Active Acne Research Articles

Serum Survivin Level as A Novel Biomarker in Acne Vulgaris Patients

Background: Acne vulgaris is a common skin disease characterized by sebum overproduction, which is hormonally mediated, follicular hyper-keratinization and chronic inflammation of the pilosebaceous unit. Survivin is a member of inhibitors of the apoptosis (IAP) gene family. It is a 16.5 kDa protein that inhibits apoptosis and regulates cell division, proliferation, and survival. Objective: To determine the survivin level in acne vulgaris patients and detect the relation of its levels with acne severity and presence of acne scarring. Patients and Methods: Forty acne vulgaris patients were included in this case control study along with forty age and sex matched healthy controls. The patients were recruited from Dermatology, Venereology and Andrology Department, Faculty of Medicine, Zagazig University Hospitals in the period from October 2017 to May 2018. Results: Results showed that there were statistical significant difference in survivin level among the three groups showing highest levels in scar group followed by active acne group then control group (P < 0.001). These findings support that there is a relationship between survivin and developing acne and acne scars. Moreover we found that there was statistical significant increase in survivin level among cases of active acne with progressive course compared to stationary cases (P=0.001). There was also statistical significant positive relation between survivin level and acne severity. Conclusion: The findings of this study showed a significant association between survivin level and both active acne and acne scars, in addition to positive relation between survivin level and severity of acne. All these findings prove that survivin protein has a potential important role in acne pathogenesis and mechanism of acne scarring.

Serum Survivin Level as A Novel Biomarker in Acne Vulgaris Patients

Background: Acne vulgaris is a common skin disease characterized by sebum overproduction, which is hormonally mediated, follicular hyper-keratinization and chronic inflammation of the pilosebaceous unit. Survivin is a member of inhibitors of the apoptosis (IAP) gene family. It is a 16.5 kDa protein that inhibits apoptosis and regulates cell division, proliferation, and survival. Objective: To determine the survivin level in acne vulgaris patients and detect the relation of its levels with acne severity and presence of acne scarring. Patients and Methods: Forty acne vulgaris patients were included in this case control study along with forty age and sex matched healthy controls. The patients were recruited from Dermatology, Venereology and Andrology Department, Faculty of Medicine, Zagazig University Hospitals in the period from October 2017 to May 2018. Results: Results showed that there were statistical significant difference in survivin level among the three groups showing highest levels in scar group followed by active acne group then control group (P < 0.001). These findings support that there is a relationship between survivin and developing acne and acne scars. Moreover we found that there was statistical significant increase in survivin level among cases of active acne with progressive course compared to stationary cases (P=0.001). There was also statistical significant positive relation between survivin level and acne severity. Conclusion: The findings of this study showed a significant association between survivin level and both active acne and acne scars, in addition to positive relation between survivin level and severity of acne. All these findings prove that survivin protein has a potential important role in acne pathogenesis and mechanism of acne scarring.

Exploring Occupational, Recreational, and Environmental Associations in Patients With Clinically Manifest Cardiac Sarcoidosis

BackgroundSarcoidosis is a condition of unknown etiology. A number of occupational, recreational, and environmental exposures have been associated with the development of extra-cardiac sarcoidosis. Patients with clinically manifest cardiac sarcoidosis (CS) have a distinct clinical phenotype. We sought to explore the exposures associated with clinically manifest CS. MethodsTwo groups of patients were recruited in a prospective registry: cases (patients with clinically manifest CS) and controls (patients without sarcoidosis and who had similar cardiac presentations to cases). A validated survey, previously used in other sarcoidosis phenotypes, was sent to all patients. ResultsA total of 113 patients met the inclusion criteria and were sent the survey, of whom 79 of 113 (69.9%) completed the survey. We found 3 environmental associations. First, we found a negative association of CS with smoking, with 8 of 43 (18.6%) CS patients being current or ex-smokers compared to 17 of 36 (47.2%) of the controls. Second, we found a positive association with mold exposure, with 21 of 43 (48.8%) CS patients having a prior history of mold exposure compared to 9 of 36 (25.0%) of the controls. After multivariable analysis, there remained significant associations between CS and smoking (odds ratio 0.14 [95% confidence interval 0.04-0.51], P = 0.002) and mold exposure (odds ratio 5.69 [95% confidence interval 1.68-19.25], P = 0.005). Finally, patients with CS and self-reported acne had a significantly longer duration of active acne (7.82 ± 3.97 years) than did control patients 2.67 ± 1.03 years (P = 0.006). ConclusionsWe found a negative association between smoking history and the diagnosis of CS. We also found a significant 5-fold increase in mold exposure and a positive association with duration of acne in patients with CS compared to controls.

A split-face comparison of a fractional microneedle radiofrequency device and fractional radiofrequency therapy for moderate-to-severe acne vulgaris.

Radiofrequency equipment, including invasive fractional microneedle radiofrequency (FMR) and noninvasive fractional radiofrequency (FR), has facilitated progress in the field of active acne treatment, but clinical data are limited. This study aimed to compare the efficacy and safety of FMR and FR in the treatment of moderate-to-severe acne vulgaris. Ten patients with moderate-to-severe acne were enrolled in a 24-week, prospective, single-blind, randomized, comparative clinical trial with a split-face design. Fractional microneedle radiofrequency treatment was provided on one side of the face and FR on the opposite side. Three consecutive treatments were performed at 4-week interval. Objective assessment of efficacy was performed using the Acne Severity Index (ASI), and acne inflammatory lesions and noninflammatory lesions were evaluated. After the first treatment, ASI and both inflammatory and noninflammatory lesions of the FMR-treated side were improved to a greater degree than the FR-treated side. Patients' subjective satisfaction was also better regarding the FMR-treated side. After subsequent treatments, efficacy improves for both groups, and no significant differences in the above efficacy parameters between the two groups were observed. Pain scores were significantly higher for the FR-treated side than the FMR-treated side. Fractional microneedle radiofrequency is faster and more effective than FR for the treatment of moderate and severe acne after only one treatment. However, after several treatment sessions, both FMR and FR proved to be safe and effective for long-term treatment of moderate-to-severe acne. Therefore, invasive radiofrequency, such as FMR, or noninvasive radiofrequency, such as FR, can successfully treat active acne.

A Morphological Study of Acne Scarring and Its Relationship between Severity and Treatment of Active Acne.

Background:Scarring is one of the most dreadful complications of acne for which patients seek surgical treatment.Objective:The aim of this research was to study the morphological features of acne scarring and the relationship between severity of acne and its treatment with type and severity of acne scars.Materials and Methods:This was a hospital-based, noninterventional, cross-sectional study carried out over a period of 1 month on 100 patients with post-acne scarring. A morphological evaluation of the types, sites, and severity of acne scars was done, and details of the severity and treatment of acne were recorded.Results:Of 100 patients included in the study, 61 were male and 39 were females. Females had an earlier onset of acne (15.8 years) as compared to males (16.5 years). The mean duration of active acne was longer in males (99.3 months) than that in females (74.4 months). Male patients had more severe acne vulgaris as compared to females (P = 0.0001). Of 100 patients, 52 started treatment 1 year after the onset of acne, and 18 patients had never taken any anti-acne medication. Morphologically, majority of post-acne scars were ice pick scars in 94% patients, followed by rolling scars in 86%, boxcar scars in 54%, and keloidal scars in 10% patients. Male patients had more severe acne scarring than females (P < 0.05). Of 54 patients with severe acne, 22 progressed to moderate grade and 32 patients progressed to severe grade of acne scarring. Significant reduction in the severity of acne scarring was observed in patients who received isotretinoin as compared to that in patients who received oral antibiotics.Conclusion:Majority of patients with active acne delay treatment, which leads to increased acne scarring. Ice pick scars are the most common type of acne scars, and keloidal scars are more common in males. Males have a longer duration of acne, they delay treatment, and have more severe acne scarring. Early introduction of oral isotretinoin may help to reduce the severity of acne scarring. Public education is essential to urge patients to seek early and appropriate treatment of acne that can reduce the incidence and severity of acne scarring and its psychosocial consequences.

Prevalence and Psychological Impact of Acne Vulgaris in Female Undergraduate Medical Students of Rawalpindi and Islamabad, Pakistan.

Background:Acne vulgaris is a common skin disease, affecting approximately 9.4% of the world’s population, with considerable effect on the quality of life. According to a previously conducted study, the prevalence rate of acne in Pakistan was found to be 5%. And to this date, no reliable data is available about the prevalence of acne in Rawalpindi and Islamabad, Pakistan.ObjectivesTo determine the prevalence of acne vulgaris and its psycho-social impact on female undergraduate medical students of Rawalpindi and Islamabad.MethodsA cross-sectional study was conducted during the month of August 2019 among female undergraduate medical students from three randomly selected medical colleges of Rawalpindi and Islamabad. The diagnosed cases of acne vulgaris were assessed by using the Dermatology Life Quality Index (DLQI). The collected data were then analyzed using SPSS version 20 (IBM Corp., Armonk, NY, US).ResultsThe prevalence of acne vulgaris was found to be 14.47% in female undergraduate medical students of Rawalpindi and Islamabad. Sixty percent (n=99) were found to have itchy sores and stinging skin, 66.7% (n=110) were embarrassed by their acne-prone skin, and the social activity of 60% (n=99) of the participants was affected by their active acne. Of the students, 73.9% were not affected by their acne while studying or working. Around 61.2% (n=101) complained that their acne treatment was a problem and hiding it took time or made a mess.Two percent showed a severe impact, with 14% having very large, 44% moderate, 30% low, and the remaining 10% with no effect of acne in their psychosocial functioning.ConclusionAcne vulgaris is a chronic skin disease that considerably affects the psychosocial functioning of female undergraduate medical students. A holistic approach in treating acne requires the participation of a dermatologist and mental health professional.

"Anterior" chemabrasion for acne scars treatment.

Acne is one of the most prevalent skin conditions seen by dermatologists. Acne scars are a frequent complication of acne that may negatively impact on person’s physical, mental and social well-being, as although active acne can persist for a decade or more, acne scars may persist for a lifetime. Although a wide range of treatments are currently being used, there is a lack of high-quality evidence on which is the most effective treatment for acne scars, especially for those with huge severity. Therefore, based on personal experience of various clinical scenarios, the present study aimed to provide both patients and health care providers insights about the suitability of different new techniques for treating acne scars to better improve the quality of life of patients suffering from this condition.

Novel Histological Evidence of Collagen and Elastin Regeneration in Fractional RF-Treated Acne Scars

Introduction: Fractional radiofrequency (RF) technology has been shown to be a gold standard therapy for acne scars. We have previously published clinical and histological results from the treatment of 8 patients with active acne and acne related scarring using a fractional RF device. Evidence of safety and efficacy was demonstrated, including long term follow-up clinical results from 4 patients, up to two years post last fractional treatment. In the current article we present histology evidence of acne scar skin renewal 3.5 years post treatment. Methods: Skin biopsies from acne scars in a concealed facial area were taken before, after four treatments and at 3.5 years after the last fractional treatment. Biopsies were examined with standard hematoxylin and eosin (H&E) stain, as well as Verhoeff’s Van Gieson (VVG) and Shikata stains for elastic fibers. Results: Histological findings demonstrate regeneration of elastic fibers and reduction of the dermal fibrosis. Scar depth of Patient #2 was reduced by 80% in the corresponding follow-up period. Conclusion: The long-term histological results further support the previously published findings that fractional RF is a safe and effective treatment for acne related scars.

Comparative study of 35% glycolic acid, 20% salicylic–10% mandelic acid, and phytic acid combination peels in the treatment of active acne and postacne pigmentation

Background:Acne is a commonly encountered disorder in the dermatological practice. Chemical peeling is one of the treatment modalities in acne and postacne pigmentation. Although various peeling agents are available, studies comparing their efficacy are lacking. Moreover, there is a paucity of studies comparing the efficacy of combination peels in Asian population.Materials and Methods:Forty-five patients with mild to moderate acne were divided into three groups of fifteen each. Groups A, B, and C underwent peeling sessions biweekly with 35% glycolic acid, 20% salicylic–10% mandelic acid, and phytic acid peels, respectively, for a total of six sessions. All other anti-acne treatments were stopped. Lesion count was carried out at baseline and at each follow-up visit. Acne scoring and postacne hyperpigmentation index were noted at each visit. Photographic record was maintained.Results:Significant reduction in inflammatory and noninflammatory lesion count was noted at 12 weeks in all the three study groups. Reduction in acne score at the end of 12 weeks in the three study groups was 70.55%, 74.14%, and 69.7%, respectively. A significant decline was observed in the postacne hyperpigmentation index in all the three study groups at the end of 12 weeks (P = 0.034).Conclusion:All three chemical peels are effective in the treatment of mild to moderate acne in Asian population. No significant adverse effects were noted.

Treatment of active acne by a novel high-power diode laser at 1060 nm: A case report

Treatment of active acne by a novel high-power diode laser at 1060 nm: A case report

Type I and type II acute-phase proteins in acne vulgaris

Background Acne vulgaris is a common inflammatory skin condition affecting a large section of the population. However, the serum levels of acute phase proteins (APPs) in those patients have not been studied enough. Objective To study the serum levels of different APPs in acne vulgaris patients and to investigate their clinical relevance. Patients and methods Sixty moderate to severe active acne vulgaris patients according to Global Acne Grading system, in addition to forty age, sex and BMI matched acne free control subjects were included. Double-antibody sandwich ELISA kits were used for measuring high sensitivity C reactive protein (hs-CRP), ferritin and hepcidin according to manufacturer’s protocols. Results Serum levels of hs-CRP and hepcidin were significantly higher in patients than control subjects (P=0.01 and 0.02 respectively). The serum level of hsCRP in severe acne vulgaris patients was significantly higher than in moderate disease (P=0.02). Patients with post inflammatory hyperpigmentation showed significantly higher hepcidin level than those without post inflammatory hyperpigmentation (P= Conclusion Serum levels of CRP and hepcidin are elevated in acne vulgaris. hs-CRP correlates with the disease severity. The possible effect of hepcidin on melanocytes activity requires further investigation.

Survivin and insulin-like growth factor-I: potential role in the pathogenesis of acne and post-acne scar.

Backgrounds/objectives:Acne is an inflammatory disease of the pilosebaceous unit (PSU). The over-expression of survivin and insulin-like growth factor (IGF)-I in some fibrotic disorders suggests a possible implication in the pathogenesis of acne and or post-acne scar. We aimed to evaluate their potential role in pathogenesis in acne and post-acne scar.Methods:Serum survivin and IGF-I levels were estimated in 30 patients with acne and post-acne scar compared to 30 controls.Results:There was a statistically significant difference in survivin and IGF-I levels between controls and patients (P < 0.05). However, there was no linear correlation between survivin and IGF-I.Conclusions:Survivin and IGF-I could have a possible role in the pathogenesis of active acne and in post-inflammatory acne scar.

Acne disparities in Native Americans

Acne disparities in Native Americans

Lesional and circulating levels of interleukin-17 and 25-hydroxycholecalciferol in active acne vulgaris: Correlation to disease severity.

The immunological aspects of inflammatory acne are still incompletely understood, so this study aimed to investigate the possible role of IL-17 and 25 hydroxycholecalciferol (25(OH)D3) in the disease pathogenesis and progression. Across-sectional study has been conducted on 135 patients with active acne vulgaris of various severities and 150 matched controls. ELISA assays of serum and tissue levels of IL-17 and 25(OH)D3, also immunohistochemical and Western blotting demonstration of the expression patterns of lesional IL-17 in comparison with control group, were performed. The mean serum levels of IL-17 were 544.2pg/mL±477.4 SD and 42.2pg/mL±8.1 SD for acne patients and controls, respectively, with significantly higher levels among the patient group (P<0.05). Higher IL-17 expression levels in active acne lesions when compared with its level in healthy skin of the controls. The mean serum levels of 25(OH)D3 among patients and controls were 33.3ng/mL±9.7 SD and 51.7ng/mL±2.7 SD, respectively, with significantly lower levels among the patient group (P<0.05). There were significantly negative correlations between IL-17 and 25(OH)D3 levels (P<0.001 for both). Deficiency of vitamin D3 accompanied with higher IL-17 in an inverse pattern may have a possible role in active acne vulgaris.

The Spectrum and Sequelae of Acne in Black South Africans Seen in Tertiary Institutions

Introduction: Acne is a chronic disorder of the pilosebaceous unit affecting all ethnic groups. It remains in the top 5 skin conditions seen worldwide. The paucity of data characterizing acne in South African Blacks led us to the documentation of types and sequelae of acne. Methods: This is a cross- sectional study describing the spectrum and variants of acne in 5 tertiary hospitals in the second most populous province in South Africa over 3 months (January 1 – March 31, 2015). Results: Out of 3,814 patients seen in tertiary dermatology clinics, 382 (10%) had a primary diagnosis of acne or rosacea, forming the fourth most common condition seen. Acne accounted for 361 (94.5%); acne vulgaris was the commonest subtype at 273 (75.6%), followed by steroid-induced acne 46 (12.7%), middle-age acne 6 (1.7%), acne excoriée 2 (0.6%), and “undefined” 34 (9.4%). Conclusion: The observation of steroid-induced acne as the second most common variant in Black patients underlines the need to enquire about steroid use and education about the complications of using steroid-containing skin-lightening creams. Treatment of postinflammatory hyperpigmentation should be part of the armamentarium for holistic acne treatment in Blacks, as it remains a major concern even after active acne has resolved.

Laser treatments of active acne.

The utility of laser therapy is increasingly being recognized in the treatment of active acne vulgaris. We aimed to perform a narrative review of the medical literature on the use of laser therapy for the treatment of active acne vulgaris. We performed a PubMed literature search on September 1, 2016 using the search terms "active acne," "acne," "laser therapy," and "laser surgery." Case reports, case series, cohort, and controlled trials were included. Studies of lasers in the treatment of acne, including erbium glass, Nd:YAG, pulse dye laser (PDL), potassium titanyl phosphate (KTP) laser, and laser-based photodynamic therapy, have been published. While treatment of active acne with lasers has been successful, many studies are limited by small patient number and lack of control populations and comparison to standard therapies for active acne. Laser therapies are increasingly becoming part of or an adjunct to the medical treatment of active acne and are a useful treatment modality.

Assessment of Serum Desnutrin Levels in Patients with Acne Vulgaris

Background: Acne vulgaris is a common chronic skin disease involving blockage and/or inflammation of pilosebaceous units (hair follicles and their accompanying sebaceous gland). Desnutrin is the major triglyceride lipase in the adipose tissue of mice and excessive secretion from adipocytes results in decreased triacylglycerol storage and increased lipolysis, fatty acid oxidation and thermogenesis. Objective: The aim of this study is to evaluate serum level of Desnutrin in acne vulgaris patients and correlate it with disease severity. Patients and Methods: This study was performed on 40 patients with active acne lesions and 40 healthy subjects with no previous history of acne and no active acne lesions as controls. The control group was composed of age, gender, and Body mass index (BMI) matched individuals. All the patients were recruited from the outpatient clinic of Dermatology & Venereology Department, Ain Shams University hospitals, from March 2016 till August 2016.Serum desnutrin assessment was done by ELISA kit using Sandwich-ELISA as a method. The Micro elisa stripplate has been pre-coated with a Horse Radish Peroxidase antibody specific to desnutrin. The optical density was measured spectrophotometrically. Results: There was a significantly lower level of serum desnutrin among cases compared to that of control group, while the fasting blood glucose level was significantly higher among cases compared to that of control group. The collective data from both study groups showed a significant negative correlation between the mean serum fasting blood glucose level and desnutrin level. There was no significant correlation between the severity of acne and serum desnutrin level. Conclusion: The level of serum desnutrin can affect the occurrence and the progression but not the severity of acne among susceptible individuals. The level of fasting blood glucose is also of value regarding the occurrence of acne and has a negative effect on the level of desnutrin.

Evaluation of the prevalence, risk factors, clinical characteristics, and burden of acne scars among active acne patients in Brazil, France, and the USA

Evaluation of the prevalence, risk factors, clinical characteristics, and burden of acne scars among active acne patients in Brazil, France, and the USA

Efficacy and safety of superficial chemical peeling in treatment of active acne vulgaris.

Acne vulgaris is an extremely common condition affecting the pilosebaceous unit of the skin and characterized by presence of comedones, papules, pustules, nodules, cysts, which might result in permanent scars. Acne vulgaris commonly involve adolescents and young age groups. Active acne vulgaris is usually associated with several complications like hyper or hypopigmentation, scar formation and skin disfigurement. Previous studies have targeted the efficiency and safety of local and systemic agents in the treatment of active acne vulgaris. Superficial chemical peeling is a skin-wounding procedure which might cause some potentially undesirable adverse events. This study was conducted to review the efficacy and safety of superficial chemical peeling in the treatment of active acne vulgaris. It is a structured review of an earlier seven articles meeting the inclusion and exclusion criteria. The clinical assessments were based on pretreatment and post-treatment comparisons and the role of superficial chemical peeling in reduction of papules, pustules and comedones in active acne vulgaris. This study showed that almost all patients tolerated well the chemical peeling procedures despite a mild discomfort, burning, irritation and erythema have been reported; also the incidence of major adverse events was very low and easily manageable. In conclusion, chemical peeling with glycolic acid is a well-tolerated and safe treatment modality in active acne vulgaris while salicylic acid peels is a more convenient for treatment of darker skin patients and it showed significant and earlier improvement than glycolic acid

Study of glycolic acid and salicylic acid peels as a sole therapy in treatment of acne vulgaris

Introduction: Acne vulgaris is a very common physiological condition of adolescents, better regarded as a disease due to some inflammatory component. 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 significant improvement in the treatment of acne. This study aims to observe the therapeutic response of two chemical peels, 35% glycolic acid and 30% salicylic acid on active acne lesions, when given as monotherapy. Materials & Methods: A total of 200 patients of either sex with acne were randomly selected and enrolled for the study, two groups of 100 patients each were made of 35% GA and 30% SA respectively. No other concurrent therapy was given. Individual lesions of each type were calculated before and after completing 6 treatment sessions and the numbers were observed to know the effect of both the acids on different types of lesions. Results: After 6 sessions, in the glycolic acid group the reduction in average number of comedones was 88.45%, inflammatory papules 88.65%, pustules 89.62% & nodules/cysts 83.33%. Whereas, in the Salicylic acid group, the reduction was 89.00%, 90.36%, was 84.87% & 100% in comedones, papules, pustules & nodules/cysts respectively. Conclusion: In our observation, both 35% glycolic acid and 30% salicylic acid are significantly effective as monotherapy in patients of acne. They not only clear the acne lesions but also show improvement in post acne scar and hyperpigmentation to some extent.