Minocycline and Its Impact on Microbial Dysbiosis in the Skin and Gastrointestinal Tract of Acne Patients

BackgroundAssociations between acne and gastrointestinal comorbidities suggest that microbial dysbiosis and intestinal permeability may promote inflammatory acne, a condition often managed with oral antibiotics.ObjectiveWe performed a case-control study to investigate the skin and gut microbiota in 8 acne patients before and after receiving oral minocycline compared to controls matched by age ±5 years, sex, and race.MethodsDNA was extracted from stool samples and facial skin swabs. Sequencing of the V3V4 region of the bacterial 16S rRNA gene was performed using Illumina MiSeq and analyzed using QIIME/MetaStats 2.0 software.ResultsAcne patients included 7 female and 1 male, ages 20~32. Shannon diversity was not significantly different between the skin (p=0.153) or gut (p<0.999) microbiota of acne patients before and after antibiotics. The gut microbiota in pre-antibiotic acne patients compared to acne-free controls was depleted in probiotics Lactobacillus iners (p=0.001), Lactobacillus zeae (p=0.001), and Bifidobacterium animalis (p=0.026). After antibiotics, the gut microbiota of acne patients was depleted in Lactobacillus salivarius (p=0.001), Bifidobacterium adolescentis (p=0.002), Bifidobacterium pseudolongum (p=0.010), and Bifidobacterium breve (p=0.042), while the skin microbiota was enriched in probiotics Bifidobacterium longum (p=0.028) and Leuconostoc mesenteroides (p=0.029) and depleted in Staphylococcus epidermidis (p=0.009) and Prevotella nigrescens (p=0.028). At the phylum level, significant enrichment of Bacteroidetes in stool of acne patients following antibiotic treatment (p=0.033) led to a decreased Firmicutes to Bacteroidetes ratio.ConclusionMinocycline produces significant derangements in the microbiota of the skin and gut, including many probiotic species, highlighting the potential for more targeted antimicrobial treatments for acne.     

Cardiff Acne Disability Index in Sarawak, Malaysia

Background

Acne is considered a cosmetic nuisance in Malaysia since no insurance coverage is provided for its treatment. Its psychological impact is unknown.

Objective

The aim of this study is to determine the impact of acne on quality of life and its relationship with severity.

Methods

A cross-sectional study using the Cardiff acne disability index (CADI) and Global Acne Grading System for acne severity grading was done in three government-run dermatology clinics in Sarawak, Malaysia.

Results

The study cohort of 200 patients had a mean CADI score of 5.1. Most of the patients (59.5%) had mild CADI impairment, with the domain of feelings most affected. Patients with a family income <1,000 United States Dollor/month had a higher mean CADI (mean 5.5 vs. 4.4; p=0.04). Females, indigenous groups, and patients with tertiary education tended to have more severe CADI impairment (p>0.05). The correlation between CADI and mild acne severity was low (Pearson correlation coefficient=0.35; p<0.001) but became insignificant for moderate and severe acne.

Conclusion

Acne impairment in Sarawak was moderate and must be addressed. It should be viewed as a psychologically disabling disease requiring optimal management and resource allocation.     

光、激光及射频技术治疗寻常痤疮

痤疮是一种十分常见﹑累及皮脂腺、毛囊的多因素疾病。痤疮治疗中,光疗法具有起效快、疗程短、不良反应少等优点,但这些尚不能完全代替常规的传统治疗,对于那些不愿接受传统治疗、治疗无效或不能耐受的患者,光、激光和射频是其理想选择。     

女性更年期痤疮患者的临床特征及睾酮和雌二醇水平的检测

目的 探讨女性更年期痤疮患者血清性激素水平的变化,临床特征及治疗方法。方法 对66例患者的临床特征及治疗进行了观察;测定其中35例患者的血清睾酮和雌二醇水平。结果 患者睾酮、雌二醇与正常人对照组相比较差异无显著性,但睾酮/雌二醇显著高于正常人对照组(P<0.05)。63.6%的患者在更年期发病。皮损以上唇及颏部最多,其次为颊部、额部,多呈散在分布,以粉刺及炎性丘疹或丘脓疱疹为主,少数有炎性结节。多为轻至中度痤疮。78.8%的患者一般治疗即可治愈,其余患者用性激素治愈。结论 更年期因卵巢功能衰退,雌激素分泌减少,雌雄激素比例失衡,肾上腺源性雄激素相对过甚而导致痤疮。更年期痤疮多为轻至中度,皮损以粉刺、炎性丘疹或丘脓疱疹为主,以上唇及颏部最多。绝大多数患者一般治疗即可治愈。     

Personality Traits and Common Psychiatric Conditions in Adult Patients with Acne Vulgaris

Background

We believe that instances of neuroticism and common psychiatric disorders are higher in adults with acne vulgaris than the normal population.

Objective

Instances of acne in adults have been increasing in frequency in recent years. The aim of this study was to investigate personality traits and common psychiatric conditions in patients with adult acne vulgaris.

Methods

Patients who visited the dermatology outpatient clinic at Bozok University Medical School with a complaint of acne and who volunteered for this study were included. The Symptom Checklist 90-Revised (SCL 90-R) Global Symptom Index (GSI), somatization, depression, and anxiety subscales and the Eysenck Personality Questionnaire-Revised Short Form (EPQ-RSF) were administered to 40 patients who fulfilled the inclusion criteria before treatment. The results were compared with those of a control group.

Results

Of the 40 patients included in this study, 34 were female and 6 were male. The GSI and the somatization, depression, and anxiety subscales of the SCL 90-R were evaluated. Patients with adult acne had statistically significant higher scores than the control group on all of these subscales. In addition, patients with adult acne had statistically significantly higher scores on the neuroticism subscale of the EPQ-RSF.

Conclusion

Our results show that common psychiatric conditions are frequent in adult patients with acne. More importantly, neurotic personality characteristics are observed more frequently in these patients. These findings suggest that acne in adults is a disorder that has both medical and psychosomatic characteristics and requires a multi-disciplinary approach.     

An Open-Label, Split-Face Trial Evaluating Efficacy and Safty of Photopneumatic Therapy for the Treatment of Acne

Background

Acne vulgaris is the most common skin disease worldwide, with many available treatment modalities, including oral and topical medications and laser therapy. Recently, a novel device (Isolaz, Pleasanton, CA, USA) that combines vacuum pressure and a broadband light source (400 nm to 1,200 nm) was developed for the treatment of acne.

Objective

To determine the clinical efficacy and safety of photopneumatic therapy for the treatment of acne vulgaris of the face.

Methods

Twenty adults with mild to moderate facial acne vulgaris received 4 successive treatments on one side of the face with a combined photopneumatic device (intense pulsed light: fluence=5.8 J/cm²; negative pressure=iMP mode) at 2 week intervals. Acne lesions on the opposite side of the face were not treated. Lesion counts were performed at baseline, prior to each treatment session, and at 3 months after the final treatment session.

Results

Significant lesion improvements and reduced numbers of acne lesions were observed on the treated side of the faces. Most patients experienced global clinical improvement. No severe side effects occurred during the study, with only a few patients experiencing transient erythema, purpura and/or exacerbation of pre-existing acne.

Conclusion

Photopneumatic therapy is a safe and effective treatment for mild to moderate acne vulgaris.     

脉冲染料激光联合美满霉素、阿达帕林凝胶治疗重度痤疮临床疗效观察

目的探讨585nm闪光灯泵脉冲染料激光联合美满霉素?阿达帕林凝胶治疗重度痤疮的疗效及安全性。方法将56例重度痤疮患者随机分为治疗组和对照组各28例,治疗组采用585nm闪光灯泵脉冲染料激光联合美满霉素000、阿达帕林凝胶治疗,对照组仅采用585nm闪光灯泵脉冲染料激光治疗。染料激光光斑为7mm,治疗能量密度为5～7J/cm2,治疗次数1～8次。结果治疗组有效率为89.29%,对照组为57.14%,两组有效率差异有显著性(P<0.05)。结论 585nm闪光灯泵脉冲染料激光联合美满霉素?阿达帕林凝胶治疗重度痤疮安全有效。     

寻常痤疮患者血清P物质的检测分析

目的 探讨P物质（SP）在寻常痤疮发病机制中的作用.方法 对50例寻常痤疮患者及35例正常人血清中的SP浓度进行检测分析.结果 寻常痤疮患者组血清P物质浓度高于健康对照组,差异有统计学意义（P＜0.05）.其中Ⅰ级痤疮患者组与对照组血清P物质浓度比较差异无统计学意义（P＞0.05）,Ⅱ级痤疮患者组与对照组血清P物质浓度比较差异有统计学意义（P＜0.05）,Ⅲ级及Ⅳ级痤疮患者组与对照组血清P物质浓度比较差异有统计学意义（P＜0.01）.组间比较：Ⅱ级、Ⅲ级及Ⅳ级痤疮患者组分别与Ⅰ级痤疮患者组血清P物质浓度比较差异有统计学意义（P＜0.05）.Ⅱ级、Ⅲ级及Ⅳ级痤疮患者组血清P物质浓度组间两两比较差异无统计学意义（P＞0.05）.结论 SP可能在寻常痤疮发病中起重要作用,且与寻常痤疮的病情轻重程度密切相关.     

维胺酯治疗痤疮的疗效观察及实验研究

目的观察维胺酯治疗痤疮的临床疗效,并从分子水平上探讨维胺酯对雄激素受体的影响。方法将痤疮患者分为观察组及对照组,观察组口服维胺酯4周,采用Samuelson九度分级法评定疗效;同时,体外培养角质形成细胞并用维胺酯处理,后用Northern杂交及Western杂交分别检测处理前后的该细胞雄激素受体的mRNA及蛋白质的表达水平。结果观察组的总有效率为74.55%,显效率为44.55%,对照组总有效率为35.19%,显效率为23.15%,经卡方检验,两组总有效率及显效率差异均有显著性(P<0.0001);同时,体外培养的角质形成细胞用维胺酯处理后,其雄激素受体的mRNA的表达水平随维胺酯处理浓度的增加而呈逐渐下降趋势,其雄激素受体的蛋白质表达水平亦随维胺酯处理浓度的增加而呈逐渐下降趋势。结论维胺酯不但临床上治疗痤疮疗效显著,而且实验结果提示其疗效与其下调角质形成细胞的雄激素受体有关。     

红蓝光治疗仪治疗痤疮疗效观察

目的探讨欧美娜(0mnilux)蓝光、红光治疗仪治疗痤疮的疗效。方法将入选的738例痤疮患者随机分为两组,治疗组506例,清洁面部后(黑头粉刺明显者用粉刺挤压器清理面部粉刺后)用红、蓝光交替照射,距离为蓝光1.0～4.0cm,红光约10.0cm,每次20min,2次/w,8次为1个疗程;Ⅲ、Ⅳ度患者以红光治疗为主,非光疗日外搽克林霉素凝胶、维胺酯维E乳膏等,炎症较重者于口服阿奇霉素,皮脂分泌旺盛者口服螺内酯或西米替丁等。对照组仅予药物治疗,同治疗组。两组均治疗4周后判定疗效。结果治疗组有效率为65.61%,对照组为54.35%,两组比较差异有统计学意义(P<0.01)。但治疗组有120例不能忍受红光刺激,有2例退出治疗。结论欧美娜红蓝光治疗仪治疗痤疮疗效肯定,但副作用较大。     

女性痤疮与多囊卵巢综合征的相关性研究

目的 检测成年女性痤疮患者体内性激素水平的变化,探讨其与多囊卵巢综合征（PCOS）的相关性。方法 采用放射免疫分析法,对50例痤疮患者进行血清性激素水平测定和妇科经阴道超声检查。以30例正常成年女性为对照。结果 痤疮组睾酮、二氢睾酮、脱氢表雄酮及黄体生成素水平增高,与正常对照组比较差异有高度显著性（P＜0．001或P＜0．01）;雌二醇、卵泡刺激素、孕酮水平变化不明显（P均＞0．05）。50例中有28例患PCOS。对其中10例应用达英－35治疗,可降低血清雄激素水平。结论 高雄激素血症和PCOS与成年女性痤疮有关,且是其长期不愈的重要原因。达英－35对此类痤疮有较好疗效。     

Anxiety Sensitivity and Quality of Life in Patients with Acne

BackgroundAnxiety sensitivity (AS) is a continuous fundamental fear and defined as extreme fear of anxiety sensations and symptoms. High AS can cause tendency to anxiety disorders. There are many studies evaluating the anxiety in patients with acne; however, AS has not been investigated.ObjectiveWe aimed to investigate AS in patients with acne.MethodsTwo hundred and fourteen acne patients and 117 healthy control subjects, aged older than 16 years were enrolled in the study. Severity of acne was evaluated by Global Acne Grading System. The acne patients and healthy controls were asked to complete the anxiety sensitivity index-3 (ASI-3), the Beck anxiety inventory (BAI) and the Turkish version of acne quality of life index.ResultsAnxiety and AS levels in acne patients were significantly higher than healthy controls (p<0.001). Quality of life was impaired in acne patients. Quality of life was negatively correlated with anxiety and AS levels in acne patients (p=0.014, p=0.019, respectively). There was no correlation between quality of life and disease severity (p=0.556) and also there was no correlation between psychiatric scale scores (ASI-3, BAI) and disease severity (p=0.147, p=0.871, respectively).ConclusionTo our knowledge, our study is the first to report that AS is high in acne patients. Clinically, our results suggest that there might be a relationship between AS and acne. We conclude that further studies are needed in order to clarify the relationship between acne and AS and to investigate the efficacy of cognitive behavioral treatments in acne patients.