Acne Vulgaris

Acne vulgaris is a multifactorial disorder of the pilosebaceous unit. The clinical picture can range from mild comedones to fulminant, scarring cases. Approximately 83–100% of all adolescents experience acne vulgaris at some point of their lives. Although acne often tends to resolve following the adolescent period, many men and women continue to suffer from either active acne or postinflammatory scars into their twenties and thirties. Most patients with acne vulgaris are in the complicated adolescence period and thus carry a distinctive psychosocial burden. They possess a disease stigma on their skin for the external world to criticize every day. For all these reasons, acne is a disease which should be treated promptly and efficiently in all age groups. This chapter will provide a comprehensive and up-to-date review of pathophysiology of acne vulgaris, new molecular mechanisms on the evolving acne lesions, epidemiology of the disease, and latest treatment options. The molecular biology of acne lesions, novel treatment options including cosmetic approaches, their role in acne pathogenesis, pathophysiology, and mechanism of actions of the drugs, safety, and efficacy issues, and various treatment regimens will be discussed along with novel discoveries and areas in which further research is needed

Acne Rosacea

Rosacea is a common chronic inflammatory cutaneous disorder with variable presentation and severity. Disease usually occurs between the ages of 30 and 50 years. Women are more commonly affected than men. Rosacea is divided into four subtypes: erythematotelangiectatic, papulopustular, phymatous, and ocular, and one variant: lupoid or granulomatous rosacea. Erythematotelangiectatic rosacea is manifested as flushing and persistent centrofacial erythema, and papulopustular rosacea as papules and pustules in a centrofacial distribution. With disease progression, phymas consisting of sebaceous gland hypertrophy can develop. Ocular rosacea can result in blepharitis and conjunctivitis. Diagnosis is made clinically. Management of rosacea consists of protective measures such as sun protection and gentle skin care and topical and systemic treatments to suppress inflammation and erythema

Treatment Indications of Carbon Solution-Assisted Nd:YAG Laser According to Patient Satisfaction: A Retrospective Study

Background: Carbon solution-assisted Nd:YAG lasers were previously used in enlarged pores; hair removal; acne and acne scars; and facial rejuvenation. Objective:The aim of this study is to determine the patient satisfaction for different treatment indications of carbon solution-assisted 1064 nm Nd:YAG lasers. Patients and Method: This is a retrospective study that included the patients who were treated with carbon solution-assisted 1064 nm Nd:YAG laser with any indication in a private dermatology practice. A pre-prepared carbon solution was applied 30 minutes before the laser treatment with the following parameters: a spot size of 8mm, fluence of 1.3 J/cm2 and a frequency of 8Hz. Patient satisfaction was assesed with GAIS. Results: A total of 272 patients were included; of these 70 patients had acne lesions, 135 patients had melasma, 27 patients had post-inflammatory hyperpigmentation, 17 patients had ephelides and 23 patients had solar lentigines. The mean patient satisfaction for solar lentigo patients (4.35/5) was greater than for that of acne patients (4.26/5) which was greater than that of ephelide patients (3.94/5) which was greater than that of melasma patients (3.67/5) which was greater than that of post inflammatory hyperpigmentation patients (2.30/5) Conclusion: This study revealed that carbon solution-assisted 1064 nm Nd:YAG laser therapy is effective in the treatment of solar lentigo, acne vulgaris, ephelides and melasma. However, it fails to provide therapeutic efficacy in post inlammatory hyperpigmentation

Efficacy of Rituximab in Patients with Autoimmune Bullous Disease: A Retrospective Cohort Study

INTRODUCTION: The aim of this study was to evaluate the effectiveness of rituximab in autoimmune bullous diseases. METHODS: In this study, the data of patients who received rituximab treatment for autoimmune bullous disease in our clinic between 2012 and 2019 were retrospectively reviewed. The patients age, sex, diagnosis, presence of cutaneous/mucosal involvement before infusion, number of infusions, anti-desmoglein 1, anti-desmoglein 3 and indirect immunofluorescence data before and after treatment, treatment responses and side effects were recorded. RESULTS: In our study, we found a significant decrease in anti-desmoglein 1 and anti-desmoglein 3 levels and accumulations in indirect immunofluorescence after rituximab treatment. (P <0.001 for both) DISCUSSION AND CONCLUSION: The results from our study showed that rituximab is an effective agent that can be used with systemic steroid treatment

Evaluation of the glycemic effect of methotrexate in psoriatic arthritis patients with metabolic syndrome: A pilot study

Methotrexate (MTX) is a systemic immunosuppressant drug used for the treatment of psoriasis and psoriatic arthritis. Previous studies demonstrated a potential association between psoriasis and diabetes mellitus, obesity, atherosclerosis, hypertension, eventuating into metabolic syndrome. This study aimed at exploring the glycemic effects of MTX in psoriatic arthritis (PsA) patients. In this prospective cross-sectional study, 27 patients with PsA were evaluated. The status of PsA and presence of accompanying metabolic syndrome was determined by standard criteria and indices. Blood indicators including HbA1c, erythrocyte sedimentation rate, fasting blood sugar, total cholesterol, high-density lipoprotein, triglycerides, and C-reactive protein were examined before and 12 weeks after MTX therapy. There were no significant changes between HbA1c levels before and after MTX therapy in both genders (men: P=0.131, women: P=0.803). In addition, HbA1c levels in PsA patients with metabolic syndrome were not different before and after treatment (P=0.250). Finally, HbA1c levels did not change in PsA patients without metabolic syndrome before and after therapy (P=0.506). MTX in PsA patients does not appear to have hyperglycaemic effects in the short-term and can be safely used in patients with metabolic syndrome and diabetes