Background: Acne vulgaris is a common chronic inflammatory skin disease. Long term therapy involving antibiotics warrants for drug with a long half-life to increase compliance of patients. Methods: A twelve-week prospective randomized study was performed on 40 subjects with moderate to severe facial acne to compare the efficacy of oral azithromycin with oral doxycycline. Thirty-six subjects completed the study. Subjects in azithromycin group received azithromycin 250mg three times a week plus topical benzoyl peroxide 5% (BPO), whereas subjects in doxycycline group received doxycycline 100mg daily plus topical BPO 5%. Efficacy evaluation included treatment success rate (Comprehensive Acne Severity Score /CASS of 0 or 1 or improvement of two grades from baseline) and lesion counts. Results: Treatment was successful in 94.4% of subjects in azithromycin group, compared to 88.9% in doxycycline group (p=1.000) at week 12.However, percentage of clear or almost clear by CASS was higher in the doxycycline group ( 83.3% vs 66.7%; p= 0.443).Percentage reduction of inflammatory lesion counts in azithromycin and doxycycline group following treatment for 12 weeks were 78.3% and 85.3% (p=0.133) respectively, whereas for non-inflammatory lesion counts were 77.7% and 78.8% (p=0.852) respectively. Nausea was reported in 77.8% at week 6 and 66.7% at week 12 in doxycycline group, but none in azithromycin group. There were no significant differences in incidence of diarrhoea and abdominal pain. Conclusion Azithromycin 250mg three times a week plus topical BPO 5% is as effective as doxycycline 100mg daily plus topical BPO 5%.
Azithromycin ; Doxycycline ; Acne Vulgaris--therapy

Background: Acne vulgaris is a chronic inflammatory condition of the pilosebaceous unit. Isotretinoin is used to treat moderate to severe acne that is resistant to antibiotics and topical agents. However, it may cause alterations in lipids and liver enzymes. Methods: A total of 129 patients with acne vulgaris (moderate to severe facial acne) treated with isotretinoin were recruited between May 2020 and July 2021 from the dermatology clinics at Hospital Serdang and Hospital Kuala Lumpur. Of these, 120 patients with complete data of lipid panel (total cholesterol, low density lipoprotein cholesterol [LDL], triglycerides [TG], and high density lipoprotein cholesterol [HDL]) and hepatic panel (alanine transaminase [ALT] and aspartate transaminase [AST]) levels at baseline, and in three subsequent follow-up visits (i.e., one, three, and six months) were included in the analyses. Abnormalities were graded according to standard laboratory values and their severity according to the National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE)grading system. Results: Of the 120 study participants, 83% were female and 37% were male between the ages of 15 and 36 years. We observed a significant increase in median values at baseline and at the six-month follow-up for total cholesterol (p<0.0001), triglycerides (p<0.0001), LDL (p<0.0001), ALT (p<0.0001), and AST (p<0.0001). We observed a significant correlation between body mass index and the HDL (r2 =- 0.26, p=0.01) and ALT (r2 =0.383, p=7.9x10-06) levels. Based on the CTCAE grading system, almost all study participants with abnormal results had grade 1 abnormalities. Only one patient had a grade 2 abnormality in ALT, which required treatment discontinuation. Conclusion Low dose isotretinoin therapy for acne vulgaris may cause mild and non-progressive elevation of LDL, total cholesterol, and liver transaminases which do not require treatment withdrawal in most cases.
Isotretinoin--therapeutic use ; Acne Vulgaris-therapy

OBJECTIVE: To evaluate the efficacy and safety of 585 nm Q-switched laser in the treatment of acne inflammatory lesions and postinflammatory erythema. METHODS: A total of 25 patients with moderate facial acne, symmetrical distribution of inflammatory lesions and postinflammatory erythema on both sides of the face, were enrolled. Among the 25 patients, 22 patients completed all the treatment and evaluation, and 3 patients were lost to follow-up. 585 nm Q-switched laser was used on a randomly selected side of the face for three times of treatment at a 2 week interval. The evaluations were made before each treatment, 2 and 4 weeks after the last treatment, therefore the evaluation time points were before the treatment, weeks 2, 4, 6, and 8, respectively, for a total of 5 times. Acne severity was assessed using the investigator' s global assessment (IGA) score, and erythema severity was assessed using the investigator' s subjective erythema score and narrow-spectrum reflectance spectrophotometer at each follow-up. RESULTS: After 3 times of treatment, there was statistically significant difference between the IGA score in week 8 and before treatment on both sides(Z=2.64, P < 0.01; Z=2.67, P < 0.01). There was no significant difference in IGA score between the treatment side and the control side before treatment and in week 8 (P=0.59, P=0.26). There was statistically significant difference between the investiga-tor' s subjective erythema score in week 8 and before treatment on the treatment side(Z=4.24, P < 0.01), while no significant difference was showed on the control side(Z=1.73, P=0.08). In week 8, the investigator's subjective erythema score of the treatment side was lower than that of the control side (Z=3.61, P < 0.01). The erythema index of the treatment side was significantly decreased at 5 time points (P < 0.01), and the index decreased significantly in week 8 compared with the index before treatment (P < 0.01), while the erythema index of the control side was not significantly different at 5 time points. The treatment related adverse events included erythema and edema after treatment and pain during treatment, the severity was mild to moderate, which resolved spontaneously within 1 to 3 days. Nine patients were very satisfied with the treatment, 7 patients were satisfied, and 6 patients considered average. CONCLUSION 585 nm Q-switched laser has some effect in the treatment of postinflammatory erythema, and it ensures good tolerance and safety. There was no statistically significant difference between the treatment side and the control side on the improvement of acne inflammatory lesions.
Acne Vulgaris/therapy* ; Erythema/etiology* ; Face ; Humans ; Immunoglobulin A ; Treatment Outcome

Objective To explore the effects of dermabrasion combined with ReCellon large superficial facial scars caused by burn, trauma and acnes.Methods Nineteen patients with large superficial facial scars were treated by the same surgeon with dermabrasion combined with ReCell. According to the etiology, patients were classified into post-burning group (n=5), post-traumatic group (n=7) and post-acne group (n=7). Fifteen patients completed the follow-ups, 5 patients in each group. Healing time, complication rate, the preoperative and 18-month-post-operative assessments using Patient Satisfaction Score (PSS), Vancouver Scar Scale (VSS), and Patient and Observer Scar Assessment Scale (POSAS) of each group were analyzed to compare the effect of the combined therapy on outcomes.Results The healing time of post-burning group (19.6±4.0 days), post-traumatic group (15.8±2.6 days), and post-acne group (11.4±3.1 days) varied remarkably (F=7.701, P=0.007). The complication rates were 60%, 20%, and 0 respectively. The post-operative POSAS improved significantly in all groups (P<0.05), where the most significant improvement was shown in the post-acne group (P<0.05). The post-operative PSS and VSS improved only in the post-traumatic group and post-acne group (all P<0.05), where the more significant improvement was also shown in the post-acne group (P<0.05).Conclusions The combined treatment of dermabrasion and ReCellhas remarkable effect on acne scars, moderate effect on traumatic scars and is not suggested for burn scars. POSAS should be applied to assess the therapeutic effects of treatments for large irregular scars.
Acne Vulgaris ; therapy ; Adolescent ; Adult ; Burns ; therapy ; Cicatrix ; therapy ; Dermabrasion ; instrumentation ; methods ; Humans ; Wound Healing

Acne Vulgaris ; diagnosis ; drug therapy ; etiology ; immunology ; Dermatomycoses ; complications ; drug therapy ; Female ; Humans ; Malassezia

OBJECTIVETo evaluate the therapeutic effect and safety of acupuncture and moxibustion for treatment of acne, and to analyze the current situation of clinical studies at present.

METHODSRetrieve PubMed, Cochrane library, CBM databank, CNKI databank, etc., and collect the randomized and controlled trials of treatment of acne with acupuncture and moxibustion, and select clinical trials conforming with the enrolled criteria, and conduct evaluation of quality with Cochrane systematic manual 5.0, and RevMan 4.2.8 was used for statistical analysis.

RESULTSSeventeen papers, including 1,613 cases, conformed with the enrolled criteria. Seventeen studies adopted the cured rate as the evaluation index, Meta-analysis showed treatment of acne by acupuncture and moxibustion with routine western medicine as control, significant difference for inter-group comparison [combined RR (random efficacy model) = 2.96, 95% CI (1.63, 4.91), Z=4.08. P<0.0001]; comprehensive acupuncture and moxibustion therapy was controlled with single acupuncture moxibustion therapy, significant difference for inter-group comparison [combined RR (fixed efficacy model) = 2.51, 95% CI (1.76, 3.57), Z=5.11, P<0.00001].

CONCLUSIONAcupuncture-mox ibustion is safe and effective for treatment of acne, and it is possibly better than routine western medicine, and the comprehensive acupuncture-moxibustion therapy is better than single acupuncture-moxibustion therapy. The conclusion has not been determined yet, because lower quality of a part of literature enrolled.

Acne Vulgaris ; therapy ; Acupuncture Therapy ; Humans ; Meta-Analysis as Topic ; Moxibustion ; Randomized Controlled Trials as Topic

Acne Vulgaris ; therapy ; Acupuncture Points ; Acupuncture Therapy ; methods ; Adult ; Female ; Humans ; Needles

OBJECTIVETo compare the efficacy differences between fire needling therapy and oxycycline tablets for the treatment of moderate to severe acne vulgaris.

METHODSSixty cases of moderate to severe acne vulgaris were randomly divided into a fire needling group and a medication group, 30 cases in each one. The pricking method of fire needling at Ashi points around damaged skin was applied in the fire needling group, once every five days for totally 4 times. The oral administration of oxycycline tablets, 100 mg, was applied in the medication group, twice daily for 20 days, also external application of adapalene gel before sleep was adopted. The fading time of skin damage, including papule, pustule, nodule and cyst in the two groups was recorded and clinical efficacy was compared. After the treatment, two-month follow-up was performed to observe the recurrence rate in the two groups.

RESULTSThe curative rate was 69.0% (20/29) in the fire needling group, which was statistically different from 40.0% (12/30) in the medication group (P < 0.05). The fading time of each type of skin damage in the fire needling group was shorter than that in the medication group [papule: (2.67 +/- 0.66) d vs (4.36 +/- 0.61) d; pustule: (2.47 +/- 0.57) d vs (4.27 +/- 0.55) d; nodule: (7.76 +/- 1.06) d vs (9.88-1.30) d; cyst: (11.81 +/- 1.54) d vs (14.79 +/- 0.89) d, all P < 0.05]. The recurrence rate was 46.4% (13/28) in the fire needling group, which was not significantly different from 44.0% (11/24) in the medication group (P > 0.05).

CONCLUSIONThe acne vulgaris could be fast and effectively treated by fire needling therapy, which has shorter fading time than oxycycline tablets. However, the preventive effect is not different between the two theraies.

Acne Vulgaris ; therapy ; Acupuncture Therapy ; Adolescent ; Adult ; Female ; Humans ; Male ; Middle Aged ; Treatment Outcome

OBJECTIVETo verify the clinical efficacy of warming moxibustion on cystic acne.

METHODSNinety-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. The efficacy, the scale change in skin lesion before and after treatment and adverse reactions were observed in three groups.

RESULTSAfter treatment, the total effective rate was 84.4% (27/32) in observation group, was 71.0% (22/31) in control group 1 and was 51.6% (16/31) in control group 2. The efficacy in observation group was superior to that in control group 2 (P < 0.05), but there was no significant difference between observation group and control group 1 (P > 0.05). The improvement in skin lesion in observation group was equal to that in control group 1 (P > 0.05), and was superier to that in control group 2 (P < 0.05). Control group 1 presented some adverse reactions, such as dry skin and cheilitis.

CONCLUSIONWarming moxibustion can improve the efficacy of body acupuncture and fire needling on cystic acne, which is equal to the efficacy of Isotritinoin soft capsule, but no any adverse reaction is induced.

Acne Vulgaris ; therapy ; Adolescent ; Adult ; Cysts ; therapy ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; Moxibustion ; methods

Acne Vulgaris/therapy* ; Acupuncture Points ; Acupuncture Therapy ; Hot Temperature ; Humans ; Quality of Life ; Spleen ; Stomach ; Treatment Outcome