Pustule Formation Research Articles

34888 Refractory pustular psoriasis treated successfully with IL-23 inhibitors. Report of 1 patient with generalized pustular psoriasis and 4 patients with palmoplantar pustulosis

Introduction: It is known that the key inflammatory cytokines in plaque psoriasis are TNF-a/IL-23/IL-17/IL-22. Conversely, recent data demonstrate that pustular psoriasis is mainly characterized by a neutrophil-driven inflammatory response following “hyperactivation” of the IL-36 axis. However, it appears that these 2 pathways cross-talk to each other and act synergistically in the pathophysiologic mechanism of pustule formation. In terms of guidance to treatment, no robust data exist. Considering the advances into the pathophysiology, arises the question whether the novel IL-23 antagonists could lead to clinical improvement. Methods: We present a 75-year-old female patient with generalized-pustular-psoriasis for 10 years and 4 patients (2 females and 2 males) 53, 58, 60, and 62 years old with palmoplantar-pustulosis for 3, 5, 5, and 6 years, respectively. The former had unsuccessfully undergone every available at that point systemic therapy (both conventional and biologic) whereas the laters had failed acitretin, MTX/acitretin, apremilast/acitretin, acitretin/MTX/apremilast respectively. All five had PGA score >3. We initiated an IL-23 inhibitor. Patient with the generalized-pustular form and 2 patients with the palmoplantar form received risankizumab whereas the other 2 guselkumab. Results: All 4 had reached PPPGA 0/1 by week 12, whereas the patient with generalized pustular form had reached PGA 1 by week 16. Formers are currently undergoing the sixth month of therapy, whereas the later the eighteenth month and still present great response. Conclusions: Il-23 might be a key operator in the interconnection of the complex pathogenetic pathways in pustular psoriasis. Therefore, IL-23 inhibition could be a therapeutic option. More data are required.

Dispensability of Ascorbic Acid Uptake and Utilization Encoded by ulaABCD for the Virulence of Haemophilus ducreyi in Humans.

Compared with wounded skin, ascorbic acid is enriched in pustules of humans experimentally infected with Haemophilus ducreyi. Compared with the broth-grown inocula, transcription of the H. ducreyi ulaABCD operon, which encodes genes for ascorbic acid uptake, is increased in pustules. We hypothesized that ascorbic acid uptake plays a role in H. ducreyi virulence. Five volunteers were infected with both H. ducreyi strain 35000HP and its isogenic ulaABCD deletion mutant at multiple sites; the papule and pustule formation rates of the mutant and parent strains were similar. Thus, ascorbic acid uptake is not essential for H. ducreyi virulence in humans.

Pustular diseases and keratinocyte-myeloid synergy.

Pustules are among the most common lesions produced in human skin. Infections by pathogens and drug-induced reactions are frequent causes of pustule formation. In recent years immune-mediated pustular diseases have drawn attention. It is proposed to classify pustular diseases according to the initiating events and sites: purely epidermal pustules, follicular pustules or pustules noted in autoinflammatory syndromes. The unifying pathology in all of the three categories is a microinvasion of activated neutrophils into epidermal or adnexal epithelia. Formation of pustules involves established IL-17 / IL-23, IL-36 / IL-36RN driven pathology, or IL-1 /caspase-activated autoinflammation. Pathophysiology demonstrates an intriguing synergy of keratinocytes with neutrophils. This is called keratinocyte-myeloid synergy (KMS). Non-infectious pustules are formed by IFNα controlling the production of chemoattractants (IL-8, LTB4) or induced by IL-1-regulated inflammasomes and caspase/ IFNβ-induced chemotaxins. The presence of physical barriers, for example, cornified cell layers (str. corneum), is instrumental in establishing chemotactic gradients and blocking migrating neutrophils. In follicular KMS-driven pustular disorders, in contrast to epidermal pustules, neutrophil-mediated toxicity propagates lasting and expanding ulcerating diseases with increased levels of circulating immunoglobulin A (IgA). Complexed IgA is suggested to propagate ongoing pustular diseases. These are prerequisites essential for developing pustules in burdensome human skin diseases.

MANAGEMENT OF MUKHADUSHIKA (ACNE VULGARIS) BY AN AYURVEDIC APPROACH – A CASE STUDY

One of the most prevalent disorders seen in modern clinical practice is mukhadushika, which is characterized by facial eruptions that look like thorns (shalmalikantakavata). It is seen more from an aesthetic perspective than a medicinal one. It is classied in the Samhitas as a Kshudraroga, which are regarded to be mild illnesses. However, in rare instances like Mukhadushika, this can lead to a signicant aesthetic handicap and cause great emotional anguish. It can be likened to Acne vulgaris, a persistent inammatory disorder of the pilosebaceous follicles on the face, based on its clinical characteristics. It is characterized by the formation of papules, pustules, cysts, and comedones (black heads), some of which may heal to leave pitted scars. To some degree or another, modern medicine has been unable to completely eradicate this illness. The ShodhanaChikitsa like Virechana, Vamana, Nasya, and Lepa have been primarily referenced in the classics for this condition. In the treatment of Mukhadushika, clinical observation has demonstrated the effectiveness of Sadyovirechana and Manjishtha lepa. Here is a case report of a 19 years old male who arrived with red, sensitive acne on cheeks and chin along with excruciating discomfort and a burning feeling.

Clinical, Dermoscopic and Histopathologic Features of Cicatricial AlopeciaA Prospective Cohort Study

Introduction: Cicatricial Alopecia (CA) is a scarring form that arises due to permanent hair follicle destruction. It can either primarily affect the follicles or by an external process leads to secondary alopecia causing scarring and considerable disfigurement of the scalp. Hence initial diagnosis, aetiology of the contributing factors and earlier intervention are vital. Aim: To identify the diagnostic features of CA based on clinical, dermoscopic and histopathological (HP) findings and the underlying aetiological causes. Materials and Methods: This prospective cohort study was conducted in a tertiary care centre of Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India from November 2016 to September 2017. Total 50 clinically diagnosed CA cases were randomly selected and case history, related skin findings, predisposing factors and other findings associated with scarring were documented. Dermatological examination and Hair pull test was done. Trichoscopic examination was done using a non polarized dermoscopy with specific emphasis on the follicular ostia and morphological patterns. Scalp biopsy was done. The collected data were analysed in terms of frequency and percentage and Chi-square test was also performed with p-value <0.05 as statistically significant. Results: Out of total 50 patients, 22 (44%) were males, and 28 (56%) females with the mean age of 35.46±15.03 years. Total 29 (58%) patients had multiple lesions and 21 (42%) had localized involvement of alopecia in the scalp. Focal type was noted in 86%, and diffuse type in 14%. In this study, 80% of CA were of primary causes with only 20% secondary causes. Lichen Plano Pilaris (LPP) and trauma were the most common primary and secondary causes. The dermoscopic features of absent follicular orifice, arborising thicker blood vessel and pustule formation were statistically significant (p-value <0.001) for the diagnosis of CA. The most common histopathological feature was basal cell vacuolization (54%), followed by hyperkeratosis (52%), and follicular plugging (46%). Conclusion: The clinical, dermoscopic and histopathological findings of this study were consistent for diagnosis and differentiating primary CA. Histopathology is the final confirmatory diagnostic tool when characteristic clinical and dermoscopic features are absent.

Ocorrência de Ferrugem em Myrcianthes pungens (O. BERG) D. Legrand Causada por Austropuccinia psidii no Estado do Rio Grande do Sul

Abstract Guabiju tree (Myrcianthes pungens) belongs to the Myrtaceae family, with wide occurrence in Rio Grande do Sul (RS), southern Brazil, demonstrates great commercial potential regarding the consumption of its fresh fruit, which has a sweet taste and can be used in drinks, jellies and ice creams, in addition to its nutraceutical properties. As their main characteristic, rusts present the formation of orange pustules containing urediniospores of the pathogen on affected organs. The action of the pathogen causes deformation of stems, leaves, flowers and fruits, thus interfer-ing with the physiological processes of the plant. Thus, the present work aimed at presenting information on the occurrence and confirmation of the causal agent of guabiju rust, in addition to reporting the accessions most susceptible and resistant to Austropuccinia in the guabiju working collection of Eldorado do Sul, RS, Brazil. The diagnosis of the disease was based on symptoms, observation of fungal structures by light microscopy and molecular analyses. From microscopy, ellipsoid to ovoid and slightly equinulate urediniospores were observed, characteristic of Austropuccinia sp. The sequence of the internal transcribed spacer (ITS) region of the isolate showed 99.06% similarity with sequences from the same region of A. psidii deposited on the nucleotide database - GenBank (NCBI). This is the first report of rust associated with guabiju in the state of Rio Grande do Sul, Brazil. From the diagrammatic scale developed, it was possible to identify different levels of susceptibility to A. psidii in guabiju accessions under study.

Pathophysiology of Generalized Pustular Psoriasis.

Generalized pustular psoriasis (GPP) is a rare, severe form of pustular psoriasis characterized by widespread, recurrent episodes of neutrophil-rich pustule formation in the epidermis, which can be accompanied by fever and systemic inflammation. Recent clinical, histologic, and genetic evidence indicates that GPP is a distinct entity from plaque psoriasis, with different cytokine pathways predominant in the manifestation of each disease. The interleukin-36 (IL-36) signaling cascade plays a key role in regulating the innate immune system, and its dysregulation appears central to the pathogenesis of GPP. The altered expression of various IL-36 pathway constituents has been shown to cause a positive feedback loop of uncontrolled signaling and excess production of inflammatory cytokines, which in turn leads to chemokine induction and neutrophil recruitment in the epidermis. Given the potentially life-threatening nature of GPP episodes, drug interventions that rapidly achieve disease resolution are required. Early phase data indicate that treatments targeting various components of the IL-36 inflammatory cascade represent promising areas of research. However, there are currently no therapeutic agents specifically approved for GPP in the USA or Europe. Understanding the inflammatory pathways, associated risk factors, and role of neutrophils in the manifestation and perpetuation of GPP flares remains a key goal in developing effective therapeutics. In this article, we summarize the current understanding of GPP, describe novel therapeutic opportunities, and detail how the unique pathophysiology of the disease may inform future treatment strategies.Electronic supplementary materialThe online version of this article (10.1007/s40257-021-00655-y) contains supplementary material, which is available to authorized users.

Update on the aetiology and mechanisms of generalized pustular psoriasis.

Generalized pustular psoriasis (GPP) is a chronic disease characterized by non-bacterial pustules. Variants in several genes, such as IL36RN, AP1S3, and CARD14, are involved in the pathogenesis of GPP. The prevalence of different gene variants varies among ethnicities, and some variants are related to concurrent psoriasis vulgaris or age at onset. Flares can be triggered by medications (most commonly corticosteroids), infections (possibly due to Toll-like receptor [TLR] and antimicrobial peptides), pregnancy (the onset of GPP has been attributed to endocrine abnormalities such as hypoparathyroidism and hypocalcaemia), hypocalcaemia (presumably due to low levels of calcium and vitamin D regulating the proliferation and differentiation of keratinocytes), and other factors including stress and sun exposure. The mechanisms of pustule formation involve: 1) the LL37/TLR pathway, in which LL37 acts as an alarmin, interacting with TLR and activating the NF-κB and MAPK pathways; 2) the balance between calcium and 1,25(OH)2D levels, and 3) neutrophils and the complement system.

Equine Coital Exanthema: New Insights on the Knowledge and Leading Perspectives for Treatment and Prevention

Equine coital exanthema (ECE) is a highly contagious, venereally-transmitted mucocutaneous disease, characterized by the formation of papules, vesicles, pustules and ulcers on the external genital organs of mares and stallions, and caused by equid alphaherpesvirus 3 (EHV-3). The infection is endemic worldwide and the virus is transmitted mainly through direct contact during sexual intercourse and by contaminated instruments during reproductive maneuvers in breeding facilities. The disease does not result in systemic illness, infertility or abortion, yet it does have a negative impact on the equine industry as it forces the temporary withdrawal of affected animals with the consequent disruption of mating activities in breeding facilities. The purpose of this review is to provide up-to-date relevant information on the knowledge of EHV-3 infection and to analyze new approaches on diagnostics, treatment and prevention in the interest of minimizing the negative consequences of ECE in light of the current situation of the equine industry.

Pathergy Phenomenon.

Skin pathergy reaction (SPR) is a hyperreactivity response to needle induced trauma which is characterized by a papule or pustule formation, 24–48 h after sterile-needle prick. It is affected by a wide array of factors, including the physical properties of the needles being used, number of pricks and disease related factors such as male gender, active disease. There is a great variation in reactivity among different populations with very low positivity rate in regions of low prevalence like Northern Europe, and higher prevalance mainly in communities living along the historical Silk Road, like Turkey, China and Middle Eastern countries. SPR is not constant during the disease course, has lost its sensitivity over decades and can be positive in various disorders including Sweet's syndrome, pyoderma gangrenosum, Crohn's diesease, A20 haploinsufficiency, deficiency of IL-1-receptor antagonist and few others. Nevertheless, it is a criteria included into many currently used diagnostic or classification criteria for Behçet's disease. Although, not being fully uncovered yet, available data points to the activation of both innate and adaptive immune system with an inflammatory response mediated by polymorphonuclears and T-cells. In addition to its utility in diagnosis of Behçet's Disease, SPR may serve as a model for investigating the inflammatory pathways involved in the etiopathogenesis of this complex disease.

Morphological and cultural variability of most widely used antagonist, Trichoderma spp.

Use of Biological control agents becomes key element of sustainable agriculture which maintain ecological balance and shows antagonism against many major problematic plant diseases of world. Among the all BCAs, Trichoderma species are most extensively studied species in fungal genera. In order to utilize full potential of Trichoderma species as an antagonist against target phytopathogenic fungi in several ways, it becomes essential to have systemic knowledge concerning to the behavior of these fungi. So present study carried out for characterization of an antagonist used for management of predominant soil borne fungal pathogens i.e. Trichoderma spp. These isolates of Trichoderma spp. were subjected to the cultural studies by growing on Potato dextrose agar plates and accordingly sorted them into groups of respective species on basis of macroscopic i.e. colony characters like growth rates, pustule formation, pigmentation showing defined characteristics for that respective species.

Real life data on the biopsychosocial effects of Adalimumab in the management of hidradenitis suppurativa: A multicenter cross sectional analysis and consideration of a multisystem monitoring approach to follow up.

Hidradenitis suppurativa (HS) is a chronic relapsing, remitting disease which results in the formation of inflammatory nodules and pustules in intertriginous areas. HS is a complex disease with known psychosocial impact. Adalimumab is a biologic, used for treatment resistant HS, which working by inactivating TNF-alpha. Our primary objective was to determine the effects of adalimumab on HS-PGA and DLQI scores in patients with HS that had been on the treatment for at least 6 months. Our secondary objective was to note and assess the significance of adverse effects and impacts on wider health, namely occupational and social. A retrospective cross-sectional study was performed using clinic notes from routine follow ups in biologic clinics in three specialist HS centers. About 77% (n = 78/101) patients demonstrated improvements in their HS-PGA scores. Significant improvements in the DLQI scores of the patient cohort (P = .0001, 95% CI -12.8 to -5.9) have also been demonstrated. A total of 31.7% (32/101) patients experienced adverse effects spanning multiple organ systems, with 27.7% (28/101) requiring treatment cessation. Three of these patients stopped due to the worsening of preexisting mental health symptoms. Adalimumab is effective in reducing HS-PGA and DLQI scores, but patients still complain of systemic effects necessitating drug cessation in some instances. A holistic and multisystemic approach to follow up is required, and there is scope for further studies examining temporal causality in the context of adalimumab and its multisystemic physical and psychological effects.

Survey and isolation of Trichoderma spp. from rhizosphere soils of Western Maharashtra

In this study, the total 45 samples were collected from areas of Western Maharashtra. Out of these only 20 rhizospheric soil samples had the population of Trichoderma spp. The Trichoderma was isolated from the soil samples collected from the different locations of western Maharashtra by serial dilution technique and plating method. By visual observations 6, T. hamatum, 7, T harzianum (Rifai), 3, T. koningii (Oudem) and 4, T. asperellum (Samuels) were identified. T. harzianum and T .hamatum were present in most of the soil samples collected from Western Maharashtra region. The T. asperellum species was obtained from soil samples collected from Dhabewadi, sakri, Pachora and Tasgaon region of western Maharashtra. These isolates of Trichoderma spp. were studied and identified on basis of macroscopic i.e. colony characters like growth rates, pigmentation, colony edge, pustule formation showing defined characteristics for that respective species.

Fresh water skin disease in dolphins: a case definition based on pathology and environmental factors in Australia

A distinct ulcerative dermatitis known as “freshwater skin disease” is an emerging clinical and pathological presentation in coastal cetaceans worldwide. In Australia, two remarkably similar mortality events enabled the creation of a case definition based on pathology and environmental factors. The first affected a community of endemic Tursiops australis in the Gippsland Lakes, Victoria, while the second occurred among T. aduncus resident in the Swan-Canning River system, Western Australia. The common features of both events were (1) an abrupt and marked decrease in salinity (from > 30ppt to < 5ppt) due to rainfall in the catchments, with hypo-salinity persisting weeks to months, and (2) dermatitis characterized grossly by patchy skin pallor that progressed to variable circular or targetoid, often raised, and centrally ulcerated lesions covering up to 70% of the body surface. The affected skin was often colonized by a variety of fungal, bacterial and algal species that imparted variable yellow, green or orange discoloration. Histologic lesions consisted of epidermal hydropic change leading to vesiculation and erosion; alternately, or in addition, the formation of intra-epithelial pustules resulting in ulceration and hypodermal necrosis. Thus, the environmental factors and characteristic pathologic lesions, are necessary components of the case definition for freshwater skin disease.

Behçet’s syndrome in pediatric age

Introduction: Behcet's syndrome is a systemic vasculitis characterized by recurrent oral and/or genital ulcers, and several systemic manifestations. The authors describe the case of a pediatric-onset Behcet's syndrome. Case report: An 11-year-old boy was referred to the Pediatric consultation after two episodes of great saphenous vein thrombophlebitis. He had experienced daily oral aphthae for the past three years, and various episodes of folliculitis with pustule formation. Laboratory study was normal. The boy showed no signs of uveitis. The diagnosis of Behcet's syndrome diagnosis was established according to the international criteria, with positive HLA- B51 testing. Colchicine was initiated, with favourable response. Conclusions: Due to clinical feature overlap with other conditions, Behcet's syndrome diagnosis remains challenging. Consensus pediatric classification criteria developed in 2016 enabled greater sensitivity and earlier diagnosis.

Acute generalized exanthematous pustulosis induced by hydroxychloroquine prescribed for COVID-19

Acute generalized exanthematous pustulosis (AGEP) is a rare drug reaction characterized by acute, extensive formation of numerous nonfollicular sterile pustules on a background of edematous erythema.1 Hydroxychloroquine (HCQ) is widely used to treat rheumatic and dermatologic diseases, and is well known to cause AGEP.1 At the end of 2019, a novel coronavirus was identified as the cause of a cluster of pneumonia cases in Wuhan, city of China. It rapidly spread in China and outside, and on March 12, 2020, the World Health Organization declared a pandemic.

Cyclosporine for treatment of acute generalized exanthematous pustulosis: A retrospective analysis

Abstract Background Acute generalized exanthematous pustulosis (AGEP) is a severe cutaneous adverse reaction, typically to a medication, that is characterized by fever, neutrophilia, and a disseminated non-follicular pustular eruption. AGEP is typically self-resolving upon withdrawal of the offending agent, however it is not without complications and distributive shock due to systemic inflammatory response can lead to hemodynamic instability and organ failure1-2. These patients have been successfully treated with systemic corticosteroids3. Cyclosporine use in patients with AGEP has been limited to only a few case reports4, 5. To date, no studies have evaluated the utility of cyclosporine in the management of AGEP. We report the largest cohort of patients with AGEP treated with cyclosporine and compare them to patients treated with systemic glucocorticoids. Methods This was a retrospective study of adults admitted to Massachusetts General Hospital or Brigham and Women's Hospital with a diagnosis of AGEP from 2009-2019. The patients were identified via a query of electronic medical record systems at both hospitals, and their records were reviewed to find those who received cyclosporine, matched to approximately 3 age- (+/- 5 years) and sex-matched controls per case that received systemic glucocorticoids, amounting to a total of 23 controls. The patients were followed daily while inpatient, and within 2 weeks of discharge. Time from treatment initiation to first noted improvement (defined by defervescence, or symptomatic improvement), time to cessation of pustule formation, time to resolution of erythema, and length of hospital stay were analyzed. Results The data from patients who received cyclosporine and systemic glucocorticoids was analyzed, with characteristics of the study population presented in Table 1. There was a high prevalence of patients who met SIRS criteria in patients treated with cyclosporine (62.5%), as well as in those with glucocorticoids (61%), implying that this cohort consisted of more severe cases of AGEP. The time from drug eruption onset to cessation of pustule formation was similar in both the cyclosporine group (2.5 days) and corticosteroid group (3 days). Patients treated with cyclosporine were able to achieve initial noted clinical improvement in 1.5 days, and had comparable durations of hospitalization and time to resolution of erythema as patients who received glucocorticoids. No patients had major adverse side effects from cyclosporine or glucocorticoids. Discussion To date, this represents the largest cohort of patients with AGEP successfully treated with cyclosporine. Cyclosporine appears to be non-inferior to glucocorticoids with regards to cessation of the eruption and providing clinical improvement. In this cohort, the patients who received cyclosporine were those with relative contraindications to systemic corticosteroids, such as diabetes, history of steroid use with poor tolerance (i.e. delirium, emotional lability, etc.). As cyclosporine was administered primarily based on provider preferences in the setting of the aforementioned comorbidities, some selection bias was unavoidable in this cohort. The small sample size and retrospective nature also limit this study. Nevertheless, cyclosporine appears to be a non-inferior therapeutic alternative to glucocorticoids in the appropriate patient who presents with AGEP, and future prospective studies are needed to further examine its utility in AGEP.

Serum Elafin in Patients with Acne Vulgaris

Acne vulgaris is the formation of comedones, papules, pustules, nodules, and/or cysts as a result of obstruction and inflammation of pilosebaceous units, Elafin is a human protein that is produced naturally in the skin, lung and breast, protecting the respective tissue from destruction by the immune system.to estimate the serum level of elafin and CRP in acne patients, to compare levels in patients and controls and to detect its role in pathogenesis of AV. This study included 50 patients torment from av (Group An). Clinched alongside addition, 30 Obviously sound people about matched period and sex were picked as An control bunch (Group B). Constantly on patients were subjected will full history taking, clinical examination What's more research center investigations for: serum level about elafin Also crP. Certain family history exhibited clinched alongside 18 for patients, 4 of patients were smokers, 32 patients needed a connection to sun exposure, Previously, 26 from claiming patients lesions were connected with secondary caloric diet, 29 connected with abundance anxiety. Seriousness might have been assessed, 17 required mild, 20 required moderate Furthermore 13had extreme acne, What's more skin break out scar might have been structured Previously, 15. Higher evaluations and also skin break out scar creation were essentially connected with higher serum elafin What's more crp focuses. Skin break out gathering indicated essentially higher serum levels from claiming both elafin Also CRP, The point when contrasted with control aggregation. Elafin hormone Furthermore crp are connected with those powerlessness of advancement about av Also need An part On its pathogenesis What's more seriousness.

Use of a monofilament debridement pad in the treatment of acne vulgaris.

Acne vulgaris (acne) presents with increased oil-sebum secretion and subsequent formation of comedones, papules, pustules and nodules. Skin cleansing is part of the daily routine to improve skin condition. A monofilament debridement pad has shown to be effective when used for wound debridement and skin cleansing in dermatological conditions. The pad may offer benefits when used for acne affected skin. The in vitro cleansing capacity of the monofilament fibre pad was analysed and compared with commercially available cosmetic pads. For this purpose, a sebum model consisting of glass plates coated with an oil-red-stained layer of artificial sebum was used. To gain clinical experience a case series evaluated cleansing efficacy of the monofilament debridement pad in combination with polyhexanide and sodium-hypochlorite based solutions. Over a period of four months, seven individuals suffering from retentive moderate facial acne who visited the dermatology clinic for their acne used the pad as necessary, ranging from twice weekly to daily, dependent on the sensitivity of the patient's skin condition. The in vitro study exhibited a significantly better cleansing efficacy of the monofilament debridement pad compared with the cosmetic pads. After single use of the pad subject scores on sebum reduction revealed excellent/very good in 42.9% and acceptable in 57.1% of cases. After repeated use of the monofilament pads scores on sebum reduction of excellent/very good were given in 85.7% and acceptable in 14.3% of cases. Subject scored handling of the pad and comfort during use also received favourable ratings. These initial results show the potential of the monofilament debridement pad for cleansing of acne-prone and acne affected skin. More robust studies are needed to confirm these results.

ATENÇÃO FARMACÊUTICA A PACIENTES DO SISTEMA ÚNICO DE SAÚDE COM ACNE GRAVE: UM SERVIÇO DE SAÚDE NO AMBIENTE ACADÊMICO

Acne é uma doença cutânea, genética-hormonal que provoca a formação de comedões, pápulas e pústulas na região da face e do tórax. A presente pesquisa avaliou o impacto da Atenção Farmacêutica a pacientes do Sistema Único de Saúde (SUS) que recebem isotretinoína sistêmica gratuitamente para o tratamento de acne grave em um serviço de saúde desenvolvido em uma farmácia universitária pública inserida no Componente Especializado da Assistência Farmacêutica. Trata-se de um estudo descritivo, retrospectivo e quantitativo baseado na análise das fichas de acompanhamento farmacoterapêutico, intervenções farmacêuticas e exames laboratoriais documentados em registros internos de pacientes assistidos pela Farmácia Escola da Universidade Federal do Piauí no período de novembro de 2015 a julho de 2017. Foram analisados os registros de 23 pacientes nos quais foram constatados 34 tipos de reações adversas ao medicamento, além de 4 intervenções farmacêuticas, predominantemente relacionadas ao risco de interações medicamentosas. A pesquisa ressalta a notoriedade da iniciativa da implantação desse tipo de serviço em locus acadêmico para a formação de novos profissionais da saúde, além dos benefícios do acompanhamento farmacêutico aos pacientes com acne grave.