A. tubingensis) have been selected for the study and they are responsible for acne, directly or indirectly. ResultsThe gel's physical characteristics met the required benchmarks. These four gel formulations effectively inhibit the growth of selected strains. According to studies, the gel was also very efficient against fungal strains and gram-negative organisms. Zones of inhibition (ZOI) were found between 2.3 and 11.2 µm. The highest ZOI was measured against P. aeruginosa. ConclusionThe herbal gel was found to have highly promising anti-bacterial and anti-fungal activity against acne and many skin-related infections in a concentration-dependant manner but more research is needed.

The journey of patients with skin diseases from the first consultation to the diagnosis in a representative sample of the European general population from the EADV burden of skin diseases study.

The journey of patients with skin diseases through healthcare has been scarcely investigated. To analyse the journey of people with skin diseases in the different healthcare environment in Europe. This multinational, cross-sectional, European study was conducted on a representative sample of the adult general population of 27 European countries. The prevalence of the most frequent skin diseases was determined. Information was collected on the patient journey from the first medical consultation to the diagnosis, and the reasons for not consulting a healthcare professional. On a total of 44,689 individuals, 30.3% reported to have consulted a dermatologist during the previous 2 years. Participants consulted mainly for mole control or skin cancer screening (22.3%), followed by chronic skin diseases (16.2%). The diagnoses of acne, atopic dermatitis, psoriasis and rosacea were made most frequently by a dermatologist, while fungal skin infections were diagnosed more often by a general practitioner (GP), and sexually transmitted diseases (STD) by other specialists. The diagnosis was not always definitive at the first consultation, in particular for STD. The percentage of people who did not consult a healthcare professional for their skin disease was particularly high for acne (36.4%), alopecia (44.7%) and fungal infection (30.0%). Moreover, 17.7% of respondents with psoriasis did not consult. A high percentage of participants with alopecia thought that the disease was not worrying, while patients with psoriasis often answered that they were able to manage the disease since they had already consulted a doctor. Many patients with acne (41.1%) and fungal infection (48.2%) thought that they were able to handle the disease by themselves. The analysis of the self-reported medical journey of patients with common skin diseases may allow to understand the unmet needs of patients, thus improving outcomes and reducing expenses.

Formulation Of Benzoyl Peroxide Microsponge-Based Transdermal Gel For Acne Infection And Its Evaluation.

Benzoyl peroxide is a peroxide with antibacterial, irritating, keratolytic, comedolytic, and anti-inflammatory properties. When benzoyl peroxide is applied topically, it breaks down and releases oxygen, which kills the germs of Propionibacterium acnes. Benzoyl peroxide's irritating impact causes an increase in epithelial cell turnover, which causes the skin to peel and aids in the healing of comedones. Treatment for acne vulgaris involves the use of benzoyl peroxide. The research is aimed at studying the formulation of Microsponge gel preparation of benzoyl peroxide by using Carbopol 934 as a gelling agent and evaluation of microsponge gel formulation for its physicochemical properties. Microsponges of Anti-acne agent benzoyl peroxide drug were prepared by quasi-emulsion method, and in-vitro drug release using a suitable membrane model using a simple diffusion cell. Prior to drying, the microsponge was filtered and rinsed using distilled water. Formulation containing benzoyl peroxide and Eudragit RS100 with a ratio of 1:4 showed a high 87.5% drug content and 78.20 % yield. The drug content of the microsponge gel was found to be 84%. Microbiological study on S. aureus was conducted by the cylinder cup method and found good results. The in-vitro diffusion of microsponge formulations was sustained for 8 hours. The drug release rate for Eudragit RS-100 was reported to be 88.87% after 8 hours based on the polymer: drug ratio (4:1). The quasi-emulsion solvent diffusion method was used to successfully prepare benzoyl peroxide microsponges using Eudragit RS100, Ethyl Cellulose, and HPMC K4M as polymers. The formulations with the highest medication concentration were made with the porous polymer Eudragit RS100.

Bacterial network construction and molecular docking approach to study interaction of Myristica fragrans on Acne infections

Acne vulgaris is a very common bacterial infection caused. Herbal remedies have always give a positive response in treatment of various disease in disorders. The present study works on predicting the probable interactions between the Myristica fragrans bioactives with the bacterial targets via network pharmacology and docking techniques. The bio-actives and disease targets were obtained from open databases and literature review. Protein and pathway enrichment analysis was done by utilizing metascape and STRING tool. Cytoscape tool were utilized for construction of network. The compounds were further assessed using molsoft tools and docking was done using auto-dock tools. The potential bio-actives were selected further the network construction gave insights on the highest degree values. The targets with highest interactions were docked and the complex which showed good binding was selected. It was found that Stigmasterol and Campesterol have the highest potential and can be considered as hit compounds for further studies too. 

Real-world effectiveness of abrocitinib treatment in patients with difficult-to-treat atopic dermatitis.

Abrocitinib is a JAK-1 selective inhibitor registered for the treatment of moderate-to-severe atopic dermatitis (AD). Although efficacy and safety have been shown in phase 3 clinical trials, data on real-world patients with a treatment history of advanced systemics are scarce. The objective of the study was to evaluate the effectiveness and safety of abrocitinib treatment in patients with difficult-to-treat AD in daily practice. In this prospective observational single-centre study, all AD patients who started abrocitinib treatment in the context of standard care between April 2021 and December 2022 were included. Effectiveness was assessed using clinician- and patient-reported outcome measures. Adverse events were evaluated. Forty-one patients were included. The majority (n = 30; 73.2%) had failed (ineffectiveness) on other targeted therapies, including JAK inhibitors (n = 14, 34%) and biologics (n = 16, 39%). Abrocitinib treatment resulted in a significant decrease in disease severity during a median follow-up period of 25 weeks (IQR 16-34). Median EASI score at baseline decreased from 14.7 (IQR 10.4-25.4) to 4.0 (IQR 1.6-11.4) at last review (p < 0.001). Median NRS itch decreased from 7.0 (IQR 5-8) to 3.0 (IQR 1-2) at last review (p < 0.001). The most frequently reported AEs included gastrointestinal symptoms (27.6%), acne (20.7%) and respiratory tract infections (17.2%). 16 (39%) patients discontinued abrocitinib treatment due to ineffectiveness, AEs or both (41.2%, 41.2% and 11.8%, respectively). Abrocitinib can be an effective treatment for patients with moderate-to-severe AD in daily practice, including non-responders to other targeted therapies.

Steroid Toxicity in Immune Thrombocytopenia – A Series of Unfortunate Events: A Case Report

Immune thrombocytopenia (ITP) is a common bleeding disorder characterised by isolated thrombocytopenia, due to immune-mediated accelerated platelet destruction, usually without any specific or identifiable precipitating factor. ITP most commonly presents with bleeding associated with a low platelet count &lt;100×109/L. Corticosteroids are the first line of treatment in adults. However, steroid-induced complications are widespread in patients with ITP, and sometimes are more atrocious than the risk of bleeding associated with thrombocytopenia. The authors report the case of a 29-year-old male with ITP with recurrent episodes of epistaxis, who was treated with prednisolone for 8 weeks and developed acne, steroid-induced hyperglycaemia, and urinary tract infection with epididymitis and pyocele. A few weeks later, the patient developed blurring of vision, and was found to have central serous chorioretinopathy. They were treated adequately for each of these complications, and had complete resolution of symptoms following cessation of steroids. While acne and hyperglycaemia are common, urinary tract infections with epididymitis and central serous chorioretinopathy are infrequent complications following steroid administration. The complexity of adverse events and the challenges in diagnosing and treating these unique complications prompted the authors to report this case.

International Consensus Statement on the Management of Glenohumeral Arthritis in Patients ≤ 50 Years Old.

The purpose of this study was to implement a modified Delphi technique among a group of experts affiliated with American Shoulder and Elbow Surgeons (ASES) and European Society for Surgery of the Shoulder and Elbow (SECEC) to determine areas of consensus regarding what factors influence their decision to manage a patient surgically and what specific treatment modalities they utilize for patients ≤ 50 years of age with glenohumeral arthritis (GHA). The panel of experts comprised 168 shoulder and elbow specialists, 138 ASES and 30 SECEC members. In the first round, an open-ended questionnaire was utilized to solicit features that are important in making decisions regarding treatment. The second round involved ranking the features identified in the first round as to their importance in helping decision making for surgery. The results of round two were then utilized and 18 complex surgical cases previously treated by one of the lead authors were provided for the study. One additional case was included to address the management of Cutibacterium acne (C.Acne) infection. 159 (95.0%) participants completed the round one survey, 142 (89%) responded to the second and third round survey. In total 50 individual factors were positively associated with the decision to proceed with surgery. Ten of these were strongly supportive of surgery. Eight out of 18 clinical cases demonstrated >80% agreement on the surgical treatment modality chosen. Over 90% of respondents chose rTSA to manage pathology when an incompetent rotator cuff was present. Over 90% of respondents managed AVN with hemiarthroplasty (HA). Over 70% of respondents chose aTSA for inflammatory arthritis with low demand on their shoulder. 79% of respondents chose a stemless humeral component when a HA or aTSA was chosen in response to the proposed surgical cases. If arthroscopy was chosen there was good agreement on five core procedures. There was only fair consensus on the approach to C.acnes in patients with GH OA≤ 50 years of age. The optimal treatment of glenohumeral arthritis in patients ≤ 50 years of age remains controversial, and there are many treatment options to consider when responding to the variety of clinical presentations and anatomic pathologies. While physicians and patients engage in the shared decision-making process regarding the final choice for management, this consensus statement serves as a basis for discussion amongst colleagues and between patients and surgeons though it clearly demonstrates that the topic must be further investigated prospectively and with large cohorts.

Cutibacterium acnes KCTC 3314 Growth Reduction with the Combined Use of Bacteriophage PAP 1-1 and Nisin.

Severe acne has high psychological impacts recorded worldwide, from depression to suicide. To control acne infection, bacteriophage could be used in synergy or combination with antibiotics/antimicrobials. Bacteriophages are specific to their hosts without interfering with the normal skin microbes and have the ability to lyse bacterial cells. In this current study, the bacteriophage PAP 1-1 was isolated, characterized, and tested against the pathogenic acne-causing bacterium Cutibacterium acnes. Examination under transmission electron microscopy (TEM) revealed that the newly isolated phage has a morphology typical of siphoviruses. Phylogenetic analysis, utilizing the maximum likelihood (ML) algorithm based on complete genome sequences, revealed that PAP 1-1 clustered together with bacteriophages active to Propionibacterium acnes (now known as C. acnes), forming a distinct evolutionary lineage. The genomic analysis further identified the presence of an endolysin gene in PAP 1-1, suggesting its potential to regulate the growth of C. acnes. Subsequent experiments conducted in RCM broth confirmed the ability of PAP 1-1 to effectively control the proliferation of C. acnes. In combination with bacteriocin from Lactococcus lactis CJNU 3001 and nisin, PAP 1-1 greatly decreased the viable cell counts of C. acnes in the broth.

Characterization of the newly isolated phage Y3Z against multi-drug resistant Cutibacterium acnes

Cutibacterium acnes (C. acnes) is a symbiotic bacterium that plays an important role in the formation of acn e inflammatory lesions. As a common component of the acne microbiome, C. acnes phages have the potential to make a significant contribution to treating antibiotic-resistant strains of C. acnes. However, little is known about their genetic composition and diversity. In this study, a new lytic phage, Y3Z, infecting C. acne, was isolated and characterized. Electron microscopy analysis revealed this phage is a siphovirus. Phage Y3Z is composed of 29,160 bp with a GC content of 56.32%. The genome contains 40 open reading frames, 17 of which had assigned functions, while no virulence-related genes, antibiotic resistance genes or tRNA were identified. The one-step growth curve showed the burst size was 30 PFU (plaque-forming unit)/cell. And it exhibited tolerance over a broad range of pH and temperature ranges. Phage Y3Z could infect and lyse all C. acnes isolates tested, though the host range of PA6 was restricted to C. acnes. Based on the phylogenetic and comparative genomic analyses, Y3Z may represent a new siphovirus infecting C. acnes. Characterization of Y3Z will enrich our knowledge about the diversity of C. acnes phages and provide a potential arsenal for thetreatment of acne infection.

Analyzing the Predictability of an Artificial Intelligence App (Tibot) in the Diagnosis of Dermatological Conditions: A Cross-sectional Study.

Artificial intelligence (AI) aims to create programs that reproduce human cognition and processes involved in interpreting complex data. Dermatology relies on morphological features and is ideal for applying AI image recognition for assisted diagnosis. Tibot is an AI app that analyzes skin conditions and works on the principle of a convolutional neural network. Appropriate research analyzing the accuracy of such apps is necessary. This study aims to analyze the predictability of the Tibot AI app in the identification of dermatological diseases as compared to a dermatologist. This is a cross-sectional study. After taking informed consent, photographs of lesions of patients with different skin conditions were uploaded to the app. In every condition, the AI predicted three diagnoses based on probability, and these were compared with that by a dermatologist. The ability of the AI app to predict the actual diagnosis in the top one and top three anticipated diagnoses (prediction accuracy) was used to evaluate the app's effectiveness. Sensitivity, specificity, and positive predictive value were also used to assess the app's performance. Chi-square test was used to contrast categorical variables. P<.05 was considered statistically significant. A total of 600 patients were included. Clinical conditions included alopecia, acne, eczema, immunological disorders, pigmentary disorders, psoriasis, infestation, tumors, and infections. In the anticipated top three diagnoses, the app's mean prediction accuracy was 96.1% (95% CI 94.3%-97.5%), while for the exact diagnosis, it was 80.6% (95% CI 77.2%-83.7%). The prediction accuracy (top one) for alopecia, acne, pigmentary disorders, and fungal infections was 97.7%, 91.7%, 88.5%, and 82.9%, respectively. Prediction accuracy (top three) for alopecia, eczema, and tumors was 100%. The sensitivity and specificity of the app were 97% (95% CI 95%-98%) and 98% (95% CI 98%-99%), respectively. There is a statistically significant association between clinical and AI-predicted diagnoses in all conditions (P<.001). The AI app has shown promising results in diagnosing various dermatological conditions, and there is great potential for practical applicability.

TREATMENT OF COMBINED ACNE AND GENITOURINARY INFECTIONS CAUSED BY CHLAMYDIA AND MYCOPLASMAS.

The aim: To substantiate, develop and apply in clinical practice a method for the treatment of combined acne and genitourinary infections caused by chlamydia and mycoplasmas. Materials and methods: Acne was diagnosed clinically. Chlamydia trachomatis; Mycoplasma genitalium; Mycoplasma hominis; Ureaplasma urealyticum were identified using polymerase chain reaction. 30 patients with combined acne and urogenital chlamydia and/or mycoplasmas received sequential oral antibiotic therapy with josamycin (1500 mg daily) and gatifloxacin (400 mg daily) for 10 days each. Simultaneously with antibiotic therapy, concomitant symptomatic and topical treatment was provided. Results: The elimination of pathogens of urogenital chlamydia and/or mycoplasmas was achieved with 29 out of 30 patients (93.3%). At the same time a complete regression of facial rash inflammatory elements was detected at 18 (60%) treated patients, while with the remaining 12 (40%) the regression was significant. Conclusions: Antibiotic therapy was used in the treatment for both acne and urogenital chlamydia and/or mycoplasmas. An original method of complex treatment of combined acne and urogenital chlamydia and/or mycoplasmas was substantiated, developed and successfully applied. The offered method of treatment can be considered as a proof of high effectiveness both for elimination of pathogens from the genitourinary system of patients, and for complete or significant elimination of inflammatory facial rash.

Purse-string suture combined with subcision and dermal graft for the treatment of wide depressed scars and boxcars.

Dermal layer injuries can result in depressed or indented scars even when there is no subcutaneous injury. These scars can result from acne, chickenpox, trauma, or skin infection. Several procedures, including primary closure, subcision, microneedling, and dermal grafting, have been reported to be used to treat depressed scars, boxcars, or acne cosmetics. These procedures have not, however, been shown to be very effective when applied to the treatment of deep depressed scars, boxcars, or acne cosmetics. In this retrospective study, we assessed scar improvement in patients with deep depressed facial scars and boxcars treated with our novel combination of techniques. This study included all patients treated for deep depressed scars and boxcars at our clinic from 2018 to 2021. To be included, patients had to present in our clinic for the treatment of deep depressed scars or boxcars, have no prominent subcutaneous layer injury, and have full set of clear pre-and post-procedure photographs. All patients initially received technique combination including scar subcision, inner purse-string suturing, and dermal grafting for the first stage surgery treatment. In cases of residual uneven superficial scars, laser dermabrasion resurfacing was used as second-staged treatment. Preoperative and six-month postoperative scar appearance photographs were assessed for improvement by our three nonmedical staff members and divided into four improvement groups, as minimal, moderate, good, and excellent. This study included a total of 24 patients (20 females and four males) with facial scarring. Two patients (8.3%) had moderate, 13 (54.2%) good and nine (37.5%) excellent improvement post-treatment. There were no instances of minimal improvement. Four patients received second stage laser dermabrasion resurfacing for residual uneven superficial scars. We concluded deep depressed scars and boxcars can be easily, safely, and effectively treated using our novel combined scar subcision, inner purse-string suturing, and dermal grafting treatment with possible second-staged laser dermabrasion, and without major complications.

Nanoencapsulation of Tea Catechins for Enhancing Skin Absorption and Therapeutic Efficacy.

Tea catechins are a group of flavonoids that show many bioactivities. Catechins have been extensively reported as a potential treatment for skin disorders, including skin cancers, acne, photoaging, cutaneous wounds, scars, alopecia, psoriasis, atopic dermatitis, and microbial infection. In particular, there has been an increasing interest in the discovery of cosmetic applications using catechins as the active ingredient because of their antioxidant and anti-aging activities. However, active molecules with limited lipophilicity have difficulty penetrating the skin barrier, resulting in low bioavailability. Nevertheless, topical application is a convenient method for delivering catechins into the skin. Nanomedicine offers an opportunity to improve the delivery efficiency of tea catechins and related compounds. The advantages of catechin-loaded nanocarriers for topical application include high catechin loading efficiency, sustained or prolonged release, increased catechin stability, improved bioavailability, and enhanced accumulation or targeting to the nidus. Further, various types of nanoparticles, including liposomes, niosomes, micelles, lipid-based nanoparticles, polymeric nanoparticles, liquid crystalline nanoparticles, and nanocrystals, have been employed for topical catechin delivery. These nanoparticles can improve catechin permeation via close skin contact, increased skin hydration, skin structure disorganization, and follicular uptake. In this review, we describe the catechin skin delivery approaches based on nanomedicine for treating skin disorders. We also provide an in-depth description of how nanoparticles effectively improve the skin absorption of tea catechins and related compounds, such as caffeine. Furthermore, we summarize the possible future applications and the limitations of nanocarriers for topical delivery at the end of this review article.