Non-inflammatory Lesions Research Articles

Clinical Differential Diagnosis between Nonodontogenic and Endodontic Radiolucent Lesions in Periapical Location: A Critical Review.

In endodontics, accurate diagnoses are important for the selection of appropriate and successful therapy. Several nonendodontic entities in periapical location may resemble those of inflammatory endodontic origin and impact therapeutic approaches. The aim of this study was to review noninflammatory entities mimicking dentoalveolar abscesses or apical periodontitis and to discuss clinical and pathological features. In this review study, the authenticated search engine in PubMed (MEDLINE) database was used to find articles by using "Nonvital Pulp Dentoalveolar Abscess", "Nonvital Pulp And Apical Periodontitis", "Periapical Abscess", "Chronic Dentoalveolar Abscess", "Chronic Apical Periodontitis", "Periapical Granuloma", And "Radicular Cyst". Each of these predefined keywords were combined with the terms "Misdiagnosed", "Mimicking", "Masquerading", or "Simulating" to search for reported cases indexed from 1978 to 2020. All case reports fulfilling the selection criteria were reviewed to identify radiolucent nonendodontic periapical lesions focused on the questions: "Which pathological entities mimick radiolucent endodontic lesions in periapical location? Based on endodontic clinical parameters, what are the contrasting features?" Out of 426 articles, 111 were relevant to the subject, including a series of cases and case reports. Only well-documented English and recent papers were considered. A total of 30 noninflammatory entities appeared clinically as radiolucent endodontic lesion in periapical location. Lesions simulating chronic apical periodontitis represented 83.3% and dentoalveolar abscess 16.7%. Interestingly, primary malignancies and metastasis counted 43.3% and pain was a typical symptom. Swelling was a noncontributory clinical feature in distinguishing periapical lesions. Lack of pulp response was registered in 68.4% of nonedodontic lesions. A flowchart was generated to summarize clinicopathological aspects of radiolucent nonendodontic entities appearing as dentoalveolar abscesses or apical periodontitis In relation to clinical practice, it is very important for us to note that, a group of pathological entities may simulate radiolucencies of endodontic origin in periapical location, especially malignancies and non-inflammatory odontogenic lesions.

Evaluation of role of priming agents in salicylic acid peel: A comparative study

Introduction: Salicylic acid is increasingly used as a superficial peeling agent for acne. Widespread use has caused increasing awareness about the adverse events associated with SA like erythema, exfoliation, itching, redness etc. Appropriate use of priming agents like retinoids, hydroquinone etc., can help in reduction of ADRs and can affect final treatment result. Aim: Evaluation of efficacy and safety of salicylic acid (SA) peel with or without priming agents in patients of acne. Methodology: A prospective, randomized, open-label, parallel-group study was carried out in patients with acne. Total 72 patients were randomized in to three groups A, B and C to receive 30% salicylic acid (SA) peel with either 0.05% tretinoin or 4% hydroquinone or without any priming agent. Objective and subjective assessment in improvement in acne was compared. For safety analysis, all reported adverse drug events were compared. Results: Mean age of patients was 22.46±5.32 years. Both non-inflammatory and inflammatory acne lesions reduced with SA peel in all three groups. Improvement in total acne score is significantly higher in SA peel with priming agents (p

Efficacy and safety of topical clascoterone cream for treatment of acne vulgaris: A systematic review and meta-analysis of randomized placebo-controlled trials.

To systematically and meta-analytically pool evidence from randomized placebo-controlled trials that examined the efficacy and safety of topical clascoterone cream in patients with acne vulgaris. Four databases were screened from inception to 10 October 2020. Included studies were assessed for risk of bias. Efficacy outcomes included investigator's global assessment (IGA) treatment success and absolute change in inflammatory lesion counts (ILCs) and noninflammatory lesion counts (NILCs). Safety outcomes included the proportion of patients with any treatment-emergent adverse event (TEAE) as well as incidence of any TEAE, serious adverse events (AEs), AEs related to study drug, AEs leading to study drug discontinuation, nasopharyngitis, headache, oropharyngeal pain, and vomiting. Dichotomous data were analyzed using the risk ratio (RR) and 95% confidence interval (95% CI) whereas continuous data were analyzed using the mean difference (MD) and 95% CI. Review Manager Software version 5.4.1 was used for statistical analysis. Five clinical trials, comprising 2457 patients (1357 and 1100 patients received clascoterone and placebo, respectively) were included. Studies revealed an overall low risk of bias. Clascoterone significantly increased IGA success rates (RR = 2.87, 95% CI [2.11, 3.89], P < .001) and decreased NILCs (MD = -5.64, 95% CI [-8.41, -2.87], P < .01) without substantially impacting the ILCs (MD = -1.82, 95% CI [-5.06, 1.43], P = .27). No significant differences were noted between both groups for all safety outcomes, except for nasopharyngitis which was significantly lower in the clascoterone group (RR = 0.47, 95% CI [0.27, 0.83], P = .01). Topical clascorterone cream is safe and effective in the treatment of acne vulgaris.

The effectiveness of galactomyces ferment filtrate, dexpanthenol and Centella asiatica combination serum in the treatment of post-acne hyperpigmentation

Background: Acne vulgaris is a chronic inflammation of the pilosebaceous gland that may result in both non-inflammatory and inflammatory lesions. Post-acne hyperpigmentation (PAH) is caused by a hypermelanotic reaction to skin inflammation. It can occur secondary to the inflammation process and depending on the severity, may persist for a prolonged period.Objective To determine the effectiveness of galactomyces ferment filtrate (GFF), dexpanthenol, and Centella asiatica combination serum in the treatment of PAHMethods: This was a placebo-controlled randomized clinical trial. There are 68 subjects that were divided into two groups: the experimental group received combination serum while the control group received placebo for 8 weeks. Three drops of serum were applied to the area with PAH twice daily in the morning and at night. The melanin, erythema, roughness, and L*, a*, and b* scores were assessed objectively using mexameter, chromameter and skin analyzer for every two weeks. Pearson’s correlation test and independent T-test were used to assess the trend of the parameters and compare the results of both groups.Results: The results of statistical calculations using Pearson correlation test showed the treatment group showed a significant decreasing trend of the melanin and spots score. Both groups showed significant decreasing trend in erythema, L* score and roughness. However, no significant difference was found between both groups in all parameters.Conclusion: The combination serum may decrease the melanin and spot scores suggesting that it affects the melanocyte activity. It has shown a good efficacy in treating PAH.

99mTc-antitumor necrosis factor-alpha scintigraphy for the detection of inflammatory activity in rheumatoid arthritis.

Tumor necrosis factor-alpha (TNF-α) is an important inflammatory cytokine. 99mTc-anti-TNF-α antibody scintigraphy has proven to be a viable alternative to MRI in specific cases. The objective of this study was to evaluate the performance of scintigraphy with 99mTc-anti-TNF-α in the identification of inflammatory foci in individuals diagnosed with rheumatoid arthritis using MRI as the gold standard. This cross-sectional, descriptive and analytical-qualitative clinical study compared the performance of 99mTc-anti-TNF-α scintigraphy with that of MRI with intravenous administration of gadolinium (used as the gold standard) and a clinical examination (Disease Activity Score 28) in 220 joints of 20 patients with a diagnosis of rheumatoid arthritis and one healthy control. The concordance of scintigraphy with MRI in individuals with a diagnosis of rheumatoid arthritis was 79%. The accuracy, sensitivity and specificity of scintigraphy for distinguishing between inflammatory and noninflammatory sites were 92, 89, and 93%, respectively. No adverse reactions to the examinations were reported. Scintigraphy with 99mTc-anti-TNF-α was well-tolerated and had a good ability to distinguish between inflammatory and noninflammatory lesions in patients with rheumatoid arthritis.

Non-inflammatory and non-neoplastic soft tissue lesions of the tympanic cavity

Objectives: Tympanic cavity (TC) is an anatomically challenging region for the diagnosis of lesions located inside it. Radiological diagnosis and demonstration of the anatomic localization of sporadic lesions such as vascular malformations and meningocele are essential for the prevention of complications that may occur during operation and recurrent unnecessary interventions. The aim of the present study was to demonstrate the radiological appearance of the vascular variations and the post-traumatic soft tissue lesions which are rarely encountered in TC. Methods: A total of 3525 temporal multi-slice computed tomography (MSCT) images were evaluated between 2010–2018. Twelve cases with non-inflamatory and non-neoplastic soft tissue lesions in TC were detected and 2 with meningocele were included in the study. Results: Of the 12 cases, 6 were males and 6 were females. The mean age of the patients was 26.16 years. Four cases had an aberrant internal carotid artery (ICA), being bilateral in 2 cases and right sided in the remaining 2 cases. Six cases had dehiscent mega jugular bulb (DMJB); and 2 cases had post-traumatic meningocele. Conclusion: Vascular malformations and meningoceles are rarely observed in TC. They may present nonspecific clinical signs and symptoms; however, they should be evaluated with MSCT and MRI before the surgical interventions regarding the middle ear to prevent possible complications.

Comparative Efficacy of Pharmacological and Nonpharmacological Interventions for Acne Vulgaris: A Network Meta-Analysis.

Acne has several effects on physical symptoms, but the main impacts are on the quality of life, which can be improved by treatment. There are several acne treatments but less evidence comparing their relative efficacy. Thus, we assessed the comparative efficacy of pharmacological and nonpharmacological interventions for acne. We searched PubMed, Embase, and the Cochrane Central Register of Controlled Trials from inception to April 2019, to include randomized controlled trials for acne that compared topical antibiotics (TA), benzoyl peroxide (BPO), topical retinoids (TR), oral antibiotics (OA), lasers, light devices including LED device (LED), photodynamic therapy (PDT), and intense pulsed light, chemical peels (CP), miscellaneous therapies or complementary and alternative medicine (MTCAM), or their combinations. We performed Bayesian network meta-analysis with random effects for all treatments compared with placebo and each other. Mean differences (MDs) of lesions count and risk ratios of adverse events with their 95% credible intervals (CrIs) were calculated, and all interventions were ranked by the Surface Under the Cumulative Ranking (SUCRA) values. Additional frequentist additive network meta-analysis was performed to detect the robustness of results and potential interaction effects. Sensitivity analyses were carried out with different priors, and metaregression was to adjust for nine potential effect modifiers. In the result, seventy-three randomized controlled trials (27,745 patients with mild to moderate acne), comparing 30 grouped intervention categories, were included with low to moderate risk of bias. For adverse effects, OA had more risk in combination treatment with others. For noninflammatory lesions reduction, seventeen interventions had significant differences comparing with placebo and three interventions (TR+BPO: MD = −21.89, 95%CrI [−28.97, −14.76]; TR+BPO+MTCAM: −22.48 [−34.13, −10.70]; TA+BPO+CP: −20.63 [−33.97, −7.13]) were superior to others with 94, 94, and 91% SUCRA values, respectively. For inflammatory lesions reduction, nineteen interventions were significantly better than placebo, and three interventions (TR+BPO: MD = −12.13, 95%CrI [−18.41, −5.80]; TR+BPO+MTCAM: −13.21 [−.39, −3.04]; LED: −11.30 [−18.34, −4.42]) were superior to others (SUCRA: 81, 81, and 77%, respectively). In summary of noninflammatory and inflammatory lesions results, TR+BPO and TA+BPO were the best options compared to others. The frequentist model showed similar results as above. In summary, current evidence supports the suggestion that TR+BPO and TA+BPO are the best options for mild to moderate acne. LED is another option for inflammatory lesions when drug resistance occurs. All the combinations involved with OA showed more risk of adverse events than others. However, the evidence of this study should be cautiously used due to the limitations.

Two Percentage of Ketoconazole Cream for the Treatment of Adult Female Acne: A Placebo-Controlled Trial.

IntroductionOur objective was to determine the efficacy of ketoconazole (KTZ) 2% cream for the treatment of mild adult female acne (AFA).Materials and methodsThis placebo-controlled trial was conducted in District Headquarters (DHQ) Teaching Hospital, Sahiwal, Pakistan. The study was completed in a period of January 2019-June 2020. A total of 60 females of age > 25 years having mild AFA were included. In Group I, the patients were advised to apply 2.0% KTZ cream covering the whole skin area twice daily for a period of eight weeks. In Group II (placebo group) patients, a topical cream containing propylene glycol was applied for similar period. After eight weeks, the cream was discontinued and participants were advised to use routine skincare products, and follow-up was done after two weeks. The main study outcome was reduction in the total count of acne lesions including both inflammatory and non-inflammatory lesions and overall success rate of treatment.ResultsMean age was 36.2 ± 6.3 years in KTZ group versus 35.4 ± 6.5 years in control group. Mean duration of acne was 14.3 ± 7.3 years in KTZ group versus 15.1 ± 6.9 years in control group. Improvement in facial adult female acne scoring tool (AFAST) scale (AFAST-F) was observed in 13 (43.3%) patients in KTZ group and in only 4 (13.3%) patients in control group (p value = 0.009). Improvement in submandibular AFAST (AFAST-S) was observed in 12 (40.0%) patients in KTZ group and in eight (26.7%) patients in control group. The overall success rate of treatment was 14 (46.7%) in KTZ group versus 4 (13.3%) in control group (p value = 0.012).ConclusionsIn our study, we found significant improvement in reduction of acne lesions as well as complete recovery using 2.0% ketoconazole for the treatment of mild AFA. So KTZ can be used as a preferred treatment option for these patients.

Topical dermocosmetics and acne vulgaris.

Acne is a highly common skin disease especially among teenagers. Modern acne treatments are based also on the use of moisturizers, cleansers and sunscreens. In choosing the right cleanser, it is important to consider some aspects: the interaction between skin type and the cleanser, the optimal time and method of cleaning and the cosmetic perception of the patient. The aim of our review is to highlight the importance of choosing the most suitable topical dermocosmetics for the different skin types, as well as the most effective timing and method to combine dermocosmetics with the standard acne treatment. A search in literature for selected key words was performed using PubMed. Additional papers were identified based on author expertise. Treatment of acne patients should include education for proper daily skin hygiene, including protection from environmental damage. However, given the low number of clinical studies on cleansers, it is difficult to make reliable recommendations. The correct choice and use of topical dermocosmetics are fundamental in the management of acne patients. Daily use of moisturizers, cleansers and sunscreens can reduce both inflammatory and non-inflammatory acne lesion counts and may be helpful for acne treatment if combined with specific drugs.

Bacterial identification of acne vulgaris

Background:Â Acne vulgaris (AV) is a chronic inflammation of the pilosebaceous unit with clinical polymorphic lesion consist of non-inflammatory (open and closed comedones) and inflammatory lesions (papules, pustules, and nodules) with varying degree of inflammation and depth. Earlier studies showed that other bacteria might also found and played a role in acne pathogenesis besides Cutibacterium acnes (C. acnes).Patients and Methods:Â This descriptive observational study used cross-sectional method. Samples were collected from 40 subjects with AV. We took the samples from non-inflammatory (closed comedones) and inflammatory lesions (pustule) in each subject, followed by Gram staining, aerobic and anaerobic bacterial culture, and bacterial identification. This research has been approved by the Ethical Committee, Faculty of Medicine, University of Sumatera Utara.Results:Â There were 12 bacterial species that were identified from 80 samples. We identified Cutibacterium acnes (21,2%) in anaerobic culture. While in aerobic culture, we identified Staphylococcus epidermidis (47,5%), Staphylococcus hominis (17,5%), Staphylococcus aureus (8,7%), Staphylococcus haemolyticus (8,7%), Leuconostoc mesentroides (6,2%), Micrococcus luteus (3,7%), Kocuria varians (2,5%), Staphylococcus vitulinus (1,2%), Staphylococcus cohnii (1,2%), Staphylococcus arlettae (1,2%) and Dermacoccus nishinomyaensis (1,2%).Conclusion:Â The two most common bacteria in acne vulgaris are Staphylococcus epidermidis and Cutibacterium acnes

Differences of Microbiomes Found in Non-Inflammatory and Inflammatory Lesions of Acne Vulgaris.

PurposeBacterial activity and inflammation both influence acne vulgaris (AV) formation. Cutibacterium acnes is considered as an actor involved in inflammation of AV. Besides Cutibacterium acnes, other microbiomes found in AV may also play a role in the pathogenesis. This research was conducted to overview microbiomes found in non-inflammatory and inflammatory lesions of AV.Patients and MethodsAn observational descriptive study with cross-sectional approach was designed. Sample collection was performed with 40 subjects with AV. In every patient, both non-inflammatory (closed comedone) and inflammatory (pustule) lesion samples were collected by swab. Afterward, bacterial culture was performed, continued by bacterial identification.ResultsIn non-inflammatory lesions, the growth of nine bacterial species was observed from 40 samples. In an anaerobic culture, Cutibacterium acnes (17,5%) was identified. In aerobic cultures, different bacterial species were found including Staphylococcus epidermis (52.5%), Staphylococcus hominis (12.5%), Staphylococcus haemolyticus (7.5%), Micrococcus luteus (7.5%), Leuconostoc mesentroides (7.5%), Staphylococcus aureus (5%), Kocuria varians (5%), and Staphylococcus vitulinus (2.5%). In inflammatory lesions, nine bacterial species were found, in which was the anaerobic culture we identified Cutibacterium acnes (25.0%). Aerobic cultures have revealed the growth colonies of Staphylococcus epidermidis (42.5%), Staphylococcus hominis (22.5%), Staphylococcus aureus (12.5%), Staphylococcus haemolyticus (10.0%), Leuconostoc mesentroides (5.0%), Staphylococcus cohnii (2.5%), Staphylococcus arlettae (2.5%), and Dermacoccus nishinomyaensis (2.5%). Two mixed bacterial growths were observed in non-inflammatory lesions, while four mixed bacterial growths were found in inflammatory lesions.ConclusionDifferences in bacterial isolates were observed both in non-inflammatory and inflammatory lesions of AV.

Acne Vulgaris: An Ayurvedic Review

Acne vulgaris is a very common skin disorder found in adolescent age group. It is a cutaneous disorder of the pilo-sebaceous unit involving the abnormalities in the production of sebum. It is characterized by both inflammatory (papules, pustules and nodules) and non-inflammatory (comedones, open and closed) lesions. In Ayurveda, this disease has been postulated by the name of mukhadushika and yuvanpidika. Acharya sushruta in his sushruta samhita has described this disorder under Kṣudra Roga adhyay. Due to imbalance in life style, stress and pollution, this problem is increasing day by day. Guru Aahar, Madyapaan, Anidra, Upvas, Krodha, Santap, Svabhav are some of the factor responsible for the development of Mukhadushika. It is generally due to vitiation of Vata, Kapha and Rakta resulting in Shalmali like eruption on face. In Ayurveda for the treatment of Yuvana pidika (Kshudra-roga) both shaman as well as shodhan chikitsa are described.

A Double-Blinded, Randomized, Vehicle-Controlled Study of the Efficacy of Moisturizer Containing Licochalcone A, Decanediol, L-Carnitine, and Salicylic Acid for Prevention of Acne Relapse in Asian Population.

Many topical agents are available for treating the acute phase of acne; however, few agents have been proven beneficial during the maintenance phase. Objective. To evaluate the efficacy and safety of moisturizer containing licochalcone A, 1,2-decanediol, L-carnitine, and salicylic acid during the maintenance phase of mild to moderate acne in Thai patients. Methods. One hundred and ten patients with mild to moderate acne vulgaris were initially treated with a fixed combination of adapalene 0.1%/benzoyl peroxide 2.5% gel once daily for 8 weeks. Fifty patients who achieved at least 50% reduction in lesion counts or at least a 2-grade improvement in the Investigator's Global Assessment (IGA) grade from baseline were enrolled in the maintenance phase, which was an investigator-masked, left-right comparison, randomized, controlled, intraindividual study. Moisturizers with and without the active study ingredients were applied twice a day to each side of the face, respectively, for 12 weeks. Assessments included acne lesion counts, acne severity by IGA scoring, skin bioengineering measurements, and skin tolerability as assessed by both patient and physician. Results. The treatment group had a significant reduction in the mean counts of noninflammatory, inflammatory, and total lesions compared to the vehicle group at week 12 and also between baseline and week 12. There was no significant difference in the mean scores for skin dryness, stinging/burning, or pruritus at any time point between groups. Conclusions. Moisturizer containing licochalcone A, 1,2-decanediol, L-carnitine, and salicylic acid reduced acne lesions and prevented the development of new lesions during the maintenance phase. This trial is registered with ClinicalTrials.gov registration no. NCT04002024.

A Comparative Study on Efficacy of Azithromycin and Doxycycline in the Treatment of Acne Vulgaris at a Tertiary Care Centre

Comparing the efficacy of doxycycline and azithromycin in the treatment of patients with acne vulgaris. A total of 110 patients with acne vulgaris participated in this comparative,prospective, longitudinal study and were randomly assigned to two groups (azithromycin and doxycycline). Grading of scores were determined and recorded at baseline using the sign and symptom scores validated by Jerry KL Tan whereas the severity of acne was evaluated by counting the number of lesions. Patients were followed up for a period of 4 weeks.Clinical assessment was made at the end of 4 weeks and data was analysed. Pre and post treatment evaluations were done by using score scale where the number of non-inflammatory, inflammatory and total lesions were counted. Chi-square test was used to compare the results and p 0.05) in efficacy was found when the azithromycin treated group was compared with doxycycline treated group after one month of therapy. Both drugs were effective in reducing the severity of Acne vulgaris when compared separately before and after therapy with azithromycin being a little superior in the reduction of the percentage of number of inflammatory lesions than Doxycycline. The reduction in the percentage in the number of inflammatory lesions post 1 month was better with azithromycin group as compared to Doxycycline, whereas there was improvement with respect to the reduction in number of noninflammatory lesions and total lesions in both groups but was not significant between the groups However, there was no significant difference between the efficacy of Azithromycin and Doxycycline treated group after one month period of therapy

Passion fruit purple variant (Passiflora edulis Sims var. edulis) seeds extract 10% cream in acne vulgaris treatment: an open-label pilot study.

Purple variant of passion fruit (Passiflora edulis Sims var. edulis) is a tropical plant commonly used in the beverage industry. The seeds have high content of linoleic acid and piceatannol which has been reported and showed antibacterial, anti-inflammatory, and antioxidant activities. However, there is no report regarding its effect on acne vulgaris. To determine the efficacy of topical use of Passiflora edulis Sims var. edulis seeds extract on acne vulgaris. In this open-label uncontrolled trial, 45 subjects with acne vulgaris were given passion fruit purple variant seeds extract 10% cream for 8weeks. Noninflammatory, inflammatory, and total acne lesions count along with ultraviolet-induced red fluorescence (UVRF) measurement were done at weeks 0, 2, 4, 6, and 8. All reported adverse events were documented, and patient satisfaction rates were determined at week 8. Paired T-test and Wilcoxon test were done with P≤0.05 indicating significance. There were significant reductions in noninflammatory (80.9%), inflammatory (71.1%), and total (73%) lesion count after 8weeks of the cream application (P<0.001). Significant reduction in UVRF spot quantity (36%) and percentage area (45.9%) were found at week 8 (P<0.001). Only 2.2% of subjects experienced an adverse event of mild and transient peeling. Most of the subjects (77.8%) noticed significant improvement in their acne vulgaris and expressed good satisfaction rate. Topical use of passion fruit purple variant seeds extract improves acne vulgaris with reduction in lesion counts and UVRF, minimal adverse events, and good satisfaction rate. Additional prospective studies are required.

Presenting an atlas of Hunner lesions in interstitial cystitis which can be identified with office cystoscopy.

To assist clinicians in proper visual diagnosis of Hunner lesions by providing an atlas of representative images of the variability in Hunner lesion appearance. Available cystoscopic images of Hunner lesions were reviewed from patients with interstitial cystitis or bladder pain syndrome (IC/BPS) treated by a single clinician between 2011 and 2020. For most patients, initial cystoscopy was performed in the office under local anesthesia. Images were categorized by variations in appearance. Data including Hunner lesion descriptions and patient demographics were retrospectively collected from the medical record. Only patients who had images available, received triamcinolone injection and/or fulguration of Hunner lesions, and reported improvement of their symptoms following treatment were included in the atlas. Thirty-one IC/BPS patients with Hunner lesions had cystoscopic images available for review. We created an atlas of representative images. Variations in appearance include classic lesions with or without a central coagulum, inflamed lesions, non-inflamed lesions, groupings of lesions, and lesions with a red waterfall bleeding appearance. There is variation in cystoscopic appearance of Hunner lesions. Most Hunner lesions can be identified during office visits using flexible cystoscopy and local anesthesia without hydrodistention or general anesthesia. Proper visual diagnosis of Hunner lesions is of upmost importance as these patients with IC/BPS respond greatly to endoscopic intervention. This atlas will serve as a reference for clinicians and researchers, so they are able to better identify and manage these patients.

A comparative study of efficacy of resurfacing with fractional carbon dioxide laser versus derma roller in the treatment of post acne scars

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Acne vulgaris is a chronic skin disease which can present as non-inflammatory lesions, inflammatory lesions, or a mixture of both, resulting in distressing and difficult to treat scars. The objective of this study is to compare the efficacy of fractional carbon dioxide (CO&lt;sub&gt;2&lt;/sub&gt;) laser technique (FCLT) versus derma roller therapy (DT) with respect to post-acne scars and to study their respective side effects.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; A total of 200 patients of post acne scars were enrolled for this study from the outpatient Department of Dermatology, Venereology and Leprology, Navodaya Medical College Hospital and Research Centre, Raichur. The patients were randomly allocated into two groups of 100 patients each in which one group was treated with derma roller therapy and the other group was treated with fractional CO&lt;sub&gt;2&lt;/sub&gt; laser every 4 weeks over a period of 24 weeks each.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; In the derma roller group, 89 patients completed the treatment with 11 drop out cases. The percentage reduction in the mean objective scores was found to be 37.63%. In the fractional CO&lt;sub&gt;2 &lt;/sub&gt;laser group, 93 patients completed the treatment with 7 drop out cases. The percentage reduction in mean objective scores was found to be 41.22%.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Comparing the efficacy of derma roller therapy and fractional CO&lt;sub&gt;2&lt;/sub&gt;laser resurfacing method in the treatment of post acne scars, both the modalities were found to be equally efficacious.&lt;/p&gt;

COMPARISON OF MALASSEZIA SPP. PROPORTIONS IN INFLAMMATORY AND NON-INFLAMMATORY FACIAL ACNE VULGARIS LESIONS

Objective: The skin microbiome plays a role in the pathogenesis of acne vulgaris (AV). Among other species, Malassezia spp. can be found in the pilosebaceous follicle. However, its role on the pathogenesis of AV has not yet been described. The objective of this study was to identify the presence and the distribution of Malassezia spp. in facial AV lesions and also to compare the distribution of Malassezia spp. between inflammatory and non-inflammatory lesions.&#x0D; Methods: One hundred and twenty subjects were allocated into two groups: inflammatory lesions and non-inflammatory lesions. Samples were taken from hair follicles and examined by microscopy using 20% potassium hydroxide and Parker ink and cultured for species identification.&#x0D; Results: There was no difference in the spore load between the two groups (p=0.142). Malassezia spp. were isolated from 64.2% of subjects and consisted of M. dermatis (43%), M. sympodialis (18%), M. slooffiae (16%), M. japonica (5%), M. furfur (5%), M. pachydermatis (3%), and M. restricta (1%). There was a higher Malassezia spp. proportion in non-inflammatory lesions (p=0.019). The predominant species in inflammatory AV lesions was M. dermatis (45,8%), followed by M. sympodialis (17.1%), and M. slooffiae (11.4%).&#x0D; Conclusion: Malassezia spp. were found in facial acne lesions. M. dermatis was the predominant species found in facial AV, followed by M. sympodialis, and M. slooffiae. A higher proportion of Malassezia spp. was found in non-inflammatory lesions.

The effects of green tea on acne vulgaris: A systematic review and meta-analysis of randomized clinical trials.

Green tea extract (GTE) has been studied for the treatment of acne based on its anti-inflammatory/antioxidant properties. This systematic review and meta-analysis aimed to examine the effects of GTE on acne. Electronic databases, including PubMed, Embase, and the Cochrane Library were systematically searched up to August 2019. The effect size of acne lesion counts is presented as mean differences and 95% confidence intervals (CIs). Five randomized-controlled studies were included in the meta-analysis (N; experimental = 125, control = 122). GTE significantly reduced the number of inflammatory lesions (-9.38; 95% CI: -14.13 to -4.63). In subgroup analysis, topical GTE application significantly reduced the inflammatory lesion counts (-11.39; 95% CI: -15.91 to -6.86) whereas oral GTE intake showed minimal effect (-1.40; 95% CI: -2.50 to -0.30). Although GTE did not significantly reduce the number of non-inflammatory lesions (-21.65; 95% CI: -47.52 to 4.22), when stratified by the route of admission, non-inflammatory acne lesions were significantly reduced by topical GTE application (-32.44; 95% CI: -39.27 to -25.62) but not with oral GTE administration (0.20; 95% CI: 0.00 to 0.40). This systematic review and meta-analysis suggest that topical GTE application is beneficial for the treatment of acne without causing significant adverse events while oral GTE intake has limited effects. Further high-quality clinical trials are warranted.

CORRELATION STUDY OF ACNE VULGARIS AND SERUM VITAMIN D LEVELS IN ADOLESCENTS

Objective: Approximately 9.4% of the world population is affected by acne during adolescence. Several previous studies have shown a significant relationship between acne vulgaris (AV) and serum vitamin D levels. The purpose of this study was to determine the correlation between AV and serum vitamin D levels in adolescents.&#x0D; Methods: This cross-sectional study included 60 healthy students with AV aged 15-18 y from three high schools in Depok, which were selected via simple random selection, and the selection of participants was based on consecutive sampling selection after screening with the inclusion criteria. Serum vitamin D levels were evaluated using a direct Chemiluminescence immunoassay (CLIA) method. The lesions of AV were counted by a dermatologist. Dietary vitamin D and fat intake were assessed using a semiquantitative Food Frequency Questionnaire and 24-hour dietary recall. The data were processed using SPSS Statistics 20.0 and analyzed using Pearson or Spearman correlation tests.&#x0D; Results: The mean serum vitamin D level was 17.29±6.77 ng/ml. The mean number of non-inflammatory lesions was 20.5±12.08, and the median number of inflammatory lesions was 6 (range 0-28). The correlation between the number of non-inflammatory lesion and serum vitamin D levels was r = 0.25 (p = 0.052) and the correlation between the number of inflammatory lesions and serum vitamin D levels was r = 0.047 (p = 0.72).&#x0D; Conclusion: Serum vitamin D levels are not significantly correlated with AV despite whether the lesions are inflammatory or non-inflammatory.