Pilosebaceous Follicles Research Articles

Impact of prodigiosin on staphylococcus aureus isolated from acne vulgaris

Acne is a skin disorder characterized by clogged hair follicles and chronic inflammation of the pilosebaceous follicles. A total of one hundred and five acne swabs were collected from patients with acne vulgaris infection at Baghdad's hospitals. For primary identification, 54 (45%) samples had a positive S. aureus culture on Mannitol salt agar (MSA) for 24 hours at 37°C. In addition, four pre-isolated also identified S. marcescens (pigment producers) which were identified by vitek-2 technique were taken for prodigiosin extraction, mineral salt broth with peptone (0.5 percent) was utilized, followed by pigment extraction, partial purification, also pigment measurement by spectrophotometer. Furthermore, using a microtiter plate assay, the bacterial ability to form biofilms was assessed for 20 S. aureus isolates (multidrug resistant isolates). The results revealed that only 8 strong isolates were biofilm producers, while 5 in addition 7 isolates were moderate also weak biofilm producers. The minimal inhibitory concentration of tetracycline also prodigiosin generated by isolated S. marcescens were determined using the broth microdilution technique for S. aureus isolates (S7 also S8). From overnight cultures of S. aureus (S7 also S8), DNA was effectively extracted.

The efficacy of polycaprolactone filler injection on enlarged facial pores

Facial pores, visible topographic change of skin representing enlarged openings of pilosebaceous follicles, are common aesthetic concern. The aim of this study was to examine the efficacy of polycaprolactone (PCL) filler on enlarged facial pores and skin texture improvement. A total of seven participants with enlarged facial pores were included in the study and underwent deep dermal injection of PCL based filler (Ellanse M, Sinclair Pharma; London, United Kingdom). Skin quality measurements including skin evenness, red areas, UV spots, wrinkles and pore numbers evaluated with an automated aesthetic camera (FotoFinder®, Teach Screen Systems software GmbH; Bad Birnbach, Germany) before and 3 months after the injection session. Adverse events during procedure were monitored and recorded. Subjects were asked to report any injection related side effects. The average size of enlarged pores was 33.51 ± 41 before treatment and 20.51 ± 35 after treatment. The difference was statistically significant (P< 0.05). The skin evenness, red areas, UV spots, and wrinkles showed no significant improvement after filler injection. No serious adverse events were reported at follow-up visit. The PCL based filler seems to be notably effective in improvement of enlarged facial pores especially in moderate to severe cases. However, further structured studies with larger sample size and control group could be more beneficial to elucidate the possible efficacy of PCL filler injection on the skin quality characteristics.

Epidermoid Cyst of Sole

An epidermoid cyst is benign cystic tumor coated with squamous epithelium and contains keratin. It generally appear on the body parts which have pilosebaceous follicles, such as head, neck, and body. The manifestation of the disease is a skin-colored, mobile, painless nodule with a punctum in the center. Epidermoid cyst of sole is often similar to clavus, callus, and verruca plantaris. However, epidermoid cyst of sole is rare because the area is without pilosebaceous follicles. The etiopathology is believed due to trauma that causes implantation of epidermal cells into the dermis layer, thus triggering the formation of epidermoid cysts. This case report a girl with an epidermoid cyst of sole that was initially thought as a verruca plantaris and clavus. A 14-year-old girl complained about a bump on her right foot that got bigger during nine months. The lesions surface was slippery, and the patient felt pain when walking. The patient denied any trauma or changing footwear with friends or relatives. Examination in the right lateral plantar pedis region, a nodule was found skin-colored, round, measuring 2x2 cm, and solitary. The patient was planned to undergo excochleation, but since a white cystic mass was found during the operation, it was continued with extirpation surgery. The histopathological examination results showed a stroma with keratin, which was concluded as an epidermoid cyst. In the case of epidermoid cysts with atypical clinical symptoms and unusual lesion locations, histopathological examination is required for a definite diagnosis.

THE EFFECT OF THE USE OF MASK ON THE INCIDENCE OF ACNE VULGARIS IN STUDENTS OF MEDICAL FACULTY DIPONEGORO UNIVERSITY

Background: Acne vulgaris (AV) is an inflammatory condition of pilosebaceous follicles that is commonly experienced in adolescents and young adults. The pathogenesis of AV is multifactorial, such as caused by inflammation and external factors of acne exposome, which have an impact on the pathogenesis of acne in the use of masks.Objective: To determine the effect of using a mask and the number of acne vulgaris on students of the Faculty of Medicine, Diponegoro University.Methods: This research is an observational type with a cross sectional design. The research subjects were 58 students of the Faculty of Medicine, Diponegoro University with an age range of 19-23 years who used masks. The data obtained are primary data from the questionnaire. The analytical test used is bivariate chi square analysis.Results: This study showed that there was no significant effect between the type of mask and the incidence of acne vulgaris p 0.610 (p&gt;0.05), the duration of the use of masks and the incidence of acne vulgaris p 0.200 (p&gt;0.05), and the frequency of using masks with the incidence of acne vulgaris p 0.689. (p&gt;0.05)Conclusion: There is no effect between the use of masks and the incidence of acne vulgaris.

Conceptual Study of Yuvanpidika W. S. R. ToAcne Vulgaris: A Review

Ayurvedais the science of life which described the Hitaand Ahitatowards Ayu.If man doesn’t follow the rules described in Ayurveda, it leads to imbalance of Doshaultimately this produces different disorders. Yuvanpidikais one of Kshudrarogas which mainlyaffects the skin of face. According to Ayurvedatext it occurs due to imbalance of Kapha,Vata, and Rakta. Acne is as chronic inflammatory condition of the pilosebaceous follicles on face and sometimes on chest and upper back also mostly affect almost 85%of teenagers.

The use of isotretinoin in acne therapy in early childhood and its effect on the occurrence of acne symptoms later in life. Eight-year follow-up.

IntroductionAcne vulgaris is a chronic inflammatory skin disease of the pilosebaceous follicles that affects patients of all ages.AimUse of isotretinoin in the early stages of the disease to prevent subsequent lesions of acne, including prolonged treatment and acne scars at a later age.Material and methodsA retrospective, comparative study was carried between January 2010 and November 2018. The study population consisted of 90 children aged 9–18 years with acne. During treatment by isotretinoin the clinical evaluation was done every month. Patients were divided into three groups according to age. One of the qualification criteria was follow-up visits.ResultsA total of 90 children (67.8% females; mean age: 13.5 years) were enrolled. In group A (30 individuals – aged 9–11) and B (30 individuals – aged 12–13), treatment was terminated 2 months after clinical improvement (mean: 3 months). In control group C (30 individuals – aged 14–18), treatment was carried out using average cumulative dose 135 mg/kg bw/day. All groups showed up for follow-up. after 1 to 8 years. In groups A and B, 13 people underwent a second acne treatment; in 3.33% oral isotretinoin was used, in 18.33% topical treatment. In group C, 30 (100%) individuals underwent a second acne treatment; in 20% oral isotretinoin was used, and 80% required a topical treatment. Acne scars and post acne hyperpigmentation have been documented in 73.33% in group C.ConclusionsEarly, reasonable and short-term use of isotretinoin can reduce the incidence of acne in the future and reduce the occurrence of secondary acne symptoms.

Assessment of serum androgen levels in women with acne vulgaris in Southeastern Nigeria: a cross-sectional study.

Introductionandrogens play an important role in the pathogenesis of acne vulgaris. They cause hyperkeratinization of the pilosebaceous follicles and seborrhea. Endocrine diseases characterized by increased levels of androgens often present with acne vulgaris. A correlation between serum androgen levels and acne severity exists, and the assessment of serum androgen levels is therefore essential in women with severe acne vulgaris and treatment resistant acne.Methodsthe study was conducted in the Dermatology Clinic of the University of Nigeria Teaching Hospital, Ituku Ozalla. Seventy females with acne vulgaris and seventy females without acne vulgaris were recruited as subjects and controls respectively. Blood samples were taken from subjects and controls to measure levels of serum testosterone, dehydroepiandrosterone sulfate (DHEAS) and androstenedione. Acne severity was measured using global acne grading system (GAGS).Resultsthe median levels of DHEAS and androstenedione (1.20µg/ml and 1.80ng/ml respectively) were higher in subjects than 1.00µg/ml and 1.70ng/ml in controls respectively, although these findings were not statistically significant. There was also no significant difference between the levels of serum testosterone in both the subjects and the controls. No correlation existed between levels of serum androgens and acne severity.Conclusionthere was no statistically significant difference in the serum androgen levels between the subjects and the control population, and no relationship between androgen levels and severity of acne vulgaris was demonstrated.

Intense pulsed light (IPL) as adjuvant therapy for acne vulgaris: A case series

Background: Acne vulgaris is a chronic inflammatory disease of the pilosebaceous follicle with polymorphic clinical manifestation typically found on facial, neck and/or back area. The pathogenesis is complex and multifactorial. Management of acne vulgaris is determined based on its severity. Adjuvant therapies, such as intense pulsed light (IPL), have been described in accelerating the healing process during treatment. Case Illustration: We report two cases regarding the usage of IPL as adjuvant therapy in acne vulgaris. Both patients were diagnosed with moderate acne vulgaris. The first patient was given topical adapalene 0.1% gel every night and sunscreen in the morning, and the other patient was given clindamycin gel applied twice a day, benzoyl peroxide 2.5% cream applied once a day at night, and sunscreen in the morning. Both patients were treated using IPL as their adjuvant therapy every three weeks, with a total of 2 IPL sessions in 2 months. Evaluation using clinical and ultraviolet-induced red fluorescence (UVRF) examination showed gradual improvement. Discussion: IPL as an adjuvant therapy of acne vulgaris has been thought to interfere with the function of the sebaceous glands by its direct phototoxic effects and thermal damage. It also has bactericidal effects on C. acnes through the formation of free radicals. The combination of topical treatment and IPL yielded clinical improvements in both patients. Conclusion: IPL may be beneficial as adjuvant therapy in acne vulgaris in this case series. Keywords : acne vulgaris, adjuvant therapy, intense pulsed light, UVRF

Cutibacterium acnes and Staphylococcus epidermidis: the unmissable modulators of skin inflammatory response.

Acne is a multifactorial inflammatory dermatose that affects all age categories from teenagers to adults, resulting in important psychological impacts. Multiple hypotheses currently attempt to decrypt the physiopathology of this disease, and four main actors were identified as highly implicated in it: hyperkeratinization of the pilosebaceous follicle, hyperseborrheae, host factors (innate immunity) and skin microbiota. In this letter, we present results illustrating the impact of skin microbiota on inflammatory skin response, and how far the proper balance between each bacterial community, especially C.acnes and S.epidermidis, is crucial to maintain an appropriate inflammatory response on the skin. The data presented in this study demonstrate that within the skin microbiota, an imbalance between Cutibacterium acnes and Staphylococcus epidermidis, is able to induce the activation of inflammation-related markers such as IL-1ra, IL-6, IL-8, G-CSF and the molecules C5/C5a, soluble CD14MIP-3beta, Serpin E1, VCAM-1 and beta-defensin-2. Moreover, S.epidermidis appears to have a more important role than C.acnes on the induction of inflammation-related markers, particularly on IL-6. This work is the basis of future in vitro studies to further understand acne physiopathology, inspiring the development of future innovative therapies based on skin microbiota modulation.

Evaluation of Clinical Profile of Acne Vulgaris in a Tertiary Care Teaching Hospital

Background: Acne vulgaris is thought to be the most prevalent skin disease seen in clinical practice, and it is caused by a combination of causes that start in the pilosebaceous follicle. Subjects and Methods: There were a total of 114 patients, 32 men and 82 women. Patients with acne vulgaris who came to the outpatient department and agreed to participate in the study were included, but those who refused or had drug-induced or other acne-related eruptions were excluded. Results: The most prevalent age group to be involved was 20–25 years of age (36.0%), followed by 15–20 years of age (31.6%) and 25–30 years of age (19.3%). Cheeks 8.61%, forehead 64.9%, mandible 33.3%, and chin 27.2% were all damaged in all cases. Truncal involvement was lower in the chest (10.5%), back (13.2%), shoulder (9.6%), and upper arm (.3.5%). Around 43.9% of people had grade III acne, 29.8% had grade II acne, 14.9% had grade IV acne, and 11.4% had grade I acne. Females (50.0%) had more grade II and III acne than males (23.7%). Conclusion: The majority of the patients were from 20-25 years of age group. The survey also revealed a rise in the number of adult acne cases. In every case, the face was implicated, with the cheek area being the most engaged. The most prevalent grades were II and III, and females outnumbered males with these grades. Scarring corresponded to the length of acne, with icepick scars being the most common. In most cases, postacne hyperpigmentation was seen, which corresponded to the inflammatory nature of the lesions.

ASSOCIATION BETWEEN MAGNESIUM LEVELS AND THE SEVERITY OF ACNE VULGARIS

Introduction: Acne vulgaris is a cosmetic problem that often occurs in 80% of the population, especially reproductive age (12-25 years). Acne vulgaris is a chronic inflammatory disease of pilosebaceous follicles with multifactorial causes and clinical manifestations of blackheads, papules, pustules, nodules, and cysts. Magnesium plays a role in increasing skin hydration, increasing skin permeability, barrier repair, and facilitating skin proliferation and epidermal differentiation to reduce inflammation. Hypomagnesium is thought to increase inflammation and affect androgen hormones, especially testosterone, which plays a role in increasing the hyperactivity of the sebaceous glands in the pathogenesis of Acne Vulgaris. Purpose: To determine the difference in magnesium levels in each severity degree of acne vulgaris, namely mild, moderate, and severe. Method: This study is an analytic observational study with a cross-sectional design. The sampling technique is purposive sampling with a total sample of 30 people. Data retrieval in this study was carried out using photo taking of three sides of the face (front, right oblique, left oblique). Then proceed with a three cc venous blood draw to measure magnesium levels in the blood. Results: This study found a significant difference between magnesium levels and the severity of acne vulgaris with a value of p = 0.032 (p &lt;0.05). Magnesium levels in severe acne vulgaris were higher than moderate and mild acne vulgaris. However, magnesium levels in all samples were still within the normal range. There was a moderate positive correlation between the two variables with a p-value = 0.016 (p &lt;0.05). Conclusion: There was a significant difference between magnesium levels and the severity of acne vulgaris, and there is a moderate positive correlation between magnesium levels and the severity of acne vulgaris, which means that the higher the magnesium level, the more severe the degree of acne vulgaris.

Relation between Acne Vulgaris and Metabolic Syndrome in Males

Abstract Background: Acne is a multifactorial and inflammatory disease of pilosebaceous follicles, which affects most adoles-cents. Metabolic Syndrome (MetS) is a multiplex syndrome and has been reported to be associated with many dermatologic diseases, such as acne vulgaris. Aim of Study: Study the prevalence of MetS in post-adolescent male patients with AV (aged >!20 years), and assess the relation between MetS and severity of AV in these patients. Patients and Methods: A randomized case control study was conducted on 52 post adolescent male patients with acne and 52 patients (age and sex matched) as control. All patients were subjected to clinical assessment including: Evaluation of MetS components: (Body Mass Index (BMI) calculation: [Weight (kg) / height (m)2] & waist circumference) and estimation of biochemical parameters (fasting serum triglyc-erides, HDL and fasting blood glucose). Dermatological evaluation was done for assessment of acne severity. Results: MetS prevalence was statistically significant higher in AV patients (19.2%) compared to controls (5.8%). (x2=4.37, p=0.037). There was a statistical significant relation between AV and risk of developing MetS as odds ratio was 3.9 (1.003 to 15.07), p=0.049. There was statisti-cally insignificant relation between the severity of AV and MetS prevalence. Conclusion: MetS prevalence was higher in AV patients than in control and was more common in patients with severe acne. There was a statistical significant relation between AV and risk of developing MetS.

Individualised Homeopathic Treatment of Acne-An Analysis of 83 Patients.

Acne is a common disorder of the pilosebaceous follicle. The face, back and chest are usually involved. It leads to significant diminution in quality of life. Numerous treatments are documented in therapeutic guidelines. Naturopathic approaches have been proposed in some, but the role of homeopathy is not examined. In this study, 83 patients treated for acne with individualised homeopathic medicine alone were reviewed. Most had received conventional acne treatment, with limited success prior to presentation for homeopathy. Each patient was prescribed a single homeopathic medicine and followed up at 6- to 8-week intervals. The individualisation process resulted in 17 different medicines being used in this group. Photographic documentation was obtained per patient, with informed consent. Patients were classified as mild (comedonal acne with no papules or pustules), moderate (inflammatory and non-inflammatory lesions) and severe (predominantly inflammatory lesions: pustules, cysts, nodules). Results of treatment were recorded as remission (decrease in new lesion number, duration and intensity), failure to respond, and lost to follow-up (LTF). The average age of patients was 21.5 years (range 11-45 years). The F:M ratio was 55 (66.3%):28 (33.7%). Average pre-treatment duration was 5.5 years (0.25-22 years). Seven (8.4%) patients had mild acne, 37 (44.6%) moderate, and 39 (47%) severe acne. There were 13 (15.7%) LTFs, two (2.4%) failed to respond, and 68 (81.9%) went into remission. Average time to remission was 1.9 months (range 1.5-6 months), with no relapses or side-effects. The most commonly prescribed medicines were Lycopodium (38.6%), Palladium (15.7%) and Platinum (12.1%). Individualised homeopathy may be useful for acne therapy. The most useful medicines appeared to be Lycopodium, Palladium and Platinum, though 17 different medicines were used in this study, underscoring the value of individualisation of therapy, a key characteristic of homeopathy.

Efficacy assessments of tretinoin-loaded nano lipid carriers in acne vulgaris: a double blind, split-face randomized clinical study

Here, we assessed the efficacy and safety of Nano lipid carrier (NLC) drug delivery system containing tretinoin (NLC-TRE) in comparison with the conventional 0.05% tretinoin cream (TRE cream) in mild to moderate acne vulgaris. A stable and appropriate NLC-TRE formulation was prepared using a high-pressure homogenizer and particle characterization and physicochemical properties were evaluated under accelerated conditions. Efficacy assessment was performed via a split-face clinical study, by comparing the number of acne lesions, porphyrin production and skin biophysical parameters in both sides of the face randomly treated with NLC-TRE and TRE cream. Plasma concentration of tretinoin after topical application of NLC-TRE was measured for primary safety evaluation. We acquired a stable, spherical nanoparticles with particle size of 118.5nm, PI equal to 0.485 and ZP of -44.7mV. The rate of decrease of acne lesions was significantly higherin NLC- TRE side (p value < 0.001). The size and intensity of porphyrin production in pilosebaceous follicles were significantly reduced only on NLC-TRE side (p value < 0.01). The plasma concentration of the tretinoin, after 8weeks' application remained lower than the toxic levels. The NLC-TRE formula provides better efficiency and good loading capacity of TRE in the drug delivery system.

Sodium Hypochlorite 0.005% Versus Placebo in the Treatment of Mild to Moderate Acne: A Double-Blind Randomized Controlled Trial.

Acne vulgaris is a common inflammatory disease of the pilosebaceous follicle that affects many teenagers and young people. There is an obvious need for topical treatments with good tolerability and efficacy for the management of acne lesions. This study determined the therapeutic efficacy of topical sodium hypochlorite solution (0.005%) in the treatment of mild to moderate acne lesions. This placebo-controlled randomized controlled trial compared 0.005% sodium hypochlorite to placebo administered topically on each side of the patients' faces 3 times a day for 1 month. The numbers of papules and pustules were recorded at baseline, 1, 2 and 4 weeks after initiation. The total number of papules and pustules decreased after topical application of sodium hypochlorite 0.005% for 1 month. Topical sodium hypochlorite solution (0.005%) can be effective in the treatment of mild to moderate acne, and its clinical efficacy was evaluated between the male and female groups and between the hormonal and non-hormonal ones. Our study was registered in the Iranian Registry of Clinical Trials (IRCT) with the code number IRCT20200701047976N1.

Which factors influence Demodex proliferation? A retrospective pilot study highlighting a possible role of subtle immune variations and sebaceous gland status.

Demodex folliculorum and brevis are commensal mites that live in low densities in human pilosebaceous follicles as part of the normal adult microbiota, but that give rise to demodicosis and, possibly, rosacea, when they proliferate excessively. This proliferation is favored by various factors, including age, marked immunosuppression, sebaceous gland hyperplasia, and hypervascularization-related factors. To study possible factors influencing mite proliferation, we explored the effects of different variables on Demodex densities (Dd) in a retrospective study of two groups of subjects selected on the basis of their clinical diagnosis: Demodex+, consisting of subjects with demodicosis or with centro-facial papulopustules suggesting rosacea (n=844, mean Dd 263.5±8.9D/cm2 ), and Demodex-, consisting of subjects with other facial dermatoses or healthy facial skin (n=200, mean Dd 2.3±0.4D/cm2 ). Demodex densities were measured using two consecutive standardized skin surface biopsies (SSSB1 [superficial] and SSSB2 [deep]) taken from the same facial site on each subject. In the Demodex+ group: the SSSB1 decreased with age in women (p=0.004), and the SSSB2 increased with age in men (p=0.001) (the pattern was similar for SSSB1+2, but not statistically significant); Dds were lower in those who had received cortisone (either topically or systemically); 13 subjects (1.5%) had known immunosuppression, 62 (7.3%) had hypothyroidism, and in 20 (3.6% of the women) there was a reported link with pregnancy; 78 of the subjects (9.2%) were part of a pair from the same family or household; when associated bacterial infection was suspected, Staphylococcus epidermidis was often isolated. Our results suggest close interactions between the mite, sebaceous gland size and function, and subtle variations of immune status. Potential factors influencing Demodex proliferation should be further investigated, including hypothyroidism, pregnancy, corticosteroid administration, Staphylococcus epidermidis, contagiousity, and genetic background.

Interleukin-35 Level in Acne Vulgaris

Background: Acne vulgaris is a multifactorial disease affects the pilosebaceous follicle and results in inflammatory and non-inflammatory lesions with certain role of cytokines in its pathogenesis. Interleukin-35 (IL-35) cytokine has been shown to exhibit immunosuppressive activities, which are distinct from other members of IL-12 family. IL-35 is also unique in that it is expressed primarily by regulatory T- cells (Tregs) rather than by antigen-presenting cells (APCs). Objective: To investigate the role of IL-35 in the pathogenesis of acne vulgaris by assessing its levels in lesional skin and serum of patients with acne vulgaris compared with normal individuals. Patients and methods: 44 subjects were divided into 2 groups: Group 1: It included measurement of serum and tissue level of interleukin 35 in 22 acne vulgaris patients with age group (15-30). All of them were subjected to detailed history taking, dermatological and general examination. Group 2: It included 22 healthy, age, and gender matched individuals as a control group. Result:Our results show a highly statistically significant difference between acne patient and control regarding IL-35 level in serum and tissue. Conclusion: Our study may provide evidence that serum and tissue IL-35 are important anti-inflammatory cytokines. They are actively expressed by the sebaceous glands. They have significant higher expression in acne patients. They are hypothesized to play a key role in acne cure at multiple points, through their anti-inflammatory action. This effect may be hindered in acne vulgaris by undiscovered obstacles.

Comparison of Oral Isotretinoin vs Azithromycin in the Treatment of Acne Vulgaris

Background: Acne vulgaris is a chronic inflammatory disease of the pilosebaceous follicles, common inadolescents, characterized by comedones, papules, pustules, cysts, nodules, and occasionally scars. Thisstudy was designed to compare multi B vitamins, folic acid and homocysteine levels in patients withmoderate to severe acne vulgaris with those of the apparently healthy control group and to investigate theeffect of isotretinoin and azithromycin treatments on these biochemical parameters and comparison betweentwo drugs.Methods: This study was conducted on sixty women patients with acne and thirty as a control group. Thepatients were allocated into two groups, A and B, group A was given 500 mg of azithromycin taken onalternative days for 3 months and group B was given 40mg/day isotretinoin for 3 months.Results: The study showed significant differences (p&lt;0.05) in serum levels of vitamins B6, B7, B12 andfolic acid, while no significant difference in serum homocysteine in patient group when compared to controlgroup. The results showed significant positive correlation between serum vitamins and clinical score andsignificant difference were detected in both group when compared between pre and post treatment.Conclusions: The results indicate higher pre-treatment vitamin B12 levels, versus the control group andpositive correlation between clinical score and vitamin B12, support the assertion that vitamin B12 playsa role in the etiopathogenesis of acne vulgaris. Both azithromycin and isotretinoin were effective in acnetreatment but azithromycin has less side effects.

MEDICINAL LEECH FOR THE TREATMENT OF ACNE VULGARIS W.S.R. TO MUKHADUSHIKA: A RANDOMISED CLINICAL STUDY

Acne vulgaris is a chronic inflammatory disorder of the pilo-sebaceous follicles characterised by comedones, papules, pustules, nodules and often scars mainly seen on cheeks, chin, nose, forehead and upper trunk during adolescence. The symptoms of Acne vulgaris resemble Mukhadushika as per Ayurvedic classics. Acharya Sushruta has mentioned Mukhadushika as one of the Kshudra Rogas. In Mukhadushika, there are Shalmali kantak like eruptions on the face which are impregnated with Meda caused due to vitiation of Kaphadosha, Vatadosha and Raktadhatu which destroy the beauty of the face and makes the appearance ugly. The disease almost take place in adolescent and young age group prominently therefore is also known as Yuvanapidika. Acharya Sushruta stated Jalaukavacharana is the preferred method of bloodletting in Sukumara. Aim: To evaluate the efficacy of Jalaukavacharana in the management of Acne vulgaris w.s.r. to Mukhadushika. Methodology: Fourteen patients of age group 15-30 years having signs and symptoms of Mukhadushika were selected and four sittings of Jalaukavacharana on a seven day interval were given. Apart from treatment duration of 28 days, a follow-up was also done after 30 days. Results: Intervention was found to be highly significant (p&lt;0.001) in Vedana, Kandu, Daha, number of Pidika, size of Pidika, Pidika ghanata, Shotha, Vaivarnyata. However, significant effect (p&lt;0.05) was found in Vranavastu and non-significant result (p&gt;0.05) was found in Srava. Conclusion: The results are satisfactory. Jalaukavacharana is proved to be an effective, time saving, affordable and acceptable treatment in Mukhadushika without causing any adverse effect.

Correlation Between Stress Scale and Serum Substance P Level in Acne Vulgaris.

IntroductionAcne vulgaris is a chronic inflammatory disease of pilosebaceous follicles with polymorphic lesions, consisting of comedones, papules, pustules and nodules with varying degrees of severity. Stress is one of the triggers of acne vulgaris. Peripheral nerves release substance P in response to stress. Substance P causes proliferation and differentiation of sebaceous glands and increases lipid synthesis in sebocytes.PurposeTo determine the correlation between stress scale and serum substance P level in acne vulgaris.Patients and MethodsThis study was an observational analytic study with a cross-sectional design involving 30 patients with acne vulgaris and 30 controls. History taking, dermatological examination and the Holmes−Rahe stress scale questionnaire were performed with each patient to evaluate stress scale, followed by taking blood samples to assess substance P serum levels using the ELISA test. The collected data were analyzed using the Spearman correlation test.ResultsIn both groups, the majority of subjects were 23–27 years old (36.7%) and most of them were female (76.7%). The majority in the acne vulgaris group had low scores on the stress scale, represented by 17 patients (56.7%). The main cause of stress in the acne vulgaris group was a major change in sleeping habits (66.7%). In the acne vulgaris group, the highest mean value of serum substance P level in high stress scale group was 168.2 pg/mL. There was a positive correlation between stress scale and serum substance P level in acne vulgaris with moderate strength and this was statistically significant (r = 0.446; p = 0.014). Meanwhile, stress scale and serum substance P level in controls were not correlated and this was not statistically significant (r = −0.090; p = 0.636).ConclusionThere was a correlation between stress scale and serum substance P level in acne vulgaris.