Quality of medical care of patients with acne vulgaris in Germany - nationwide survey of pharmacy clients.
J Dtsch Dermatol Ges. 2009 Jul 1; Franzke N, Zimmer L, Schäfer I, Radermacher C, Kresken J, Augustin MBackground: No empirical "real world" data on the health care of patients with acne vulgaris in Germany currently exist. The objective of this study was to get an informative basis of health care of patients with acne vulgaris in Germany, taking into account both doctor-prescribed medication and self-medication. Patients and Methods: Surveying both medically and self-treated patients, n = 504 patients with acne vulgaris were interviewed in 48 pharmacies nationwide. In addition to socio-demographic data, the duration of illness, localization and therapy as well as patient-relevant outcomes such as patient benefit, psychological strain and markers of compliance were evaluated. The participation and significance of individual treatment providers were also evaluated. Results: A large percentage of the patients found acne vulgaris to be burdensome. Despite the longstanding necessity of treatment and the chronic course of the illness, the treatment of acne vulgaris was deemed a rather satisfactory experience by most of those affected. Dermatologists were most frequently consulted for treatment. A great number of medicinal products were further acquired through self-medication or after consulting with a pharmacist. The medically regulated therapies predominantly complied with the latest guidelines. Conclusions: Acne vulgaris is a burdensome, socio-economically relevant illness, and dermatologists treat most cases in Germany. Surveying across a network of pharmacies offers a unique access to relevant treatment data. Selection effects, particularly by choice of doctors and self-medication, were minimized.
Treatment of Punched-Out Atrophic and Rolling Acne Scars in Skin Phototypes III, IV, and V with Variable Square Pulse Erbium:Yttrium-Aluminum-Garnet Laser Resurfacing.
Dermatol Surg. 2009 Jun 22; Wanitphakdeedecha R, Manuskiatti W, Siriphukpong S, Chen TMBACKGROUND Treatment of acne scars remains a challenge, especially in dark-skinned individuals. Treatment parameters may be optimized by selecting appropriate pulse width and laser energy that enhance tissue thermal response with limited morbidity. OBJECTIVE To determine the efficacy and side effects of variable square pulse (VSP) erbium:yttrium-aluminum-garnet (Er:YAG) laser resurfacing for treatment of punched-out atrophic and rolling acne scars. METHODS Twenty-four subjects with acne scars were treated monthly for 2 months with four passes of VSP Er:YAG laser resurfacing using a 7-mm spot size and a fluence of 0.4 J/cm(2). Subjects were divided into two groups and treated with two different pulse widths: 300 mus (short pulse, SP) and 1,500 mus (extra-long pulse, XLP). Objective and subjective assessments were obtained at baseline and 1, 2, and 4 months after treatment. RESULTS In the SP group, skin smoothness improved significantly (p
SAPHO syndrome in an adult with ulcerative colitis responsive to intravenous pamidronate: a case report and review of the literature.
Rheumatol Int. 2009 Jun 24; Siau K, Laversuch CJSynovitis, acne, pustulosis, hyperostosis, osteitis (SAPHO) syndrome is a rare group of sterile, inflammatory osteoarticular disorders classically associated with skin lesions. It is occasionally associated with enteropathic disease such as ulcerative colitis. We present a 39-year-old patient with chronic ulcerative colitis who developed enteropathic SAPHO and responded well to pamidronate. We discuss the clinicopathological features with particular attention to bone pathology, and perform a literature review of this fascinating syndrome.
Acne's relationship with psychiatric and psychological morbidity: results of a school-based cohort study of adolescents.
J Eur Acad Dermatol Venereol. 2009 Jun 23; Magin P, Pond C, Smith W, Goode SAbstract Background There is a considerable number of studies linking acne with psychological and psychiatric morbidities, although this literature is not entirely consistent and is largely cross-sectional in methodology. Objective This study aims to establish the relationship of acne and psychological and psychiatric morbidity in adolescents in a community setting and, via a longitudinal methodology, provide evidence for causality in the relationship. Methods The study was a 12-month cohort study. Two hundred and forty-four students in Years 8, 9 and 11 (ages 14-17) at four Australian high schools were assessed at baseline 6 months and 12 months. Presence and severity of acne were assessed, along with a number of psychological and psychiatric morbidities and personality traits (depression, anxiety, overall psychiatric morbidity, self-consciousness, neuroticism and introversion/extraversion) and other demographic variables. Results Of the 244 participating students, 209 (86%) completed all three rounds of data collection. A further 26 (11%) completed two rounds. The study failed to demonstrate an association of the presence of acne or of acne severity with the examined measures of psychological and psychiatric morbidity, and no evidence for an effect of acne in their causation. Conclusion The relationship of acne and psychological morbidities found in previous health care settings was not found in this community sample. This may be due to differences between community and clinical acne populations. Other possible reasons for this finding are attenuation of psychological morbidity in subjects in this study by successful acne treatment, and the role of personality traits in the complex relationship between acne and psychological morbidities. It is suggested that this relationship would be best investigated by means of longer-term cohort studies enlisting subjects at an early age, prior to the onset of acne. Conflicts of interest None declared.