Acne Medications

Dermatol Surg. 2009 Apr 27; Kim S, Cho KHBACKGROUND Many methods have been proposed for the treatment of acne scars, with variable cosmetic results. Nonablative skin resurfacing is one method that has been proposed. Because of a need for more noticeable clinical improvements, the ablative fractional laser was recently introduced. OBJECTIVE To reduce complications and improve the results of ablative fractional laser resurfacing by combining this treatment of acne scars with nonablative lasers. METHODS A series of 20 patients (skin phototypes IV-V) with atrophic facial acne scars were randomly divided into two groups that received three successive monthly treatments with an ablative fractional laser using high (group A) and low (group B) energy on one facial half and an ablative fractional laser with low energy plus a nonablative resurfacing laser on the other facial half. Patients were evaluated using digital photography at each treatment visit and at 3 months postoperatively. Clinical assessment scores were determined at each treatment session and follow-up visit. RESULTS Although the use of the ablative fractional laser with high energy resulted in an improvement in patients' acne scars, the combination of ablative fractional laser resurfacing and nonablative laser resurfacing yielded the best results, as assessed in photographs as well as by the overall appearance of the acne scars. With the combination method, fewer complications were observed. The authors have indicated no significant interest with commercial supporters.

J Eur Acad Dermatol Venereol. 2009 Apr 24; Kalkan G, Karadag AS, Astarcı HM, Akbay G, Ustun H, Eksioglu MAbstract Background Papulopustular lesions (PPL) are commonly seen cutaneous lesions in Behçet's disease (BD). Some authorities do not recommend using cutaneous lesions for diagnostic criteria because these lesions are confused with acne vulgaris. Objective To understand if PPL have diagnostic value in BD. Methods Biopsy was performed on papulopustular lesions of Behçet's patients for histopathological examination to compare with the control group composed of patients with acne vulgaris. Forty two patients with BD and 21 control patients with acne vulgaris were enrolled in the study. Histopathological findings were classified as leukocytoclastic vasculitis, lymphocytic vasculitis, superficial and/or deep perivascular infiltration, and folliculitis and/or perifolliculitis. Results Of the specimens from 42 Behçet's disease patients, 7 (16.7%) revealed leukocytoclastic vasculitis and 3 (7.1%) had lymphocytic vasculitis, 15 (35.7%) had superficial perivascular and/or interstitial infiltration, 12 (28.6%) had superficial and deep perivascular and/or interstitial infiltration, 5 (11.9%) had folliculitis or perifolliculitis. Of the control group patients, 9 (42.9%) had folliculitis or perifolliculitis, 8 (38.1%) revealed superficial perivascular inflammation and 4 (19.0%) revealed mixed superficial and deep perivascular inflammation. Vasculitis was not encountered in any control group specimens. Vasculitis ratio was statistically higher in Behcet's disease patients (P = 0.016). Conclusions We evaluated more patients than previous related studies reported in the literature. Histopathological findings of vasculitis were encountered only in BD group. Non-vasculitis histopathological findings were also encountered in the control group patients. In conclusion, PPL can be used as a diagnostic criterion of BD subsequent to finding vasculitis in histopathological examination of the biopsy specimen of the PPL. Conflicts of interest None declared.

Arch Gynecol Obstet. 2009 May 22; Siddiqui IA, Tamimi W, Tamim H, Aleisa N, Adham MBACKGROUND: Polycystic ovary syndrome (PCOS) is an endocrine metabolic dysfunction closely associated with obesity, which predisposes to pregnancy complications. PCOS is a common endocrine disorder affecting 5-10% of the population. It is characterized by chronic anovulation and hyperandrogenism with clinical manifestations of oligomenorrhea, hirsutism and acne. Obese females are at higher risk for metabolic syndrome due to severe hyperandrogenemia, which also leads to high blood pressure. OBJECTIVES: To determine, among patients with PCOS, the correlation of body mass index (BMI) with (1) the clinical manifestations of PCOS and (2) blood pressure. METHOD: We performed a cross-sectional study of 62 women of reproductive age (29-43 years), who attended the Obstetrics and Gynecology Clinic at King Fahd National Guard Hospital in Riyadh, Kingdom of Saudi Arabia, with the confirmed diagnosis of PCOS. These patients were divided into two BMI groups: nonobese (BMI less than 25 kg/m(2)) and obese (BMI more than 25 kg/m(2)). Patients' waist to hip ratio, acne, hirsutism, and systolic and diastolic blood pressures were also recorded as clinical manifestations in PCOS and compared between the two BMI groups. RESULTS: The mean age of the patients was 35.85 +/- 5.03 years, BMI was 31.91 +/- 6.40 kg/m(2), waist-hip ratio was 0.82 +/- 0.067, Ferriman and Gallway's score for hirsutism was 3.63 +/- 4.35, systolic blood pressure was 113.02 +/- 16.10 mmHg, diastolic blood pressure was 71.79 +/- 10.04 mmHg, and acne was present in 24 cases (38.7%). When the groups were compared according to BMI, a significant increase in systolic and diastolic blood pressures (p = 0.001 and 0.003, respectively) was seen in obese patients, but there was no significant rise in the waist-hip ratio and hirsutism score. CONCLUSION: We observed a significant and progressive effect of BMI on clinical manifestations and blood pressure levels in patients with PCOS.

Braz J Med Biol Res. 2009 Jun; 42(6): 501-5Abulnaja KOAcne vulgaris is a multifactorial disease affecting a majority of the adolescent population. The objective of this study was to test for a correlation between fasting serum lipid profiles and levels of testosterone, insulin, leptin, and interleukin 1-beta (IL-1beta) and the incidence of severe acne vulgaris in obese adolescent females. Four groups of adolescent females were studied: obese with acne, obese without acne, non-obese with acne, and non-obese without acne. Obese females with acne, compared to obese females without acne and non-obese subjects, had significantly higher serum triglycerides, low-density lipoprotein cholesterol and apolipoprotein-B (apo-B) (mean +/- SD: 197 +/- 13.7 vs 171 +/- 11.5, 128 +/- 8.3 vs 116 +/- 7.7, 96 +/- 13.7 vs 85 +/- 10.3 mg/dL, respectively) but significantly lower high-density lipoprotein cholesterol and apo-A1 levels (40 +/- 3.3 vs 33 +/- 3.5 and 126 +/- 12 vs 147 +/- 13 mg/dL). Serum testosterone, insulin and leptin levels were significantly higher in obese subjects with or without acne compared to non-obese females with or without acne (3 +/- 0.5 vs 2.1 +/- 0.47, 15.5 +/- 3.3 vs 11.6 +/- 3, 0.9 +/- 0.2 vs 0.6 +/- 0.15 nmol/mL, respectively). Serum IL-1b was significantly elevated in obese and non-obese subjects with acne compared to subjects without acne; in those without acne, these levels were higher in obese than non-obese subjects (2.4 +/- 0.2, 1.4 +/- 0.1 vs 1.8 +/- 0.12 and 1.3 +/- 0.11 pg/mL, respectively). Our results indicate that there is a relationship between obesity (BMI >27) and acne. By early recognition, the etiology and treatment protocol of acne may prevent unwanted conditions.