Facial dermatoses
Aimilios Lallas, Enzo Errichetti, Dimitrios Ioannides in Dermoscopy in General Dermatology, 2018
The clinical spectrum of acne includes comedones and inflammatory lesions, i.e., erythematous papules, pustules, and nodules.1–7 Closed comedo, also known as “whitehead,” appears as a small whitish/skin-colored papule (Figure 5.1A), whereas open comedo, also called “blackhead,” presents as a blackish spot corresponding to pilosebaceous orifice filled with keratin, skin debris, and sebum (Figure 5.2A).1–7 Clinical pattern and disease severity widely vary among patients and even during the course of the disease in a single patient, ranging from mild comedonal acne, with or without sparse inflammatory lesions (including papules and pustules—Figure 5.3A), to acne conglobata with deep-seated inflammation, abscesses, nodules, sinus tracts, and in the late stage, polyporus/fistulated comedones or secondary comedones (Figure 5.4).1–7 Postinflammatory hyperpigmentation and atrophic or hypertrophic scars may develop, representing a late complication of the inflammatory processes.1–7
Sebum
Enzo Berardesca, Peter Elsner, Klaus-P. Wilhelm, Howard I. Maibach in Bioengineering of the Skin: Methods and Instrumentation, 2020
Acne, in its variants from comedones to the cystic nodules of acne conglobata, is the most important and an extremely frequent disease of the pilosebaceous unit. Because the development of acne is closely correlated to seborrhea and because suppression of sebum production is a powerful therapeutic principle for acne management, the quantification of skin surface lipids and sebum has long been of interest to dermatologists and pharmacologists. Solvent extraction of skin surface lipids was the first and most widely used noninvasive technique for the study of sebum production.2 While this technique produced valid results, it is rather cumbersome and not suited for repeated applications on the same skin area over a longer period. The “cigarette paper” (gravimetric) method developed by Strauss and Pochi3 overcame some of these drawbacks. Briefly, delipidized sheets of cigarette paper are pressed onto the skin for several hours. Excreted lipids are absorbed by the cigarette paper and can be harvested by solvent extraction of the paper. After evaporation of the solvent, the lipids can be weighed and they can be subjected to chemical analysis. Nevertheless, the gravimetric method is time consuming, and depends on a specialized laboratory because it is subject to significant experimental errors.4 The ground glass technique was the next step in the noninvasive quantification of sebum:5 a ground glass plate pressed onto the skin became more translucent, depending on the amount of sebum present. The Sebumeter, described below, is a modification of this technique, whereas the Sebutape may be regarded as a “relative” of the cigarette paper method.
Rosacea/Acne Rosacea
Charles Theisler in Adjuvant Medical Care, 2023
The anti-inflammatory and antioxidant actions of zinc have also been utilized for the management of other follicular occlusion disorders like hidradenitis suppurativa, acne conglobata, and folliculitis decalvans. Brocard et al. observed clinical response without significant side effects in all 22 patients of hidradenitis suppurativa when treated with zinc gluconate 90 mg/day.6 Similarly, Kobayashi et al. reported complete cure of acne conglobata and dissecting cellulitis with oral zinc sulphate.7 However, the overall benefit of zinc in these disorders remains understudied.8
Pamidronate in chronic non-bacterial osteomyelitis: a randomized, double-blinded, placebo-controlled pilot trial
Published in Scandinavian Journal of Rheumatology, 2020
CM Andreasen, AG Jurik, BW Deleuran, HC Horn, TB Folkmar, T Herlin, EM Hauge
CNO is characterized by chronic and relapsing episodes of osteoarticular inflammation. Clinically, patients present with musculoskeletal complaints such as pain, tenderness, and swelling referable to the involved skeletal sites. CNO is often associated with skin eruptions such as palmoplantar pustulosis and acne conglobata, but also synovitis (3, 4, 7). Bone lesions in adults are predominantly sited in the anterior chest wall (ACW), the spine, and the pelvis (3, 8). In children, bone lesions have a predilection for the metaphysis of the lower extremities, the spine, the pelvis, and the clavicles (9, 10). Imaging features are characteristic in the form of osteitis and hyperostosis. Whole-body magnetic resonance imaging (WBMRI) enables assessment of the overall status of bone inflammation and is increasingly used in CRMO and in both arthritis and SpA (11–13).
Clascoterone cream (1%) topical androgen receptor inhibitor for the treatment of acne in patients 12 years and older
Published in Expert Review of Clinical Immunology, 2021
Nine subjects experienced AEs that led to discontinuation including moderate application site swelling, moderate application site dryness, moderate acne cystic, moderate application site acne, moderate acne conglobata, moderate acne, mild polycystic ovaries, severe suicide attempt, and moderate hair color changes. Clascoterone cream-related AEs (n = 19) were mild sunburn, moderate application site swelling, moderate application site pruritus, moderate application site erythema, mild or moderate application site dryness, mild or moderate application site acne, mild or moderate application site pain, mild dysgeusia, moderate acne (for each, n = 2), moderate cystic acne, moderate acne conglobata, mild contact dermatitis, severe pruritus, and moderate hair color changes. There were no systemic events or any differences between genders.
Emerging drugs for the treatment of hidradenitis suppurativa
Published in Expert Opinion on Emerging Drugs, 2020
Alecia S Folkes, Faris Z Hawatmeh, Alan Wong, Francisco A Kerdel
Fluorescent light energy (FLE) is a noninvasive therapeutic mechanism that induces photobiomodulation (PBM) and has recently been seen to play a beneficial role in treating HS and other inflammatory diseases such as acne conglobata [12]. PBM has both antibacterial and anti-inflammatory effects [12]. In vitro-studies show that FLE decreases pro-inflammatory cytokines, in particular TNF- a and IL-6, resulting in decrease response of human epidermal keratinocytes and human dermal fibroblasts [12]. This plays an essential role in regulating immune responses in inflammatory conditions [12]. FLE has been found to not only help in resolving active lesions but also decreases associated redness [12]. There has been an observed increase in collagen production aiding in healing of the skin lesions and improving not only the appearance of scars, but overall appearance of the skin [12]. Not much research has been done on the overall efficacy of FLE, but should be considered as a potential treatment option [12].
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