Acne Therapy Research Articles

Ameliorative effect of Lactobacillus plantarum CCFM8661 on oleic acid-induced acne: Integrated the gut microbiota link to the acne pathogenesis.

Acne vulgaris is an inflammatory disease of the pilosebaceous unit of the skin that has serious adverse effects on the physical and mental health of patients. Probiotics are extensively employed in dermatology and could be an alternative option for acne therapy. Here, we evaluated the effect of oral ingestion of live and inactivated Lactobacillus plantarum CCFM8661 on oleic acid-induced acne using a mouse model. Results found that live L. plantarum CCFM8661 suppressed the skin inflammation and serum hormone (insulin and testosterone) production in acne mice. Parallelly, live L. plantarum CCFM8661 effectively reduced the formation of skin lipids (TG and NEFA), and normalized the expression of skin lipid metabolism-related genes (PPRA-γ, SREBP-1c, ACCα, FASN, PPRA-α, ACOX1, HSL and ATGL). In comparison, inactivated L. plantarum CCFM8661 had no effect on skin inflammation or serum hormone secretion, but decreased the skin TG and normalized the expression of skin lipid metabolism-related genes (PPRA-γ, SREBP-1c, FASN and ATGL) in acne mice. Both live and inactivated L. plantarum CCFM8661 raised the richness of gut microbiota, reduced the ratio of Bacteroidetes: Firmicutes, and decreased the relative abundance of Staphylococcus in the feces of acne mice. Oral ingestion of L. plantarum CCFM8661, particularly live cells, could alleviate acne by suppressing skin inflammation, normalizing the metabolism of hormones and skin lipids, which may be achieved by improving the gut microbial ecosystem. This article is protected by copyright. All rights reserved.

Emerging Insights into the Applicability of Essential Oils in the Management of Acne Vulgaris.

The occurrence of pustules, comedones, nodules, and cysts defines acne vulgaris, a prevalent chronic inflammatory dermatological condition. In the past few decades, essential oils extracted from varied natural sources have acquired recognition due to their potential medicinal applications in acne therapy. However, there is not yet sufficient medical data to fully characterize this interaction. Multiple factors contribute to the development of acne vulgaris, including excessive sebaceous production, inflammatory processes, hyperkeratinization, and infection with Cutibacterium acnes. Essential oils, including oregano, lavender, lemon grass, myrtle, lemon, thyme, eucalyptus, rosemary, and tea tree, have been found to possess anti-inflammatory, antioxidant, and antimicrobial properties, which may target the multifactorial causes of acne. Analytical methods for determining antioxidant potential (i.e., total phenolic content, diphenyl-1-picrylhydrazyl free radical scavenging assay, reducing power assay, ferrous ion chelating activity, thiobarbituric acid reactive species assay, β-carotene bleaching assay, etc.) are essential for the evaluation of these essential oils, and their method optimization is crucial. Further studies could include the development of novel acne treatments incorporating essential oils and an assessment of their efficacy in large clinical trials. In addition, further research is necessary to ascertain the mechanisms of action of essential oils and their optimal doses and safety profiles for optimal implementation in the management of acne vulgaris.

Isotretinoin-unresponsive acne as a sign of a congenital disorder: a case of 21-hydroxylase deficiency.

Acne is a multifactorial and common disorder among young people and a frequent reason for dermatology consultation. When moderate-to-severe acne is not responsive to conventional treatments, oral isotretinoin is a very effective solution. However, there are cases in which this treatment fails to produce the expected results. In this case, an 18-year-old male patient with acne, unresponsive to traditional acne therapies, experienced only a partial benefit from oral isotretinoin. Endocrinology consultation and hormonal work-up revealed androgen metabolism anomalies suggestive of a non-classical form of congenital adrenal hyperplasia due to 21-hydroxylase deficiency. In this case report, the authors discuss when to suspect, how to diagnose, and how to manage similar cases.

A multicentric, prospective, observational study evaluating the use patterns of Sebium night peel for acne-prone skin and associated conditions

Background: Acne is a common skin disorder that affects both adolescents and adults and is categorized as an inflammatory dermatosis. Persistent adult acne is prevalent in more than 80% of cases. Chemical peels are widely used in acne therapy due to their various benefits, including exfoliation, acne lesion reduction, complexion radiance improvement, and scar repair. The procedure, consisting of 2 to 8 sessions, is ideal for adult women with oily skin, acne breakouts, and concerns about photoaging and complexion radiance. Methods: A cohort of Indian dermatologists were provided a questionnaire related to the quantum of weekly acne patients seen and their clinical expertise regarding the use of Sebium Night Peel containing 15% glycolic acid, the Fluidactiv™ patented complex & D-panthenol. These results were later analyzed using a standardised visual analogue scale. Results: The study enrolled 826 patients, and complete responses were received from 73 dermatologists practicing clinical and aesthetic dermatology across major cities in India. The study revealed that 97% of dermatologists would recommend the Sebium Night Peel as a chemical peel for patients with acne and acne-related complications. The majority of dermatologists rated the peel's tolerability and safety as "good" across various evaluation criteria. Additionally, 97% of dermatologists reported no safety concerns associated with the Sebium Night Peel. Conclusions: This study establishes the Sebium Night Peel as a preferred and effective chemical peel for managing acne-prone skin and associated conditions, as endorsed by dermatologists across India.

Prescribing Patterns of Oral Antibiotics and Isotretinoin for Acne in a Colorado Hospital System: Retrospective Cohort Study.

Guidelines established by the American Academy of Dermatology recommend oral antibiotics as first-line therapy for mild, moderate, and severe acne. However, it is recommended to minimize the duration of oral antibiotic use, and there is increasing support for other systemic agents for acne. We sought to characterize the use of oral antibiotics and isotretinoin for the treatment of acne in the pediatric and young adult population aged 10 through 20 years and the adult population aged 21 to 45 years from 2011 to 2019. We conducted a retrospective, observational cohort study using electronic data from the enterprise data warehouse of the University of Colorado Anschutz Medical Campus and its affiliates, with data in the format of the Observational Health Data Sciences and Informatics (OHDSI) Observational Medical Outcomes Partnership (OMOP) common data model. Categorical values (sex, race, and ethnicity) were compared using chi-square tests, and continuous variables (age) were compared using 2-tailed t tests. Our cohort of 15,704 patients was composed of mostly White (12,776/15,704, 81.4%), non-Hispanic or Latino (13,307/15,704, 84.7%), and female (11,093/15,704, 70.6%) patients. Among the 4605 male patients in the eligible cohort, 1810 (39%) received an oral antibiotic treatment, in comparison to 3109 (28%) of the 11,093 eligible women (P<.001). Among the 4605 men who were eligible for treatment with isotretinoin in this population, 988 (21.5%) received a course of isotretinoin, compared to only 10.4% (1159/11,093) eligible women (P<.001). Male patients were 1.67 times more likely to have received an antibiotic prescription(odds ratio [OR] 1.67, 95% CI 1.55-1.79) and over twice as likely to have received an isotretinoin prescription (OR 2.34, 95% CI 2.13-2.57) than female patients. Minocycline was the most frequently prescribed antibiotic for the treatment of acne in this study cohort. From 2015 to 2019, there was no significant change in the number of antibiotic prescriptions over time. Men were significantly more likely to receive both oral antibiotics and isotretinoin than female patients. Multiple factors could be contributing to this discrepancy, including the burden of iPLEDGE, additional systemic treatment options for female patients, and the difference in acne severity across sexes. We could not determine the difference in severity of acne between male and female patients in our cohort, and further research is needed to ascertain the variation across sexes.

Photodynamic therapy of acne

Acne is one of the most common skin conditions in the world. A number of studies have shown that photodynamic therapy (PDT) is safe and effective for both inflammatory and non-inflammatory acne and can significantly improve skin conditions in this disease. The effectiveness of PDT against acne is mainly due to a decrease in the amount of sebum produced by the sebaceous glands due to a decrease in their activity as a result of direct photodynamic damage to the sebaceous glands, eradication of Cutibacterium acnes, and a decrease in the level of hyperkeratosis. Compared with systemic drug therapy, PDT treatment of severe acne has the following advantages: fast results, high efficiency, high selectivity, no systemic adverse reactions and drug resistance, and low recurrence rate. Most often for PDT in patients with acne, drugs based on 5-aminolevulinic acid (5-ALA) and its methyl ester (ME-ALA) are used. At the moment, there are no unified recommendations on PDT regimens for the treatment of this skin pathology. Various studies demonstrate the high efficiency of PDT with a wide range of doses of 5-ALA (3-20%) and ME-ALA (4-16%), light doses (15-120 J/cm2 ), and exposure time (30-90 min). The general trend in studies by different authors is that gentle low-intensity PDT regimens for acne demonstrate the same high efficiency with a significant reduction in pain during irradiation and local skin reactions (erythrema, edema, and hyperpigmentation).

Treatment of mild to severe acne with 1726 nm laser: A safe alternative to traditional acne therapies.

Acne is the most common reason for dermatology consultation in adolescents and young adults. Consultation is often delayed despite unsuccessful self-treatment. Postponing effective treatment places acne sufferers at higher risk for permanent acne scars and post-inflammatory pigment changes. This review discusses clinical challenges with present therapeutic options for acne treatment and the role of a 1726 nm laser for acne. Current acne treatment guidelines were reviewed. A literature review was conducted for trials of light-based acne therapy. The selectivity of previous light-based therapies was reviewed. Available acne therapy is effective, but treatment-related side effects are common. Acne treatment guidelines do not include recommendations for light-based treatments. Different types of light-based treatments have been tried but until now no wavelength specifically targeted sebaceous glands. The 1726 nm laser is safe and effective for treating mild to severe acne in all Fitzpatrick skin types. Acne resolution is apparent within the first month and improves for up to 2 years beyond treatment.

Fabrication and functional attributes of nanotherapeutically engineered system for co-administration of adapalene and lycopene for enhanced acne management: an in vitro and in vivo investigation

BackgroundAcne vulgaris is caused due to several different biological, environmental and specific pathological factors, resulting in secretion of unregulated amount of sebum by the sebaceous glands. Acne is thought to be a minor, self-restraint, puberty leading and hormone-induced cosmetic disorder. It significantly affects the quality of life leading to social disengagement, anxiety, depression, necessitating its therapeutic management in due course of time. Thus, despite not being fatal it has social and mental impact on individual’s life. Pathogenesis of acne is complex and multifactorial involving diverse physiological, environmental factors and significant role of propionibacterium acne. Retinoids have been used as preferred first-line therapy for treatment of acne, but they have many limitations. Adapalene has found to be acting synergistically with other drugs like benzoyl peroxide, salicylic acid, clindamycin, etc., and various other topical antioxidants.ResultsThe study investigates the formulation and characterization of novel nanostructured lipid vesicles (NLVs) co-loaded with adapalene and lycopene, through topical gel. The high-pressure homogenization method was used to prepare nanostructured lipid vesicles followed by incorporation into hydrophilic gel vehicle. This novel system was scientifically tested for various evaluation parameters like size and vesicle size distribution, polydispersity index, drug entrapment efficiency and in vitro drug release characteristics, along with rheological behavior of formulation gel. Skin permeation and biodistribution characteristics through skin were also evaluated, and better localization of drug in dermis and reduced systemic penetration were the key observation in prepared formulation.ConclusionThe simultaneous co-administration of lycopene resulted in an additive effect in therapeutic management of acne. It can be predicted that this novel NLVs-based gel along with synergistic effect of lycopene will definitely result in better therapeutic efficacy and reduced systemic adverse effects of adapalene. This combination can be explored as future alternative for acne therapy.

Low-Dose versus Conventional-dose Oral Isotretinoin Regimens: A Systematic Review on Randomized Controlled Comparative Studies of Different Regimens.

The effectiveness of Isotretinoin is superior compared to other acne therapies, particularly in reducing acne lesion counts. Concerns, however, arise relating to the most optimal dosage regimen with the best efficacy and lesser side effect. We intend to review existing randomized controlled comparative studies of isotretinoin in different regimens. PubMed, Cochrane, Scopus, and ScienceDirect were searched. The inclusion criteria is the RCT article. Full-text reading excluded articles that did not use GAGS as the method of measurement. Out of 921 articles that were electronically searched, 6 RCTs were extracted and summarized descriptively. After full-text reading, 4 RCTs were included. We then conducted risk of bias assessments for the selected studies using The Cochrane Risk of Bias Tool. Across all trials, low-dose regimens were preferable in all types of acne-owing to its similar efficacy to conventional dose but with fewer occurrence of side effects as well as better patients' satisfaction and compliance. Furthermore, a continuous low-dose regimen had the best efficacy in comparison to other regimens of low-dose treatment. The limitations of our study include a slight difference in dosage between selected studies. Other limitations are that some studies did not explain the side effects and relapse rate thoroughly and did not state the compliance scoring method used. This review recommends continuous low-dose treatment as the chosen regimen for acne vulgaris. However, further evaluation regarding relapse rate compared to the conventional dose is needed.

P102 Severe atopic eczema is associated with reduced acne vulgaris in Bangladeshi children and young adults: a retrospective analysis from a cross-sectional study

Abstract Atopic eczema (AE) is the most common inflammatory dermatosis, affecting up to 20% of children. Loss of function (LoF) mutations in FLG are the most strongly implicated genetic risk factor for eczema. To understand the effect of FLG on the pathobiology of AE, we knocked down FLG in primary keratinocytes using short hairpin RNA and performed phosphoproteomic analysis, which showed downregulation of the AKT signalling pathway, confirmed using Western blotting to phospho-AKT and immunostaining of biopsies from patients with AE. Given that AKT signalling is increased in acne vulgaris, we hypothesized that loss of FLG may protect patients with AE from acne. The Tower Hamlets Eczema Assessment (THEA) study is a cross-sectional study that aims to phenotype and genotype 1000 Bangladeshi children and young adults with AE. So far, 620 participants have undergone genotyping, 37% of whom have LoF mutations in FLG. We selected patients from this cohort who were older than 12 years of age. In total, 204 patients (99 FLG wild type, 86 heterozygotes, 19 compound heterozygotes) were included. We identified a diagnosis of acne or previous prescription of topical acne therapies or tetracycline antibiotics from the patients’ general practice e-health records. We stratified the patients by genotype, Eczema Area and Severity Index (EASI) score, Patient Oriented Eczema Measure (POEM) score, transepidermal water loss (TEWL) and palmar hyperlinearity groups. The χ2-test was used to determine differences between groups. A lower proportion of patients with AE with FLG mutations had acne (27% wild type vs. 19% FLG mutations), which was more pronounced, but not statistically significant, in the compound heterozygote group (16%). We saw a nonsignificant reduction in acne in patients who had the top 25% of TEWL measurements, those with the most severe form of hyperlinearity and those with higher POEM scores. Patients with severe AE, measured as an EASI score &amp;gt; 21, had a more reduced incidence of acne than those with lower EASI scores (9% vs. 26%; P = 0.04). Overall, this suggests that patients with more severe AE are protected from developing acne. There was insufficient evidence to establish if this was mediated by a reduction in filaggrin (FLG) and AKT signalling. This may be because the groups were too small to determine this. Given that all patients with severe AE have reduced FLG expression regardless of genotype, it is possible that this is mediated through FLG–AKT signalling.

Acne-like Eruptions: Disease Features and Differential Diagnosis

The term “acne-like eruptions” encompasses a variety of skin conditions resembling acne vulgaris. While both acne-like dermatoses and true acne are frequently observed in clinical settings, differentiating between the two might be challenging. Similar to acne, the lesions of acne-like eruptions may exhibit papules, pustules, nodules, and cysts. However, contrary to acne, comedones are uncommon but may still be observed in certain types of acne-like eruptions. Moreover, acne-like eruptions can be differentiated from acne based on their sudden onset, the propensity to occur across all age groups, the monomorphic appearance of lesions, and the distributions extending outside the seborrheic regions. The development of acne-like eruptions cannot be attributed to a single underlying mechanism; nevertheless, various factors such as patient age, infections, occupation, habits, cosmetics, and medications may be involved. The observed lesions may not respond to standard acne therapy, necessitating that treatment strategies are tailored in accordance with the identified causative agents. The following review aims to outline distinct entities of acne-like eruptions and present features that set them apart from true acne. Acne-like eruptions in the adult population, infectious diseases resembling acne, and acne-like eruptions resulting from exposure to chemical and physical agents are addressed in this paper. An understanding of the clinical presentation, pathophysiology, and epidemiology of this group of dermatoses is pivotal for a precise diagnosis and provision of appropriate care.

Liposomes containing azithromycin and green tea as an anti-acne treatment: Formulation and Characterization

Liposomes and other novel drug delivery carriers are highly adaptable, allowing for the distribution of a wide range of pharmacological compounds. The antibiotic azithromycin is widely regarded as the most effective treatment for acne. Lower efficacy or higher negative effects have led to decreased use of topical azithromycin. In this study, liposomes have been chosen because it is hypothesised that this may lessen the drug's side effects when used in conjunction with Azithromycin. Traditional herbal therapies have been intensively investigated as alternatives to conventional treatments for many ailments due to the possibility for side effects and antibiotic resistance from conventional pharmaceuticals. Thanks to its antibacterial qualities, green tea is one of the most effective natural therapies for acne. The lipid film hydration method was used to create drug-loaded liposomes, and the optimal component ratios were established. Liposomes were studied for their in-vitro drug release properties and characterised for their vesicle size, shape, encapsulation effectiveness, and drug content. Formulations F1 and F6, which included a 1:1 ratio of fat to cholesterol, showed the highest levels of encapsulation efficiency (69.5% and 66.2%, respectively) and in-vitro drug release (82.5 and 82.2 percent, respectively). Carbopol gel has been modified to include liposomal formulations, and the results have been compared to those of commercially available gels that do not use liposomes. Within 24 hours, the release of azithromycin (90.5%) was greater in the non liposomal marketed gel than in the liposomal gel (77.5% and 74.8%) of green tea. Green tea liposomes used in the formulation had a MIC value that was comparable to that of commercially available, non-liposomal gel. It was discovered that azithromycin was more effective than green tea in killing Micrococcus luteus.

ROLE OF GLYCOLIC ACID PEELING (35%) IN MANAGEMENT OF ACNE VULGARIS: A PROSPECTIVE COMPARATIVE STUDY

Introduction: Acne vulgaris is a common dermatological disorder primarily affecting adolescents and young adults. In spite of various modalities of treatment available, it still poses a therapeutic problem to the dermatologists. The advent of new and potent topical therapeutic modalities such as chemical peeling has resulted in signicant improvement in the treatment of acne. This study aims to observe the therapeutic res Objective: ponse of 35% glycolic acid peeling in active acne lesions as an adjuvant to conventional anti acne therapy. This Materials &amp; Methods: was randomized control study in which 100 patients of mild – moderate grade acne vulgaris were taken and divided into 2 groups of 50 each. Group A was given conventional anti acne management and group B was given Glycolic acid peeling every 3 weeks in addition to the conventional anti acne management. Follow up was done for 4 months and results were compared between the 2 groups. we found that acne grade improved faster in Group B patients (patients undergoi Result &amp; Conclusion: ng GLA peel). Although Group B patients showed faster improvement in clearance of acne lesions but by the end of the study i.e., at 15 weeks both the group had equal response rate. This means that glycolic acid peeling can be used as an adjuvant with conventional antiacne management to fasten the resolution of acne lesions but nal response after full course of treatment is similar in both group

Formulation and in vitro study of nanoparticles loaded Anredera cordifolia leaf extract as anti-acne

Background: The ethanolic extract of Anredera cordifolia (AC) leaves has previously been investigated to have antibacterial activity against Propionibacterium acnes. An active antibacterial compound against propionibacterium acnes was flavonoid. Objective: This study aimed to compare antimicrobial activity differences between nanoparticles and extract alone. Method: AC leaves were extracted and then formulated into nanoparticles using chitosan as the polymer and sodium tripolyphosphate (Na-TPP) as a crosslinker. The nanoparticle-preparation method was ionic gelation, while the antibacterial study used the disc method. Result: Nanoparticle evaluations showed an average size of 84.93±15.36nm, a polydispersity index of 0.22, a percent entrapment efficiency of 55.06±1.05%, and an average yield of 11.00±1.27%. Based on statistical t-test analysis, nanoparticles differed significantly from extract alone in antimicrobial activity. Conclusion: Nanoparticles significantly increase the antibacterial effectiveness of extract through the synergism effect between chitosan and flavonoid content in the extract. Hence nanoparticles serve good potency to deliver extract for acne therapy.

Acne disease in germ cell tumors. A brief review of the literature and a description of our own clinical observation

malignant neoplasms (MNP). The frequency of PNS in MNP ranges from 1 to 20 % according to different authors. One of the manifestations of PNS is acne, which occurs against the background of malignant neoplasm due to hormonal disorders.The presented article describes a clinical case of a patient with a mixed germ cell tumor and metastases in the retroperitoneal lymph nodes. The germ cell tumor produced human beta-chorionic gonadotropin, which led to the development of acne as a PNS.Antitumor treatment (surgical removal of the tumor and polychemotherapy) normalized the levels of human beta-chorionic gonadotropin and serum testosterone, which in turn led to regression of acne without acne therapy.

922 Analysis of inflammatory pathways induced in dendritic cell-types by different strains of cutibacterium acnes: Lessons for acne therapy

922 Analysis of inflammatory pathways induced in dendritic cell-types by different strains of cutibacterium acnes: Lessons for acne therapy

Ethosomes Loaded with Spiranolactone for Acne treatment through Topical Gel Formulation

The goal of this work was to create Spiranolactone-loaded ethosomes and use them as a topical acne therapy gel. The size of the vesicle, Spiranolactone filling, and encapsulation function of ethosomes were all created and tested. Improved ethosomes were produced as Carbomer 974 gels and tested for transdermal permeability and porosity, as well as in vitro transplantation, against traditional hydroethanolic gels. With Spiranolactone efficiency of loading and encapsulation of 0.433±0.006 mg/mL and 39.29±0.65 percent, the produced ethosomes had a mean size of vesicle 68.1±1.8 nm. A well-developed ethosomal gel had 2.5 times the transdermal flux and 2.1 times the skin implantation of regular gels. For mild skin irritation, ethosomal gel has a superior anti-acne impact. This research reveals that ethosomal formation is a good way to transfer spiranolactone to the skin, and that spiranolactone ethosomal gels could be used to treat acne in the future.

Diagnosis and Treatment of Acne Vulgaris: A Narrative Literature Review

Acne vulgaris usually occurs during puberty due to hormonal changes. However, acne can also occur in adulthood due to factors such as stress, genetics, and overuse of cosmetics. There are various types of treatments for acne, ranging from topical treatments to oral medications and cosmetic procedures. This literature review aimed to describe the diagnosis and treatment of acne vulgaris. Acne is a common skin condition, and the degree of acne can vary from mild to severe. Acne can be classified according to its severity, namely acne degrees I (mild), II (moderate), III (severe), and IV (very severe). Acne therapy that is appropriate to the degree can help reduce inflammation and speed up the healing of skin affected by acne. In grade I acne, therapy begins with topical treatments such as benzoyl peroxide, salicylic acid, or retinoids. In grade II acne, acne therapy involves topical and oral treatments. Oral antibiotics such as tetracycline or doxycycline can help reduce skin inflammation. In grade III acne, acne treatment usually requires stronger oral medications such as isotretinoin. In grade IV acne, acne therapy usually requires more aggressive interventions such as cyst drainage or laser treatment to remove acne scars. In conclusion, determining the right degree of acne vulgaris can improve the accuracy of therapy and cure.

EFFECTS OF ISOTRETINOIN ON PLATELET COUNT AND MEAN PLATELET VOLUME DURING TREATMENT OF ACNE VULGARIS

The most effective systemic therapy for acne is Isotretinoin. However, Isotretinoin has many side effects, including known side effects like dryness, palmoplantar exfoliation, rash, teratogenicity, raised intraocular pressure, and deranged liver functions and lipid profile. Its lesser-known side effects include its effects on platelet count and mean platelet volume (M.P.V.). This Quasi-experimental case series was conducted to observe the change in platelet count and mean platelet volume in patients taking Isotretinoin for acne vulgaris, attending the dermatology outpatient department at Jinnah Hospital Lahore from May 10th 2016 to November 9th 2016. After ethical committee approval and informed consent, subjects of acne vulgaris with an indication for Isotretinoin were included in the study from O.P.D. Relevant demographic and clinical details were recorded in a standardized predesigned proforma. Citrated blood samples were taken under aseptic conditions. Baseline platelet counts and mean platelet volume were determined using an auto-analyzer in the pathology laboratory of Jinnah hospital Lahore. All the patients were advised to take daily Isotretinoin at a dose of 0.5 mg/kg for 12 weeks. Platelet counts and mean platelet volume were again measured after twelve weeks after the start of treatment. A total of 100 patients completed the study. The age of the patients ranged from 18 to 60 years with a mean + sd age of 27.26+5.88 years. Out of these 41%(n=41) were male and 59%(n=59) were females. The severity of acne was measured using Global Acne Grading System (G.A.G.S.). It was recorded that 62%(n=62) had moderate, 22%(n=22) had severe while 16%(n=16) had very severe acne vulgaris. The mean pre-treatment platelet count was 271273+9139 c/µL, while 259192+11717 c/µL was post-treatment. The mean difference was 12080+8140 c/µL, and the p-value was 0.001. The mean platelet volume was 10.63+1.01 fl as pre-treatment and 9.77+1.01 fl as post-treatment. The mean difference was 0.85+0.04 fl, and the p value was 0.001. We concluded that Isotretinoin decreases platelet count and means platelet volume in patients receiving isotretinoin treatment for acne vulgaris.

Sarecycline inhibits protein translation in Cutibacterium acnes 70S ribosome using a two-site mechanism.

Acne vulgaris is a chronic disfiguring skin disease affecting ∼1 billion people worldwide, often having persistent negative effects on physical and mental health. The Gram-positive anaerobe, Cutibacterium acnes is implicated in acne pathogenesis and is, therefore, a main target for antibiotic-based acne therapy. We determined a 2.8-Å resolution structure of the 70S ribosome of Cutibacterium acnes by cryogenic electron microscopy and discovered that sarecycline, a narrow-spectrum antibiotic against Cutibacterium acnes, may inhibit two active sites of this bacterium's ribosome in contrast to the one site detected previously on the model ribosome of Thermus thermophilus. Apart from the canonical binding site at the mRNA decoding center, the second binding site for sarecycline exists at the nascent peptide exit tunnel, reminiscent of the macrolides class of antibiotics. The structure also revealed Cutibacterium acnes-specific features of the ribosomal RNA and proteins. Unlike the ribosome of the Gram-negative bacterium Escherichia coli, Cutibacterium acnes ribosome has two additional proteins, bS22 and bL37, which are also present in the ribosomes of Mycobacterium smegmatis and Mycobacterium tuberculosis. We show that bS22 and bL37 have antimicrobial properties and may be involved in maintaining the healthy homeostasis of the human skin microbiome.