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Dinu M, Tatu AL, Cocoș DI, Nwabudike LC, Chirilov AM, Stefan CS, Earar K, Dumitriu Buzia O. Natural Sources of Therapeutic Agents Used in Skin Conditions. Life (Basel) 2024; 14:492. [PMID: 38672762 PMCID: PMC11051086 DOI: 10.3390/life14040492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 04/07/2024] [Accepted: 04/09/2024] [Indexed: 04/28/2024] Open
Abstract
Skin conditions are numerous and often have a major impact on patients' quality of life, and effective and safe treatment is very important. The conventional drugs used for skin diseases are usually corticosteroids and antimicrobial products that can induce various side effects, especially with long-term use, which is why researchers are studying alternatives, especially biologically active natural products. Three products caught our attention: bee venom (BV), due to reported experimental results showing anti-inflammatory, antibacterial, antiviral, antioxidant, antimycotic, and anticancer effects, Ficus carica (FC) due to its demonstrated antioxidant, antibacterial, and anti-inflammatory action, and finally Geranium essential oil (GEO), with proven antifungal, antibacterial, anti-inflammatory, and antioxidant effects. Following a review of the literature, we produced this paper, which presents a review of the potential therapeutic applications of the three products in combating various skin conditions and for skin care, because BV, FC, and GEO have common pharmacological actions (anti-inflammatory, antibacterial, and antioxidant). We also focused on studying the safety of the topical use of BV, FC, and GEO, and new approaches to this. This paper presents the use of these natural therapeutic agents to treat patients with conditions such as vitiligo, melasma, and melanoma, as well as their use in treating dermatological conditions in patients with diabetes.
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Affiliation(s)
- Monica Dinu
- Centre in the Medical-Pharmaceutical Field, Faculty of Medicine and Pharmacy, “Dunarea de Jos” University of Galati, 800008 Galati, Romania; (M.D.); (C.S.S.); (K.E.); (O.D.B.)
| | - Alin Laurențiu Tatu
- Clinical Medical Department, Faculty of Medicine and Pharmacy, “Dunarea de Jos” University of Galati, 800008 Galati, Romania;
- Dermatology Department, “Sf. Cuvioasa Parascheva” Clinical Hospital of Infectious Diseases, 800179 Galati, Romania
- Multidisciplinary Integrative Center for Dermatologic Interface Research MIC-DIR, 800010 Galati, Romania
| | - Dorin Ioan Cocoș
- Centre in the Medical-Pharmaceutical Field, Faculty of Medicine and Pharmacy, “Dunarea de Jos” University of Galati, 800008 Galati, Romania; (M.D.); (C.S.S.); (K.E.); (O.D.B.)
| | | | - Ana Maria Chirilov
- Centre in the Medical-Pharmaceutical Field, Faculty of Medicine and Pharmacy, “Dunarea de Jos” University of Galati, 800008 Galati, Romania; (M.D.); (C.S.S.); (K.E.); (O.D.B.)
| | - Claudia Simona Stefan
- Centre in the Medical-Pharmaceutical Field, Faculty of Medicine and Pharmacy, “Dunarea de Jos” University of Galati, 800008 Galati, Romania; (M.D.); (C.S.S.); (K.E.); (O.D.B.)
| | - Kamel Earar
- Centre in the Medical-Pharmaceutical Field, Faculty of Medicine and Pharmacy, “Dunarea de Jos” University of Galati, 800008 Galati, Romania; (M.D.); (C.S.S.); (K.E.); (O.D.B.)
| | - Olimpia Dumitriu Buzia
- Centre in the Medical-Pharmaceutical Field, Faculty of Medicine and Pharmacy, “Dunarea de Jos” University of Galati, 800008 Galati, Romania; (M.D.); (C.S.S.); (K.E.); (O.D.B.)
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Armillei MK, Lomakin IB, Del Rosso JQ, Grada A, Bunick CG. Scientific Rationale and Clinical Basis for Clindamycin Use in the Treatment of Dermatologic Disease. Antibiotics (Basel) 2024; 13:270. [PMID: 38534705 DOI: 10.3390/antibiotics13030270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 02/27/2024] [Accepted: 03/07/2024] [Indexed: 03/28/2024] Open
Abstract
Clindamycin is a highly effective antibiotic of the lincosamide class. It has been widely used for decades to treat a range of skin and soft tissue infections in dermatology and medicine. Clindamycin is commonly prescribed for acne vulgaris, with current practice standards utilizing fixed-combination topicals containing clindamycin that prevent Cutibacterium acnes growth and reduce inflammation associated with acne lesion formation. Certain clinical presentations of folliculitis, rosacea, staphylococcal infections, and hidradenitis suppurativa are also responsive to clindamycin, demonstrating its suitability and versatility as a treatment option. This review describes the use of clindamycin in dermatological practice, the mechanism of protein synthesis inhibition by clindamycin at the level of the bacterial ribosome, and clindamycin's anti-inflammatory properties with a focus on its ability to ameliorate inflammation in acne. A comparison of the dermatologic indications for similarly utilized antibiotics, like the tetracycline class antibiotics, is also presented. Finally, this review addresses both the trends and mechanisms for clindamycin and antibiotic resistance, as well as the current clinical evidence in support of the continued, targeted use of clindamycin in dermatology.
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Affiliation(s)
- Maria K Armillei
- Program in Translational Biomedicine, Yale School of Medicine, Yale University, New Haven, CT 06511, USA
| | - Ivan B Lomakin
- Department of Dermatology, Yale University, New Haven, CT 06520, USA
| | - James Q Del Rosso
- College of Osteopathic Medicine, Touro University Nevada, Henderson, NV 89014, USA
- JDR Dermatology Research, Las Vegas, NV 89148, USA
- Clinical Research and Strategic Development, Advanced Dermatology and Cosmetic Surgery, Maitland, FL 32751, USA
| | - Ayman Grada
- Department of Dermatology, Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA
| | - Christopher G Bunick
- Program in Translational Biomedicine, Yale School of Medicine, Yale University, New Haven, CT 06511, USA
- Department of Dermatology, Yale University, New Haven, CT 06520, USA
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Monteiro RC, Fernandes M. Are antibiotics still relevant in acne? A review of the therapeutic conundrum. Int J Dermatol 2024; 63:306-310. [PMID: 37743606 DOI: 10.1111/ijd.16854] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Revised: 07/13/2023] [Accepted: 09/08/2023] [Indexed: 09/26/2023]
Abstract
Antibiotics have constituted the mainstay of acne therapy despite acne being classified as an inflammatory disorder. The indiscriminate usage of antibiotics over the years has thus fueled the issue of antimicrobial resistance. Cutibacterium acnes (C. acnes) can acquire resistance due to chromosomal mutation or genetic acquisition. C. acnes can transfer resistance to other resident flora, complicating the management of skin and soft tissue infections. It can also transfer resistant strains to other body sites and to immunocompromised and elderly patients thus putting them at risk of serious infections. Recent studies have highlighted the physiologic role of C. acnes in maintaining the normal homeostasis of the skin microbiome. The role of Malassezia in causation of acne has piqued interest in recent times. The efficacy of antibiotics in acne is attributed to their para-antibiotic, anti-inflammatory action rather than antimicrobial action. Thus, usage of low-dose antibiotics and alternatives to antibiotics has been advocated. Some alternative therapies showing efficacy in acne are probiotics, oral zinc, precision therapy using succinic acid, bacteriophages, and anti-biofilm therapy like myrtacin, topical azelaic acid, and salicylic acid. Using isotretinoin in early stages of acne can reduce the incidence of scarring and alleviate the need for antibiotics. Thus, a gradual shift from antibiotics to alternative therapies in acne is the need of the hour.
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Affiliation(s)
| | - Merwyn Fernandes
- Department of Radiodiagnosis & Imaging, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, 575001, India
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Zaklan D, Nešić D, Mitrović D, Lazarević S, Đanić M, Mikov M, Pavlović N. Influence of Bile Acids on Clindamycin Hydrochloride Skin Permeability: In Vitro and In Silico Preliminary Study. Eur J Drug Metab Pharmacokinet 2024; 49:219-228. [PMID: 38332426 DOI: 10.1007/s13318-024-00878-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/17/2024] [Indexed: 02/10/2024]
Abstract
BACKGROUND AND OBJECTIVE Topical clindamycin formulations are widely used in clinical practice, but poor bioavailability and restricted skin penetration considerably limit their therapeutic efficacy. Penetration enhancement represents a promising and rational strategy to overcome the drawbacks of conventional topical pharmaceutical formulations. We aim to assess the influence of cholic acid (CA) and deoxycholic acid (DCA) on the permeability of clindamycin hydrochloride by performing the in vitro skin parallel artificial membrane permeability assay (skin-PAMPA) at two relevant pH values (5.5 and 6.5) and the interactions of tested substances with skin ATP-binding cassette (ABC) transporters in silico. METHODS After the incubation period, the clindamycin hydrochloride concentrations in both compartments were determined spectrophotometrically, and the apparent permeability coefficients (Papp) were calculated. Vienna LiverTox web service was used to predict the interactions of clindamycin and bile acids with potential drug transporters located in human skin. RESULTS Both CA and DCA at the highest studied concentration of 100 μM in the tested solutions increased the skin-PAMPA membrane permeability of clindamycin hydrochloride. This effect was more pronounced for CA and at a higher studied pH value of 6.5, which is characteristic of most dermatological indications treated with topical clindamycin preparations. Clindamycin transport may also be mediated by ABC transporters located in skin and facilitated in the presence of bile acids. CONCLUSIONS The results of this study provide a solid foundation for further research directed at the improvement of topical formulations using bile acids as penetration-enhancing excipients, as well as the therapeutic efficacy of clindamycin hydrochloride.
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Affiliation(s)
- Dragana Zaklan
- Department of Pharmacy, Faculty of Medicine, University of Novi Sad, Hajduk Veljkova 3, 21000, Novi Sad, Serbia.
| | - Dušan Nešić
- Department of Pharmacy, Faculty of Medicine, University of Novi Sad, Hajduk Veljkova 3, 21000, Novi Sad, Serbia
| | - Darko Mitrović
- Department of Pharmacy, Faculty of Medicine, University of Novi Sad, Hajduk Veljkova 3, 21000, Novi Sad, Serbia
| | - Slavica Lazarević
- Department of Pharmacology, Toxicology and Clinical Pharmacology, Faculty of Medicine, University of Novi Sad, Hajduk Veljkova 3, 21000, Novi Sad, Serbia
| | - Maja Đanić
- Department of Pharmacology, Toxicology and Clinical Pharmacology, Faculty of Medicine, University of Novi Sad, Hajduk Veljkova 3, 21000, Novi Sad, Serbia
| | - Momir Mikov
- Department of Pharmacology, Toxicology and Clinical Pharmacology, Faculty of Medicine, University of Novi Sad, Hajduk Veljkova 3, 21000, Novi Sad, Serbia
| | - Nebojša Pavlović
- Department of Pharmacy, Faculty of Medicine, University of Novi Sad, Hajduk Veljkova 3, 21000, Novi Sad, Serbia
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Leelawattanachai J, Panyasu K, Prasertsom K, Manakasettharn S, Duangdaw H, Budthong P, Thepphornbanchakit N, Chetprayoon P, Muangnapoh K, Srinives S, Waraho-Zhmayev D, Triampo D. Highly stable and fast-dissolving ascorbic acid-loaded microneedles. Int J Cosmet Sci 2023; 45:612-626. [PMID: 37133325 DOI: 10.1111/ics.12865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 02/14/2023] [Accepted: 05/01/2023] [Indexed: 05/04/2023]
Abstract
OBJECTIVES Ascorbic acid has many benefits to the skin. Numerous attempts to promote its topical delivery show great challenges since its chemical instability and poor skin impermeability. Microneedle delivery is a simple, safe, painless and effective means to deliver therapeutic or nourishing molecules into the skin. The purpose of this study was twofold: (a) to develop a new formulation of ascorbic acid-loaded microneedles to enhance ascorbic acid stability by investigating an optimal amount of polyethyleneimine as an additive to the dextran-based microneedle formulation and (b) to assess microneedle properties in terms of dissolving rate, skin penetration ability, biocompatibility and antimicrobial activity. METHODS The microneedles formulated with ascorbic acid and varied polyethyleneimine concentrations were fabricated and subsequently tested for ascorbic acid stability using 2,2-diphenyl-1-picrylhydrazyl assay. The dissolution rate and skin penetration depth were investigated in porcine skin and the reconstructed human full-thickness skin model respectively. The skin irritation tests were done according to the Organisation for Economic Co-operation and Development Test Guideline No. 439. An antimicrobial disc susceptibility test was performed against Escherichia coli, Staphylococcus aureus and Staphylococcus epidermidis. RESULTS Among varied amounts of 0%, 1.5%, 3.0% and 4.5% (w/v), the 3.0% polyethyleneimine showed the most desirable characteristics, including well-preserved shape integrity after demoulding, significantly improved stability of ascorbic acid (p < 0.001) from 33% to 96% antioxidant activity after 8 weeks of storage at 40°C, increased dissolving rate (p < 0.001) by being completely dissolved within 2 min after the skin insertion, passing skin penetration and biocompatibility tests as well as having a broad spectrum of antimicrobial property. CONCLUSION With a safety profile and enhanced properties, the new formulation of ascorbic acid-loaded microneedles shows outstanding potential as commercially available cosmetics and healthcare products.
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Affiliation(s)
- Jeerapond Leelawattanachai
- National Nanotechnology Center (NANOTEC), National Science and Technology Development Agency (NSTDA), Pathum Thani, Thailand
| | - Kedsara Panyasu
- National Nanotechnology Center (NANOTEC), National Science and Technology Development Agency (NSTDA), Pathum Thani, Thailand
| | - Kornkanok Prasertsom
- National Nanotechnology Center (NANOTEC), National Science and Technology Development Agency (NSTDA), Pathum Thani, Thailand
| | - Supone Manakasettharn
- National Nanotechnology Center (NANOTEC), National Science and Technology Development Agency (NSTDA), Pathum Thani, Thailand
| | - Hathaiphat Duangdaw
- Department of Chemical Engineering, Faculty of Engineering, Mahidol University, Nakhon Pathom, Thailand
| | - Pitchaon Budthong
- Department of Pharmaceutical Sciences, Faculty of Pharmacy, Srinakharinwirot University, Nakhon Nayok, Thailand
| | | | - Paninee Chetprayoon
- Toxicology and Bio Evaluation Service Center (TBES), National Science and Technology Development Agency (NSTDA), Pathum Thani, Thailand
| | - Kullachate Muangnapoh
- National Metal and Material Technology Center (MTEC), National Science and Technology Development Agency (NSTDA), Pathum Thani, Thailand
| | - Sira Srinives
- Department of Chemical Engineering, Faculty of Engineering, Mahidol University, Nakhon Pathom, Thailand
| | - Dujduan Waraho-Zhmayev
- Biological Engineering Program, Faculty of Engineering, King Mongkut's University of Technology Thonburi, Bangkok, Thailand
| | - Darapond Triampo
- Department of Chemistry and Center of Excellence for Innovation in Chemistry, Faculty of Science, Mahidol University, Nakhon Pathom, Thailand
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Makevych N, Kutsyk R, Kurovets L. THE EFFECT OF RUTA GRAVEOLENS L. ETHANOLIC EXTRACTS ON SKIN ISOLATES OF STAPHYLOCOCCI AND PROPIONIBACTERIUM ACNES. WIADOMOSCI LEKARSKIE (WARSAW, POLAND : 1960) 2023; 76:1642-1649. [PMID: 37622509 DOI: 10.36740/wlek202307119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/26/2023]
Abstract
OBJECTIVE The aim: To define antimicrobial properties of 50%, 70% and 90% ethanolic extracts of Ruta graveolens L. against macrolide resistant (MLS-resistant) skin isolates of staphylococci and Propionibacterium acnes, and to determine MIC and MBC of investigated extracts. PATIENTS AND METHODS Materials and methods: Extracts were prepared by the method of maceration. Bacterial cultures were identified by biochemical microtests. Identification of MLS-resistance type was performed by using disc-diffusion method. The MIC and MBC were determined by serial two-fold dilution of ethanolic extracts of Ruta graveolens L. in MHB and HBB for staphylococci and P. acnes, respectively. Bacterial growth in each well was assayed by absorption at 495 nm, using a spectrophotometer SynergyTMHTX S1LFTA (BioTek Instruments, Inc., USA). RESULTS Results: All ethanolic extracts of garden ruta were active against all staphylococci and P. acnes skin isolates and showed exclusively bactericidal activity (MBC/MIC ratios ranged from 1 to 2) against all investigated strains. 90% extract of Ruta graveolens L. showed better results than 50% and 70% extracts - average MIC and MBC concentations for P. acnes strains were 1.38«0.66 mg/mL and for staphylococcal strains average MIC was 2.1«1.16 mg/mL and MBC - 2.86«1.2 mg/mL. CONCLUSION Conclusions: 50%, 70% and 90% ethanolic garden ruta extracts showed moderate antibacterial activity against main skin pathogens, responsible for acnes vulgaris development - S. epidermidis, S. aureus and P. acnes. No difference in susceptibility between resistance and sensitive strains of staphylococci and P. acnes indicate that acquired MLS-resistance of investigated skin isolates does not affect on the level of their sensitivity to ruta extracts.
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Affiliation(s)
- Nataliia Makevych
- IVANO-FRANKIVSK NATIONAL MEDICAL UNIVERSITY, IVANO-FRANKIVSK, UKRAINE
| | - Roman Kutsyk
- IVANO-FRANKIVSK NATIONAL MEDICAL UNIVERSITY, IVANO-FRANKIVSK, UKRAINE
| | - Lesia Kurovets
- IVANO-FRANKIVSK NATIONAL MEDICAL UNIVERSITY, IVANO-FRANKIVSK, UKRAINE
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George S, Muhaj FF, Nguyen CD, Tyring SK. Part I Antimicrobial resistance: Bacterial pathogens of dermatologic significance and implications of rising resistance. J Am Acad Dermatol 2022; 86:1189-1204. [PMID: 35122894 PMCID: PMC8808428 DOI: 10.1016/j.jaad.2021.11.066] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 11/28/2021] [Accepted: 11/29/2021] [Indexed: 12/24/2022]
Abstract
Although the COVID-19 pandemic has been the defining global health crisis of our time, public health officials have been sounding the alarm of another ominous threat for years: an impending antimicrobial resistance crisis. In dermatology, antibiotics are often used for prolonged courses in the treatment of skin and soft tissue infections and common inflammatory skin conditions, increasing the risk of microbiome alteration and antibiotic-related adverse effects, all while exerting consequential selective pressures on both pathogenic and bystander bacteria. In this review, we hope to raise awareness of the crisis of antimicrobial resistance and review resistance concerns related to dermatology-relevant bacterial pathogens.
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Affiliation(s)
- Saira George
- Department of Dermatology, MD Anderson Cancer Center, Houston, Texas
| | - Fiorinda F Muhaj
- Department of Dermatology, MD Anderson Cancer Center, Houston, Texas; Department of Dermatology, University of Texas McGovern Medical School at Houston, Houston, Texas
| | | | - Stephen K Tyring
- Department of Dermatology, University of Texas McGovern Medical School at Houston, Houston, Texas; Center for Clinical Studies, Houston, Texas.
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Quattrini A, Boër C, Leidi T, Paydar R. A Deep Learning-Based Facial Acne Classification System. CLINICAL, COSMETIC AND INVESTIGATIONAL DERMATOLOGY 2022; 15:851-857. [PMID: 35585864 PMCID: PMC9109724 DOI: 10.2147/ccid.s360450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 04/23/2022] [Indexed: 11/23/2022]
Abstract
Introduction Acne is one of the most common pathologies and affects people of all ages, genders, and ethnicities. The assessment of the type and severity status of a patient with acne should be done by a dermatologist, but the ever-increasing waiting time for an examination makes the therapy not accessible as quickly and consequently less effective. This work, born from the collaboration with CHOLLEY, a Swiss company with decades of experience in the research and production of skin care products, with the aim of developing a deep learning system that, using images produced with a mobile device, could make assessments and be as effective as a dermatologist. Methods There are two main challenges within this task. The first is to have enough data to train a neural model. Unlike other works in the literature, it was decided not to collect a proprietary dataset, but rather to exploit the enormity of public data available in the world of face analysis. Part of Flickr-Faces-HQ (FFHQ) was re-annotated by a CHOLLEY dermatologist, producing a dataset that is sufficiently large, but still very extendable. The second challenge was to simultaneously use high-resolution images to provide the neural network with the best data quality, but at the same time to ensure that the network learned the task correctly. To prevent the network from searching for recognition patterns in some uninteresting regions of the image, a semantic segmentation model was trained to distinguish, what is a skin region possibly affected by acne and what is background and can be discarded. Results Filtering the re-annotated dataset through the semantic segmentation model, the trained classification model achieved a final average f1 score of 60.84% in distinguishing between acne affected and unaffected faces, result that, if compared to other techniques proposed in the literature, can be considered as state-of-the-art.
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Affiliation(s)
- Andrea Quattrini
- Department of Innovative Technologies, Institute of Information Technologies and Networking (SUPSI), Lugano, Switzerland
| | - Claudio Boër
- Department of Innovative Technologies, Institute of Information Technologies and Networking (SUPSI), Lugano, Switzerland
| | - Tiziano Leidi
- Department of Innovative Technologies, Institute of Information Technologies and Networking (SUPSI), Lugano, Switzerland
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Chilicka K, Rusztowicz M, Szyguła R, Nowicka D. Methods for the Improvement of Acne Scars Used in Dermatology and Cosmetology: A Review. J Clin Med 2022; 11:jcm11102744. [PMID: 35628870 PMCID: PMC9147527 DOI: 10.3390/jcm11102744] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 05/10/2022] [Accepted: 05/11/2022] [Indexed: 02/07/2023] Open
Abstract
Acne vulgaris is a chronic skin disease that, depending on its course, is characterized by the occurrence of various skin eruptions such as open and closed comedones, pustules, papules, and cysts. Incorrectly selected treatment or the presence of severe acne vulgaris can lead to the formation of atrophic scars. In this review, we summarize current knowledge on acne scars and methods for their improvement. There are three types of atrophic scars: icepick, rolling, and boxcar. They are of different depths and widths and have different cross-sections. Scars can combine to form clusters. If acne scars are located on the face, they can reduce the patient’s quality of life, leading to isolation and depression. There are multiple effective modalities to treat acne scars. Ablative lasers, radiofrequency, micro-needling, and pilings with trichloroacetic acid have very good treatment results. Contemporary dermatology and cosmetology use treatments that cause minimal side effects, so the patient can return to daily functioning shortly after treatment. Proper dermatological treatment and skincare, as well as the rapid implementation of cosmetological treatments, will certainly achieve satisfactory results in reducing atrophic scars.
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Affiliation(s)
- Karolina Chilicka
- Department of Health Sciences, Institute of Health Sciences, University of Opole, 45-040 Opole, Poland; (M.R.); (R.S.)
- Correspondence: ; Tel.: +48-665-43-94-43
| | - Monika Rusztowicz
- Department of Health Sciences, Institute of Health Sciences, University of Opole, 45-040 Opole, Poland; (M.R.); (R.S.)
| | - Renata Szyguła
- Department of Health Sciences, Institute of Health Sciences, University of Opole, 45-040 Opole, Poland; (M.R.); (R.S.)
| | - Danuta Nowicka
- Department of Dermatology, Venereology and Allergology, Wrocław Medical University, 50-368 Wrocław, Poland;
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10
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Martín C, Ordiales H, Vázquez F, Pevida M, Rodríguez D, Merayo J, Vázquez F, García B, Quirós LM. Bacteria associated with acne use glycosaminoglycans as cell adhesion receptors and promote changes in the expression of the genes involved in their biosynthesis. BMC Microbiol 2022; 22:65. [PMID: 35219289 PMCID: PMC8881830 DOI: 10.1186/s12866-022-02477-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 02/16/2022] [Indexed: 11/14/2022] Open
Abstract
Background Cell surface glycosaminoglycans (GAGs) participate in many physiological and pathological processes, including infections and inflammatory response. Acne is a common chronic inflammatory skin disorder that affects the pilosebaceous unit and has a multifactorial etiology, including bacterial colonization of the hair follicle. This study aimed to investigate the participation of GAG in the adhesion of Propionibacterium acnes, Staphylococcus aureus and Staphylococcus epidermidis to keratinocytes and fibroblasts of the skin by competition experiments and cell surface removal using specific liases. The alteration in the transcription of the genes responsible for the synthesis of GAG induced by the adhesion of these bacteria was also analyzed by qRT-PCR. Results GAGs are involved in bacterial adherence to skin cells, especially fibroblasts, where chondroitin sulfate displayed the higher effect. Bacterial adherence produced different alterations in the transcription of the genes responsible for GAG structures. P. acnes induced mostly changes in keratinocytes, while S. epidermidis was the main cause of alterations in fibroblasts. These variations in gene expression affected all the stages in the biosynthesis of the main species of GAGs, heparan and chondroitin sulphate. Conclusions GAGs species are involved in the adhesion of acne-related bacteria to skin cells in a differential manner depending on each microorganism and cellular type, although other receptors seem to exist. Bacterial adherence led to variations on gene expression in skin cells affecting GAG chains structure what, consequently, should alter their interactions with different ligands, affecting the development of acne disease. Supplementary Information The online version contains supplementary material available at 10.1186/s12866-022-02477-2.
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11
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Muhaj FF, George SJ, Tyring SK. Bacterial resistance and dermatological ramifications. Br J Dermatol 2022; 187:12-20. [PMID: 35083740 DOI: 10.1111/bjd.21033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 01/18/2022] [Accepted: 01/18/2022] [Indexed: 11/28/2022]
Abstract
The spread of COVID-19 serves as a reminder of the might of microbes in the era of modern medicine. For years, another threat has preoccupied infectious disease experts and public health officials alike: rising antimicrobial resistance (AMR). Resistance is exceeding stewardship efforts and the rates of new drug development and approval in the market. A dry antimicrobial pipeline is threatening our regression to a pre-antibiotic era. While the consequences of resistance may seem far removed from daily clinical practices, awareness of AMR is significant to dermatological care given that dermatologists prescribe more antibiotics per physician than other providers. Antibiotics in dermatology are often used for prolonged courses, with a significant potential for microbiome alteration and antibiotic-related adverse effects. Through this review we hope to contribute to efforts of bringing the crisis of AMR to the forefront of daily dermatological practice.
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Affiliation(s)
- F F Muhaj
- Department of Dermatology, MD Anderson Cancer Center, Houston, Texas, USA
| | - S J George
- Department of Dermatology, MD Anderson Cancer Center, Houston, Texas, USA
| | - S K Tyring
- Department of Dermatology, University of Texas McGovern Medical School at Houston, Houston, Texas, USA.,Center for Clinical Studies, Houston, Texas, USA
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12
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Cosmetic Applications of Bee Venom. Toxins (Basel) 2021; 13:toxins13110810. [PMID: 34822594 PMCID: PMC8625659 DOI: 10.3390/toxins13110810] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 11/07/2021] [Accepted: 11/10/2021] [Indexed: 12/15/2022] Open
Abstract
Bee venom (BV) is a typical toxin secreted by stingers of honeybee workers. BV and BV therapy have long been attractive to different cultures, with extensive studies during recent decades. Nowadays, BV is applied to combat several skin diseases, such as atopic dermatitis, acne vulgaris, alopecia, vitiligo, and psoriasis. BV is used extensively in topical preparations as cosmetics and used as dressing for wound healing, as well as in facemasks. Nevertheless, the safety of BV as a therapeutic choice has always been a concern due to the immune system reaction in some people due to BV use. The documented unfavorable impact is explained by the fact that the skin reactions to BV might expand to excessive immunological responses, including anaphylaxis, that typically resolve over numerous days. This review aims to address bee venom therapeutic uses in skin cosmetics.
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Valente Duarte de Sousa IC. Guidance for the pharmacological management of acne vulgaris. Expert Opin Pharmacother 2021; 23:49-62. [PMID: 34686076 DOI: 10.1080/14656566.2021.1990263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Many international guidelines and expert consensuses are available to help the clinician diagnose and treat acne vulgaris; however, a simplified practical guidance that integrates current existing published recommendations is still lacking. This article aims to give practical and simplified insight into the treatment of acne. AREAS COVERED Herein, the author discusses the treatment of comedonal, papulopustular, and nodular/cystic/conglobate acne. The author also proposes a simplified treatment escalation strategy that is based on disease severity and extension, starting with topical treatments for mild cases and progressing over to systemic therapies in more severe cases. EXPERT OPINION The ideal acne treatment would simultaneously and safely target all the pathogenic factors implicated in the appearance of acne lesions with minimal side effects. Since no such treatment currently exists, combination therapies are usually recommended for most types of acne. A major limitation in choosing an appropriate treatment plan is the discrepant use of classification systems across the published literature making it difficult to draw clear and succinct conclusions about the recommendations given. Acne is not a traditional infectious disease and so while antibiotics may improve symptoms, they do not reliably resolve the condition. Thus, there is currently a tendency to opt for antibiotic-sparing treatment strategies whenever possible.
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Chilicka K, Rogowska AM, Szyguła R, Dzieńdziora-Urbińska I, Taradaj J. A comparison of the effectiveness of azelaic and pyruvic acid peels in the treatment of female adult acne: a randomized controlled trial. Sci Rep 2020; 10:12612. [PMID: 32724156 PMCID: PMC7387545 DOI: 10.1038/s41598-020-69530-w] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Accepted: 07/12/2020] [Indexed: 11/24/2022] Open
Abstract
Chemical peels are widely used as therapeutic agents in dermatology and cosmetology. This study aims to explore the differences in the effectiveness of azelaic and pyruvic acid peels in the treatment of acne vulgaris. Eligibility criteria for participants were: female gender, 18–25 years of age, no dermatological treatment within the last 12 months and mild to moderate papulopustular acne. We treated 120 young women (with a mean age of 22 years old) with six peeling sessions at 2-week intervals. In the parallel clinical study design, one randomized group (n = 60, 50%) was treated using azelaic acid (AA), whereas the second group participated in pyruvic acid (PA) sessions. We evaluated the patients clinically twice (before and after treatment), using the Scale of Hellegren–Vincent Severity Symptoms to assess the acne diagnosis, and the Nati Analyzer to estimate the skin properties (oily skin, desquamation, porosity, and moisture). The clinical evaluation of the patients demonstrated a significant reduction of acne severity symptoms in both the AA and PA groups, after the peeling sessions. An effect was also found in terms of decreasing desquamation and the oiliness of the skin. PA showed a more significant reduction of greasy skin than AA. In conclusion, after the six peeling sessions using AA and PA, all patients showed better skin parameters in term of reduced oiliness and desquamation. Both AA and PA peelings are a safe and efficient treatment for mild acne, however, during the selection of one of the two acids, side effects, skin properties, and patients’ preferences should be taken into account. This study was registered in the ISRCTN registry (registration number ISRCTN79716614, 17/01/2020).
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Affiliation(s)
- Karolina Chilicka
- Faculty of Health Sciences, University of Opole, 45-060, Opole, Poland
| | | | - Renata Szyguła
- Faculty of Health Sciences, University of Opole, 45-060, Opole, Poland
| | | | - Jakub Taradaj
- Institute of Physiotherapy and Health Sciences, Academy of Physical Education, 40-065, Katowice, Poland
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Chilicka K, Rogowska AM, Szyguła R, Taradaj J. Examining Quality of Life After Treatment with Azelaic and Pyruvic Acid Peels in Women with Acne Vulgaris. Clin Cosmet Investig Dermatol 2020; 13:469-477. [PMID: 32801822 PMCID: PMC7395687 DOI: 10.2147/ccid.s262691] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Accepted: 07/02/2020] [Indexed: 11/24/2022]
Abstract
Purpose This randomized parallel study aims to investigate the azelaic acid (AA), and pyruvic acid (PA) peels treatment effect on health-related quality of life (QOL) in young adult women with acne vulgaris. Patients and Methods The participants were 120 female undergraduate students, with mild to moderate facial acne and an average age of 22 years old (M = 22.2, SD = 16.1). Eligibility criteria were as follows: female gender, 18–25 years of age, no dermatological treatment within the last 12 months and mild to moderate papulopustular acne. Patients were randomly divided into two groups, the first group was treated with AA, and the second group was treated with PA. Both groups received treatment every 2 weeks, for a total of 12 weeks. The Hellgren–Vincent scale was used to assess acne severity, and the Dermatology Life Quality Index (DLQI) and Skindex-29 were used to evaluate the quality of life of each patient. These scores were calculated before treatment, and after finishing the final treatment. Results All scoring systems used (Hellgren–Vincent scale, DLQI, and Skindex-29) demonstrated improvement in both groups. QOL scores were slightly better in the group using pyruvic acid compared with azelaic acid. Conclusion Both AA and PA have a significant impact on the objective assessment of acne symptoms, as well as the subjectively measured quality of life of young adult women with acne. There is a slightly greater improvement in QOL scores with PA compared with AA peeling treatment.
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Affiliation(s)
| | | | - Renata Szyguła
- Faculty of Health Sciences, University of Opole, Opole, Poland
| | - Jakub Taradaj
- Institute of Physiotherapy and Health Sciences, Academy of Physical Education, Katowice, Poland
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pH-Dependent Antibacterial Activity of Glycolic Acid: Implications for Anti-Acne Formulations. Sci Rep 2020; 10:7491. [PMID: 32367064 PMCID: PMC7198592 DOI: 10.1038/s41598-020-64545-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 04/17/2020] [Indexed: 11/28/2022] Open
Abstract
Glycolic acid is the smallest alpha hydroxy acid and widely used for skincare applications, including to treat acne vulgaris. Oftentimes, high concentrations of glycolic acid (~20–50 vol%) are incorporated into chemical peels to reduce acne-related inflammation while there is an outstanding need to determine to what extent glycolic acid can potently inhibit Cutibacterium acnes (formerly known as Propionibacterium acnes), which is a Gram-positive bacterium implicated in acne pathogenesis. Herein, we report that glycolic acid exhibits pH-dependent antibacterial activity against C. acnes and mechanistic studies identified that the nonionic form of glycolic acid is more active than the anionic form. The degree of antibacterial activity, including minimum bactericidal concentration (MBC), of glycolic acid was evaluated in the pH range of 3 to 4.5, and the greatest potency was observed at pH 3. In light of skincare formulation needs, we selected the pH 3.5 condition for further testing and determined that glycolic acid kills C. acnes cells by disrupting bacterial cell membranes. While most conventional treatments involve high concentrations of glycolic acid (>20%), our findings support the potential of developing anti-acne formulations with glycolic acid concentrations as low as 0.2% and with pH conditions that are suitable for over-the-counter applications.
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Essack S, Bell J, Burgoyne DS, Duerden M, Shephard A. Topical (local) antibiotics for respiratory infections with sore throat: An antibiotic stewardship perspective. J Clin Pharm Ther 2019; 44:829-837. [PMID: 31407824 PMCID: PMC6899613 DOI: 10.1111/jcpt.13012] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 07/10/2019] [Indexed: 01/12/2023]
Abstract
WHAT IS KNOWN AND OBJECTIVE The overuse and misuse of antibiotics, especially for viral, and self-limiting, respiratory tract infections such as sore throat, increases the risk of the development and spread of antimicrobial resistance within communities. Up to 80% of sore throat cases have a viral aetiology, and even when the infection is bacterial, most cases resolve without antibiotics. However, antibiotics are still frequently and often inappropriately prescribed for the treatment of sore throat. Furthermore, topical (local) antibiotics for treatment of sore throat are widely available over the counter. The objective of this systematic review was to establish the evidence for the benefits, risk of harm and antimicrobial resistance associated with topical (local) antibiotics used for patients with sore throat. METHODS Eligible studies included those in patients with sore throat of any aetiology receiving the topical (local) antibiotics tyrothricin, bacitracin, gramicidin or neomycin where the antibiotic was topically/locally applied via the nasal cavity or throat. Nasal applications were included as these are occasionally used to treat upper respiratory tract infections that may involve sore throat. There was no restriction or requirement regarding comparator. The outcomes of interest included efficacy, safety, and in vitro culture and antimicrobial resistance data. RESULTS AND DISCUSSION This systematic review found sparse and mainly poor-quality evidence relating to the use of topical (local) antibiotics for sore throat, and it was not possible to establish the benefits, risk of harm or impact of use on antimicrobial resistance. WHAT IS NEW AND CONCLUSIONS Further research is necessary to ascertain the risks and benefits of topical (local) antibiotics, their contribution to antimicrobial resistance and the risk of harm. We do, however, question whether it is appropriate and rational to use topical (local) antibiotics for the treatment of sore throat caused by respiratory tract infections in the absence of robust evidence.
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Affiliation(s)
- Sabiha Essack
- Antimicrobial Research Unit, College of Health SciencesUniversity of KwaZulu‐NatalDurbanSouth Africa
| | - John Bell
- Graduate School of HealthUniversity of TechnologySydneyNSWAustralia
| | | | - Martin Duerden
- School of Medicine, Centre for Medical EducationCardiff UniversityCardiffUK
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Mohammadi S, Pardakhty A, Khalili M, Fathi R, Rezaeizadeh M, Farajzadeh S, Mohebbi A, Aflatoonian M. Niosomal Benzoyl Peroxide and Clindamycin Lotion Versus Niosomal Clindamycin Lotion in Treatment of Acne Vulgaris: A Randomized Clinical Trial. Adv Pharm Bull 2019; 9:578-583. [PMID: 31857961 PMCID: PMC6912181 DOI: 10.15171/apb.2019.066] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2018] [Revised: 06/11/2019] [Accepted: 06/24/2019] [Indexed: 01/14/2023] Open
Abstract
Purpose: Combination of benzoyl peroxide (BPO) with topical antibiotics can lead to higher efficacy and less bacterial resistance, but it in turn increases adverse effects such as skin irritability and dryness. In this study, the efficacy of combination therapy of niosomal BPO 1% and clindamycin (CL) 1% is compared with niosomal CL in acne vulgaris. Methods: This is a double-blind clinical trial study on 100 patients with acne vulgaris in Afzalipour hospital in Kerman. Patients were randomly divided into 2 groups (case and control). The case group received niosomal combination of BPO 1% and CL 1%.The control group received niosomal CL1%. The efficacy of treatment protocols was evaluated in 2nd, 4th, 8th and 12th weeks of treatment by counting lesions (severity and grading acne lesions) and quality of life (QoL). Furthermore, side effect were evaluated at each treatment visits. Results: The reduction in mean percentage of acne lesions in case group (treated with BPO 1% and CL1%) (64.21%) was higher than control group (treated with niosomal CL 1%) (59.04%), but the statistical difference was not significant. Sum of excellent and good results were found in 80% and 76.1% of case and control groups, respectively (P=0.377). Also adding BPO to the treatment formulation in case group did not increase adverse effects, as statistical difference between 2 groups was not significant. Conclusion: Combination of niosomal BPO 1% and CL 1% in treatment of acne vulgaris showed higher efficacy with no increase in adverse effects in comparison with niosomal CL 1%, but the statistical difference was not significant.
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Affiliation(s)
- Saman Mohammadi
- Department of Dermatology, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran
| | - Abbas Pardakhty
- Pharmaceutics Research Center, Neuropharmacology Institute, Kerman University of Medical Sciences, Kerman, Iran
| | - Maryam Khalili
- Department of Dermatology, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran
| | - Reza Fathi
- Department of Dermatology, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran
| | - Maryam Rezaeizadeh
- Pharmaceutics Research Center, Neuropharmacology Institute, Kerman University of Medical Sciences, Kerman, Iran
| | - Saeedeh Farajzadeh
- Leishmaniasis Research Center, Afzalipour Hospital, Kerman University of Medical Sciences, Iran
| | - Azadeh Mohebbi
- Department of Dermatology, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran
| | - Mahin Aflatoonian
- Department of Dermatology, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran
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Ahmad MI, Keach JE, Behl T, Panichayupakaranant P. Synergistic effect of α-mangostin on antibacterial activity of tetracycline, erythromycin, and clindamycin against acne involved bacteria. CHINESE HERBAL MEDICINES 2019. [DOI: 10.1016/j.chmed.2019.03.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Mohammad Soleymani S, Salimi A. Enhancement of Dermal Delivery of Finasteride Using Microemulsion Systems. Adv Pharm Bull 2019; 9:584-592. [PMID: 31857962 PMCID: PMC6912190 DOI: 10.15171/apb.2019.067] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 06/24/2019] [Accepted: 06/25/2019] [Indexed: 12/04/2022] Open
Abstract
Purpose: Finasteride is a pharmaceutical agent that treats hair loss and acne with hormonal patterns. Due to its poor water solubility, and the smaller surface area in comparison to total skin surface area, penetration of the drug into hair follicles and skin is low. The aim of this research was to formulate, characterize and evaluate in vitro skin permeability of finasteride microemulsions (MEs). Methods: Finasteride MEs were prepared using a pseudo-ternary phase diagram method with an appropriate ratio of oil mixture, surfactant-co-surfactant mixture and water. MEs containing 1% finasteride were prepared with a suitable amount of oily phase and surfactant and cosurfactant. The physicochemical properties of these MEs and in vitro skin permeability of MEs were evaluated. Results: The results showed that the mean droplet size range of ME samples was 5-17 nm and pH was 5.1-5.7. The viscosity of MEs ranged from 86.4-209.6 cps. The drug release profile showed that 49.510% of the drug was released (ME-F-6) over the 24 hours of the experiment. The kinetics of drug release from all selected MEs were approximately described by Higuchi and first-order modeling. All ME formulations with different compositions and properties significantly increased flux and permeability coefficient from rat skin. The selected MEs exhibit 99.9% finasteride after six months of storage. Conclusion: This study showed that any change in the content and composition of MEs could change the physical and chemical properties in addition to ME permeability parameters. The MEs increased permeability of the skin to finasteride.
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Affiliation(s)
- Saeed Mohammad Soleymani
- Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Department of Pharmaceutics, Faculty of pharmacy, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Anayatollah Salimi
- Department of Pharmaceutics, Faculty of pharmacy, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Nanotechnology Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Platsidaki E, Dessinioti C. Recent advances in understanding Propionibacterium acnes ( Cutibacterium acnes) in acne. F1000Res 2018; 7. [PMID: 30613388 PMCID: PMC6305227 DOI: 10.12688/f1000research.15659.1] [Citation(s) in RCA: 90] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/12/2018] [Indexed: 01/08/2023] Open
Abstract
The skin commensal
Propionibacterium acnes, recently renamed
Cutibacterium acnes, along with the other major pathophysiological factors of increased seborrhea, hyperkeratinization of the pilosebaceous unit, and inflammation, has long been implicated in the pathogenesis of acne. Recent advances have contributed to our understanding of the role of
P. acnes in acne. Although there are no quantitative differences in
P. acnes of the skin of patients with acne compared with controls, the
P. acnes phylogenic groups display distinct genetic and phenotypic characteristics,
P. acnes biofilms are more frequent in acne, and different phylotypes may induce distinct immune responses in acne.
P. acnes plays a further important role in the homeostasis of the skin’s microbiome, interacting with other cutaneous commensal or pathogenic microorganisms such as
Staphylococcus epidermidis,
Streptococcus pyogenes, and
Pseudomonas species. In the era of increasing antimicrobial resistance, the selection of acne treatment targeting
P. acnes and the prevention of antibiotic resistance play a key role in improving outcomes in acne patients and public health.
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Affiliation(s)
- Eftychia Platsidaki
- Department of Dermatology, Andreas Syggros Hospital, University of Athens, Athens, Greece
| | - Clio Dessinioti
- Department of Dermatology, Andreas Syggros Hospital, University of Athens, Athens, Greece
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Tkachenko N, Chagarovskyi O, Dets N, Sevastyanova E, Lanzhenko L. “Lving” and “probiotic” cosmetics: modern view and defenitions. FOOD SCIENCE AND TECHNOLOGY 2017. [DOI: 10.15673/fst.v11i4.735] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
In the presented article, based on the detailed analysis of scientific sources and many years of own experience in production of the probiotic foods, the definition of “probiotics” in cosmetics, as well as the definition of “living” and “probiotic” cosmetics is proposed.The skin is a complex barrier organ that has a symbiotic relationship between microbial communities and host tissue via complex signals provided by the innate and the adaptive immune systems. It is constantly exposed to various endogenous and exogenous factors – physical, chemical, bacterial and fungal, as well as the effects of the hormonal disorders, which affect this balanced system potentially leading to inflammatory skin conditions comprising infections, allergies or autoimmune diseases. In opposition to the gut and stool microbiome, which has been studied and described for many years, investigations on the skin or scalp microbiome lasts only for last 10 years. Therefore, the screening of effective means of correcting and/or maintaining the human normoflora for the preservation of healthy skin microbiome today is an urgent task.It is well known that probiotics and prebiotics are helpful for specific disorders in the human body. Skeptics wonder: can the probiotics and prebiotics be scientifically applied in cosmetics? Different clinical studies indicated that they have special effects in cutaneous apparatus directly or indirectly, which can be considered from different aspects. Probiotic bacteriotherapy can have great potential in accelerating wound healing, in preventing and treating the skin diseases including eczema, atopic dermatitis, acne, allergic inflammation or skin hypersensitivity, UV-induced skin damage and cosmetics products. Therefore, some firms are already incorporating bacteria and/or their lysates into skin creams with the promise of «rebalancing» the community of bacteria that live in the human body and delivering healthier, more radiant-looking skin. However, such parameters as the type of probiotic, the form in which it is added to the formulation (living bacteria, lysates, etc.) and the recommended concentrations of these ingredients in cosmetic products that are safe and effective are still not defined. Due to currently widespread use of probiotic cosmetic products in the world beauty industry, the concept of "probiotic" in the cosmetic industry requires a clear definition.
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Spittaels KJ, Coenye T. Developing an in vitro artificial sebum model to study Propionibacterium acnes biofilms. Anaerobe 2017; 49:21-29. [PMID: 29175428 DOI: 10.1016/j.anaerobe.2017.11.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Revised: 11/07/2017] [Accepted: 11/20/2017] [Indexed: 12/20/2022]
Abstract
AIM The aim of the present study was to develop a new model system to study Propionibacterium acnes biofilms. This model should be representative for the conditions encountered in the pilosebaceous unit. METHODS AND RESULTS The new model, consists of an artificial sebum pellet supported by a silicone disc. Sebum pellets were inoculated with various P. acnes strains isolated from both normal and acneic skin. Growth and biofilm formation was verified by conventional plating at different time points, as well as by resazurin assays and fluorescence microscopy after LIVE/DEAD staining. The artificial sebum pellets were also used in assays to measure the production of certain virulence factors implicated in the pathogenesis of acne, including lipase, protease and the presence of CAMP factors. CONCLUSION The artificial sebum model can sustain biofilm growth of P. acnes, as was determined by increasing CFU counts for up to 1 week after inoculation. Metabolic activity and biofilm formation were confirmed using resazurin staining and fluorescence microscopy respectively. The production of virulence factors in this model was demonstrated as well.
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Affiliation(s)
- Karl-Jan Spittaels
- Laboratory of Pharmaceutical Microbiology, Ghent University, Ghent, Belgium
| | - Tom Coenye
- Laboratory of Pharmaceutical Microbiology, Ghent University, Ghent, Belgium.
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Takoudju EM, Guillouzouic A, Kambarev S, Pecorari F, Corvec S. In vitro emergence of fluoroquinolone resistance in Cutibacterium (formerly Propionibacterium) acnes and molecular characterization of mutations in the gyrA gene. Anaerobe 2017; 47:194-200. [PMID: 28602804 DOI: 10.1016/j.anaerobe.2017.06.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Revised: 06/02/2017] [Accepted: 06/07/2017] [Indexed: 12/11/2022]
Abstract
In vitro occurrence of levofloxacin (LVX) resistance in C. acnes and characterization of its molecular background were investigated. The mutation frequency was determined by inoculation of 108 cfu of C. acnes ATCC 11827 (LVX MIC = 0.25 mg/L) on LVX-containing agar plates. The progressive emergence of resistance was studied by a second exposure to increasing LVX concentrations. For mutants, the QRDR regions including the gyrA and parC genes were sequenced and compared to both C. acnes ATCC 11827 and C. acnes KPA171202 reference sequences (NC006085). The importance of the efflux pump system in resistance was investigated by using inhibitors on selected resistant mutants with no mutation in the QRDR. C. acnes growth was observed on LVX-containing plates with mutation frequencies of 3. 8 cfu × 10-8 (8 × MIC) and 1.6 cfu × 10-7 (4 × MIC). LVX resistance emerged progressively after one-step or two-step assays. In LVX-resistant isolates, the MIC ranged from 0.75 to >32 mg/L. Mutations were detected exclusively in the gyrA gene. Ten genotypes were identified: G99 C, G99 D, D100N, D100 H, D100 G, S101L, S101W, A102 P, D105 H and A105 G. Mutants S101L and S101W were always associated with a high level of resistance. Mutants with no mutation in the QRDR were more susceptible when incubated with an efflux pump inhibitor (phenyl-arginine β-naphthylamide) only, suggesting, for the first time, the expression of such a system in C. acnes LVX-resistant mutants.
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Affiliation(s)
- Eve-Marie Takoudju
- Service de Bactériologie-Hygiène Hospitalière, CHU NANTES, Nantes, France
| | | | - Stanimir Kambarev
- CRCINA, INSERM, CNRS, Université d'Angers, Université de Nantes, Nantes, France
| | - Frédéric Pecorari
- CRCINA, INSERM, CNRS, Université d'Angers, Université de Nantes, Nantes, France
| | - Stéphane Corvec
- Service de Bactériologie-Hygiène Hospitalière, CHU NANTES, Nantes, France; CRCINA, INSERM, Université d'Angers, Université de Nantes, Nantes, France; Nantes Study Group Member of CRIOGO (Centre de Référence des Infections Ostéo-articulaires du Grand Ouest), Nantes, France.
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Unno M, Cho O, Sugita T. Inhibition of Propionibacterium acnes lipase activity by the antifungal agent ketoconazole. Microbiol Immunol 2017; 61:42-44. [PMID: 28111792 DOI: 10.1111/1348-0421.12464] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Revised: 01/11/2017] [Accepted: 01/16/2017] [Indexed: 12/22/2022]
Abstract
The common skin disease acne vulgaris is caused by Propionibacterium acnes. A lipase secreted by this microorganism metabolizes sebum and the resulting metabolites evoke inflammation in human skin. The antifungal drug ketoconazole inhibits P. acnes lipase activity. We previously showed that the drug also inhibits the growth of P. acnes. Thus, ketoconazole may serve as an alternative treatment for acne vulgaris, which is important because the number of antibiotic-resistant P. acnes strains has been increasing.
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Affiliation(s)
- Mizuki Unno
- Department of Microbiology, Meiji Pharmaceutical University, 2-522-1 Noshio, Kiyose, Tokyo 204-8588, Japan
| | - Otomi Cho
- Department of Microbiology, Meiji Pharmaceutical University, 2-522-1 Noshio, Kiyose, Tokyo 204-8588, Japan
| | - Takashi Sugita
- Department of Microbiology, Meiji Pharmaceutical University, 2-522-1 Noshio, Kiyose, Tokyo 204-8588, Japan
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López-Estebaranz J, Herranz-Pinto P, Dréno B. Consensus-Based Acne Classification System and Treatment Algorithm for Spain. ACTAS DERMO-SIFILIOGRAFICAS 2017. [DOI: 10.1016/j.adengl.2016.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Abstract
Acne, one of the most common skin diseases, affects approximately 85% of the adolescent population, and occurs most prominently at skin sites with a high density of sebaceous glands such as the face, back, and chest. Although often considered a disease of teenagers, acne is occurring at an increasingly early age. Rosacea is a chronic facial inflammatory dermatosis characterized by flushing (or transient facial erythema), persistent central facial erythema, inflammatory papules/pustules, and telangiectasia. Both acne and rosacea have a multifactorial pathology that is incompletely understood. Increased sebum production, keratinocyte hyper-proliferation, inflammation, and altered bacterial colonization with Propionibacterium acnes are considered to be the underlying disease mechanisms in acne, while the multifactorial pathology of rosacea is thought to involve both vasoactive and neurocutaneous mechanisms. Several advances have taken place in the past decade in the research field of acne and rosacea, encompassing pathogenesis and epidemiology, as well as the development of new therapeutic interventions. In this article, we provide an overview of current perspectives on the pathogenesis and treatment of acne and rosacea, including a summary of findings from recent landmark pathophysiology studies considered to have important implications for future clinical practice. The advancement of our knowledge of the different pathways and regulatory mechanisms underlying acne and rosacea is thought to lead to further advances in the therapeutic pipeline for both conditions, ultimately providing a greater array of treatments to address gaps in current management practices.
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Affiliation(s)
| | | | - Jerry Tan
- University of Western Ontario, Windsor, ON, Canada
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28
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Draft Genome Sequence of an Erythromycin-Resistant Propionibacterium acnes Isolate Recovered from Folliculitis of the Scalp. GENOME ANNOUNCEMENTS 2017; 5:5/4/e01490-16. [PMID: 28126936 PMCID: PMC5270695 DOI: 10.1128/genomea.01490-16] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Propionibacterium acnes is now well-known and recognized for its implication in the pathogenesis of acne vulgaris. Here, we report the draft genome sequence of an erythromycin-resistant P. acnes strain isolated from a case of folliculitis of the scalp belonging to phylotype IA1 and sequence type 18 (ST18).
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29
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Lee CJ, Chen LG, Liang WL, Wang CC. Multiple Activities of Punica granatum Linne against Acne Vulgaris. Int J Mol Sci 2017; 18:ijms18010141. [PMID: 28085116 PMCID: PMC5297774 DOI: 10.3390/ijms18010141] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Revised: 12/11/2016] [Accepted: 12/13/2016] [Indexed: 12/05/2022] Open
Abstract
Acne is a common skin condition with sebum overproduction, hyperkeratosis, Propionibacterium acnes (P. acnes) and Staphylococcus aureus, and inflammation. Punica granatum (pomegranate) is well-known for its anti-inflammatory effects; however, few studies have discussed the anti-acne effects of pomegranate. In this study, we found that pomegranate extract (PG-E) significantly reduced P. acnes-induced edema in Wistar rat ears. Therefore, an evaluation platform using multiple pathogenic mechanisms of acne was established to explore the anti-acne effects of pomegranate. Results showed that PG-E inhibited bacterial growth and lipase activity. Through a bioguided-fractionation-isolation system, four hydrolysable tannins, punicalagin (1), punicalin (2), strictinin A (3), and granatin B (4), were isolated. Compounds 1 and 2 had greater anti-bacterial activities and anti-testosterone-induced HaCaT proliferative effects than the others. Compounds 1, 3, and 4 displayed lipase inhibitory effects. Compound 4 decreased cyclooxygenase-2 expression and downregulated prostaglandin E2 production in heat-killed P. acnes-treated RAW 246.7 cells. In conclusion, PG-E is abundant in hydrolysable tannins that display multiple anti-acne capacities, including anti-bacterial, anti-lipase, anti-keratinocyte proliferation, and anti-inflammatory actions. Hence, PG-E has great potential in the application of anti-acne and skin-care products, and punicalagin (1), the most effective component in PG-E, can be employed as a quality control marker.
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Affiliation(s)
- Chia-Jung Lee
- PhD Program for Clinical Drug Discovery of Chinese Herbal Medicine, College of Pharmacy, Taipei Medical University, Taipei 11031, Taiwan.
| | - Lih-Geeng Chen
- Department of Microbiology, Immunology and Biopharmaceuticals, College of Life Sciences, National Chiayi University, Chiayi 60004, Taiwan.
| | - Wen-Li Liang
- School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei 11031, Taiwan.
| | - Ching-Chiung Wang
- PhD Program for Clinical Drug Discovery of Chinese Herbal Medicine, College of Pharmacy, Taipei Medical University, Taipei 11031, Taiwan.
- School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei 11031, Taiwan.
- Orthopedics Research Center, Taipei Medical University Hospital, Taipei 11031, Taiwan.
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30
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Draft Genome Sequences of Four Propionibacterium acnes Strains Isolated from Implant-Related Infections. GENOME ANNOUNCEMENTS 2016; 4:4/6/e01395-16. [PMID: 27979946 PMCID: PMC5159579 DOI: 10.1128/genomea.01395-16] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Propionibacterium acnes was previously described as a potential implant-related pathogen. Here, we report the draft genome sequence of four P. acnes strains, isolated from spine material, hip arthroplasty, and knee arthroplasty infections in France belonging to different sequence types (ST18, ST27, and ST36).
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31
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López-Estebaranz JL, Herranz-Pinto P, Dréno B. Consensus-Based Acne Classification System and Treatment Algorithm for Spain. ACTAS DERMO-SIFILIOGRAFICAS 2016; 108:120-131. [PMID: 27816123 DOI: 10.1016/j.ad.2016.10.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Revised: 09/14/2016] [Accepted: 10/02/2016] [Indexed: 01/24/2023] Open
Abstract
Acne is a chronic inflammatory disease whose psychosocial effects can greatly impair quality of life. Various scales are used to classify the severity of acne, and several treatment algorithms are currently applied: no consensus on a common scale or treatment guidelines has been reached. A group of Spanish experts therefore met to identify a scale the majority could accept as the most appropriate for classifying severity and treating accordingly. The group chose the following classifications: comedonal acne, mild or moderate papulopustular acne, severe papulopustular acne, moderate nodular acne, and nodular-cystic acne (or acne tending to leave scars). Consensus was reached on first- and second-choice treatments for each type and on maintenance treatment. The experts also issued specific recommendations on antibiotic use (starting with mild or moderate papulopustular acne), always in combination with retinoids and/or benzoyl peroxide. The use of isotretinoin (starting at severe papulopustular or moderate nodular acne) was also covered.
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Affiliation(s)
| | | | - B Dréno
- Hospital Universitario de Nantes, Nantes, Francia
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Dréno B, Araviiskaia E, Berardesca E, Gontijo G, Sanchez Viera M, Xiang LF, Martin R, Bieber T. Microbiome in healthy skin, update for dermatologists. J Eur Acad Dermatol Venereol 2016; 30:2038-2047. [PMID: 27735094 PMCID: PMC6084363 DOI: 10.1111/jdv.13965] [Citation(s) in RCA: 123] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Accepted: 08/04/2016] [Indexed: 12/19/2022]
Abstract
The skin is a complex barrier organ made of a symbiotic relationship between microbial communities and host tissue via complex signals provided by the innate and the adaptive immune systems. It is constantly exposed to various endogenous and exogenous factors which impact this balanced system potentially leading to inflammatory skin conditions comprising infections, allergies or autoimmune diseases. Unlike the gut and stool microbiome which has been studied and described for many years, investigations on the skin or scalp microbiome only started recently. Researchers in microbiology and dermatology started using modern methods such as pyrosequencing assays of bacterial 16S rRNA genes to identify and characterize the different microorganisms present on the skin, to evaluate the bacterial diversity and their relative abundance and to understand how microbial diversity may contribute to skin health and dermatological conditions. This article aims to provide an overview on the knowledge about the skin microbiota, the microbiome and their importance in dermatology.
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Affiliation(s)
- B Dréno
- Department of Dermato-cancerology, Nantes University, Nantes, France
| | - E Araviiskaia
- Department of Dermatology, First Pavlov State Medical University of St. Petersburg, St. Petersburg, Russia
| | - E Berardesca
- San Gallicano Dermatological Institute, Rome, Italy
| | - G Gontijo
- Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - M Sanchez Viera
- Institute for Dermatology, Skin Health, Aging and Cancer, Madrid, Spain
| | - L F Xiang
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - R Martin
- L'Oréal Research and Innovation, Tours, France
| | - T Bieber
- Department of Dermatology and Allergy, University Medical Center, Bonn, Germany
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Draft Genome Sequence of Highly Rifampin-Resistant Propionibacterium namnetense NTS 31307302T Isolated from a Patient with a Bone Infection. GENOME ANNOUNCEMENTS 2016; 4:4/4/e00819-16. [PMID: 27516511 PMCID: PMC4982290 DOI: 10.1128/genomea.00819-16] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Propionibacterium namnetense was recently described as a potential bone pathogen, which is closely related to Propionibacterium acnes, a skin commensal microorganism. Here, we report the draft genome sequence of the highly rifampin-resistant strain NTS 31307302T isolated from a patient with a tibia infection.
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Totté JEE, van der Feltz WT, Bode LGM, van Belkum A, van Zuuren EJ, Pasmans SGMA. A systematic review and meta-analysis on Staphylococcus aureus carriage in psoriasis, acne and rosacea. Eur J Clin Microbiol Infect Dis 2016; 35:1069-77. [PMID: 27151386 PMCID: PMC4902839 DOI: 10.1007/s10096-016-2647-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2016] [Accepted: 04/09/2016] [Indexed: 10/28/2022]
Abstract
Staphylococcus aureus might amplify symptoms in chronic inflammatory skin diseases. This study evaluates skin and mucosal colonization with S. aureus in patients with psoriasis, acne and rosacea. A systematic literature search was conducted. Both odds ratios (OR) for colonization in patients versus controls and the prevalence of colonization in patients are reported. Fifteen articles about psoriasis and 13 about acne (12 having a control group) were included. No study in rosacea met our inclusion criteria. For psoriasis, one study out of three controlled studies showed increased skin colonization (OR 18.86; 95 % confidence interval [CI] 2.20-161.99). Three out of the five studies that reported on nasal colonization showed significant ORs varying from 1.73 (95 % CI 1.16-2.58) to 14.64 (95 % CI 2.82-75.95). For acne one of the three studies that evaluated skin colonization reported a significant OR of 4.16 (95 % CI 1.74-9.94). A relation between nasal colonization and acne was not found. Limitations in study design and low sample sizes should be taken into consideration when interpreting the results. Colonisation with S. aureus seems to be increased in patients with psoriasis. This bacterial species, known for its potential to induce long-lasting inflammation, might be involved in psoriasis pathogenesis. Information on acne is limited. Prospective controlled studies should further investigate the role of S. aureus in chronic inflammatory skin diseases.
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Affiliation(s)
- J E E Totté
- Department of Dermatology, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
| | - W T van der Feltz
- Molecular and Cellular Life Sciences, Utrecht University, Utrecht, The Netherlands
| | - L G M Bode
- Department of Medical Microbiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - A van Belkum
- bioMérieux, Scientific Office, La Balme Les Grottes, France
- Department of Medical Microbiology and Infectious Diseases, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - E J van Zuuren
- Department of Dermatology, Leiden University Medical Center, Leiden, The Netherlands
| | - S G M A Pasmans
- Department of Dermatology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
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Gollnick HP, Bettoli V, Lambert J, Araviiskaia E, Binic I, Dessinioti C, Galadari I, Ganceviciene R, Ilter N, Kaegi M, Kemeny L, López-Estebaranz JL, Massa A, Oprica C, Sinclair W, Szepietowski JC, Dréno B. A consensus-based practical and daily guide for the treatment of acne patients. J Eur Acad Dermatol Venereol 2016; 30:1480-90. [PMID: 27177989 DOI: 10.1111/jdv.13675] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Accepted: 02/11/2016] [Indexed: 01/01/2023]
Abstract
BACKGROUND Many current guidelines provide detailed evidence-based recommendations for acne treatment. OBJECTIVE To create consensus-based, simple, easy-to-use algorithms for clinical acne treatment in daily office-based practice and to provide checklists to assist in determining why a patient may not have responded to treatment and what action to take. METHODS Existing treatment guidelines and consensus papers were reviewed. The information in them was extracted and simplified according to daily clinical practice needs using a consensus-based approach and based on the authors' clinical expertise. RESULTS As outcomes, separate simple algorithms are presented for the treatment of predominant comedonal, predominant papulopustular and nodular/conglobate acne. Patients with predominant comedonal acne should initially be treated with a topical retinoid, azelaic acid or salicylic acid. Fixed combination topicals are recommended for patients with predominant papulopustular acne with treatment tailored according to the severity of disease. Treatment recommendations for nodular/conglobate acne include oral isotretinoin or fixed combinations plus oral antibiotics in men, and these options may be supplemented with oral anti-androgenic hormonal therapy in women. Further decisions regarding treatment responses should be evaluated 8 weeks after treatment initiation in patients with predominant comedonal or papulopustular acne and 12 weeks after in those with nodular/conglobate acne. Maintenance therapy with a topical retinoid or azelaic acid should be commenced once a patient is clear or almost clear of their acne to prevent the disease from recurring. The principal explanations for lack of treatment response fall into 5 main categories: disease progression, non-drug-related reasons, drug-related reasons, poor adherence, and adverse events. CONCLUSION This practical guide provides dermatologists with treatment algorithms adapted to different clinical features of acne which are simple and easy to use in daily clinical practice. The checklists to establish the causes for a lack of treatment response and subsequent action to take will facilitate successful acne management.
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Affiliation(s)
- H P Gollnick
- Department of Dermatology & Venereology, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - V Bettoli
- Department of Clinical and Experimental Medicine, O.U. of Dermatology, Azienda Ospedaliero-Universitaria, University of Ferrara, Ferrara, Italy
| | - J Lambert
- Department of Dermatology, University Hospital of Antwerp, University of Antwerp, Edegem, Belgium
| | - E Araviiskaia
- Department of Dermatology and Venereal Diseases, First I. P. Pavlov State Medical University of St. Petersburg, St. Petersburg, Russia
| | - I Binic
- Department of Dermatovenerology, Faculty of Medicine, University of Nis, Nis, Serbia
| | - C Dessinioti
- Department of Dermatology, A. Syggros Hospital, University of Athens, Athens, Greece
| | - I Galadari
- School of Medicine, United Arab Emirates University, Al-Ain, United Arab Emirates
| | - R Ganceviciene
- Clinic of Infectious, Chest Diseases, Dermatovenereology and Allergology, Vilnius University, Vilnius, Lithuania
| | - N Ilter
- Department of Dermatology, Gazi University Medical School, Ankara, Turkey
| | - M Kaegi
- Hautzentrum Zürich, Zürich, Switzerland
| | - L Kemeny
- Department of Dermatology and Allergology University of Szeged, Szeged, Hungary
| | | | - A Massa
- Clínica Dermatológica Dr António Massa, Porto, Portugal
| | - C Oprica
- Department of Laboratory Medicine, Karolinska Institutet Karolinska University Hospital Huddinge, Stockholm, Sweden.,Diagnostiskt Centrum Hud, Stockholm, Sweden
| | - W Sinclair
- Department of Dermatology, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa
| | - J C Szepietowski
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland
| | - B Dréno
- Department of Dermato-Cancerology, University of Nantes, Nantes, France
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36
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Kokhan MM, Keniksfest YUV, Polishchuk AI. Reasonable selection of a topical therapy for different forms of acne. VESTNIK DERMATOLOGII I VENEROLOGII 2016. [DOI: 10.25208/0042-4609-2016-92-2-81-86] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Modern data of the acne pathogenesis, including the role of Propionibacterium acnes in the early stages of the acne formation and their provocative role in the development of the inflammatory process are presented. Priority importance of topical retinoids and combination products containing fixed combinations adapalene with benzoyl peroxide or antibiotic clindamycin in the acne treatment are shown. There are presented the facts of the effectiveness of Clenzit gel (adapalene 0.1%) and Clenzit-C (adapalene 0.1% and clindamycin phosphate 1.0%) and an algorithm for the choice of drug depending on clinical and morphological features of the skin process that allows to optimize the treatment of patients with various forms of acne.
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Semprini A, Braithwaite I, Corin A, Sheahan D, Tofield C, Helm C, Montgomery B, Fingleton J, Weatherall M, Beasley R. Randomised controlled trial of topical kanuka honey for the treatment of acne. BMJ Open 2016; 6:e009448. [PMID: 26832428 PMCID: PMC4746462 DOI: 10.1136/bmjopen-2015-009448] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE To investigate the efficacy of Honevo, a topical 90% medical-grade kanuka honey, and 10% glycerine (honey product) as a treatment for facial acne. DESIGN Randomised controlled trial with single blind assessment of primary outcome variable. SETTING Outpatient primary care from 3 New Zealand localities. PARTICIPANTS Of 136 participants aged between 16 and 40 years with a diagnosis of acne and baseline Investigator's Global Assessment (IGA) for acne score of ≥ 2.68, participants were randomised to each treatment arm. INTERVENTIONS All participants applied Protex, a triclocarban-based antibacterial soap twice daily for 12 weeks. Participants randomised to the honey product treatment arm applied this directly after washing off the antibacterial soap, twice daily for 12 weeks. OUTCOME MEASURES The primary outcome was ≥ 2 point decrease in IGA score from baseline at 12 weeks. Secondary outcomes included mean lesion counts and changes in subject-rated acne improvement and severity at weeks 4 and 12, and withdrawals for worsening acne. RESULTS 4/53 (7.6%) participants in the honey product group and 1/53 (1.9%) of participants in the control group had a ≥ 2 improvement in IGA score at week 12, compared with baseline, OR (95% CI) for improvement 4.2 (0.5 to 39.3), p=0.17. There were 15 and 14 participants who withdrew from the honey product group and control group, respectively. CONCLUSIONS This randomised controlled trial did not find evidence that addition of medical-grade kanuka honey in combination with 10% glycerine to standard antibacterial soap treatment is more effective than the use of antibacterial soap alone in the treatment of acne. TRIAL REGISTRATION NUMBER ACTRN12614000003673; Results.
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Affiliation(s)
- Alex Semprini
- Medical Research Institute of New Zealand, Wellington, New Zealand
| | | | | | | | | | - Colin Helm
- Clinical Horizons, Tauranga, New Zealand
| | | | - James Fingleton
- Medical Research Institute of New Zealand, Wellington, New Zealand
| | | | - Richard Beasley
- Medical Research Institute of New Zealand, Wellington, New Zealand
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Nguyen TA, Eichenfield LF. Profile of clindamycin phosphate 1.2%/benzoyl peroxide 3.75% aqueous gel for the treatment of acne vulgaris. Clin Cosmet Investig Dermatol 2015; 8:549-54. [PMID: 26604811 PMCID: PMC4629949 DOI: 10.2147/ccid.s79628] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Acne vulgaris is a common and chronic skin disease, and is a frequent source of morbidity for affected patients. Treatment of acne vulgaris is often difficult due to the multifactorial nature of this disease. Combination therapy, such as that containing clindamycin and benzoyl peroxide, has become the standard of care. Several fixed formulations of clindamycin 1% and benzoyl peroxide of varying concentrations are available and have been used with considerable success. The major limitation is irritation and dryness from higher concentrations of benzoyl peroxide, and a combination providing optimal efficacy and tolerability has yet to be determined. Recently, a clindamycin and benzoyl peroxide 3.75% fixed combination formulation was developed. Studies have suggested that this formulation may be a safe and effective treatment regimen for patients with acne vulgaris. Here, we provide a brief review of acne pathogenesis, benzoyl peroxide and clindamycin, and profile a new Clindamycin-BP 3.75% fixed combination gel for the treatment of moderate-to-severe acne vulgaris.
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Affiliation(s)
- Tuyet A Nguyen
- Division of Pediatric and Adolescent Dermatology, Rady Children's Hospital, San Diego, CA, USA ; Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Lawrence F Eichenfield
- Division of Pediatric and Adolescent Dermatology, Rady Children's Hospital, San Diego, CA, USA ; Department of Dermatology, University of California, San Diego, La Jolla, CA, USA
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