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Acne, topical antibiotics for [keywords]
- Azelaic Acid in the treatment of acne in adult females: case reports. [Journal Article]
- Skin Pharmacol Physiol 2014.:18-25.
Acne, one of the most common skin problems in dermatological practice, is a condition that affects not only adolescents but also adults. While approximately 80% of cases occurring in adulthood are persistent from teenage years, around 20% are described as 'late-onset' disease, appearing for the first time in adulthood. The disease can be triggered by hormonal changes (including a change from one contraceptive to another), or it can be induced by certain nonhormonal medications, emotional stress, and various underlying diseases such as polycystic ovary syndrome. In many cases acne becomes a chronic skin condition with undulating activity, including improvement and relapse phases, and is often experienced as a major psychological burden. It is, therefore, even more important to provide an effective as well as a safe and tolerable treatment. The spectrum of topical acne treatments has expanded substantially in recent years and various topical medications are available, ranging from azelaic acid, antibiotics, retinoids and benzoyl peroxide to several fixed combinations of these active compounds. The following case collection illustrates how 15% azelaic acid gel, as a well-established monotherapy, can be successfully employed to treat mild-to-moderate forms of adult female acne. © 2013 S. Karger AG, Basel.
- Acne in Patients with Skin of Color: Practical Management. [JOURNAL ARTICLE]
- Am J Clin Dermatol 2013 Nov 5.
Acne vulgaris is a prevalent and non-discriminatory condition affecting individuals of all races and ethnicities. As people with skin of color make up a rapidly expanding segment of the US population, dermatologic care must evolve accordingly to address their distinct concerns. Patients with skin of color with acne can be particularly challenging, given their potential for cosmetically disturbing complications, including post-inflammatory hyperpigmentation and keloid development. A variety of treatments have been shown to be effective in preventing or treating these complications. Topical retinoids are considered first-line therapy for acne in patients of color; topical alternatives include azelaic acid, dapsone, and antimicrobials. Hydroquinone may be used in combating post-inflammatory hyperpigmentation, specifically. For more severe acne, oral agents, including oral antibiotics or isotretinoin, may be used. Most recently, various lasers and phototherapies have been suggested for their safety and efficacy in patients with skin of color with acne. Ultimately, recognizing the clinical and histologic differences, as well as the variations in treatment regimens for darker skin types will allow for better care and patient satisfaction.
- Topical Antibiotic Monotherapy Prescribing Practices in Acne Vulgaris. [JOURNAL ARTICLE]
- J Dermatolog Treat 2013 Oct 30.
Abstract Objective: To evaluate the frequency of dosing topical antibiotics as monotherapy in the treatment of acne vulgaris, and physician specialty prescribing these medications. Methods: This study is a retrospective review of all visits with a sole diagnosis of acne vulgaris (ICD-9-CM code 706.1) found on the National Ambulatory Medical Care Survey (NAMCS) in 1993 to 2010. We recorded the number of visits surveyed where acne vulgaris was the sole diagnosis, number of visits where topical antibiotics were the only treatment prescribed, and the specialty of physician in each encounter. Results: Topical erythromycin or clindamycin were the sole medication prescribed in 0.81% of the visits recorded, with 60% of these prescriptions arising from dermatologists and 40% from non-dermatologists. The trend of prescribing topical antibiotic monotherapy is declining (p < 0.001) over the 18-year study period. Conclusions: The development of resistance of P. acnes to topical antibiotic regimens has led to the need to reevaluate the use of topical antibiotics in the treatment of acne vulgaris. While the rate of topical antibiotic monotherapy has is declining, their use should be reserved for situations where the direct need for antibiotics arises. If a clinician feels that antibiotics are a necessary component to acne therapy, they should be used as part of a combination regimen.
- Photopneumatic technology used in combination with profusion therapy for the treatment of acne. [Journal Article]
- J Clin Aesthet Dermatol 2013 Sep; 6(9):36-40.
Background:Topical and oral medications, such as retinoids, benzoyl peroxide, antibiotics, and isotretinoin, have been the standard of care for the treatment of mild-to-moderate acne for the last several decades. More recently, a number of pubHshed studies on optical treatments, such as ultraviolet light, visible (blue) light, and intense pulsed Hght systems, have also shown clinical improvement in the appearance of acne. Specifically, photopneumatic technology, which utilizes gentle pneumatic energy (vacuum) to draw the target tissue into the treatment tip and then deHver broadband pulsed Hght to the dermal targets, has demonstrated marked improvement in the appearance of acne lesions and side effects associated with acne.
Objective:To demonstrate the safety and efficacy of using a combination treatment of the photopneumatic system and profusion therapy using three currently marketed topical agents for the treatment of mild-to-moderate acne on the face and/or body, including neck, chest, or back.
Methods:A prospective, multicenter, dinical trial of 41 individuals with mild-to-moderate acne was performed. Patients received up to four treatments at 1- to 2-week intervals with the photopneumatic system and profusion therapy with three separate topical agents. Study investigators and subjects evaluated dinical efficacy at 1-month and 3-month follow-up visits.
Results:At three months, a 69-percent reduction was noted in inflamed acne lesions and a 41-percent reduction in noninflamed acne lesions was noted by physician assessment. Additionally, at this same time point, subjects reported moderate-to-marked (26-75%) improvement in acne lesions. Eighty-one percent of subjects (22/27) were either satisfied or very satisfied with treatment outcome. There were no adverse events caused by malfunction of the device, and no serious adverse events or deaths.
Conclusion:The results, as well as the reported patient satisfaction and safety, suggest that the treatment of acne with the photopneumatic system in combination with profusion using currently available topical acne agents demonstrated significant treatment results.
- Do we really need topical antibiotics in our new treatment paradigm of acne vulgaris? A novel question to consider based on an updated model of pathogenesis. [Editorial]
- J Drugs Dermatol 2013 Aug; 12(8 Suppl):s107.
- Topical antibiotics and benzoyl peroxide for treatment of acne. [Comment, Letter]
- Am Fam Physician 2013 Jul 1; 88(1):Online.
- Dermatologic conditions in skin of color: part I. Special considerations for common skin disorders. [Journal Article]
- Am Fam Physician 2013 Jun 15; 87(12):850-6.
Skin of color traditionally refers to that of persons of African, Asian, Native American, Middle Eastern, and Hispanic backgrounds. Differences in cutaneous structure and function can result in skin conditions with distinct presentations and varying prevalence that require unique treatment. Skin cancers have different presentations in these populations. The ability to recognize and diagnose skin cancer in a timely manner is important for reducing morbidity and mortality. Basal cell carcinoma often is pigmented, squamous cell carcinoma occurs in areas of chronic scarring and inflammation, and melanoma presents in non-sun-exposed areas, such as the soles and nail beds. Diagnosis requires biopsy, with the technique depending on size and location of the lesion. Treatment options range from topical to surgical. Acne commonly results in postinflammatory hyperpigmentation and keloids. Combination therapy with topical antibiotics and benzoyl peroxide is generally more effective than monotherapy for treating acne. Use of retinoids at lower concentrations and at less frequent dosing can help prevent postinflammatory hyperpigmentation.
- Propionibacterium acnes: an update on its role in the pathogenesis of acne. [JOURNAL ARTICLE]
- J Eur Acad Dermatol Venereol 2013 Aug 1.
In recent years, significant progress has been made in the understanding of the pathophysiological mechanisms of acne and the role of Propionibacterium acnes. With this review, the authors aim to provide an update on the current understanding of the role of P. acnes in the development of acne lesions and analysing the potential implications for future treatments. A total of 188 articles published between January 1980 and March 2013 were searched using key words such as acne, P. acnes, microbiology, Corynebacterium acnes, acne vulgaris, pathogenesis, antibiotic, vaccination and a combination of those key words. From those articles, 77 were analysed in depth. Recent data confirm that P. acnes has a strong proinflammatory activity and targets molecules involved in the innate cutaneous immunity, keratinocytes and sebaceous glands of the pilosebaceous follicle and leads to the development of comedones. Furthermore, the profile of its different strains may differ between healthy subjects and acne patients. The better understanding of the role of P. acnes may allow for new perspectives in the treatment of acne. Novel therapies should target molecules implicated in the activation of innate immunity, including toll-like receptors, protease-activated receptors and topical antimicrobial peptides; the latter may be an alternative to topical antibiotics and thus a solution for limiting bacterial resistance induced by topical macrolides. Vaccines may also be promising. However, the most appropriate candidate remains to be selected.
- Evidence on acne therapy. [Journal Article]
- Sao Paulo Med J 2013; 131(3):193-7.
Among the current treatments available for acne vulgaris, many widely practiced options lack support from studies at the best level of scientific evidence. The aim of this narrative review was to present the very latest information on topical and systemic treatments for acne vulgaris. Information from systematic reviews and well-designed clinical trials, obtained through a systematic search of the major medical databases, is emphasized. There are important issues regarding the clinical management of acne that still lack consistent grounding in scientific evidence. Among these are the optimum dose and duration of treatment with oral antibiotics that can be given without inducing bacterial resistance, and the safety of oral isotretinoin.
- Treatment of preadolescent acne in the United States: an analysis of nationally representative data. [Journal Article]
- Pediatr Dermatol 2013 Nov; 30(6):689-94.
The prevalence of acne in younger children is increasing. Of the acne treatments that the U.S. Food and Drug Administration (FDA) has approved for ages 12 years and older, it is unclear which medications are being prescribed off-label for this younger patient population. The purpose of this study is to compare the therapies being prescribed to preadolescent patients with acne (defined in this study as ages 7 to 11 years) with those being prescribed to adolescent patients (ages 12 to 18 years) and to determine whether prescribing patterns differ between dermatologists and pediatricians. Leading therapies for the treatment of children with a diagnosis of acne were collected from the National Ambulatory Medical Care Survey (NAMCS) from 1993 to 2009. Data were stratified according to age group and physician specialty. Physicians prescribed a wide variety of FDA-approved and off-label medications to preadolescent patients with acne. The leading medications were topical treatments, including adapalene (14.4%), benzoyl peroxide (12.8%), and tretinoin (12.5%). Treatment of this age group differed substantially between specialties, with dermatologists frequently prescribing topical retinoids and primary care physicians preferring antibiotics, particularly oral antibiotics. Limitations included a lack of data on acne severity and morphology through NAMCS, as well as the absence of longitudinal data. With the limited number of FDA-approved treatment options, off-label prescribing for acne in preadolescent patients is common. Furthermore, this study identified a potential knowledge gap between pediatricians based on their prescribing patterns in this patient population.