The effect of oral isotretinoin on visual contrast sensitivity and amount of lacrimation in patients with acne vulgaris

Context: Acne vulgaris is a puberty-onset chronic inflammatory disease of the pilosebaceous unit. Isotretinoin is a derivative of vitamin A commonly used for severe and nodulocystic acne. While isotretinoin has many side effects related to the eye, visual system and lacrimation, there is no information regarding isotretinoin’s influence on contrast sensitivity.

Aim: To investigate the effect of isotretinoin on visual contrast sensitivity and the amount of lacrimation.

Materials and methods: The study included 25 patients (16 females and 9 males) who underwent isotretinoin treatment. The treatment duration ranged from 4 to 7 months. Patients were examined both before the start and at the end of treatment using the Schirmer test in each eye. The contrast sensitivity measurement was performed both individually for each eye and in a binocular fashion using the Pelli–Robson Sensitivity Chart.

Results: The results of the Schirmer test before treatment were 19.74?±?3.63?mm for the right eye and 19.66?±?3.63?mm for the left eye. Post-treatment measurement results were 17.24?±?3.5?mm for the right eye and 16.68?±?3.73?mm for the left eye. There was a statistically significant difference between the before and after treatment measurements (p?<?0.000). Before treatment, contrast sensitivity was 1.45?±?0.19 for the right eye and 1.42?±?0.2 for the left eye. The binocular measurement was 1.54?±?0.14. After treatment, the right eye was 1.47?±?0.19, the left eye was 1.46?±?0.18, and the binocular measurement was 1.54?±?0.18. There were no statistically significant differences between before and after treatment (p?>?0.05).

Discussion: There are contradicting reports on the results of the Schirmer test. The only similar study that has evaluated contrast sensitivity used the drug acitretin, the results of which are consistent with those the present study.

Conclusion: Our study is significant in that it is the first to investigate the effects of isotretinoin on visual contrast sensitivity that is closely associated with real-world performance. Our results need to be supported by future studies.     

Chemical pharmacotherapy options for managing adult acne

Introduction: The incidence of adult acne is increasing worldwide. Despite clinical overlap with conventional acne, it has distinct features.

Areas covered: A literature search of English-language review articles, randomized control studies and retrospective studies conducted over the past 30 years was performed using PubMed and Google Scholar. Search terms included acne, adult, topical medication, oral medication and skin of color. We highlight important clinical features and treatment modalities pertinent to the evaluation and management of adult acne. Given the relative dearth of literature detailing treatment options specific to adult acne, we offer expert opinion regarding management of the condition especially in special populations such as skin of color and pregnancy.

Expert Opinion: It is unclear whether adult acne represents a distinct entity or a continuum of adolescent disease. Providers may opt to use topical medication as first-line, but should have a low threshold for switching to systemic therapy given the magnitude of psychosocial and emotional burden associated with the condition.     

微创结合光动力治疗中重度痤疮的临床观察和护理

目的 观察微创结合光动力治疗中重度痤疮的临床效果.方法 收集来本院皮肤科门诊就诊的中重度痤疮患者60例,采用随机数字表法将其分为观察组与对照组,各30例.观察组采用微创结合光动力疗法进行治疗,对照组使用光动力疗法进行治疗,两组患者治疗前和治疗后痤疮皮损面积和严重程度指数评分、治疗后的临床疗效以及不良反应发生率进行比较.结果 治疗后两组患者的粉刺、丘疹、脓疱和结节、囊肿个数以及GAGS评分均低于治疗前,且治疗后观察组的粉刺、丘疹、脓疱和结节、囊肿个数以及GAGS评分均低于对照组,差异有统计学意义(P＜0.05);观察组总有效率为93.3％,对照组总有效率为63.3％,差异有统计学意义(P＜0.05);两组患者在红斑、肿胀疼痛、反应性痤疮、色素沉着和面部瘙痒方面的不良反应发生率比较,差异无统计学意义(P＞0.05),而对照组的脱屑反应发生率高于观察组,差异有统计学意义(P＜0.05).结论 微创结合光动力治疗中重度痤疮的疗法简单、安全、有效,推荐在临床上应用.     

中药消痤汤联合维A酸治疗寻常性痤疮疗效观察

目的:观察中药消痤汤内服联合0.025%维A酸外用治疗寻常性痤疮的临床疗效及安全性。方法:86例寻常性痤疮患者随机分为观察组和对照组各43例,观察组采用中药消痤汤煎服,1剂/d,对照组口服琥乙红霉素0.25 g,tid;两组均每晚1次用0.025%维A酸乳膏外涂,疗程6周。比较两组疗效与药品不良反应。结果:观察组和对照组愈显率分别为69.77%和41.86%,差异有统计学意义(P<0.01);总有效率分别为88.37%和69.77%,差异有统计学意义(P<0.05)。两组复发率分别为10.00%和22.22%,差异无统计学意义(P>0.05),两组均未发生严重不良反应。结论:中药消痤汤内服联合0.025%维A酸外用治疗寻常性痤疮有较好的临床疗效,安全性好。     

Male Testosterone Does Not Adapt to the Partner's Menstrual Cycle

Background

It has not yet been established whether men in heterosexual relationships adapt their hormone levels to their female partner's menstrual cycle to allocate reproductive resources to the period when the female is actually fertile.

异维A酸对肽聚糖诱导的SZ95人皮脂腺细胞相关炎症基因表达的影响

目的 观察异维A酸体外对肽聚糖诱导的SZ95人皮脂腺细胞中与痤疮发病可能相关的炎症基因表达的影响,探讨异维A酸治疗痤疮的分子机制。方法 将培养的SZ95细胞分成3组,对照组不做处理,另外两组用20 mg/L肽聚糖单独（肽聚糖组）或联合10-5 mol/L异维A酸（共刺激组）共同处理。作用3 h后,实时荧光定量PCR检测上述各组SZ95细胞中白细胞介素（IL）-1α、IL-1β、IL-6、IL-8、肿瘤坏死因子α（TNF-α）以及Toll样受体2（TLR2）和其下游基因MyD88 mRNA表达水平;作用24 h后酶联免疫吸附试验检测各组细胞培养上清液中IL-1α、IL-1β、IL-6、IL-8、 TNF-α蛋白表达水平;作用48 h后Western印迹检测TLR2和MyD88蛋白表达水平。采用SPSS 23软件, 3组间指标的比较采用单因素方差分析,并采用Bonferroni校正进行两两比较。结果 对照组、肽聚糖组和共刺激组IL-1α、IL-1β、IL-6、IL-8及TNF-α mRNA和蛋白表达水平差异均有统计学意义（均P < 0.01）;其中,肽聚糖组上述指标均高于对照组及共刺激组,差异均有统计学意义（均P < 0.016 7）。上述3组间MyD88 mRNA表达差异也均有统计学意义（分别为6.707 ± 0.950、10.270 ± 0.477、7.892 ± 0.900,F = 10.17,P < 0.01）,肽聚糖组高于对照组及共刺激组,差异均有统计学意义（t值分别为4.740、3.298,均P < 0.016 7）。肽聚糖组TLR2 mRNA和蛋白表达水平均高于对照组,但与共刺激组比较差异无统计学意义。结论 异维A酸抑制肽聚糖诱导的SZ95人皮脂腺细胞中与痤疮发病可能相关的炎症因子的表达,其机制可能是通过抑制天然免疫应答中MyD88的表达而非TLR2本身,这可能是异维A酸治疗痤疮的机制之一。     

基于面部不同埋线方法的综合针灸疗法治疗女性青春期后痤疮的疗效及其作用机制

背景　痤疮是青春期常见的毛囊皮脂腺的慢性炎症性疾病,青春期后女性患者较多,皮疹持续时间较长,严重影响患者容貌美观和身心健康。常规埋线对女性青春期后痤疮有较好疗效,而平滑线埋线是基于浅筋膜理论的一种埋线方法,目前临床尚无两种埋线方法的疗效比较研究。目的　探讨基于面部不同埋线方法的综合针灸疗法治疗女性青春期后痤疮的疗效及其作用机制。方法　选取2015年7月—2017年7月连云港市第一人民医院针灸科门诊收治的女性青春期后痤疮患者61例,分为平滑线组31例和常规埋线组30例。两组均接受综合针灸疗法,在此基础上平滑线组于2次体穴埋线后第2周予平滑线埋线;常规埋线组于2次体穴埋线后第2、8周予常规埋线。两组均干预8周（1个疗程）,12周后评定两组痤疮皮损疗效、痤疮皮损评分、伴随症状疗效、伴随症状评分及不良反应发生情况。结果　平滑线组痤疮皮损疗效、伴随症状疗效优于常规埋线组（P<0.05）。治疗前、后两组痤疮皮损、伴随症状评分比较,差异无统计学意义（P>0.05）。两组治疗后痤疮皮损、伴随症状评分均低于本组治疗前（P<0.05）。两组均未发生明显不良反应。结论　基于面部不同埋线方法的综合针灸疗法对女性青春期后痤疮皮损和伴随症状均有较好的临床疗效;面部埋线作用机制主要与经络、浅筋膜、卫气等理论密切相关;平滑线埋线较常规埋线患者痛苦小,且有较好的改善皱纹效果,因此平滑线埋线优于常规埋线,值得临床推广应用。     

南阳市大学生痤疮患病情况及影响因素研究

目的 了解南阳市大学生痤疮患病情况及影响因素,为痤疮的预防提供科学依据。方法 采用多级整群随机抽样方法,对南阳市大学生进行问卷调查,内容包括一般情况、痤疮患病情况及影响因素等。结果 痤疮总患病率为67.68%,其中男性患病率为66.90%,女性患病率为68.36%;单因素分析显示:痤疮与便秘[OR=2.901,95%CI(1.593,5.282)]、化妆品的使用[OR=1.676,95%CI(1.050,2.676)]、油性皮肤[OR=1.750,95%CI(1.311,2.335)]、阳性家族史[OR=1.502,95%CI(1.165,1.937)]、精神紧张[OR=2.362,95%CI(1.469,3.799)]、烟酒[OR=1.845,95%CI(1.321,2.575)]、喜食甜食[OR=1.346,95%CI(1.038,1.745)]或油腻食物[OR=1.389,95%CI(1.092,1.767)]有统计学意义(P≤0.05),logistic回归分析发现,便秘、油性皮肤、精神紧张、烟酒与痤疮有统计学意义。结论 痤疮是南阳市大学生的常见病,受多种因素影响,针对患病情况及影响因素,开展健康教育工作。     

Quality of life,self-esteem and psychosocial factors in adolescents with acne vulgaris

Background

Dermatological diseases, among which acne vulgaris, have psychological impact on the affected generating feelings of guilt, shame and social isolation.

Objectives

To compare quality of life, self-esteem and other psychosocial variables amongst adolescents with and without acne vulgaris, and between levels of severity.

Methods

Cross-sectional observational study in a sample of 355 high school students from the city of João Pessoa. Data collection was performed with questionnaires and clinical-dermatological evaluation. The primary variables were the incidence of AV; quality of life, set by the Children''s Dermatology Quality of Life Index and Dermatology Quality of Life Index; and self-esteem, measured by the Rosenberg Self-Esteem Scale. For calculation of statistical tests, we used the SPSS 20.0 software, considering p=0.05.

Results

The sample, with an average age of 16, showed 89.3% prevalence of acne vulgaris. The most prevalent psychosocial issue was "afraid that acne will never cease", present in 58% of affected youth. The median score of Quality of Life in Children''s Dermatology Index was different amongst students with and without acne vulgaris (p=0.003), as well as the Quality of Life in Dermatology (p=0.038) scores, so that students with acne vulgaris have worse QoL. There was a correlation between the severity of acne vulgaris and worse quality of life. Self-esteem was not significantly associated with the occurrence or severity of acne vulgaris.

Conclusions

acne vulgaris assumes significance in view of its high prevalence and the effect on quality of life of adolescents, more severe at the more pronounced stages of disease (p<0.001). The psychosocial impact of acne vulgaris should be valued in the management of patients with this condition.