Photopneumatic monotherapy improved acne in all skin types
Photopneumatic monotherapy improved acne in all skin types
Today's report also covers stigma in acne, symptoms of 'maskne', dry eye adverse effects, and more (1,500 words, 7 minutes, 30 seconds)
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Good morning, and welcome to the eighth issue of Focus on Acne, presented by Skin Spectrum Weekly. This series provides up-to-date information on developing therapies and trends in acne treatment. We appreciate your feedback and suggestions and invite you to be in touch. Please write to us at health@chronicle.org
Photopneumatic monotherapy improved acne in all skin types
In a small study, monotherapy with a new photopneumatic device significantly reduced acne lesions and resulted in clearer skin in all Fitzpatrick skin types. The authors reported minor adverse events and that subject satisfaction was favorable.
For the open-label study, published in The Journal of Clinical and Aesthetic Dermatology (June 2024; 17(6):13-20), researchers enrolled 30 male and female subjects between the ages of 12 and 40 years with any Fitzpatrick Skin Phototype. Each subject had facial acne and a baseline Investigator's Global Assessment (IGA) score of 2 (mild) or 3 (moderate), with ≥10 to ≤50 inflammatory lesions, ≥10 but ≤100 non-inflammatory lesions, and ≤1 facial nodule.
The participants were treated with a photopneumatic device that combined gentle vacuum with pulsed broadband light for seven weeks.
Researchers observed significant decreases in inflammatory and non-inflammatory lesion counts at all time points versus baseline (for each, p<0.001). IGA scores were improved from baseline at most timepoints and 66.7% of participants (20/30) achieved a one or more grade reduction in IGA score at Day 49 (p<0.001). Consistent improvements in Acne Self-assessment, Acne-specific Quality of Life, and Treatment Satisfaction Questionnaires were reported. All subjects had favourable investigator and subject tolerability assessments.
Internalized stigma high in acne, rosacea patients
Patients with acne vulgaris (AV) or rosacea experience a high degree of internalized stigma, which is associated with low quality of life and health status, researchers report in Cureus (May 21, 2024; 16(5):e60731).
The authors describe background Internalized stigma (IS) as the acceptance of unfavourable stereotypes about a disease that society has created and withdrawing from society with feelings of shame and worthlessness.
They conducted this study to examine the level of IS in AV and rosacea patients and compare these patient groups.
Researchers included 53 AV and 46 rosacea patients aged 18-65 years in the study and applied versions of the Internalized Stigma Scale (ISS) adapted for AV and rosacea to all the patients. Participants also responded to the "Dermatology Life Quality Index" (DLQI) questionnaire.
The data showed total DLQI, total ISS, and its subscales' scores of all patients to be positively correlated with each other. When the researchers compared rosacea and AV patients with each other, they observed no difference regarding DLQI and ISS scores.
Microbiota interactions that control “maskne” symptoms identified
Researchers have identified a mechanism through which indirect microbiota interactions under facemasks can control the symptoms of “maskne” by suppressing a pathogen.
The authors of the paper, published in NPJ Biofilms and Microbiomes (June 20, 2024; 10(1):50), note that prior research has shown that anaerobic bacteria are the putative causal microbes in the skin irritation associated with long-term wear of medical facemasks, sometimes known colloquially as “maskne.”
To better understand the pathogenesis of facemask-associated skin conditions, they characterized the role of the skin microbiota in the development of maskne through both culture-dependent and -independent methodologies.
Their metagenomic analysis revealed that most of the facemask microbiota were anaerobic bacteria originating from the skin rather than saliva.
Because prior research had demonstrated a direct interaction between pathogenic bacteria and antagonistic strains in the microbiome, the investigators expanded their analysis to include indirect interaction between pathogenic bacteria and other indigenous bacteria classified as either 'pathogen helper (PH)' or 'pathogen inhibitor (PIn)' strains.
When they conducted in vitro screening of bacteria isolated from facemasks, the authors identified both strains that antagonized and promoted pathogen growth. They then validated these data using a mouse skin infection model, where they observed attenuation of symptoms following pathogen infection. They also found the inhibitor of pathogen helper (IPH) strain, which did not directly attenuate pathogen growth in vitro and in vivo, functioned to suppress symptom development and pathogen growth indirectly through PH inhibitory antibacterial products such as phenyl lactic acid.
They conclude this study is the first to define a mechanism by which indirect microbiota interactions under facemasks can control symptoms of maskne by suppressing a skin pathogen.
Baseline serum lipids predict dry eye in acne ptx treated with isotretinoin
Baseline levels of triglycerides and total cholesterol are both significant predictors of the severity of dry eye symptoms in acne patients treated with isotretinoin, according to a new study (Cureus, May 23, 2024; 16(5):e60922)
Researchers retrospectively reviewed data on 30 acne patients treated with isotretinoin for at least four months at the dermatology clinics of Qassim University Medical City, Saudi Arabia.
The investigators reviewed the patients’ baseline levels of triglycerides and total cholesterol. They had the patients complete the Ocular Surface Disease Index (OSDI) questionnaire to assess the severity of eye dryness.
Among the participants, 16 (53.3%) were females and 14 (46.7%) were males, with an average age of 22.1 years. The duration of treatment was between 120 and 140 days in 13 (43.3%) participants and 140 and 180 days in 17 (56.7%) participants. The mean ± 1 standard deviation (SD) was reported for each of the three variables, with an Ocular Surface Disease Index (OSDI) score of 27.6 ± 19.2, a baseline total cholesterol of 4.4 ± 0.9 mmol/L, and a baseline triglyceride level of 0.83 ± 0.4 mmol/L.
Using a multiple linear regression model, the researchers used baseline triglycerides and total cholesterol as predictors of the OSDI score.
They found a significant dependent interaction between baseline total cholesterol and triglycerides and their effect on the OSDI score, with a higher OSDI score at higher levels of both triglycerides and cholesterol and a lower OSDI score at lower levels of both triglycerides and cholesterol.
The study result showed that, in acne patients treated with isotretinoin for at least four months, a higher baseline level of both triglycerides and total cholesterol is associated with worse dry eye symptoms compared to those with lower baseline levels.
Despite study limitations due to the small sample size, the authors write they hope that their results will open the door to future studies with a larger sample size to further confirm their findings, generalize the result, and apply it to clinical practice to identify patients at higher risk of eye dryness.
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