Acne Medications

J Am Acad Dermatol. 2009 May; 60(5 Suppl): S1-50Thiboutot D, Gollnick H, Bettoli V, Dréno B, Kang S, Leyden JJ, Shalita AR, Lozada VT, Berson D, Finlay A, Goh CL, Herane MI, Kaminsky A, Kubba R, Layton A, Miyachi Y, Perez M, Martin JP, Ramos-E-Silva M, See JA, Shear N, Wolf J, The Global Alliance to Improve Outcomes in Acne published recommendations for the management of acne as a supplement to the Journal of the American Academy of Dermatology in 2003. The recommendations incorporated evidence-based strategies when possible and the collective clinical experience of the group when evidence was lacking. This update reviews new information about acne pathophysiology and treatment-such as lasers and light therapy-and relevant topics where published data were sparse in 2003 but are now available including combination therapy, revision of acne scarring, and maintenance therapy. The update also includes a new way of looking at acne as a chronic disease, a discussion of the changing role of antibiotics in acne management as a result of concerns about microbial resistance, and factors that affect adherence to acne treatments. Summary statements and recommendations are provided throughout the update along with an indication of the level of evidence that currently supports each finding. As in the original supplement, the authors have based recommendations on published evidence as much as possible.

J Dermatol. 2009 Apr; 36(4): 213-23Akaza N, Akamatsu H, Kishi M, Mizutani H, Ishii I, Nakata S, Matsunaga KPropionibacterium acnes is one of the most significant pathogenic factors of acne vulgaris. This bacteria relates to acne by various pathways. It has also been reported that P. acnes influences pro-inflammatory cytokine production in keratinocytes in vitro. However, the influence on the differentiation of keratinocytes by P. acnes has not been studied extensively. We analyzed the expression of keratinocyte differentiation-specific markers, keratins, and pro-inflammatory cytokines in normal human epidermal keratinocytes (NHEK) exposed to P. acnes in vitro. All P. acnes strains used in this study increased transglutaminase (TGase), keratin 17 (K17) and interleukin (IL) mRNA expression levels in NHEK, and decreased K1 and K10 expression levels. Some P. acnes strains increased involucrin and K6 mRNA expression levels in NHEK and decreased filaggrin, K6 and K16 expression levels in vitro. This experiment clarified that P. acnes influences the differentiation of NHEK in vitro. As a result, P. acnes influenced the expression of not only pro-inflammatory cytokines but also some keratinocyte differentiation-specific markers and keratins in NHEK. Our results suggest that P. acnes relates to acne pathogenesis by not only the induction of inflammation but also in the differentiation of keratinocytes. Moreover, it was considered that the reaction of NHEK to P. acnes may be different depending on the type of bacteria.

J Nurs Res. 2009 Mar; 17(1): 20-29Chang YT, Chen YCABSTRACT:: The purposes of this study were to assess menstrual attitudes and menstrual distress and investigate factors associated with menstrual distress among postmenarcheal female elementary students. A total of 129 female students from 12 elementary schools in Taiwan's Hualien County participated in this study. A stratified cluster random sampling method was adopted. The questionnaire used consisted of three sections asking questions regarding the individual's menstrual characteristics, menstrual attitudes, and menstrual distress. Study results showed that most respondents experienced menstrual blood seepage during the daytime and awakened at night during their periods due to worries about menstrual blood seepage. This study found that indigenous students had significantly more frequent episodes of menstrual blood seepage during the daytime and awakened at night during period than did nonindigenous students. The mean score on the Menstrual Attitude Questionnaire was 1.88 (SD = 0.36, possible score = 1-4). The three most prevalent symptoms of menstrual distress were dysmenorrhea, acne, and fatigue. The mean score on the Menstrual Distress Questionnaire was 1.00 (SD = 0.76; possible score = 0-4). Moreover, there was a significantly negative correlation between menstrual attitudes and menstrual distress and significantly positive correlations between menstrual distress and (a) time since menarche, (b) menstrual blood seepage during the daytime, and (c) menstrual blood seepage while sleeping. Study results recommend that families and elementary schools help postmenarcheal female elementary students to accept menstruation as a natural process.

J Clin Endocrinol Metab. 2009 Apr 7; Kuijper EA, Vink JM, Lambalk CB, Boomsma DIIntroduction: Intra-uterine androgens of a male fetus may influence the female fetus in opposite sex-twin pairs. As female intra-uterine overexposure to androgens could lead to polycystic ovary syndrome, the prevalence of PCOS should be higher, in women from dizygotic opposite-sex twin pairs. Therefore, the aim of the current study was to evaluate the prevalence of polycystic ovary syndrome in women from opposite-sex twin pairs compared to women from same-sex twin pairs, sisters and female spouses of twins. Subjects and Methods: Data from 1325 monozygotic twins, 1191 dizygotic twins (711 women from same-sex twin pairs and 480 women from opposite-sex twin pairs), 745 sisters of twins and 218 spouses of male twins were evaluated. PCOS was defined as less than nine natural menstrual cycles a year combined with either hirsutism or acne. The prevalence of PCOS was compared using a chi-squared test. Binary logistic regression analyses were conducted to test for confounding effects of smoking, age and BMI. Results: No significant differences in PCOS prevalence were found between women from same sex twin pairs (either monozygotic or dizygotic), opposite-sex twin pairs, sisters and spouses. Conclusion: The prevalence of polycystic ovary syndrome is not different in women from opposite-sex and same-sex twin pairs, singleton sisters or spouses. This indicates that possible androgen exposure of the female fetus, caused by a shared intra-uterine environment with a male fetus, does not result in PCOS-like traits.