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Adult cystic acne

Anna L Chien, Ji Qi, Barbara Rainer, Dana L Sachs, Yolanda R Helfrich
Acne vulgaris is a common disease of the pilosebaceous unit and affects adolescents and adults. Because high-quality guidelines regarding treatment of acne in pregnancy are scarce, management of this condition can be challenging. We describe the safety profile of common therapies and outline approaches based on available evidence. Topical azelaic acid or benzoyl peroxide can be recommended as baseline therapy. A combination of topical erythromycin or clindamycin with benzoyl peroxide is recommended for inflammatory acne...
March 2016: Journal of the American Board of Family Medicine: JABFM
Joseph L Pace
Polycystic ovary syndrome (PCOS) is the most prevalent endocrine disorder in adult women. Hyperandrogenism is the crux of the pathogenesis of both acne and hirsutism, the most frequent clinical presentations of the syndrome. The chronic anovulation that may occur, often but not always associated with enlarged cystic ovaries, has long been recognized as an important feature of PCOS. In recent years major changes have occurred with regard to PCOS: Although management of the common cutaneous manifestations, mainly acne, hirsutism, alopecia, and acanthosis nigricans, remains strictly within the realm of daily dermatologic practice, the pendulum is shifting toward greater awareness of the longer-term systemic implications of PCOS, with emphasis on the unique opportunity and privileged position of the dermatologist to diagnose this potentially serious problem at an early stage, when effective long-term treatment can be instituted...
September 2015: Clinics in Dermatology
Everardo Piñeyro-Garza, Magdalena Gómez-Silva, María Elena Gamino Peña, Jonathan Palmer, Arturo Berber
OBJECTIVE: The oral retinoid agent isotretinoin (13-cis-retinoic acid) is approved for the treatment of severe recalcitrant cystic acne. For registrational renewal of Oratane® in Mexico (isotretinoin; Laboratorios Dermatologicos Darier S.A. de C.V., Mexico), it was necessary to establish bioequivalence to the reference product Roaccutan® (Isotretinoin; Roche, Mannheim, Germany). Three prior studies failed to establish the bioequivalence of Oratane to Mexican-sourced Roaccutan. However, 13 studies demonstrated the bioequivalence of Oratane to Roaccutane® from multiple sources...
October 2015: International Journal of Clinical Pharmacology and Therapeutics
Sizheng Zhao, Nicola J Goodson
We present the case of a 35-year-old man with thoracic back pain and stiffness, whose only medical history was cystic acne treated with repeated courses of retinoids. His thoracic spine was severely limited in range of movement and was found, on X-ray, to have unilateral hyperostosis typical of diffuse idiopathic skeletal hyperostosis (DISH)--an often asymptomatic condition rarely found in those under 50. Back stiffness in young patients with prolonged retinoid exposure should be investigated.
June 23, 2015: BMJ Case Reports
Z Z N Yiu, V Madan, C E M Griffiths
Acne conglobata (AC) is a chronic, severe, inflammatory variant of acne characterized by development of cystic nodules, abscesses and sinus tracts. AC may prove resistant to conventional acne therapy. The off-label use of adalimumab for the treatment of AC has been reported recently. We present a 26-year-old man with AC resistant to conventional treatment, who was treated with 40 mg adalimumab every other week, with significant clinical improvement. We review the evidence for the use of tumour necrosis factor antagonists in AC and related conditions...
June 2015: Clinical and Experimental Dermatology
Jeremy A Brauer, Viktoryia Kazlouskaya, Hamad Alabdulrazzaq, Yoon Soo Bae, Leonard J Bernstein, Robert Anolik, Patricia A Heller, Roy G Geronemus
IMPORTANCE: Fractional laser technology is routinely used in the treatment of acne scarring, with thermal injury resulting in collagen synthesis and remodeling. Use of a picosecond pulse duration with a diffractive lens array may be a new technologic advancement in the treatment of acne scarring. OBJECTIVE: To investigate the safety and efficacy of a 755-nm alexandrite picosecond pulse duration laser with diffractive lens array for the treatment of facial acne scarring...
March 2015: JAMA Dermatology
Maria Kashat, Katherine Caretti, Jessica Kado
Tumor necrosis factor α antagonists are potent biologics used to treat a variety of autoimmune disorders such as rheumatoid arthritis, ankylosing spondylitis, Crohn disease, psoriasis, and psoriatic arthritis. These medications are known to have many side effects (eg, infusion reactions, cytopenia, risk for infection, heart failure); however, only a few cases of acne vulgaris have been associated with the use of these biologics, particularly infliximab and adalimumab. We report a rare case of etanercept-induced cystic acne...
July 2014: Cutis; Cutaneous Medicine for the Practitioner
Staci Tanouye, Ravi Gada, Abimbola Famuyide, Charles Coddington
BACKGROUND: Androgen-producing granulosa cell tumors (GCTs) are rare but should be suspected in patients presenting with rapid onset virilization and a large cystic adnexal mass. Preoperative diagnosis is difficult. By ultrasound, completely cystic, estrogen-producing GCTs are uncommon, while 39% of reported androgenic GCTs are completely cystic. We report a case of a GCT presenting with virilization and initially characterized on 3-dimensional (3-D) ultrasound. CASE: A 32-year-old woman, gravida 1 para 0010, presented with amenorrhea, rapid onset hirsutism, acne, a 15-lb (6,803 g) weight gain, and an 8...
July 2014: Journal of Reproductive Medicine
Anders Vahlquist, Lena Douhan Håkansson, Lars Rönnblom, Malgorzata Karawajczyk, Anders Fasth, Marielle E van Gijn, Dirk Roos, Per Venge
No abstract text is available yet for this article.
March 2015: Acta Dermato-venereologica
Vibeke Børsholt Rudkjøbing, Kasper Aanaes, Tine Yding Wolff, Christian von Buchwald, Helle Krogh Johansen, Trine Rolighed Thomsen
BACKGROUND: For the first time microorganisms in CF sinuses are investigated by molecular methods in response to an absence of anaerobes in CF sinus samples during a two-year period at the Copenhagen CF center. METHODS: Endoscopic sinus surgery was performed in 19 CF patients. DNA from intact bacterial cells was investigated by 16S rRNA gene analysis and quantitative PCR. Results were compared to culture-dependent routine diagnosis. RESULTS: Molecular methods showed a large microbial diversity, which included undetected anaerobes that may play a pathogenic role...
December 2014: Journal of Cystic Fibrosis: Official Journal of the European Cystic Fibrosis Society
Li Ma, Lei-Hong Xiang, Bo Yu, Rui Yin, Lei Chen, Yan Wu, Zhi-Jian Tan, Yong-Bin Liu, Hong-Qing Tian, Hui-Zhong Li, Tong Lin, Xiu-Li Wang, Yuan-Hong Li, Wei-Zheng Wang, Hui-Lan Yang, Wei Lai
OBJECTIVES: To investigate the efficacy and safety of low-concentration 5-aminolevulinic acid photodynamic therapy (ALA-PDT) in the treatment of different severity of acne vulgaris and optimize the treatment regimen. METHODS: A self-controlled multicenter clinical trial was carried out in 15 centers throughout China. A total of 397 acne patients of grade II-IV received 3- or 4-session PDT treatment. 5% ALA gel was applied topically to acne lesions for 1h incubation...
December 2013: Photodiagnosis and Photodynamic Therapy
Daniela Scalas, Janira Roana, Paolo Boffano, Narcisa Mandras, Cesare Gallesio, Mario Amasio, Giuliana Banche, Valeria Allizond, Anna Maria Cuffini
OBJECTIVE: In this study the potential presence of bacteria in radicular cyst (RC) and keratocystic odontogenic tumour(KCOT) fluids from clinically asymptomatic patients was investigated. MATERIALS AND METHODS: Cyst fluids were collected by needle aspiration from 16 patients with asymptomatic osteolytic lesions (10 RCs and 6 KCOTs) undergoing surgery. All samples were transferred into tubes containing pre-reduced transport medium, delivered to the microbiology laboratory and processed within 1h...
November 2013: Archives of Oral Biology
Shelbi C Jim On, Joshua Zeichner
Acne vulgaris is a chronic inflammatory disease of pilosebaceous follicles commonly affecting adolescents and young adults. This disease has a profound psychological impact on affected individuals and treatment has been shown to significantly improve both self-esteem and quality of life. Isotretinoin is an effective medication used primarily in severe cystic acne patients. Over the past 30 years, this medication has revolutionized the treatment of acne. However, despite its popularity there are numerous side effects associated with its use...
September 2013: Dermatologic Therapy
Valeria Alcantara, Eulalia Urgell, J Francesc Sancho, Ana Chico
OBJECTIVE: We present a rare case of Cushing syndrome due to ectopic adrenocorticotropic hormone (ACTH) secretion (EAS). To our knowledge only two similar cases have been previously reported. METHODS: This is a case report of EAS by a metastatic lingual adenoid cystic carcinoma (ACC). RESULTS: The patient was diagnosed of a Cushing syndrome caused by tumoral EAS two years after initial cancer diagnosis. Clinical presentation included asthenia, insomnia, hypertension, acne, and hyperpigmentation developing in a period of two months...
September 2013: Endocrine Practice
Amanda A Cyrulnik, Kate V Viola, Aron J Gewirtzman, Steven R Cohen
BACKGROUND: Isotretinoin, for acne treatment, is associated with high rates of permanent remission. However, at recommended doses of 0.5-1.0 mg/kg/day for 5-6 months [average cumulative dose: 120-150 mg/kg], more than 20% of patients experience a relapse within two years that requires further medical management. OBJECTIVE: To examine outcomes of high-dose isotretinoin in a cohort with cystic acne, as well as measuring its impact on quality of life (QOL). METHODS: A single dermatologist, single institution investigation within an academic tertiary care center in Bronx, NY...
September 2012: International Journal of Dermatology
Ihsan Ustun, Emine Nur Rifaioglu, Bilge Bulbul Sen, Mehmet Ugur Inam, Cumali Gokce
Isotretinoin is a retinoic acid derivative mostly used in the treatment of cystic acne vulgaris. The adverse effects of isotretinoin are well defined being the major limitation factor for its usage. The decrement of testosterone during isoretinoin treatment is defined in literature. We present a case with 20 years old man who developed gynecomastia after treatment with isotretinoin. To the best of our knowledge, this is the third report of the development of gynecomastia after isotretinoin treatment.
March 2013: Cutaneous and Ocular Toxicology
C A Morales-Cardona, G Sánchez-Vanegas
BACKGROUND: Relapse rates in patients with acne after treatment with oral isotretinoin vary between 10% and 60% depending on the dosage regimen used, the length of follow-up, and the characteristics of the study population. The aim of this study was to determine the acne relapse rate within 2 years of completion of isotretinoin therapy and to identify the prognostic factors associated with relapse. MATERIAL AND METHODS: We studied a series of patients with cystic acne who had received a cumulative therapeutic dose of at least 120 mg/kg of oral isotretinoin...
January 2013: Actas Dermo-sifiliográficas
Taher Entezari-Maleki, Molouk Hadjibabaie, Samaneh Dousti, Jamshid Salamzadeh, Alireza Hayatshahi, Mohammad Reza Javadi, Kheirollah Gholami
BACKGROUND: Isotretinoin (13-cis retinoic acid) is used for treatment of nodular cystic acne unresponsive to conventional therapy. It is an expensive, potent teratogenic drug with serious adverse drug reaction (ADRs). Recently, use of this drug has increased in Iran. To date, there are no published data about the use of isotretinoin in Iran; therefore, this study aims to assess its use in this country. METHODS: This was a prospective, drug utilization evaluation (DUE) study conducted in an institutional community pharmacy affiliated with Tehran University of Medical Sciences (TUMS)...
July 2012: Archives of Iranian Medicine
Andrew P Demidowich, Alexandra F Freeman, Douglas B Kuhns, Ivona Aksentijevich, John I Gallin, Maria L Turner, Daniel L Kastner, Steven M Holland
OBJECTIVE: To describe the genotypes, phenotypes, immunophenotypes, and treatments of PAPA syndrome (pyogenic sterile arthritis, pyoderma gangrenosum, and acne), a rare autoinflammatory disease, in 5 patients. METHODS: Clinical information was gathered from medical records and through interviews with 5 patients from 4 kindreds. PSTPIP1 (CD2BP1) exon 10 and exon 11 sequencing was performed in each patient. Neutrophil granule content and cytokine levels were determined in plasma and stimulated peripheral blood mononuclear cells (PBMCs) from patients and controls...
June 2012: Arthritis and Rheumatism
Jian-Ping Mi, Zhuo-Shen Yu
OBJECTIVE: To verify the clinical efficacy of warming moxibustion on cystic acne. METHODS: Ninety-four cases were randomized into an observation group, control group 1 and control group 2. The basic treatment of body acupuncture combined with fire needling was applied in all of three groups. In observation group, cone moxibustion was added on Guanyuan (CV 4), Qihai (CV 6) and Pishu (BL 20). In control group 1, Isotritinoin soft capsule was taken orally, and in control group 2, no any other therapy was administered...
May 2010: Zhongguo Zhen Jiu, Chinese Acupuncture & Moxibustion
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