Mild Acne Research Articles

A Pilot Study on the Comparative Efficacy and Tolerability of a Novel Dermo-cosmetic Cream with 15% Azelaic Acid for Mild to Moderate Acne: A New Approach to Acne Treatment.

Acne is a one of the most frequent skin conditions among teenagers and young adults. It is currently managed with topical retinoids and antibiotics, which can present numerous side effects, thus reducing treatment adherence and effectiveness. We evaluated the efficacy and tolerability of a novel dermo-cosmetic cream (α-AZ) in treating mild to moderate acne. Subjects were randomized into three groups: group1 received α-AZ cream, group2 was treated with α-AZ combined with an oral acne treatment routine, and group3 received a topical acne treatment, for 84days. All treated patients underwent a 28-day maintenance period with α-AZ cream. Total acne and post-inflammatory hyperpigmentation (PIH) scoring, quality of life (QoL), and skin tolerance were all evaluated during the treatment and maintenance periods. Acne and PIH lesions significantly decreased in group1 compared to group3 (p < 0.001), with a reduction in acne of 66.52 ± 2.92% in group1 versus 52.55 ± 3.90% in group3. Patients in group1 achieved nearly clear skin by the end of the treatment. α-AZ cream treatment was well tolerated and all participants experienced an enhanced QoL. Participants expressed high satisfaction. Additional enhancements in all groups were noted during the maintenance phase across all clinical parameters. The novel dermo-cosmetic α-AZ cream could serve as a valuable new approach to current treatments for mild and moderate acne. It can be used alone, as a once-daily adjuvant to oral acne treatments, or as part of a maintenance regimen. ISRCTN registry, ISRCTN70142596, registered retrospectively on 11/12/2023.

Elevated hematologic ratios are correlated with acne severity: a national, retrospective cohort study.

Prior studies demonstrated conflicting results regarding hematologic ratios in acne patients. We sought to further characterize hematologic ratios in acne patients, according to demographics and acne severity. National, retrospective cohort study of 122,822 patients using medical records from 2005 to 2024 of patients insured with the largest public healthcare organization in Israel, Clalit Health Maintenance Organization. Moderate-severe acne patients had higher neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) than mild acne patients at diagnosis and 12-18 months before diagnosis. A multivariable regression confirmed the significance of the correlation of increased NLR and PLR with acne severity. Adults and females had higher NLR and PLR than children and males, respectively, at diagnosis, and 12-18 months before diagnosis. Acne severity was significantly associated with elevated NLR and PLR. NLR and PLR may also serve as indicators of upcoming acne severity, as they were elevated 12-18 months before diagnosis. These biomarkers may contribute to the diagnosis, management, and follow-up of patients with acne.

Association of Plasma Zinc Status with Severity of Lesions in Patients with Acne Vulgaris: A Cross-Sectional Study

Background: Zinc (Zn) is an essential trace mineral that plays a critical role in maintaining overall skin health and functionality. Zn deficiency has been linked to various dermatological conditions, including acne, eczema, and delayed wound healing, highlighting the mineral’s indispensable role in promoting skin resilience and health. Some investigators have refuted these findings. Objective: was to determine plasma Zn level and Zn status in patients with Acne vulgaris (AV) belonging to Nowshera, Khyber Pakhtunkhwa (KPK) and to find any possible relationship between Zn status &amp; severity of the acne lesions. Methods: Hundred patients of either sex with untreated AV were randomly selected in a cross-sectional study. Based on the Global Acne Grading System (GAGS) the acne lesions were categorized as mild, moderate &amp; severe. Blood samples were taken for determination of serum Zn. The relationship of Zn status with severity of lesions was determined with Pearson Correlations coefficient (r). Results: The study included 42 males and 58 females with male to female ratio of 1:1.4. Mean age was 21.8 years. The average plasma zinc level across the cohort was 67.4 ± 12.6 µg/dL, with males showing slightly higher zinc levels (69.1 ± 11.8 µg/dL) than females (65.8 ± 13.2 µg/dL), though this difference was not statistically significant (p = 0.092). 22% had mild acne, 46% moderate acne and 32% had severe acne. Patients with severe acne had significantly lower plasma zinc levels (60.2 ± 10.4 µg/dL) compared to those with mild acne (73.1 ± 13.1 µg/dL) (p &lt; 0.01). Pearson’s correlation analysis revealed a significant inverse relationship between plasma zinc status and acne severity (r = -0.43, p &lt; 0.001), indicating that lower zinc levels were associated with more severe acne. No significant gender differences were observed in the relationship between zinc levels and acne severity. Conclusion: Pasma Zn concentration is markedly decreased in patients with AV and the more severe is the lesion, the more Hypozincemia. Hence, Plasma Zn status is associated negatively with severity of AV lesions in the studied population.

The effect of topical retinoids in treatment of acne vulgaris in Khartoum Teaching Dermatological Hospital

Background: Acne vulgaris is a chronic inflammatory skin disease affecting approximately 80% of young adults and adolescents. Prolonged therapy is often required for satisfactory results. Topical retinoids play a central role in acne treatment, with evidence supporting their efficacy in achieving significant improvements in acne symptoms. This study aimed to assess the effectiveness of topical retinoids in treating acne vulgaris among patients at Khartoum Dermatology and Venereal Teaching Hospital from August 2019 to August 2020. Methods: A non-randomized interventional study was conducted at Khartoum Dermatology Teaching Hospital, covering patients diagnosed with mild to moderate acne vulgaris. Data were entered, cleaned, and analysed using statistical package for the social sciences (SPSS) version 25.0. Results: The study included 100 patients. Of these, 38% were aged 25-35 years, and 70% were female. 92% had experienced acne symptoms for more than six months. Regarding treatment duration, 87% used topical retinoids for more than three months. Clinical improvement was observed in 83% of patients, while 14% showed no improvement, and 3% experienced worsened symptoms. Conclusions: Topical retinoids are effective in treating mild and moderate acne vulgaris.

Фармакоэкономический анализ различных методов лечения акне у детей и подростков

Acne is a widespread dermatological disease affecting children and adolescents that requires the use of innovative approaches to its treatment with the purpose of not only improving the patient's condition but also to minimize the treatment costs. The purpose of this research was to analyze the clinical efficacy, safety and economic feasibility of the use of the cold atmospheric plasma (CAP) in the acne therapy. Materials and methods used: the study included 176 pediatric patients aged 10 to 18 y/o (ME 16 y/o, M:F gender ratio 1:1.2) who were divided into groups depending on the severity of acne as follows: G1 with mild acne, G2 with moderate acne, and randomized into subgroups depending on the treatment methods (TM) as follows: TM1 for monotherapy with a combined external drug containing 0.1% adapalene with 2.5% benzoyl peroxide in the form of a gel, TM2 for CAP monotherapy and TM3 for combined therapy consisting of external therapy with a gel containing 0.1% adapalene with 2.5% benzoyl peroxide and the CAP treatment. The severity of acne was assessed using the acne dermatological index (ADI) and the clinical efficacy was assessed by achieving ADI0, ADI75, and ADI50. Skin moisture and pH were measured in all patients both prior to and immediately after the treatment using the PH98110 pH meter (by Kelilong, China). Adverse events (AE) were assessed during the study. The incremental cost-effectiveness ratio (ICER) was used in the pharmacoeconomic analysis. Results: during treatment in the TM1 subgroups, the full clinical effect (DIA0) was achieved in 88.89% of cases with mild acne and in 61.76% of cases with moderate acne, in the TM2 s/g, the full clinical effect was achieved in 95.24% and 68.57% of cases and in the TM3 s/g in 100% and 88.24% of cases, respectively. After the treatment, the skin pH values in patients of the TM1 s/g, G1 and G2 became lower than the reference values, TM2 and TM3 s/gs of both groups returned to normal. Skin moisture after treatment decreased in the TM1 s/g of both groups, remained the same in the TM2 s/g and the TM3 s/g of G1 and approached to normal in the TM2, TM3 s/gs of G2. AEs (lichenification, erythema and/or burning sensation of the skin) were observed in patients of s/gs TM1 and TM3 and were mild (n=24) or moderate (n=25) in severity. The ICER coefficient for the TM1 v TM3 pairwise comparison was 324,254.55 Russian rubles for G1, 184,060.00 Russian rubles for G2, and for the TM2 v TM3 comparison 25,333.33 Russian rubles for G1, 12,800.00 Russian rubles for G2, which is statistically significant (p=0.001 and p=0.04, respectively) and indicates high economic feasibility of using the TM3. Conclusion: the use of CAP in the treatment of mild to moderate acne is effective, safe and cost-effective as well.

Psychological Impact of Acne and Post Inflammatory Hyperpigmentation Among Sudanese Women

&amp;lt;i&amp;gt;Introduction: &amp;lt;/i&amp;gt;Acne vulgaris is a chronic inflammatory disorder of the skin which often causes a negative impact on a woman&amp;apos;s psychological state and quality of life. This study seeks to provide basic data and information about the psychological impact of acne on Sudanese women. &amp;lt;i&amp;gt;Methodology: &amp;lt;/i&amp;gt;A cross-sectional questionnaire-based study was conducted during the period from June 2022 to January 2023. A total of 400 females aged 15 years and above were included in this study. These are Sudanese women who had suffered from acne in their lives, and who responded to the online study questionnaire. Cardiff Acne Disability Index (CADI) was used to assess the psychological effect of acne.&amp;lt;i&amp;gt; Results: &amp;lt;/i&amp;gt;Seventy one percent of respondents had active acne. Acne scars were observed in (74.8%) of participants, while post-acne hyperpigmentation was observed in (71.3%). Facial acne was the most common, as it was observed in (75.8%) of the respondents. The mean age at acne onset was 15.66 years and ranged between 10 and 36 years. Mild and moderate acne were the most common types, accounting for (37.0%) and (41.5%) of cases, respectively. Acne was found to affect the psychological state of the vast majority of the respondents (89%). Cosmetics or makeup were used by (42.3%) of the respondents to conceal acne and scars. Late onset of acne treatment was reported in (42%) of the cases. Most respondents (72.5%) visited doctors to treat acne. The mean Cardiff Acne Disability Index (CADI) score was 4.55, which reflects mild effects of acne on the quality of life of most of the respondents. The adverse psychological impact was found to be significantly associated with increased acne severity, scarring, and hyperpigmentation as well as with university educated respondents. &amp;lt;i&amp;gt;Conclusion: &amp;lt;/i&amp;gt;It was found that acne has mild effects on the quality of life of Sudanese women. Late onset of acne treatment resulted in widespread scarring and post-inflammatory hyperpigmentation in most participants, which was associated with the psychological impact of acne. There is an urgent need to encourage early treatment of acne to reduce the physical sequalae of acne to reduce the psychosocial consequences associated with the disease and the risk of scarring and hyperpigmentation on Sudanese women. Sudanese health authorities and Sudanese doctors can address this issue through education and awareness programs.

In-vitro anti-acne activity of Teucrium oliverianum methanolic extract against Cutibacterium acnes.

Acne vulgaris is a skin infection widely seen in adolescents between 10-19years with males affected more than females. It mainly affects the face but may also affect the back and chest. The symptoms vary with mild acne manifesting as comedones and moderate acne as inflammatory lesions (papulopustular), nodules, and mild scarring while severe acne has the same symptoms that have not subsided within 6months of treatment. Various treatments including topical medications containing different antibiotics are used to treat acne. Recently, herbal treatments have been shown as better alternatives to conventional treatment. Teucrium oliverianum Ging. ex Benth (Lamiaceae) is traditionally used for skin infections such as wound healing and biofilm formation. Methanolic extract of T. oliverianum was subjected to liquid chromatography-mass spectrometry (LC-MS) analysis, and its antibacterial effect against Cutibacterium acnes. The anti-acne, anti-inflammatory, and antioxidant effects were also assessed using HaCaT cells infected with C. acnes. The cytotoxicity of the extract was evaluated using a neutral red uptake assay, and anti-inflammatory effects were determined by measuring TNF-α, IL-1β, INF-γ, and COX2 inhibition. The antioxidant action was assessed by ROS generation in HaCaT cells infected with C. acnes. LC-MS analysis of the extract showed the presence of 16 different metabolites with L-carnitine, esculin sesquihydrate, and gamma-linoleic acid as major metabolites. The methanolic extract of T. oliverianum showed an antibacterial effect against C. acnes with an IC50 value of 263.2μg/mL. The extract attenuated the cytotoxicity of C. acnes on the HaCaT cell and the IC50 was found to be 676.2μg/mL. It also decreased dose-dependently the expression of TNF-α, IL-1β, INF-γ, and inhibited COX2 in the HaCaT cells infected with C. acnes. It also decreased the generation of reactive oxygen species. The results support the use of T. oliverianum as an anti-acne agent but it possesses mild antibacterial action. It showed anti-inflammatory effects in HaCaT cells infected with C. acnes. It is also an effective antioxidant and decreased the generation of reactive oxygen species. Comparison of the anti-acne effects and adverse reactions of extract with other treatments will provide more insight into its clinical efficacy and toxicity.

Effectiveness and Safety of a Dermocosmetic Cream as an Adjunct to Adapalene for Mild and Moderate Acne in Indonesia: Results of a Multicenter Randomized Controlled Study.

Acne is a chronic inflammatory skin condition affecting mainly teenagers and adults as well. Guidelines recommend retinoids as a first-line treatment for mild-to-moderate acne. However, dermocosmetics in adjunct could potentially improve efficacy and tolerability. This study was conducted to determine the effectiveness and safety of a dermocosmetic cream containing salicylic acid, lipohydroxy acid, niacinamide, Aqua posae filiformis, procerad and zinc salt in the treatment of mild-to-moderate acne vulgaris in adjunct to different regimens of adapalene compared to adapalene only. This randomized, controlled, parallel-group, evaluator-blind study was conducted over 8weeks on male and female acne subjects at five teaching hospitals in Indonesia. A total of 291 participants were enrolled and divided into three treatment groups: Group A adapalene 0.1% cream nightly - Group B dermocosmetic cream daily + adapalene 0.1% cream every two nights - Group C dermocosmetic cream daily + adapalene 0.1% cream nightly. Clinical evaluations of treatment included scoring on Global Evaluation of Acne (GEA) scale, lesion count (Indonesian Acne Expert Meeting scale), treatment tolerability and treatment satisfaction. Evaluations were performed on Day28 and Day56 of treatment. After 28 and 56days of treatment, all groups exhibited improvements across the various measures. Data analysis, utilizing Anova for repeated measurements, revealed a statistically significant difference between GroupsC and A for reduction of GEA scores (p = 0.038) in favor of GroupC. On Day56, percentages of subjects with GEA Scale improvements of at least 1grade in comparison with baseline were in GroupC (61.7%) followed by GroupA (47.9%) and GroupB (45.3%). Better treatment tolerance and satisfaction scores were noted in GroupsB and C. Combination of the dermocosmetic cream with adapalene showed higher efficacy, tolerability and satisfaction in comparison to adapalene alone.

Treatment of Mild to Severe Acne Vulgaris With a 650-Microsecond 1064-nm Nd:YAG Laser.

Effective treatment of acne remains a challenge to dermatologists. To evaluate the efficacy and tolerability of a 650-microsecond, pulsed 1064-nm Nd:YAG laser therapy for mild to severe facial acne vulgaris. Human subjects of Fitzpatrick skin types I to VI with mild, moderate, or severe acne enrolled in the prospective, single-center study. Subjects received 5 treatments at 2-week intervals with the 650-microsecond, 1064-nm, pulsed Nd:YAG laser. Follow-up visits were 30 days and 90 days after the final treatment. At each visit, subject global assessments, lesion counts, investigator's global assessments (IGAs), and tolerability appraisals were performed. The median percent reduction in lesion count was 48.15% after 1 treatment and 83.72% at treatment 3 and remained at 86.67% at 90 days. Sixty percent of subjects noted improvement after treatment 1, and most subjects noticed improvement on or before treatment 3. Median IGA values decreased rapidly to reach a plateau of 1.0 (almost clear) at week 6 and remained there at the 30- and 90-day follow-up. Ninety percent of subjects were slightly to highly satisfied after 3 treatments, and 90% slightly to strongly agreed that their acne treatments improved their self-esteem after 4 treatments. Anesthesia or skin cooling were not used, and adverse events were not observed. The 650-microsecond, pulsed 1064-nm Nd:YAG laser has been proven to deliver long-lasting clearance of mild to severe facial acne vulgaris with high subject satisfaction and without adverse effects on skin types I to VI. J Drugs Dermatol. 2024;23(11):957-964. doi:10.36849/JDD.8171.

The Relationship of Sleep Quality with Severity Level Acne Vulgaris in Students Aged 17-21 Years Faculty of Dentistry Prima Indonesia University

Acne vulgaris is chronic inflammation of the sebaceous glands. Many factors cause acne vulgaris, one of which is sleep quality. Poor sleep quality will cause an increase in androgen hormones which are associated with an increase in the incidence of acne vulgaris. Purpose: This study aims to determine the relationship between sleep quality and the severity of Acne vulgaris in students aged 17-21 years. This research is an analytical observational research with a cross-sectional method and sampling using a purposive sampling method. Research instruments using the Pittsburgh Sleep Quality Index (PSQI) questionnaire and the severity of acne vulgaris using the Lehmann classification. The result showed that of the 70 samples collected, there were 9 men and 61 women. There were 30 people with mild degree acne, 37 people with moderate degree and 3 people with severe degree. Based on sleep quality, there were 24 people with good sleep quality and 46 people with poor sleep quality. The results of Spearman's analytical correlation showed that there was a relationship between sleep quality and the severity of Acne vulgaris (P-value = 0.005). So, it can be concluded that sleep quality is related to the severity of Acne vulgaris in students aged 17-21 years.

Clinical Evaluation of the Efficacy, Safety, and In-Use Tolerability of a Diacnemide™-Containing Acne Kit (Facial Serum and Cleanser) Regimen for the Synergistic Management of Facial Acne in Adults.

Introduction Acne is a common inflammatory condition characterized by comedones, papules, and pustules, often resulting from increased sebum production influenced by hormones such as insulin-like growth factor-1 and androgens. Factors like Cutibacterium acnes, medications, sun exposure, cosmetics, and genetics exacerbate acne. This study aims to assess the safety and effectiveness of a novel acne treatment regimen, including a cleanser and serum containing Diacnemide™ (manufactured by Beaucience India Private Limited, Faridabad, India), in improving acne symptoms in adults. Methods This prospective, interventional, open-label, single-center, single-arm clinical study was designed to evaluate the safety, efficacy, and in-use tolerability of the test treatment regimen (serum + cleanser) for facial acne. Ethical approval was obtained from the Independent Ethics Committee, and all participants provided written consent. The study assessed changes in the severity of acne by dermatological assessment using the Investigator's Global Assessment (IGA) scale, changes in inflammatory and non-inflammatory lesions, skin hydration, sebum levels, and facial blemishes using various bioinstrumentations from Courage+Khazaka Electronic GmbH, Germany - Visiopor® PP34N, Corneometer® CM 825, Sebumeter® SM 815, and Mexameter® MX 18, respectively. Evaluations were conducted at baseline, T15 minutes, day 8, and day 15 post-usage. Statistical analyses were performed using SPSS (version 29.0.1.0) and Microsoft® Excel 2019 software, with results reported using p-values and confidence intervals at a 5% significance level. Results Porphyrin measurements showed significant reductions over time, with a 27.18% decrease in quantity and a 39.86% reduction by day 15 (p < 0.0001). Porphyrin values dropped by 2.61% after 15 minutes and 7.82% by day 15 (p < 0.05). Skin hydration increased significantly, with a 97.54% increment after 15 minutes and a 102.74% increment by day 15 (p < 0.0001). Sebum levels were restored to normal levels with the dry skin observed at baseline, showing a 34.45% improvement on day 8 and 75.75% by day 15 (p < 0.0001). Facial dark spots were reduced by 10.66% by day 8 and 14.64% by day 15 (p < 0.0001), and erythema levels decreased significantly. Acne severity showed notable improvement, with 50% of the subjects having moderate acne at baseline, reduced to 20.69% with mild acne, and 79.31% with almost clear skin by day 15. Subject responses indicated high satisfaction, with 100% agreeing on the test treatment's effectiveness in reducing acne, oiliness, and inflammation and improving hydration and skin texture. Conclusion The ThriveCo acne regimen (serum + cleanser)manufactured by Anveya Living Private Limited, India, is both effective and safe for treating facial acne in healthy adults with acne. It significantly reduces porphyrin size and quantity, indicating a strong inhibition of P. acnes, and visibly improves dark spots and skin hydration. The components - Diacnemide™ and zinc pyrrolidone carboxylic acid - in the cleanser regulate sebum production and provide anti-inflammatory benefits, while the serum, containing Diacnemide™ and niacinamide, enhances skin barrier function and balances lipids. The synergistic effects of the ThriveCo Goodbye Acne Cleanser and Serum in this regimen effectively target surface bacteria like C. acnes and deeper follicular issues, promoting healthier skin and reducing acne-related symptoms.

Efficacy and Tolerability of Topical Dapsone vs Benzoyl Peroxide in Mild to Moderate Acne Vulgaris Treatment: A Retrospective Study

Aim: Acne vulgaris is a disease of the pilosebaceous unit and a chronic inflammatory process. This study aimed to compare topical 5% dapsone and 10% benzoyl peroxide in terms of efficacy, side effects, and patient satisfaction in mild to moderate acne. Material and Methods: The patients who applied to the dermatology outpatient clinic with the complaint of acne between June 20, 2022, and September 20, 2022, and were diagnosed with mild and moderate acne vulgaris, were retrospectively evaluated. Forty-eight patients in the dapsone group and 53 in the benzoyl peroxide group were included in this study. Results: At the end of the treatment, a statistically significant difference was found between the two groups in terms of ISGA values and improvement percentage in ISGA, improvement was higher in the dapsone group (both p=0.001). A statistically significant difference was found between the groups in terms of the percentage decrease in lesion counts of closed comedones, papules and pustules, inflammatory and total lesions (decreasement was higher in the dapsone group, p=0.038 for closed comedones, p=0.006 for total lesions and p&amp;lt;0.001 for others). There was no dissatisfied patient in the group using dapsone (p&amp;lt;0.001). Among the side effects, erythema was more common during the whole treatment, and dryness and burning-stinging sensation were higher at the end of the first month in the benzoyl peroxide group. Conclusion: Topical 5% dapsone is effective in the treatment of mild to moderate acne and is safe in terms of side effects compared to topical 10% benzoyl peroxide.

The possibilities of improving the effectiveness of acne therapy

Acne is one of the most urgent problems of dermatology, since this dermatosis is widespread, often occurs during puberty, is accompanied by cosmetic defects, causes increased anxiety, dysmorphic phobia and depressive states. As a result, the quality of life and the possibility of social adaptation decrease in patients. Therefore, it is necessary to optimize the treatment of this disease with the inclusion of modern highly effective drugs. When prescribing treatment, it is necessary to take into account all links in the pathogenesis of acne, and also remember that inflammation plays an important role in the development of dermatosis (especially severe course). With mild acne, it is recommended to prescribe only external therapy, with medium – external therapy and, if necessary, systemic, with severe systemic therapy is used as the main one. The appointment of antibiotics for this dermatosis is dictated by the presence of bacterial flora. Clindamycin is one of the antibiotics that effectively reduce colonization of C. аcnes. To ensure the high efficiency and safety of topical therapy, as well as the prevention of the development of resistance of microorganisms, there is a need to use a combination of at least two drugs. Thus, the combination of clindamycin with benzoyl peroxide makes it possible to increase the effectiveness of therapy due to bactericidal, bacteriostatic, anti-inflammatory and keratolytic actions. The convenient mode of use and the rapid therapeutic effect make it possible to include this combination in the group of priority drugs for the treatment of acne. Comedonolytic, anti-inflammatory and bactericidal effects are also observed in azelaic acid, and therefore drugs containing this component show a high pathogenetic effect in acne.

Polyherbal Antiacne Gel: In Vitro Antibacterial Activity and Efficacy Evaluation Against Cutibacterium acnes.

Acne is a common skin condition that affects people of all ages and can lead to significant physical and psychological distress. The first line of action against acne is topical products, though the most effective are topical antibiotics. In such a scenario, the development of effective and safe herbal formulations for the treatment of acne is of great importance. Rubia cordifolia, Aloe barbadensis, and Allium cepa extracts are rich sources of bioactive metabolites and are safe compared with antibiotics, in addition to being cost effective, sustainable, and eco-friendly. Also, their combination has not been studied for treating acne, and their potential benefits need to be investigated. The present study aimed to develop an effective polyherbal gel formulation of R. cordifolia, A. barbadensis, and A. cepa combined extract for treating acne and validate its effect with reference to conventional antibiotics. Plant materials were extracted in water by the reflux method, and phytochemical analysis was done for flavonoid, anthraquinone, and phenolic contents. The combined extract (R. cordifolia, A. barbadensis, and A. cepa extracts) was formulated in gel. The selected polyherbal gel was evaluated for in vitro antibacterial activity using agar well diffusion against Cutibacterium acnes (P. acnes) culture. Phytochemical analysis of the composite extract revealed the rich presence of flavonoids, phenolics, and anthraquinones. The polyherbal gels showed good physicochemical properties; however, FCEG-4 was selected for further studies. It was found to be effective against C. acnes (MTCC 1951) in agar well diffusion, as it showed a similar zone of inhibition as that of standard. Also, during invivo studies, FCEG-4 showed comparable efficacy with clindamycin gel. It was concluded from the study that composite extracts incorporated in an aqueous-based gel system were effective in topical therapy of mild acne vulgaris, showing similar efficacy to that of clindamycin cream.

Do patients with acne tend to have increased body fat? Comparison of body composition analysis of patients with acne vulgaris and healthy individuals: a prospective case control study.

Acne vulgaris is a chronic, inflammatory skin disease which has been associated with metabolic syndrome and obesity. However, data on body composition in patients with acne vulgaris are scarce. We aimed to assess body composition in patients with acne vulgaris, compare the results with those of healthy individuals, and evaluate the relationship between body composition and acne severity. Between March 2023 and May 2023, body composition of patients with acne vulgaris and healthy individuals was prospectively evaluated using Tanita TBF-300 body composition analyzer. This study included a total of 320 subjects, 160 patients with acne vulgaris and 160 healthy individuals. Body mass index (BMI), body fat percentage and fat mass were significantly higher in patients with acne vulgaris compared to healthy individuals (p < 0.001, each). BMI, body fat percentage and fat mass were significantly higher in female patients compared to healthy females (p < 0.001, each), higher in male patients compared to healthy males (p = 0.001, p < 0.001, p < 0.001, respectively). BMI (p = 0.006), fat free body mass (p < 0.001) and total body water (p < 0.001) were higher in male patients, while body fat percentage (p < 0.001) was higher in female patients. Patients with moderate to severe acne had higher BMI (p < 0.001), body fat percentage (p = 0.001) and fat mass (p < 0.001) than in those with mild acne. Since high body fat may indicate increased risk and severity of acne, body composition analysis may be useful in treating patients with acne and taking preventive measures against metabolic syndrome in this population.

Sirolimus for vascular anomalies associated with PTEN hamartoma tumor syndrome.

Phosphatase and tensin homolog (PTEN) hamartoma tumor syndrome (PHTS) is a rare condition associated with vascular anomalies and increased tumor risk. Sirolimus, an mTOR inhibitor used for managing vascular anomalies is underexplored in PHTS. A single-institution retrospective review of children with PHTS and vascular anomalies treated with sirolimus identified seven patients. Median age at sirolimus initiation was 10years. After a median 2.5-year follow-up, six of seven patients (86%) showed significant clinical improvement. No significant adverse effects were observed, except mild buccal ulcers and acne. This study supports sirolimus as an effective and safe treatment for vascular anomalies in a small group of children with PHTS.

Comparative study on efficacy of benzoyl peroxide with adapalene versus plain adapalene in the treatment of acne vulgaris

BACKGROUND Acne vulgaris is a dermatological disorder of pilosebaceous unit, characterized by formation of comedones and inflammatory lesions. It is one of the most common skin manifestations among adolescents, also affecting the adult population. The treatment of acne basically involves reduction of lesions and prevention of permanent scarring. The current line of treatment for mild to moderate acne is topical medications with antimicrobials and retinoids. The present study assessed the efficacy of combination of adapalene and benzoyl peroxide in comparison to adapalene for topical treatment of mild to moderate acne vulgaris. OBJECTIVE The purpose of the study was to compare the clinical efficacy of topical adapalene and topical adapalene with benzoyl peroxide in treatment of mild to moderate cases of acne vulgaris. METHODOLOGY A prospective, comparative study was carried out among 84 patients with mild and moderate acne vulgaris visiting the Department of Dermatology, Kathmandu Medical College and Teaching Hospital, Bhaktapur, Nepal from December 2019 till March 2021. The patients fulfilling the inclusion criteria were divided into two groups. Group A received topical adapalene whereas Group B received topical adapalene with benzoyl peroxide. The efficacy of treatment in both groups were determined based on the reduction of total lesion count. Both inflammatory and non-inflammatory lesions were counted at 4th week, 8th week and 12th week. RESULTS All patients were assessed according to Global Acne Grading System (GAGS) and grouped as mild and moderate. The most frequent age group affected by acne vulgaris was 18-22 years. The mean age was 22.15 ± 5.315. Females (64.30%) were affected more commonly than males (35.7%). Majority of patients presented with moderate or inflammatory acne lesions. The face (90.5%) was most commonly affected site by acne vulgaris. The number of patients enrolled in the study were 84 out of which 63 (75%) completed the study. It was found that the reduction of non-inflammatory, inflammatory and total lesion count from the baseline were highly significant in between and both the group (P&lt;0.001). A total of 52.4% had very good result of the treatment, 44.4% of them had good result and remaining 3.2% of the patients’ result was fair. However, the efficacy of benzoyl peroxide with adapalene was found to be better than adapalene alone. CONCLUSIONThis study concluded that topical benzoyl peroxide with adapalene is more efficacious to treat mild to moderate acne vulgaris.

Phototoxicity of the Ethanolic Extract of Skeletonema marinoi for the Dermocosmetic Improvement of Acne.

Acne is one of the most common dermatological conditions, peaking during adolescence and early adulthood, affecting about 85% of individuals aged 12-24. Although often associated with teenage years, acne can occur at any age, impacting over 25% of women and 12% of men in their forties. Treatment strategies vary depending on the severity, including the use of topical gels or creams containing benzoyl peroxide and retinoids, antibiotics, and systemic or topical isotretinoin. However, these treatments can cause irritation, allergies, and other toxic side effects. Currently, there is no natural-based alternative for antibacterial photodynamic therapy targeting acne using marine drugs or extracts. Through a bioguided screening approach, we identified the ethanol extract of Skeletonema marinoi as highly phototoxic against three bacterial species associated with acne-Cutibacterium acnes, Staphylococcus aureus, and Staphylococcus epidermidis. This extract exhibited phototoxicity in planktonic bacteria under white and red light, disrupted bacterial biofilms, reduced sebum production but also showed phototoxicity in keratinocytes, highlighting the importance of the specific targeting of treatment areas. Further investigations, including fractionation and high-resolution structural analysis, linked the observed phototoxicity to a high concentration of pheophorbide a in the extract. Given its notable in vitro efficacy, this extract holds promising potential for clinical evaluation to manage mild acne. This discovery paves the way for further exploration of Skeletonema pigment extracts, extending their potential applications beyond acne phototherapy to include dermocosmetics, veterinary medicine, and other phototherapy uses.

Prevalence of Helicobacter pylori infection among Patients with Acne Vulgaris

Abstract Background Acne vulgaris is one of the most common dermatologic complaints. About 85% of adolescent population and 3% of the adults between the age of 35-44 years have this disease worldwide. It is a chronic inflammatory disorder of the pilosebaceous unit. Helicobacter pylori is a gastric Gram-negative, spiral-shaped microaerophilic pathogen closely associated with gastric and extra-gastric diseases (chronic gastritis, peptic ulcers, gastric mucosa-associated lymphoid tissue lymphoma, gastric cancer, iron deficiency anemia, etc). It has been shown that H. pylori may play a potential pathogenic role in extra-intestinal diseases such as hepatobiliary, respiratory, cardiovascular, and dermatological disorders. The latter included chronic urticaria, psoriasis, henoch-schonlein purpura, and rosacea. Objective To determine the prevalence of H. Pylori infection among AV patients and correlate it with the disease severity. We included 45 patients with AV and 45 matched age and sex apparent healthy controls. Methods This case control study included 45 Patients with AV. They were recruited from the Dermatology outpatient clinic, Ain Shams University Hospitals and Teba specialized hospital in Luxur government. The study also included 45 age and sex matched healthy volunteers as a control group. They were recruited from people who don't have AV attending Al Demerdash Hospital Ain Shams University and Tepa Specialized Hospital. The study was done in the period from November 2021 to October 2022. Results Detection of H. pylori antigen in stool and H. pylori antibody IgG in serum in both groups revealed that the rates of H. pylori antigen in stool and H. pylori antibody IgG in serum were significantly higher in AV patients compared to control subjects. Also the patients with severe AV had statistically significant higher rates of H. pylori antigen in stool and H. pylori antibody in serum as compared to the patients with mild Acne and healthy controls. Also the number of AV involved sites and severity of AV were significantly correlated with H. pylori Ag in stool and H pylori Ab in serum. While there was no statistical significant correlation between (the type of AV, onset of AV and duration of AV) and H. pylori Ag in stool and H. pylori Ab in serum. Conclusion The prevalence of H. pylori infection in patients with acne vulgaris is high so it may represent a risk factor for this skin disease. Also the indicators of H. pylori infection were positively correlated with the severity of AV.

A dermocosmetic regimen is effective and safe for mild to moderate acne in subjects of all skin phototypes

AbstractBackgroundAcne vulgaris is a chronic inflammatory skin condition with a multifactorial pathogenesis. The clinical appearance of acne and its sequelae may differ according to phototypes. Data regarding the potential benefit of dermocosmetics (DC) regardless of phototype are lacking and assessing acne improvement can be difficult, given the lack of visual support in people with skin of colour. A DC regimen, combining a cleanser and a cream, both containing thermal spring water, has been developed for the management of mild‐to‐moderate acne, for all skin phototypes studied.ObjectivesTo assess the efficacy and local tolerance of a DC routine in mild‐to‐moderate acne and to visualize the clinical improvement in all skin phototypes.MethodsIn an open‐labelled, multicentre clinical study, subjects of any phototype aged above 11 years and above with mild (N = 48, 55.2%) or moderate (N = 39, 44.8%) facial acne applied the DC twice daily for 56 days. No other acne care was allowed. Acne severity, as well as inflammatory and noninflammatory lesion counts, were assessed at baseline, Days 28 and 56. Photographs were taken using a novel imaging tool based on multimodal acquisition, to show clinical improvement over time.ResultsEighty‐seven subjects, 41 adults and 46 adolescents, were included; 59.8% were female and were aged between 11 and 44 years. The total acne lesion count decreased by 34%, the noninflammatory lesion count by 28%, and the inflammatory lesion count by 52% at Day 56. All % changes were statistically significant (p &lt; 0.05). The GEA score decreased, with 25% of subjects showing at least a one‐grade improvement at Day 28 and 59% at Day 56. Local tolerance was excellent.ConclusionsThe tested DC care is beneficial for the improvement of acne and is very well tolerated in all skin phototypes studied.