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Acne on the chin and forehead from an adolescent with nonclassic congenital adrenal hyperplasia (NCCAH).
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Purpose of review:
Acne vulgaris is a global disease with increasing prevalence in adolescents. It has a profound impact on their quality of life, especially when endocrine disorders are also involved. Recent concerns regarding antibiotic stewardship, failures with antibiotic usage, and the development of antibiotic-resistant Propionibacterium acn...
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Citations
... The endocrine system is one of the key physiological aspects influenced by acne [4]. Hormonal imbalances, precisely an increase in androgens, have been associated with the development and sustenance of acne. ...
... and Tollefson [4] 2017 Endocrine disorders, particularly acne vulgaris, significantly impact adolescents' quality of life, prompting clinicians to explore hormonal therapies as a potential alternative to antibiotics due to concerns about antibiotic stewardship. ...
A suitable portion of the total population still suffers through acne vulgaris, a widespread dermatological illness that mostly affects teens and young adults. Although acne is typically considered to be a cosmetic problem, recent research has concluded that certainly it has a significant role on impacting many physiological aspects of human health. This thorough investigation attempts to examine the intricate effects of acne on human physiology, taking into consideration both systemic and local effects. The study synthesizes research from a number of scientific disciplines, including dermatology, endocrinology, immunology, and psychoneuroimmunology. It investigates the complex interrelationships between several factors, such as sebum production, follicular hyperkeratinization, hormone imbalance, and Propionibacterium acnes colonisation, that lead to the development of acne. The study also sheds information on the intricate physiological mechanisms, oxidative stress, and immune response that contribute to the aetiology of acne. Along with it, the review investigates the relationship between endocrine problems and acne, emphasizing hormonal anomalies and their possible role in acne severity. The psychological effects of acne are also discussed, including the psychological problems, concerns with self-esteem, and decreased quality of life that acne sufferers encounter. On comprehensively examining the diverse physiological aspects affected by acne, this review provides a foundation for future research endeavours and informs the development of targeted therapeutic interventions. Ultimately, the integration of multidisciplinary approaches will enable healthcare professionals to address the physiological complexities of acne and improve the overall well-being of individuals affected by this common skin condition.
... Endocrine abnormalities are also associated with acne [26]. Acne is a frequently observed clinical feature of polycystic ovarian syndrome (PCOS), congenital adrenal hyperplasia, Cushing syndrome, and androgen-secreting tumors [26,27]. ...
... Endocrine abnormalities are also associated with acne [26]. Acne is a frequently observed clinical feature of polycystic ovarian syndrome (PCOS), congenital adrenal hyperplasia, Cushing syndrome, and androgen-secreting tumors [26,27]. Among patients with female acne, acne with hyperandrogenic signs was more strongly associated with truncal acne, longer disease duration, inappropriate diet, and PCOS than acne without hyperandrogenic signs [28]. ...
Acne is a relatively common disease of the pilosebaceous units. Many aspects of facial acne have been studied. However, there is limited evidence regarding truncal acne. Truncal acne is also observed in a significant number of patients, but it is often ignored by patients and clinicians. Although the pathogenesis of facial and trunk acne is considered to be similar, the characteristics of the skin on the trunk and face are thought to be different. As truncal acne can cause scars on large areas of the body and adversely affect the quality of life of patients, more attention should be given to patients with truncal acne. Although only a few studies have been published to date, the epidemiology, etiology, severity assessment tool, assessments of the quality of life, and new treatments targeting truncal acne are currently being studied. Therefore, in this review, the latest knowledge on truncal acne will be discussed.
... Clínicamente, el síndrome de Cushing se caracteriza por la presencia de eritema facial, cara de luna llena, acné, obesidad centrípeta, acantosis nigricans, estrías en flancos y acúmulo de grasa en la región cervical y dorsal (joroba de Búfalo) (51) . ...
... Es importante recalcar que la severidad de los síntomas está íntimamente relacionada con la potencia del esteroide recibido en los casos de Cushing iatrogénico. Siempre se debe realizar un desescalonamiento progresivo en pacientes con exposiciones crónicas, no solo por el riesgo de crisis suprarrenal, sino por el po-sible empeoramiento del compromiso cutáneo por un efecto de rebote (51) . ...
El acné es una enfermedad multifactorial con influencia endocrina. El objetivo de este artículo es presentar las bases fisiopatológicas del acné y sus interacciones con el sistema endocrinológico. Se revisan la importancia de las hormonas tradicionalmente descritas, como la testosterona, la dihidrotestosterona y la insulina, como estímulos tróficos para la glándula sebácea. Así mismo, se explora la influencia de otras hormonas tradicionalmente menos asociadas al acné, como el cortisol, la proopiomelanocortina, la prolactina y la hormona de crecimiento, que han probado influenciar la secreción de sebo por la unidad pilosebácea. Finalmente, se describe la interacción de estos fenómenos fisiopatológicos en entidades como el síndrome de ovario poliquístico, la hiperplasia suprarrenal congénita y el síndrome de Cushing.
... Assim, recomenda--se a associação a contracetivo nas mulheres em idade fértil, 65 não devendo ser utilizada no género masculino pelo risco de ginecomastia. 70 ...
... 65 O efeito adverso mais relevante é a hepatoxicidade, 71 não estando aprovado nos EUA, 67 e a sua utilização na acne é progressivamente menos frequente. 70 ...
A acne vulgar é uma patologia crónica da unidade pilossebácea caracterizada por polimorfismo cutâneo, sendo das mais prevalentes na adolescência. Pode originar sequelas físicas, como cicatrizes desfigurantes, e psicológicas, nomeadamente diminuição da qualidade de vida e função psicossocial. Assim, torna-se fundamental uma estratégia terapêutica eficaz de modo a promover a sua resolução e, simultaneamente, minimizar a presença destas sequelas. Atualmente, os fármacos disponíveis são diversos, obrigando, na sua seleção, à avaliação biopsicossocial do doente. Estudos recentes têm apontado novos agentes terapêuticos promissores, nomeadamente alternativas aos retinóides tópicos, isotretinoína oral, antiandrogénios orais e antibióticos. Estes poderão permitir uma redução da resistência antibiótica e consequente aumento da eficácia com redução substancial dos efeitos adversos. O melhor perfil de segurança e tolerabilidade poderá otimizar a abordagem terapêutica atual.
... enzim aktivitesinde artışa bağlı olarak çok daha güçlü bir androjen olan dihidrotestosteron (DHT) düzeyinde artış olduğu bildirilmiştir [2][3][4][5][6] . Ayrıca aknenin temel olarak etkilediği yüz bölgesindeki sebositlerin DHT'ye oldukça duyarlı oldukları gösterilmiştir 1 . Aknede tedavi seçiminde en önemli faktör hastalığın şiddetidir. ...
... Aknede tedavi seçiminde en önemli faktör hastalığın şiddetidir. Ancak eşlik eden bir endokrinolojik patolojinin olup olması da tedaviye karar vermede önemlidir 1 . Aknede hormonal tedavinin endikasyonları Tablo 1'de görülmektedir [1][2][3]6,7 . ...
... Ancak eşlik eden bir endokrinolojik patolojinin olup olması da tedaviye karar vermede önemlidir 1 . Aknede hormonal tedavinin endikasyonları Tablo 1'de görülmektedir [1][2][3]6,7 . Akne vulgariste hormonal tedavinin temel amacı; hipofiz, adrenal ve over kaynaklı androjen üretimini baskılamak ve sebase bezlerde androjen reseptörlerini bloke ederek sonuçta sebase bezler ve foliküler keratinositler üzerindeki androjenlerin etkisini azaltmaktır [2][3][4][5][6][7][8] . ...
... It presents as inflammatory and/or non-inflammatory lesions, affecting mostly the face but also the back and chest. This condition affects 9.4% of the global population, which makes it one of the most prevalent diseases around the world especially [3]. Although it is a common condition, accurate information about acne can be scarce and despite major advancements in the field of dermatology, so far only limited information about this irritating condition are available and provided to adolescent age group. ...
of studies discussing and debating his skin condition, still there are serious psychosocial concerns, gap in knowledge and lack of
awareness among acne patients.
Methods: This is observational, cross sectional, institutional-based study to find out prevalence, awareness and psychological
impact of acne among students in Majmaah University, conducted between January-April 2018.
Results: The study showed that 56% of the university students had some form of acne. More than three quarter of the participants
were less aware and had poor level of knowledge of the disease’s etiology and aggravating factors. 61% of the students had belief
that folk medicine contributes positively in acne management. 84.6% of both male and female students responded that acne had
obvious negative effects on the life of the affected and there is a social stigma associated with it.
Conclusion: Acne is a well-known and prevalent irritating skin disease among Majmaah university students, affecting both sexes. Our
study found out very poor level of awareness and knowledge about etiology and associated aggravating factors of acne. Furthermore,
strong association of acne with severe psychological impact is also evident among (85.6%) of participants. More comprehensive health
education about acne needed to be spread among University students and community, addressing the gap in knowledge, required for
proper management of acne and to reduce the negative psychosocial impact of the disease among this age group.
Key words: Acne, Prevalence, Psychological impact
... Acne is the common well being complication in the current situation [1]. It has been reported that around the world 79-95% reported cases of acne in the age group of 16-18 years and in India, the age group of 12-17 years; 50.6% of boys and 38.13% of girls have the complication of acne out of all reported incident. ...
Acne is one of the most common problem faced by today's youth and is listed in eighth position in the prevalence. It is affecting almost 9.4% of the global population in the world. This skin ailment is mostly occurring in the teenagers. There is no medicine is available in the market which can cure acne. And also, there are some limitations to these available management therapies as well as side effects are associated with them. The overcome these drawbacks of the available therapies a herbal formulation can a better choice due to the easily availability, synergistic activity, better bioavailability and less side effects of phytoconstituents. For our study we have selected Raphanus sativum (Mulak), Piper nigrum (Marich) and Allium sativum (Rason) due to its uses and availability. We have estimated the chemical constituents and phytochemicals present in these plants and their activity against Propionibacterium acne. We have also prepared a formulation using all the three plants and tested them for their activity and drug release with the time. In the case of permeation study, after the 12 h study the percentage of drug release is calculated 76.65%. Finally, we are concluding that the prepared formulation and the herbs used both have the anti-acne activity and the skin penetration is good.
... Hormonal therapies are effective and well tolerated options for the treatment of acne vulgaris in adolescents with and without endocrine disorders. They can be used as monotherapy or in conjunction with benzoyl peroxide, topical retinoic acid, or antibiotics [291]. In the case of hormonal disturbances, the use of hormonal contraception not only improves the cosmetic situation of the patient but is also necessary to decrease the risks related to hyperandrogenemia [286]. ...
Acne, also known as acne vulgaris (AV), is a long-term skin disease that occurs when hair follicles are clogged with dead skin cells and oil from the skin. It is characterized by blackheads or whiteheads, pimples, oily skin, and possible scarring. An intact stratum corneum and barrier, normal natural moisturizing factor and hyaluronic acid levels, normal Aquaporin-3 (AQP3) expression (localized at the basal lateral membranes of collecting duct cells in the kidney), and balanced sebum secretion are qualities of the skin that fall in the middle of the oily–dry spectrum. Patients rarely, if ever, complain about reduced sebum production, but elevated sebum production, yielding oily skin that can be a precursor to acne, is a common complaint. Several factors are known to influence sebum production. AV is mostly triggered by Propionibacterium acnes in adolescence, under the influence of normal circulating dehydroepiandrosterone (DHEA). It is a very common skin disorder which can present with inflammatory and noninflammatory lesions chiefly on the face but can also occur on the upper arms, trunk, and back. Age, in particular, has a significant and well-known impact, as sebum levels are usually low in childhood, rise in the middle-to-late teen years, and remain stable into the seventh and eighth decades until endogenous androgen synthesis dwindles. Sebum, the oily secretion of the sebaceous glands containing wax esters, sterol esters, cholesterol, di- and triglycerides, and squalene, imparts an oily quality to the skin and is well known to play an important role in acne development. Acne can’t be prevented or cured, but it can be treated effectively. The pimples and bumps heal slowly, and when one begins to go away, others seem to crop up. Depending on its severity, acne can cause emotional distress and scar the skin. Acne may cause scarring of the skin, but generally causes no long-term health problems. In self-body image, some parts of the body including face play an important role. Existence of even a minor lesion in this part may be unpleasant for the patient and seems large. This image can cause mental disorders including depression and anxiety, low self-esteem, and decrease in social relationships. However, high levels of anxiety and depression in patients with facial acne are not related to oxidative stress, according to a study published online in the Journal of Cosmetic Dermatology
... The pills that reduced acne had ethinyl estradiol in them, combined with one of the following drugs: levonorgestrel, norethindrone, norgestimate, drospirenone, cyproterone acetate, chlormadinone acetate, dienogest or desogestrel. Cyproterone acetate has not been approved for contraceptive use in Germany, but it can be prescribed for the treatment of acne [297]. Cyproterone acetate (2 mg of cyproterone acetate and 0.35 of ethinyl estradiol) after 3 months of treatment caused visible improvement in acne in 40%. ...
... Intense pulsed light (IPL) has become a well-recognized method in the treatment of acne vulgaris [296]. Various types of lasers have been utilized in the treatment of scars since the 1980s, beginning with continuous wave argon, CO2, and Nd:YAG 1064 lasers, followed by the application of PDL and Er:YAG lasers for scar revision [297] Most recently, fractional photothermolysis with ablative and nonablative fractionated lasers have found use as effective treatments for scars. For hypertrophic scars and keloids, the most common non-ablative laser has been the pulsed dye laser (PDL: 585 to 595 nm). ...
... A study by Tierney et al. comparing 1550-nm NAFL to 595nm PDL for the treatment of surgical scars showed that NAFL outperformed PDL and 83% of patients preferred the half of the scar treated with a non-ablative fractional laser [301,302]. A study by Niwa et al. examined NAFL in the treatment of hypertrophic scars and found 26% to 75% clinical improvement after two to three treatment sessions done at 4-week intervals [297]. Ablative laser resurfacing, with CO2 or Er:YAG lasers, has been shown to be effective for traumatic and surgical scars, especially when resurfaced within 6 to 10 weeks after trauma or surgery or even immediately after surgery. ...
Acne, also known as acne vulgaris (AV), is a long-term skin disease that occurs when hair follicles are clogged with dead skin cells and oil from the skin. It is characterized by blackheads or whiteheads, pimples, oily skin, and possible scarring. An intact stratum corneum and barrier, normal natural moisturizing factor and hyaluronic acid levels, normal Aquaporin-3 (AQP3) expression (localized at the basal lateral membranes of collecting duct cells in the kidney), and balanced sebum secretion are qualities of the skin that fall in the middle of the oily-dry spectrum. Patients rarely, if ever, complain about reduced sebum production, but elevated sebum production, yielding oily skin that can be a precursor to acne, is a common complaint. Several factors are known to influence sebum production. AV is mostly triggered by Propionibacterium acnes in adolescence, under the influence of normal circulating dehydroepiandrosterone (DHEA). It is a very common skin disorder which can present with inflammatory and non-inflammatory lesions chiefly on the face but can also occur on the upper arms, trunk, and back. Age, in particular, has a significant and well-known impact, as sebum levels are usually low in childhood, rise in the middle-to-late teen years, and remain stable into the seventh and eighth decades until endogenous androgen synthesis dwindles. Sebum, the oily secretion of the sebaceous glands containing wax esters, sterol esters, cholesterol, di-and triglycerides, and squalene, imparts an oily quality to the skin and is well known to play an important role in acne development. Acne can't be prevented or cured, but it can be treated effectively. The pimples and bumps heal slowly, and when one begins to go away, others seem to crop up. Depending on its severity, acne can cause emotional distress and scar the skin. Acne may cause scarring of the skin, but generally causes no long-term health problems. In self-body image, some parts of the body including face play an important role. Existence of even a minor lesion in this part may be unpleasant for the patient and seems large. This image can cause mental disorders including depression and anxiety, low self-esteem, and decrease in social relationships. However, high levels of anxiety and depression in patients with facial acne are not related to oxidative stress, according to a study published online in the Journal of Cosmetic Dermatology.
... [134][135][136][137][138] Hormonal therapies are a well-tolerated and effective way to control acne with and without endocrine disorders. 139,140 CAH is linked to endocrine abnormalities with deficiency in the synthesis of cortisol from the adrenal cortex. 92,141 The majority of patients with classical or nonclassical CAH presentation have mutations in CYP21A2 (Table 1). ...
Background
Acne vulgaris is a highly prevalent inflammatory skin disorder with a complex pathogenesis, characterized by comedones, papules, pustules and nodules. Familial preponderance clearly indicates a genetic basis for acne vulgaris, but until recently solid genetic associations were lacking.
Results
The advent of high‐resolution genotyping array technologies has allowed for large‐scale studies with both family‐based and cross‐sectional designs. These studies have revealed genetic loci encompassing genes that could be active in biological pathways and processes underlying acne vulgaris. However, specific functional consequences of those variants remain elusive. In parallel, investigations into rare disorders and syndromes that incorporate features of acne or acne‐like lesions have recently accelerated our understanding of disease pathogenesis. The genes revealed by these rare disorders highlight mechanisms cardinal for pilosebaceous biology and therefore anchor our insights from genetic association studies for acne vulgaris.
Conclusions
The next phase of research will require more in‐depth mechanistic investigations of loci and genes implicated in acne phenotypes to define the key molecular players driving the disorder. Concurrently, new treatments for acne vulgaris could be developed by dissecting the candidate molecular pathways to identify druggable targets.
