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Camacho M, Viteri MI, Yepez P, Porter JE, Belhadi D, Barnes C, Guillemot J. Risk factors for acne scarring in Ecuador. PLoS One 2024; 19:e0285648. [PMID: 38718052 PMCID: PMC11078380 DOI: 10.1371/journal.pone.0285648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 04/08/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Acne is a common disease that is associated with scarring and substantial psychosocial burden. The Global Burden of Skin Disease reported that the burden from acne as measured by disability-adjusted life years (DALYs) from 188 countries and specifically that it is greatest in Western Europe, high-income North America and Southern Latin America. This paper aimed to identify risk factors for acne scarring specific to the Ecuadorian population in order to adapt the 4-ASRAT tool accordingly. METHODS This was an observational prospective study. Participants were recruited to complete a survey that was developed based on the potential risk factors for acne scarring and had facial photographs taken. To determine risk factors and their respective weighting, a logistic regression was performed. RESULTS The study included 404 participants. Results from univariate analyses indicated that being male (OR = 2.76 95%CI [1.72; 4.43]), having severe or very severe acne scarring (OR = 4.28 95%CI [1.24; 14.79]), acne duration over 1 year (OR = 1.71 95%CI [1.12; 2.60]), oily skin (OR = 2.02 95%CI [1.27; 3.22]) and the presence of acne on the neck (OR = 2.26 95%CI [1.30; 3.92]), were all significantly associated with the presence of acne scarring. Male sex (2.56 95%CI [1.58;4.17]), oily skin (1.96 95%CI [1.20;3.20]) and severe or very severe acne (3.75 95%CI [1.05;13.37]) remained significant risk factors for acne scarring in the multivariate analysis. CONCLUSION By identifying acne scarring risk factors and applying the tool in everyday dermatology visits, we can reduce the physical and psychological burden that acne scarring causes in the adolescent and adult populations. Further research should be conducted to reassess potential risk factors and complete the adaptation of the tool for the Ecuadorian population, with a larger and more representative study population.
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Affiliation(s)
- Mikaela Camacho
- Institute of Social Medicine and Global Challenges, School of Health Sciences, School of Medicine, Universidad San Francisco de Quito USFQ, Quito, Ecuador
| | - María Isabel Viteri
- Institute of Social Medicine and Global Challenges, School of Health Sciences, School of Medicine, Universidad San Francisco de Quito USFQ, Quito, Ecuador
| | - Paola Yepez
- Institute of Social Medicine and Global Challenges, School of Health Sciences, School of Medicine, Universidad San Francisco de Quito USFQ, Quito, Ecuador
| | - Jorge Estrella Porter
- Institute of Social Medicine and Global Challenges, School of Health Sciences, School of Medicine, Universidad San Francisco de Quito USFQ, Quito, Ecuador
| | - Drifa Belhadi
- Université Paris Cité, Inserm, IAME, Paris, France
- Department of Epidemiology, AP-HP, Hôpital Bichat, Biostatistics and Clinical Research, Paris, France
| | - Caroline Barnes
- School of Health Sciences, School of Medicine, Universidad San Francisco de Quito USFQ, Quito, Ecuador
| | - Jonathan Guillemot
- Institute of Social Medicine and Global Challenges, School of Health Sciences, School of Medicine, Universidad San Francisco de Quito USFQ, Quito, Ecuador
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2
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Li J, Duan F, Kuang J, Liu X, Wei J, Zhao J. Clinical factors influencing the effectiveness of microplasma fractional radiofrequency treatment for atrophic acne scars: A retrospective analysis. J Cosmet Dermatol 2024. [PMID: 38532647 DOI: 10.1111/jocd.16298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 03/12/2024] [Accepted: 03/14/2024] [Indexed: 03/28/2024]
Abstract
BACKGROUND Microplasma fractional radiofrequency (MP FRF) technology has been increasingly used for acne scars. Nevertheless, little evidence has analyzed the factors influencing its effectiveness before and during treatment. AIMS To evaluate the clinical factors affecting the effectiveness of MP FRF therapy for atrophic acne scars. METHODS We analyzed retrospectively the clinical data of 79 acne scar patients treated with MP FRF technology. The outcome of interest included the effectiveness and adverse events after MP FRF treatment. Multivariable logistic regression was utilized to evaluate clinical factors associated with effectiveness after the initial session. RESULTS All patients received 115 sessions of MP FRF therapy (average: 1.5 sessions). Twenty-eight (35.4%) patients improved moderately to excellently after one session. We found that the severe grade before treatment was negatively correlated with the effectiveness according to Goodman-Baron qualitative scores (OR = 0.02, 95% CI [0.001, 0.37], p = 0.009). The presence of icepick scars was also a negative correlation factor for the effectiveness (OR = 0.06, 95% CI [0.004, 1.00], p = 0.049). Furthermore, after excluding the effects of icepick scars and Goodman-Baron scores before treatment, ECCA scores were also correlated with effectiveness (OR = 1.04, 95% CI [1.01, 1.06], p = 0.009). CONCLUSION MP FRF therapy was effective in treating atrophic acne scars with no permanent adverse events. The severity of Goodman-Baron qualitative scores and icepick scars were independent clinical factors affecting effectiveness, suggesting the possible requirement for additional treatments other than MP FRF for severe acne scars and icepick scars.
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Affiliation(s)
- Jing Li
- Department of Dermatology, Beijing Jishuitan Hospital, Capital Medical University, Beijing, China
- Fourth Medical College of Peking University, Beijing, China
| | - Fangfang Duan
- Fourth Medical College of Peking University, Beijing, China
- Clinical Epidemiology Research Center, Beijing Jishuitan Hospital, Capital Medical University, Beijing, China
| | - Jie Kuang
- Department of Dermatology, Beijing Jishuitan Hospital, Capital Medical University, Beijing, China
- Fourth Medical College of Peking University, Beijing, China
| | - Xiao Liu
- Department of Dermatology, Beijing Jishuitan Hospital, Capital Medical University, Beijing, China
- Fourth Medical College of Peking University, Beijing, China
| | - Jia Wei
- Department of Dermatology, Beijing Jishuitan Hospital, Capital Medical University, Beijing, China
- Fourth Medical College of Peking University, Beijing, China
| | - Jinghui Zhao
- Department of Dermatology, Beijing Jishuitan Hospital, Capital Medical University, Beijing, China
- Fourth Medical College of Peking University, Beijing, China
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3
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Attia E. Atrophic Postacne Scar Treatment: Narrative Review. JMIR DERMATOLOGY 2024; 7:e49954. [PMID: 38381492 PMCID: PMC10918545 DOI: 10.2196/49954] [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: 06/21/2023] [Revised: 11/16/2023] [Accepted: 01/28/2024] [Indexed: 02/22/2024] Open
Abstract
Acne scarring is a frequent complication of acne. Scars negatively impact psychosocial and physical well-being. Optimal treatments significantly improve the appearance, quality of life, and self-esteem of people with scarring. A wide range of interventions have been proposed for acne scars. This narrative review aimed to focus on facial atrophic scarring interventions. The management of acne scarring includes various types of resurfacing (chemical peels, lasers, and dermabrasion); the use of injectable fillers; and surgical methods, such as needling, punch excision, punch elevation, or subcision. Since the scarred tissue has impaired regeneration abilities, the future implementation of stem or progenitor regenerative medical techniques is likely to add considerable value. There are limited randomized controlled trials that aimed to determine which treatment options should be considered the gold standard. Combining interventions would likely produce more benefit compared to the implementation of a single method.
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Affiliation(s)
- Enas Attia
- Department of Dermatology, Venereology, and Andrology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
- Department of Dermatology, Ain Al Khaleej Hospital, Abu Dhabi, United Arab Emirates
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4
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Schleicher S, Moore A, Rafal E, Gagne-Henley A, Johnson SM, Dhawan S, Chavda R, York JP, Sforzolini B, Holcomb K, Ablon G, Del Rosso J, Dreno B. Trifarotene Reduces Risk for Atrophic Acne Scars: Results from A Phase 4 Controlled Study. Dermatol Ther (Heidelb) 2023; 13:3085-3096. [PMID: 37838987 PMCID: PMC10689318 DOI: 10.1007/s13555-023-01042-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 09/13/2023] [Indexed: 10/17/2023] Open
Abstract
BACKGROUND Atrophic acne scarring often accompanies acne vulgaris. The efficacy of topical retinoids for treatment of acne is well documented; however, evidence for use in atrophic acne scars is limited. METHODS In this randomized, split-face, double-blind study, subjects (age: 17-34 years, N = 121) with moderate-to-severe facial acne, with acne scars present, were treated with either trifarotene 50 μg/g or vehicle once daily for 24 weeks. Efficacy was assessed by absolute and percent change from baseline in atrophic acne scar counts, Scar Global assessment (SGA), and IGA success rates as well as acne lesion counts. RESULTS At week 24, a statistically significantly greater reduction in the mean absolute change from baseline in the total atrophic scar count was noted in the trifarotene- vs vehicle-treated area (- 5.9 vs - 2.7; p < 0.0001) with differences between sides noted as early as week 2 (- 1.5 vs - 0.7; p = 0.0072). The SGA success rate was higher in the trifarotene side at week 12 (14.9% vs 5.0%, P < 0.05) and improved through week 24 (31.3% vs 8.1%, P < 0.001). Similarly, at week 24, the IGA success rate was higher with trifarotene (63.6% vs 31.3%, P < 0.0001) along with reductions in total (70% vs 45%) and inflammatory (76% vs 48%) lesion counts. The incidence of treatment-emergent adverse events was 5.8% (trifarotene) and 2.5% (vehicle); most common (> 1%) was skin tightness (1.7% vs 0.8%), and all events were mild to moderate in severity. CONCLUSIONS Trifarotene was effective and well tolerated in treating moderate-to-severe facial acne and reducing atrophic acne scars, with reduction of total atrophic scar count as early as week 2. TRIAL REGISTRATION Clinicaltrials.gov NCT04856904.
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Affiliation(s)
| | - Angela Moore
- Arlington Research Center, Inc, Arlington, TX, USA
- Baylor University Medical Center, Dallas, TX, USA
| | - Elyse Rafal
- DermResearchCenter of New York, Inc, Stony Brook, NY, USA
| | | | | | - Sunil Dhawan
- Center for Dermatology Clinical Research, Inc, Fremont, CA, USA
| | | | - J P York
- Galderma Laboratories, Dallas, TX, USA
| | | | | | - Glynis Ablon
- Ablon Skin Institute & Research Center, University of California, Los Angeles, CA, USA
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5
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Fabi SG, Beleznay K, Berson DS, Cohen JL, Lee S, Dayan SH. Treatment of acne in the aesthetic patient: A round table update. J Cosmet Dermatol 2023; 22:2391-2398. [PMID: 37403516 DOI: 10.1111/jocd.15913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 06/16/2023] [Indexed: 07/06/2023]
Abstract
BACKGROUND The popularity of social media appears to be increasing the acceptance of cosmetic treatments, prompting more consumers to seek cosmetic treatments. As the estimated prevalence of acne vulgaris among adult women may be as high as 54%, acne is commonly observed among patients presenting for cosmetic treatments. Concomitant treatment of acne in the aesthetic patient population will improve overall clinical outcomes. AIMS The goal of this work was to deliver a high-quality ethical and evidence-based educational program to physicians and adjunctive health care providers to advance patient care. METHODS This paper is based on a webcam presentation with roundtable discussion by several notable experts in their field. RESULTS A range of topical medications, injectable products, chemical peels, and energy-based devices are available for treating acne vulgaris. In most instances, these are compatible with rejuvenation procedures in the aesthetic patient. CONCLUSION The growth of social media is raising awareness of aesthetic procedures and appears to be increasing the number of patients seeking aesthetic treatment. Educating patients about the importance of treating acne vulgaris can improve overall treatment outcomes. In most instances, the presence of acne is not a barrier to aesthetic care.
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Affiliation(s)
| | - Katie Beleznay
- Humphrey & Beleznay Cosmetic Dermatology, Vancouver, British Columbia, Canada
| | - Diane S Berson
- Weill Cornell Medicine, New York-Presbyterian Hospital, New York, USA
| | - Joel L Cohen
- AboutSkin Dermatology and DermSurgery, PC, Greenwood Village, Colorado, USA
| | - Sandra Lee
- Skin Physicians & Surgeons, Upland, California, USA
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6
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Liu L, Xue Y, Chen Y, Chen T, Zhong J, Shao X, Chen J. Prevalence and risk factors of acne scars in patients with acne vulgaris. Skin Res Technol 2023; 29:e13386. [PMID: 37357642 PMCID: PMC10240192 DOI: 10.1111/srt.13386] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Accepted: 05/25/2023] [Indexed: 06/27/2023]
Abstract
BACKGROUND Acne scar is a persistent complication of acne vulgaris. However, the prevalence and risk factors are still unclear. This study aimed to assess the global prevalence and risk factors of acne scars in patients with acne. MATERIALS AND METHODS A systematic search of published studies in three databases was performed and the meta-analyses were conducted. RESULTS Finally, we included 37 studies involving 24 649 acne patients. And, the pooled prevalence of acne scars in these patients was 47% (95% confidence interval [CI]: 38-56%). Besides, the differences in prevalence were observed based on the subgroup analysis for age, gender, acne severity, source of patients, and so on. Subsequently, we quantified the relationship of three risk factors with acne scars: male gender (odds ratio [OR]: 1.58, 95% CI: 1.19-2.09), positive family history of acne (OR: 2.73, 95% CI: 1.26-5.91), and acne severity (OR for moderate acne: 2.34, 95% CI: 1.54-3.57; OR for severe acne: 5.51, 95% CI: 2.45-12.41). CONCLUSION Herein, we found that 47% of acne patients suffered from acne scars and identified three risk factors: male gender, positive family history of acne, and acne severity. In order to reduce acne scarring, attention and effective therapy early in the course of acne is important.
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Affiliation(s)
- Lin Liu
- Department of DermatologyThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
| | - Yuzhou Xue
- Department of Cardiology and Institute of Vascular MedicinePeking University Third HospitalBeijingChina
| | - Yangmei Chen
- Department of DermatologyThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
| | - Tingqiao Chen
- Department of DermatologyThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
| | - Judan Zhong
- Department of DermatologyThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
| | - Xinyi Shao
- Department of DermatologyThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
| | - Jin Chen
- Department of DermatologyThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
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7
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Layton AM, Dias da Rocha MA. Real-World Case Studies Showing the Effective Use of Azelaic Acid in the Treatment, and During the Maintenance Phase, of Adult Female Acne Patients. Clin Cosmet Investig Dermatol 2023; 16:515-527. [PMID: 36873659 PMCID: PMC9975535 DOI: 10.2147/ccid.s396023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 02/01/2023] [Indexed: 02/25/2023]
Abstract
Acne Vulgaris is a chronic inflammatory skin disease, and one of the most prevalent inflammatory dermatoses among teenagers, affecting more than >95% of boys and 85% of girls. Adult female acne (AFA) is a subtype of acne, pragmatically defined as affecting women over the age of 25. The clinical presentation of AFA may be distinguished from adolescent acne according to some key clinical and psychosocial characteristics. The etiopathogenic factors and the chronic clinical course that are implicated in AFA make management complex and challenging. A frequent tendency to relapse makes the requirement for maintenance therapy highly likely. Therefore, AFA typically requires a specific, tailored therapeutic approach. This paper presents six challenging case studies that demonstrate the efficacy of azelaic acid gel (AZA) in adult female acne. The six cases use AZA as monotherapy, as part of a combination regimen at treatment initiation, or as maintenance treatment (which is frequently required in this adult population). The positive outcomes achieved in this case series demonstrate that AZA can be efficacious, result in excellent patient satisfaction in mild to moderate adult female acne, and can be effective as a maintenance therapy.
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Affiliation(s)
- Alison M Layton
- Skin Research Centre, Hull York Medical School, University of Hull, Hull, UK
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8
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Kang C, Lu D. Combined Effect of Microneedling and Platelet-Rich Plasma for the Treatment of Acne Scars: A Meta-Analysis. Front Med (Lausanne) 2022; 8:788754. [PMID: 35237616 PMCID: PMC8882957 DOI: 10.3389/fmed.2021.788754] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Accepted: 11/29/2021] [Indexed: 01/23/2023] Open
Abstract
Background Microneedling is a promising method for the treatment of acne scars, while the effect of microneedling combined with platelet-rich plasma (PRP) remains unknown. We performed a meta-analysis of controlled studies to compare the efficacy and safety of microneedling treatment with and without additional PRP in patients with acne scars. Methods Randomized and non-randomized controlled studies were identified by search of Medline, Embase, and Cochrane's Library databases. Results were pooled with a random-effects model, incorporating the possible heterogeneity. Results Four randomized and 10 split-face non-randomized controlled studies with 472 patients were included. Compared to microneedling therapy without PRP, combined treatment with microneedling and PRP was associated with increased odds of clinical improvement of >50% in Goodman's qualitative scale [GQS: odds ratio (OR): 2.97, 95% confidence interval (CI): 1.96–4.51, p < 0.001; I2 = 0%], and a significantly improved mean GQS score (mean difference: −0.32, 95% CI: −0.44 to −0.20, p < 0.001; I2 = 0%). Combined treatment was associated with a higher patient satisfying rate (OR: 4.15, 95% CI: 2.13 to 8.09, p < 0.001; I2 = 53%), while the incidence of severe adverse events such as severe erythema (OR: 1.59, 95% CI:.73 to 3.46, P = 0.24; I2 = 0%) and severe edema (OR: 1.14, 95% CI: 0.47 to 2.76, P = 0.77; I2 = 0%) were not significantly different. Conclusions Combined treatment with microneedling with PRP is more effective than microneedling without PRP for patients with acne scars.
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9
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Tan J, Beissert S, Cook-Bolden F, Chavda R, Harper J, Hebert A, Lain E, Layton A, Rocha M, Weiss J, Dréno B. Evaluation of psychological well-being and social impact of atrophic acne scarring: A multinational, mixed-methods study. JAAD Int 2022; 6:43-50. [PMID: 35005652 PMCID: PMC8719008 DOI: 10.1016/j.jdin.2021.11.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2021] [Indexed: 11/16/2022] Open
Abstract
Background Most people with acne are at risk of developing acne scars, but the impact of these scars on patients' quality of life is poorly researched. Objective To assess the perspective of patients with acne scars and the impact of these scars on their emotional well-being and social functioning. Methods A 60-minute interview of 30 adults with acne scars informed and contextualized the development of a cross-sectional survey of 723 adults with atrophic acne scars. Results The main themes identified in the qualitative interviews included acceptability to self and others, social functioning, and emotional well-being. In the cross-sectional survey, 31.6%, 49.6%, and 18.8% of the participants had mild, moderate, and severe/very severe acne scarring. The survey revealed that 25.7% of the participants felt less attractive, 27.5% were embarrassed or self-conscious because of their scars, 8.3% reported being verbally and/or physically abused because of their scars on a regular basis, and 15.9% felt that they were unfairly dismissed from work. In addition, 37.5% of the participants believed that their scars affected people's perceptions about them, and 19.7% of the participants were very bothered about hiding their scars daily. Moreover, 35.5% of the participants avoided public appearances, and 43.2% felt that their scars had negatively impacted their relationships. Limitations The temporal evaluation of the impact was not estimated. Conclusion Even mild atrophic acne scarring can evoke substantial emotional, social, and functional concerns.
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Affiliation(s)
- Jerry Tan
- Western University Canada, Schulich School of Medicine and Dentistry, Ontario, Canada
| | - Stefan Beissert
- Department of Dermatology, University Hospital Carl Gustav Carus, Dresden, Germany
| | | | | | - Julie Harper
- The Dermatology and Skin Care Center of Birmingham, Birmingham, Alabama
| | | | - Edward Lain
- Austin Institute for Clinical Research, Pflugerville, Texas
| | - Alison Layton
- Hull York Medical School, York University, York, United Kingdom
| | - Marco Rocha
- Federal University of São Paulo, São Paulo, Brazil
| | - Jonathan Weiss
- Georgia Dermatology Partners (formerly, Gwinnett Dermatology, PC), Snellville, Georgia
| | - Brigitte Dréno
- Unité Thérapie Cellulaire et Génique, Faculté de Médecine de Nantes, Centre Hospitalier Universitaire de Nantes, Nantes, France
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10
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Costa CS, Bagatin E, Yang Z, Pacheco RL, Magin P, de Sá Urtiga Santos L, Pereira T, Riera R. Systemic pharmacological treatments for acne: an overview of systematic reviews. Hippokratia 2021. [DOI: 10.1002/14651858.cd014917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Caroline S Costa
- Department of Specialised Medicine, Discipline of Dermatology; Universidade Federal do Piaui; Teresina Brazil
| | - Ediléia Bagatin
- Department of Dermatology; Universidade Federal de São Paulo; São Paulo Brazil
| | - Zhirong Yang
- Primary Care Unit, Department of Public Health and Primary Care; School of Clinical Medicine, University of Cambridge; Cambridge UK
| | - Rafael L Pacheco
- Núcleo de Ensino e Pesquisa em Saúde Baseada em Evidências e Avaliação Tecnológica em Saúde (NEP-SBEATS); Universidade Federal de São Paulo; São Paulo Brazil
| | - Parker Magin
- Discipline of General Practice, School of Medicine and Public Health; The University of Newcastle; Newcastle Australia
| | | | - Tiago Pereira
- International Research Center HAOC. Health Technology Assessment Unit; São Paulo Brazil
| | - Rachel Riera
- Cochrane Brazil Rio de Janeiro; Cochrane; Petrópolis Brazil
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11
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Layton A, Alexis A, Baldwin H, Beissert S, Bettoli V, Del Rosso J, Dréno B, Gold LS, Harper J, Lynde C, Thiboutot D, Weiss J, Tan J. Identifying gaps and providing recommendations to address shortcomings in the investigation of acne sequelae by the Personalising Acne: Consensus of Experts panel. JAAD Int 2021; 5:41-48. [PMID: 34816133 PMCID: PMC8593750 DOI: 10.1016/j.jdin.2021.06.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/14/2021] [Indexed: 11/24/2022] Open
Abstract
Background The physical sequelae of acne include erythema, hyperpigmentation, and scarring, which are highly burdensome for patients. Early, effective treatment can potentially limit and prevent sequelae development, but there is a need for guidance for and evidence of prevention-oriented management to improve patient outcomes. Objective To identify unmet needs of acne sequelae and generate expert recommendations to address gaps in clinical guidance. Methods The Personalizing Acne: Consensus of Experts panel of 13 dermatologists used a modified Delphi approach to achieve a consensus on the clinical aspects of acne sequelae. A consensus was defined as ≥75% of the dermatologists voting "agree" or "strongly agree." All voting was electronic and blinded. Results The panel identified gaps in current guidance and made recommendations related to acne sequelae. These included identification and classification of sequelae, pertinent points to consider for patient consultations, and management aimed at reducing the development of sequelae. Limitations The recommendations are based on expert opinion and made in the absence of high-quality evidence. Conclusions The identified gaps should help inform future research and guideline development for acne sequelae. The consensus-based recommendations should also support the process of consultations throughout the patient journey, helping to reduce the development and burden of acne sequelae through improved risk factor recognition, early discussion, and appropriate management.
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Affiliation(s)
- Alison Layton
- Hull York Medical School, University of York, York, United Kingdom.,Harrogate and District NHS Foundation Trust, Harrogate, United Kingdom
| | | | - Hilary Baldwin
- Robert Wood Johnson Medical Center, New Brunswick, New Jersey.,The Acne Treatment and Research Center, Brooklyn, New York
| | - Stefan Beissert
- Department of Dermatology, University Hospital Carl Gustav Carus, Dresden, Germany
| | - Vincenzo Bettoli
- Dermatology Unit - Teaching Hospital, Azienda Ospedaliera, University of Ferrara, Ferrara, Italy
| | - James Del Rosso
- Thomas Dermatology, Las Vegas, Nevada.,JDR Dermatology Research, Las Vegas, Nevada
| | - Brigitte Dréno
- Dermato-cancérology Department, CHU Nantes, University of Nantes, Nantes, France
| | | | - Julie Harper
- Dermatology and Skin Care Center of Birmingham, Birmingham, Alabama
| | - Charles Lynde
- Department of Medicine, University of Toronto, Ontario, Canada.,Lynderm Research Inc, Ontario, Canada
| | - Diane Thiboutot
- Department of Dermatology, Pennsylvania State University College of Medicine, Hershey, Philadelphia
| | | | - Jerry Tan
- Windsor Clinical Research Inc, Ontario, Canada.,Department of Medicine, University of Western Ontario, Ontario, Canada
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12
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Double-blind, randomized controlled trial comparing the use of microneedling alone versus chemical peeling alone versus a combination of microneedling and chemical peeling in the treatment of atrophic post-acne scars. An assessment of clinical effectiveness and patients' quality-of-life. Postepy Dermatol Alergol 2021; 38:629-635. [PMID: 34658706 PMCID: PMC8501429 DOI: 10.5114/ada.2021.108913] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 03/23/2020] [Indexed: 11/17/2022] Open
Abstract
Introduction Acne vulgaris is a common, chronic disease. One of the most commonly encountered complications of acne is permanent atrophic scarring. Treatment of atrophic scars includes fillers, dermabrasion, laser resurfacing, microneedling and peelings and it is often difficult to treat. In our double-blind randomized controlled trial (RCT), we investigated the synergistic effect of microneedling with the application of trichloroacetic acid, kojic acid and hydrogen peroxide in the treatment of atrophic acne scars. Aim To assess the clinical effectiveness and patients' quality-of-life (HRQoL) after three types of atrophic post-acne scar treatment, namely microneedling alone (MN) vs chemical peeling alone (CP) vs. a combination of microneedling and chemical peeling (MN + CP). Material and methods A total of 120 patients were enrolled into the study following strict inclusion/exclusion criteria and randomized into the three treatment groups - MN, CP (a combination of trichloroacetic acid, kojic acid and hydrogen peroxide), and MN + CP. According to a preapproved protocol, each patient underwent four treatment sessions, each spread 20 days apart. Both pre- and post-treatment clinical status (using the Goodman-Baron scale; two expert raters blinded to the treatment used) and patients' HRQoL (using the Dermatology Life Quality Index) were assessed. Results During the 5-month recruitment period, a total of 120 patients were approached and agreed to take part in the study (94 females - 78.3% and 26 males) (mean age of 30.14 ±3.64 years; range: 18-45 years). Only in the MN + CP group there was a statistically significant improvement according to the G-B scale post-treatment (2.87 ±0.83 vs. 2.03 ±1.16 respectively; p = 0.0005). Patients in all three treatment groups experienced a statistically significant improvement in their HRQoL post-treatment (all p's < 0.05). Conclusions A combination of microneedling and chemical peeling produces the best, objectively measured effects in the treatment of atrophic post-acne scars. All examined treatments, even if not producing a clinically significant treatment outcome, improve patients' HRQoL.
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Dréno B, Stein Gold L. Acne Scarring: Why We Should Act Sooner Rather Than Later. Dermatol Ther (Heidelb) 2021; 11:1075-1078. [PMID: 34115309 PMCID: PMC8192685 DOI: 10.1007/s13555-021-00562-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Indexed: 12/02/2022] Open
Affiliation(s)
- Brigitte Dréno
- Department of Dermatology, CHU Nantes, CIC 1413, CRCINA, University of Nantes, Nantes, France
| | - Linda Stein Gold
- Clinical Research Division, Head of Dermatology, Henry Ford Hospital, Detroit, MI, USA. .,Henry Ford Health System, 6530 Farmington Rd, West Bloomfield Township, Detroit, MI, 48322, USA.
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14
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Safety of Combined Fractional Microneedle Radiofrequency and CO2 as an Early Intervention for Inflammatory Acne and Scarring Treated With Concomitant Isotretinoin. Dermatol Surg 2021; 46:e71-e77. [PMID: 32187040 DOI: 10.1097/dss.0000000000002364] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Fractional microneedle radiofrequency (FMRF) systems are popular options for treating acne scars. However, treatment efficacy when used in combination with traditional ablative fractional laser (AFL) and the safety profile with concomitant use of isotretinoin remain unknown. OBJECTIVE The aim of this study was to assess the safety and efficacy of an early intervention combination treatment protocol for inflammatory acne and acne scars. MATERIALS AND METHODS The electronic records of 71 patients with inflammatory acne and acne scars were included in this retrospective observational study. Data were collected for all patients who received combination FMRF and AFL. Within the study group, 43 patients were receiving low-dose isotretinoin or had completed isotretinoin within the past 3 weeks. RESULTS The mean Scar Global Assessment score significantly decreased after 3 sessions of combination treatment (n = 71). Patients with inflammatory acne showed a significant decrease in the number of inflammatory lesions (n = 30). Patients with concomitant low-dose isotretinoin use reported a further decrease in Scar Global Assessment score (n = 43). There were no reported persistent side effects, including prolonged inflammatory reaction or scarring. CONCLUSION Combination treatment with FMRF and AFL is an effective and well-tolerated treatment modality for acne scars and inflammatory acne.
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Snarskaya ES. The role and place of azelaic acid in the routes of patients with acne vulgaris. VESTNIK DERMATOLOGII I VENEROLOGII 2020. [DOI: 10.25208/vdv1175] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
The review presents data from foreign and domestic clinical studies on the efficacy and safety of azelaic acid (Skinoren) in the treatment of acne vulgaris. New aspects of pathogenesis are presented, an analysis of the database of systematic reviews of Russian, European, American researchers is presented, including an analysis of the database of systematic reviews of the Cochrane Systematic Review Intervention Version of the Cochrane Skin Group (2020) comparative studies on the effectiveness of azelaic acid, Skinoren and other topical topical medications for the treatment of acne vulgaris. Possibilities of monotherapy with the preparation of azaelaic acid Skinoren and variants of combined treatment, in particular, a combination of azelaic acid with topical retinoids, benzoyl peroxide, systemic and topical antibiotics for the treatment of acne of varying severity, are shown. Reliable efficacy, safety, the possibility of long-term therapy, high compliance allow us to conclude that Skinoren is highly effective in treating acne, and a number of priority complex advantages, such as the presence of anti-inflammatory, antibacterial, anti-keratinizing, antiandrogenic and anti-tyrosinase action, allow Skinoren to be considered as optimal. topical agent for long-term and safe treatment of acne and prevention of the development of post-acne symptom complex.
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16
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Snarskaya ES. The role and place of azelaic acid in the routes of patients with acne vulgaris. VESTNIK DERMATOLOGII I VENEROLOGII 2020. [DOI: 10.25208/vdv1175-2020-96-5-65-70] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
The review presents data from foreign and domestic clinical studies on the efficacy and safety of azelaic acid (Skinoren) in the treatment of acne vulgaris. New aspects of pathogenesis are presented, an analysis of the database of systematic reviews of Russian, European, American researchers is presented, including an analysis of the database of systematic reviews of the Cochrane Systematic Review Intervention Version of the Cochrane Skin Group (2020) comparative studies on the effectiveness of azelaic acid, Skinoren and other topical topical medications for the treatment of acne vulgaris. Possibilities of monotherapy with the preparation of azaelaic acid Skinoren and variants of combined treatment, in particular, a combination of azelaic acid with topical retinoids, benzoyl peroxide, systemic and topical antibiotics for the treatment of acne of varying severity, are shown. Reliable efficacy, safety, the possibility of long-term therapy, high compliance allow us to conclude that Skinoren is highly effective in treating acne, and a number of priority complex advantages, such as the presence of anti-inflammatory, antibacterial, anti-keratinizing, antiandrogenic and anti-tyrosinase action, allow Skinoren to be considered as optimal. topical agent for long-term and safe treatment of acne and prevention of the development of post-acne symptom complex.
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17
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Lan T, Tang L, Xia A, Hamblin MR, Jian D, Yin R. Comparison of Fractional Micro-Plasma Radiofrequency and Fractional Microneedle Radiofrequency for the Treatment of Atrophic Acne Scars: A Pilot Randomized Split-Face Clinical Study in China. Lasers Surg Med 2020; 53:906-913. [PMID: 33326634 DOI: 10.1002/lsm.23369] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 10/21/2020] [Accepted: 11/29/2020] [Indexed: 01/07/2023]
Abstract
BACKGROUND AND OBJECTIVE Both fractional micro-plasma radiofrequency (RF) and fractional microneedle RF are novel devices that can be applied for the treatment of atrophic acne scars, and they have both been proved to be effective. To compare the clinical effectiveness and adverse reactions of fractional micro-plasma RF and fractional microneedle RF for the therapy of facial atrophic acne scars in a randomized split-face study. STUDY DESIGN/MATERIALS AND METHODS Sixty patients with facial atrophic acne scars received three applications at 2-month intervals in a randomized split-face study using fractional micro-plasma RF and fractional microneedle RF on different sides of the face. Three independent dermatologists evaluated the improvement in acne scars using the ECCA grading scale (Echelle d'Evaluation Clinique des Cicatrices d'Acné) by comparing the digital images and graded the improvement in the acne scars. Patients were asked to provide a self-evaluation of satisfaction for efficacy and safety. Adverse effects were also recorded after each treatment. RESULTS In total sixty patients completed the entire study. A significant improvement was observed in the appearance of acne scars, and the mean ECCA scores improved significantly after both modalities. The mean decrease in ECCA scores from the baseline was significantly more pronounced in fractional micro-plasma RF as compared with fractional microneedle RF (41.33 ± 20.19 vs 32.17 ± 17.35; P < 0.05). The degree of clinical improvement was also significantly better for fractional micro-plasma RF. Pain, erythema, and swelling were observed in all patients after both treatments. The pain was more intense during micro-plasma RF treatment (P = 0.000), and the duration of pain and erythema were longer than with fractional microneedle RF (P = 0.000). Postinflammatory hyperpigmentation (PIH) was observed in one patient on the fractional micro-plasma RF side while no PIH was observed on the fractional microneedle RF side. No infections or worsening of scarring was observed with either treatment. No subject was dissatisfied with the efficacy of either device. Rolling scars tended to respond better to fractional micro-plasma RF treatment compared with fractional microneedle RF (P = 0.000). CONCLUSIONS Both fractional micro-plasma RF and fractional microneedle RF are effective and safe methods for improving atrophic acne scars. Fractional micro-plasma RF is significantly more effective for atrophic acne scars, especially for rolling scars. However, fractional microneedle RF has fewer side effects plus shorter downtime, and patients are more comfortable after the treatment. Lasers Surg. Med. © 2020 Wiley Periodicals LLC.
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Affiliation(s)
- Ting Lan
- Department of Dermatology, Southwest Hospital, Army Medical University, Chongqing, 400038, China.,Department of Cosmetic Dermatology, Luxury Skincenter, Xi'an, 710048, China
| | - Li Tang
- Department of Dermatology, Southwest Hospital, Army Medical University, Chongqing, 400038, China
| | - Aiai Xia
- Department of Dermatology, Southwest Hospital, Army Medical University, Chongqing, 400038, China
| | - Michael R Hamblin
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, 02114.,Department of Dermatology, Harvard Medical School, Boston, Massachusetts, 02115.,Laser Research Centre, Faculty of Health Science, University of Johannesburg, Doornfontein, 2028, South Africa
| | - Dan Jian
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China
| | - Rui Yin
- Department of Dermatology, Southwest Hospital, Army Medical University, Chongqing, 400038, China
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18
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Estrella Porter PD, Ayala Mullo JF, Barba Carrera DA, Barros Castro AX, Cabascango Vasquez ES, Del Castillo Arellano JC, Condo Espinel PX, Eid Arellano EG, Estrella Porter JA, Falconi Paez AC, Fierro Valle MC, Gallegos Miranda PJ, Guerra Velastegui AR, Guevara Baez DC, Jara Santamaria BD, Lopez Diaz JA, Mejia Viana JC, Moya Quitto GF, Muenala PM, Muenala TC, Nicolalde López BI, Oquendo Carrera AD, Ordoñez Paz AL, Ortiz Duque EF, Palacios Granda MC, Pantoja Borja NS, Puga Martinez SE, Rueda Ordoñez CJ, Soto Gutierrez LP, Tixi Tapia GE, Torres Moscoso MB, Vaca Porras MA, Viteri Suárez MI, Guillemot JR. Medical education from the point of view of medical students: Results from four participatory Delphi panels in Quito, Ecuador. MEDICAL TEACHER 2020; 42:1051-1057. [PMID: 32697116 DOI: 10.1080/0142159x.2020.1792865] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
BACKGROUND Medical curricula have historically been designed in a top-down approach, usually excluding students. While Delphi panels have been used as a tool for medical education curricula design, none have been conducted in Ecuador. In addition, no such approach has ever included students both as panelists and researchers. MATERIAL AND METHODS Four Delphi panels were developed and conducted using a participatory approach that allowed medical students to take part both as expert panelists and researchers: specifically, students developed the questionnaire and conducted a qualitative synthesis. Questionnaire responses were anonymized and dispatched online to panelists. The information was organized and collected to develop the qualitative syntheses and prepare the final statements. RESULTS Thirty-two medical students participated between February and May 2018. A total of 32 questions were developed, corresponding to five different categories. For some questions, consensus was reached; for other questions, general statements were obtained.Discussion and conclusion: Developing the questionnaire, responding to it and analyzing the answers allowed students to raise significant concerns regarding medical education topics proposing relevant policy and curricula change. Participatory Delphi panels can be an efficient tool to obtain organized feedback, improve student class involvement, and promote research skills.
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Affiliation(s)
- P D Estrella Porter
- Escuela de Medicina, Universidad San Francisco de Quito USFQ, Quito, Ecuador
- Health Research Group USFQ, Universidad San Francisco de Quito USFQ, Quito, Ecuador
| | - J F Ayala Mullo
- Escuela de Medicina, Universidad San Francisco de Quito USFQ, Quito, Ecuador
| | - D A Barba Carrera
- Escuela de Medicina, Universidad San Francisco de Quito USFQ, Quito, Ecuador
| | - A X Barros Castro
- Escuela de Medicina, Universidad San Francisco de Quito USFQ, Quito, Ecuador
| | | | | | - P X Condo Espinel
- Escuela de Medicina, Universidad San Francisco de Quito USFQ, Quito, Ecuador
| | - E G Eid Arellano
- Escuela de Medicina, Universidad San Francisco de Quito USFQ, Quito, Ecuador
| | - J A Estrella Porter
- Escuela de Medicina, Universidad San Francisco de Quito USFQ, Quito, Ecuador
- Health Research Group USFQ, Universidad San Francisco de Quito USFQ, Quito, Ecuador
| | - A C Falconi Paez
- Escuela de Medicina, Universidad San Francisco de Quito USFQ, Quito, Ecuador
| | - M C Fierro Valle
- Escuela de Medicina, Universidad San Francisco de Quito USFQ, Quito, Ecuador
| | | | | | - D C Guevara Baez
- Escuela de Medicina, Universidad San Francisco de Quito USFQ, Quito, Ecuador
| | - B D Jara Santamaria
- Escuela de Medicina, Universidad San Francisco de Quito USFQ, Quito, Ecuador
| | - J A Lopez Diaz
- Escuela de Medicina, Universidad San Francisco de Quito USFQ, Quito, Ecuador
| | - J C Mejia Viana
- Escuela de Medicina, Universidad San Francisco de Quito USFQ, Quito, Ecuador
| | - G F Moya Quitto
- Escuela de Medicina, Universidad San Francisco de Quito USFQ, Quito, Ecuador
| | - P M Muenala
- Escuela de Medicina, Universidad San Francisco de Quito USFQ, Quito, Ecuador
| | - T C Muenala
- Escuela de Medicina, Universidad San Francisco de Quito USFQ, Quito, Ecuador
| | - B I Nicolalde López
- Escuela de Medicina, Universidad San Francisco de Quito USFQ, Quito, Ecuador
| | - A D Oquendo Carrera
- Escuela de Medicina, Universidad San Francisco de Quito USFQ, Quito, Ecuador
| | - A L Ordoñez Paz
- Escuela de Medicina, Universidad San Francisco de Quito USFQ, Quito, Ecuador
| | - E F Ortiz Duque
- Escuela de Medicina, Universidad San Francisco de Quito USFQ, Quito, Ecuador
| | - M C Palacios Granda
- Escuela de Medicina, Universidad San Francisco de Quito USFQ, Quito, Ecuador
| | - N S Pantoja Borja
- Escuela de Medicina, Universidad San Francisco de Quito USFQ, Quito, Ecuador
| | - S E Puga Martinez
- Escuela de Medicina, Universidad San Francisco de Quito USFQ, Quito, Ecuador
| | - C J Rueda Ordoñez
- Escuela de Medicina, Universidad San Francisco de Quito USFQ, Quito, Ecuador
| | - L P Soto Gutierrez
- Escuela de Medicina, Universidad San Francisco de Quito USFQ, Quito, Ecuador
| | - G E Tixi Tapia
- Escuela de Medicina, Universidad San Francisco de Quito USFQ, Quito, Ecuador
| | - M B Torres Moscoso
- Escuela de Medicina, Universidad San Francisco de Quito USFQ, Quito, Ecuador
| | - M A Vaca Porras
- Escuela de Medicina, Universidad San Francisco de Quito USFQ, Quito, Ecuador
| | - M I Viteri Suárez
- Escuela de Medicina, Universidad San Francisco de Quito USFQ, Quito, Ecuador
| | - J R Guillemot
- Escuela de Medicina, Universidad San Francisco de Quito USFQ, Quito, Ecuador
- Health Research Group USFQ, Universidad San Francisco de Quito USFQ, Quito, Ecuador
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Iglin VA, Sokolovskaya OA, Morozova SM, Kuchur OA, Nikonorova VG, Sharsheeva A, Chrishtop VV, Vinogradov AV. Effect of Sol-Gel Alumina Biocomposite on the Viability and Morphology of Dermal Human Fibroblast Cells. ACS Biomater Sci Eng 2020; 6:4397-4400. [PMID: 33455174 DOI: 10.1021/acsbiomaterials.0c00721] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
This paper is the continuation of our previous work on the ability of biocomposites based on sol-gel alumina (boehmite) to promote skin recovery from burns and atrophic scars. The present study describes the increasing of the cytoplasma volume and the number of filopodias of HDF cells, which for the first time indicates their proliferation on the alumina itself and on alumina-based biocomposite. Studies in vivo confirm the efficiency of the composite in the treatment of atrophic scars.
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Affiliation(s)
- V A Iglin
- SCAMT Institute, ITMO University, 9, Lomonosova Street, Saint Petersburg 191002, Russian Federation
| | - O A Sokolovskaya
- SCAMT Institute, ITMO University, 9, Lomonosova Street, Saint Petersburg 191002, Russian Federation
| | - S M Morozova
- SCAMT Institute, ITMO University, 9, Lomonosova Street, Saint Petersburg 191002, Russian Federation
| | - O A Kuchur
- SCAMT Institute, ITMO University, 9, Lomonosova Street, Saint Petersburg 191002, Russian Federation
| | - V G Nikonorova
- Ivanovo State Medical Academy, 8, Sheremet'evsky Prospect, Ivanovo 153012, Russian Federation.,Ivanovo State Agricultural Academy named after D.K. Belyaev, 45, Sovietskaya Street, Ivanovo 153012, Russian Federation
| | - A Sharsheeva
- SCAMT Institute, ITMO University, 9, Lomonosova Street, Saint Petersburg 191002, Russian Federation
| | - V V Chrishtop
- SCAMT Institute, ITMO University, 9, Lomonosova Street, Saint Petersburg 191002, Russian Federation
| | - A V Vinogradov
- SCAMT Institute, ITMO University, 9, Lomonosova Street, Saint Petersburg 191002, Russian Federation
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20
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Estrella Porter J, Camacho M, Viteri MI, Aguilar K, Belhadi D, Bettoli V, Buestán ADR, Dréno B, Endara P, Layton A, Machado N, Mateus R, Tan J, Terán E, Yépez P, Guillemot J. Pilot study for the evaluation and adaptation of a Four Item-Acne-Scar Risk Assessment Tool (4-ASRAT): a resource to estimate the risk of acne-induced scars. F1000Res 2020; 9:651. [PMID: 32850122 PMCID: PMC7431969 DOI: 10.12688/f1000research.23737.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/11/2020] [Indexed: 11/20/2022] Open
Abstract
Background: Acne-induced scarring is associated with a similar burden as acne, i.e. diminished quality of life, and may be avoided if patients receive appropriate and timely acne treatment. In 2017, a four item-Acne-Scar Risk Assessment Tool (4-ASRAT) was designed by Tan
et al. to categorise patients with acne into lower-risk or higher-risk for acne scarring. Its applicability outside the initial study population (France, Brazil and United States) remains to be determined. Methods: A study protocol was developed to create a systematic approach for validating and adapting 4-ASRAT to different populations, Ecuador in this case. The protocol was reviewed by 11 local and international dermatologists and pilot-tested in an Ecuadorian population using a sample of 10 participants who currently had or had had acne. Feedback from the pilot study was used to improve the study protocol. The results of the pilot study are included here, and the final study protocol is available as extended data. Results: The protocol proved to be applicable. Images taken of participants were a valuable resource for dermatological evaluation about the presence or absence of acne scars. Tangential light is necessary for this evaluation. Although dermatological assessments varied, we concluded that assessment by three local dermatologists for each participant was adequate for reaching a consensus on the presence or absence of acne scars. Conclusions: Considering the morbidity related to acne and acne scars, tools designed as prevention that alert patients about risk of developing scarring are necessary. The proposed protocol shows a feasible way of validating and adapting 4-ASRAT to different populations.
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Affiliation(s)
- Jorge Estrella Porter
- Escuela de Medicina, Universidad San Francisco de Quito USFQ, Quito, Pichincha, 170901, Ecuador.,Health Research Group, Universidad San Francisco de Quito USFQ, Quito, Pichincha, 170901, Ecuador
| | - Mikaela Camacho
- Escuela de Medicina, Universidad San Francisco de Quito USFQ, Quito, Pichincha, 170901, Ecuador.,Health Research Group, Universidad San Francisco de Quito USFQ, Quito, Pichincha, 170901, Ecuador
| | - María Isabel Viteri
- Escuela de Medicina, Universidad San Francisco de Quito USFQ, Quito, Pichincha, 170901, Ecuador.,Health Research Group, Universidad San Francisco de Quito USFQ, Quito, Pichincha, 170901, Ecuador
| | - Katherine Aguilar
- SISTEMAS MÉDICOS SIME, Universidad San Francisco de Quito USFQ, Quito, Pichincha, 170157, Ecuador
| | - Drifa Belhadi
- Hôpitaux Universitaires Paris Nord Val de Seine (Bichât Claude Bernard), Paris, 75018, France
| | - Vincenzo Bettoli
- Azienda Ospedaliero-Universitaria di Ferrara, Ferrara, 44122, Italy
| | - Anita Del Rocío Buestán
- SISTEMAS MÉDICOS SIME, Universidad San Francisco de Quito USFQ, Quito, Pichincha, 170157, Ecuador
| | - Brigitte Dréno
- Centre Hospitalier Universitaire de Nantes, Nantes, 44000, France
| | - Pablo Endara
- Escuela de Medicina, Universidad San Francisco de Quito USFQ, Quito, Pichincha, 170901, Ecuador
| | - Alison Layton
- Harrogate and District NHS Foundation Trust, Harrogate, HG2 7SX, UK
| | - Nelly Machado
- SISTEMAS MÉDICOS SIME, Universidad San Francisco de Quito USFQ, Quito, Pichincha, 170157, Ecuador
| | - Rosa Mateus
- SISTEMAS MÉDICOS SIME, Universidad San Francisco de Quito USFQ, Quito, Pichincha, 170157, Ecuador
| | - Jerry Tan
- University of Western Ontario, London, N6A 5B9, Canada
| | - Enrique Terán
- Escuela de Medicina, Universidad San Francisco de Quito USFQ, Quito, Pichincha, 170901, Ecuador
| | - Paola Yépez
- Escuela de Medicina, Universidad San Francisco de Quito USFQ, Quito, Pichincha, 170901, Ecuador.,Health Research Group, Universidad San Francisco de Quito USFQ, Quito, Pichincha, 170901, Ecuador
| | - Jonathan Guillemot
- Escuela de Medicina, Universidad San Francisco de Quito USFQ, Quito, Pichincha, 170901, Ecuador.,Health Research Group, Universidad San Francisco de Quito USFQ, Quito, Pichincha, 170901, Ecuador.,SISTEMAS MÉDICOS SIME, Universidad San Francisco de Quito USFQ, Quito, Pichincha, 170157, Ecuador
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Thiboutot D, Layton A, Chren M, Eady E, Tan J. Assessing effectiveness in acne clinical trials: steps towards a core outcome measure set. Br J Dermatol 2019; 181:700-706. [DOI: 10.1111/bjd.18011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/07/2019] [Indexed: 01/09/2023]
Affiliation(s)
- D.M. Thiboutot
- Department of Dermatology The Pennsylvania State University 500 University Drive Hershey PA 17033 U.S.A
| | - A.M. Layton
- Department of Dermatology Harrogate and District NHS Foundation Trust Harrogate U.K
| | - M.‐M. Chren
- Department of Dermatology Vanderbilt University Nashville TN U.S.A
| | - E.A. Eady
- Department of Dermatology Harrogate and District NHS Foundation Trust Harrogate U.K
| | - J. Tan
- Schulich School of Medicine and Dentistry Western University Windsor ON Canada
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22
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Practical management of acne for clinicians: An international consensus from the Global Alliance to Improve Outcomes in Acne. J Am Acad Dermatol 2017; 78:S1-S23.e1. [PMID: 29127053 DOI: 10.1016/j.jaad.2017.09.078] [Citation(s) in RCA: 135] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 09/19/2017] [Accepted: 09/20/2017] [Indexed: 02/06/2023]
Abstract
Scientific advances are continually improving the knowledge of acne and contributing to the refinement of treatment options; it is important for clinicians to regularly update their practice patterns to reflect current standards. The Global Alliance to Improve Outcomes in Acne is an international group of dermatologists with an interest in acne research and education that has been meeting regularly since 2001. As a group, we have continuously evaluated the literature on acne. This supplement focuses on providing relevant clinical guidance to health care practitioners managing patients with acne, with an emphasis on areas where the evidence base may be sparse or need interpretation for daily practice.
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