The prevalence of acne in the north of Portugal

BACKGROUND: Acne is a disease that affects almost all teenagers (60-90%), and it is the pathology exhibiting the highest morbidity in the 10-24 year-olds age group. There are no consistent data at national level by which we can evaluate the preponderance of this pathology in the Portuguese population. OBJECTIVE: To estimate the prevalence of acne in teenage school students (10-12 year-olds). STUDY DESIGN: A study was carried out involving all 8 regions in the north of Portugal. One school per region was selected at random. RESULTS: As expected, the figure we obtained for the prevalence of this pathology was high (82.4%) with males being the most affected. Nevertheless, only 44% of the affected treated their acne, although the face is the part of the body most affected. In the females high androgenization (which is manifested by the presence of hair on the upper lip and on the side of the face) doubles the median of the degree of acne registered. Regional asymmetry was found in relation to information about the disorder. The degrees of acne are higher in schools in the interior. In the more rural areas, the pharmacist still plays an important role in prescribing treatment. CONCLUSION: As a rule, individuals are correctly informed about acne, confirming that the search for treatment and awareness of its value are generally helping to gradually eliminate some of the stigmas from the past.     

The prevalence of acne among a group of Portuguese medical students

Background Worldwide, very few studies have been published on the prevalence of acne among university students. Objective The main objective of this study was to estimate the prevalence of acne among Portuguese medical students. We also assessed associated factors and opinions. Methods Participants were recruited among 145 fifth year medical students. They were asked to complete a questionnaire, and were observed to grade their acne. Acne grading was done using Pillsbury criteria. Results Ninety‐eight students were assessed and returned the self‐completed questionnaire, 67 (68%) were female students and 31 (32%) male students. The observed prevalence of acne was 61 students (62.2%); 42 (69%) and 18 (30%) had acne grades I and II, respectively; only one was classified as grade III. The prevalence of acne was not significantly associated with gender (P = 0.72), family history of acne (P = 0.65), greasy hair (P = 0.18), smoking habits (P = 0.25) or self‐perceived presence of acne (P = 0.48). Regularity of menstrual cycles was not associated (P = 0.73) with the presence of acne among the 67 women. The majority thought that acne strongly affects self‐image and, to a much lesser extent, personal relationships, academic performance or recruitment to a job. Conclusion The prevalence of acne in this study was higher than that observed in previous studies among medical students and other non‐university young adults. Opinions about the causes of acne (with hormones in top of the list) were similar to previous studies. Our study sample perceived more serious consequences for self‐image than university students elsewhere and younger Portuguese school children.     

The physical basis of cosmetic defects of the nail plate

Cosmetic defects of the nail cover a range of changes. Some are variants of normal which are considered unattractive, others are part of the normal ageing process and some changes are manifestations of local or systemic disease. Interpretation of these changes relies on recognition of the specific characteristics in question and an understanding of the anatomy and biology of nails. In many instances, therapies are limited and explanation of the changes represents one of the most useful contributions the professional can make to the affected individual. This article covers some of the most common cosmetic defects of nail involving colour, surface, brittleness and behaviour of surrounding tissues. Understanding of the physical basis of these defects is limited in many cases, but current thinking is recorded.     

The facial mask as a basis of clindamycin therapy for acne vulgaris]

In 29 healthy male subjects aged between 20 to 25 years a powder face mask, consisting of 1.19% clindamycin phosphate (= 1% clindamycin base) in 70% ethanol was applied to the right side of the forehead once daily over a period of 5 days. At the same time half of the test subjects were treated in the same way on the left side of the forehead with a solution consisting of 1.19% clindamycin phosphate in 70% ethanol, and the other half with the same powder mask as on the right side but without clindamycin phosphate. The face mask containing clindamycin phosphate leads to a greater reduction of P. acnes. the total propionibacteria and the total bacterial counts (anaerobic culture) in the pilosebaceous duct than both other preparations. Compared with the initial values these do, however, reduce the bacterial count. The use of face masks containing antibiotics seems to offer a successful way of topical antibiotic treatment of acne.     

广州市天河区青少年痤疮患病情况及危险因素分析

目的:评估青少年痤疮患病情况及其危险因素。方法:采用横断面问卷调查方法,随机整群抽取2552人12~20岁的青少年,进行问卷调查。结果:总患病率为32.8%,其中男34.2%,女31.6%,两性间患病率差异无统计学意义(P=0.161);11~16岁为青少年痤疮初发高峰期。结论:广州市天河区青少年痤疮初发年龄为11~16岁,危险因素有消化道功能紊乱、生活环境、生活习惯、遗传、内分泌等。     

The effect of the menstrual cycle on acne

Acne is a common disease with an underlying hormonal basis; however, there has never been a study to determine the ways in which the different stages of the menstrual cycle affect acne in women. Four hundred female participants, aged 12 to 52 years, were questioned whether their acne got worse before, during, or after their menstrual period and also asked whether it was unrelated to the menstrual period. Their age, severity of acne, ethnicity, and oral contraceptive use were also recorded. Overall 177 of 400 (44%) of those interviewed experienced premenstrual flares of their acne. Severity of acne, ethnicity, and oral contraceptive use did not affect the premenstrual flare rate. Women older than 33 years had a higher rate of premenstrual flares relative to women aged 20 to 33 years (P =.03 by chi(2) analysis). We concluded that almost half of all women experience premenstrual flares of their acne. Premenstrual flares may be more common in older women.     

The influence of exposome on acne

Background

Acne vulgaris is one of the main reasons for dermatological consultations. Severity and response to treatment may be impacted by various external factors or exposome.

Aim

To assess the impact of environmental factors on acne and to provide a comprehensive overview of the acne exposome.

Methods

Two consensus meetings of five European dermatologists and a comprehensive literature search on exposome factors triggering acne served as a basis for this review.

Results

Acne exposome was defined as the sum of all environmental factors influencing the occurrence, duration and severity of acne. Exposome factors impact on the response and the frequency of relapse to treatments by interacting with the skin barrier, sebaceous gland, innate immunity and cutaneous microbiota. They may be classified into the following six main categories: nutrition, psychological and lifestyle factors, occupational factors including cosmetics, as well as pollutants, medication and climatic factors. Moreover, practical considerations for the dermatologist's clinical practice are proposed.

Conclusion

Exposome factors including nutrition, medication, occupational factors, pollutants, climatic factors, and psychosocial and lifestyle factors may impact on the course and severity of acne and on treatment efficacy. Identifying and reducing the impact of exposome is important for an adequate acne disease management.     

The role of inflammation in the pathogenesis of acne and acne scarring

Evidence now supports a pivotal role for cellular inflammatory events at all stages of acne lesion development, from preclinical initiation to clinical presentation of active lesions through to resolution. The emphasis has moved from acne as a primarily hyperproliferative disorder of the sebaceous follicle to that of an inflammatory skin disorder. However, although the sequence of events leading to lesion formation has become clearer, the triggers for initiation remain speculative. The development of noninvasive techniques to detect preclinical "acne-prone" follicles is essential before triggers for initiation can be defined. Finally, the differences highlighted in the inflammatory profiles of inflamed lesions from patients who scar, as compared with other nonscarring acne patients reinforces the view that acne is a disorder, which embraces a number of pathologies.     

Perceptions of acne vulgaris in final year medical student written examination answers

Misconceptions exist in the community regarding factors that exacerbate acne vulgaris. In particular stress, diet, lifestyle and personal hygiene are often erroneously claimed to be important factors. In order to investigate whether these common misconceptions persist in medical graduates, we analysed the answers of 215 sixth year medical students, who all subsequently graduated from The University of Melbourne, to a short-answer question on acne management and exacerbating factors in one of their final year examination papers. With respect to exacerbating factors, 67% of students identified stress, 10% identified lifestyle factors (smoking and alcohol consumption), and 25% claimed poor facial hygiene exacerbated acne. Diet was stated to be an important factor by 41% of students, of whom 12% specifically mentioned chocolate. Persistence of these misconceptions among medical graduates is likely to perpetuate misinformation in the community.     

寻常痤疮严重程度和痤疮瘢痕相关因素分析

目的：了解门诊痤疮患者严重程度的相关因素及导致出现痤疮瘢痕的危险因素。方法：对2331例门诊痤疮患者进行问卷调查。结果：14～19岁、居住在农村、初中文化程度、油性皮肤、伴发脂溢性皮炎、每天睡眠时间少于8h的患者痤疮病情更严重。男性、有瘢痕家族史、痤疮程度严重的患者出现痤疮瘢痕的概率比较大。结论：对于具备重度痤疮高危因素的患者，应及早干预，给予积极的治疗。由于重度痤疮出现瘢痕的概率更高，因此早期、及时的治疗对于避免出现瘢痕也有一定帮助。     

The acne questionnaire

ABSTRACT: A printed questionnaire can be used to help uncover the reason(s) for acne flares or failures in response. This method not only enhances office efficiency but is surprisingly thorough and well accepted by patients. A sample form is presented and its proper use is discussed in the text.     

An update on the presence of psychiatric comorbidities in acne patients, part 1: overview of prevalence

Acne vulgaris (AV) is a chronic inflammatory skin disease that affects millions of people. Psychologic disorders such as depression, anxiety, and body dysmorphic disorder (BDD) are common in patients with AV This article in a 2-part series provides a review of the rates of general psychologic comorbidity, depression, anxiety, and BDD.     

The effect of azelaic acid on acne

A patient with urticaria caused specifically by alcohol is described. The reaction could be blocked by indomethacin and naloxone, indicating that the eruption was mediated by endogenous opiates and prostaglandins. Sodium cromoglycate blocked the reaction completely and consistently.