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New Insights on Acne, Rosacea, and Hidradenitis Suppurativa: Etiology and Treatment

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Dermatology".

Deadline for manuscript submissions: closed (20 March 2023) | Viewed by 70770

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Special Issue Editor


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Guest Editor
Department of Dermatology, Incheon St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea
Interests: acne; rosacea; skin microbiome; lasers and light therapy; cosmetics; itch

Special Issue Information

Dear Colleagues,

Acne, rosacea, and hidradenitis suppurativa (formerly called acne inversa) are skin diseases which share similar features such as redness, papules, nodules. All can result in reduced self-esteem, anxiety, and depression.

With the recent advent of molecular biology and next-generation sequencing (NGS), knowledge on the skin microbiota in these skin conditions has grown exponentially. Additionally, the potential involvement of insulin-like growth factor (IGF)-1 has been suggested in acne, rosacea and hidradenitis suppurativa which opens the possibility for new treatment. Biologics and JAK-inhibitors are also a promising option and should be further examined.

We herein welcome papers which provide exciting new insights on acne, rosacea, and hidradenitis suppurativa.

Prof. Dr. Hei Kim
Guest Editor

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Keywords

  • acne
  • rosacea
  • hidradenitis suppurativa
  • new insights
  • etiology
  • treatment
  • skin microbiome
  • IGF-1

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Published Papers (12 papers)

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Research

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13 pages, 1274 KiB  
Article
Satisfaction with Life and Coping Strategies among Patients with Hidradenitis Suppurativa: A Cross-Sectional Study
by Julia E. Rymaszewska, Piotr K. Krajewski, Łukasz Matusiak, Joanna Maj and Jacek C. Szepietowski
J. Clin. Med. 2023, 12(8), 2755; https://doi.org/10.3390/jcm12082755 - 7 Apr 2023
Cited by 8 | Viewed by 1532
Abstract
Introduction: Hidradenitis suppurativa (HS) is a chronic recurrent inflammatory dermatosis with vast psychosocial burden. The objective of this study is to thoroughly analyze satisfaction with life (SWL) and coping strategies of HS patients in relation to the clinical and psychosocial factors. Methods: 114 [...] Read more.
Introduction: Hidradenitis suppurativa (HS) is a chronic recurrent inflammatory dermatosis with vast psychosocial burden. The objective of this study is to thoroughly analyze satisfaction with life (SWL) and coping strategies of HS patients in relation to the clinical and psychosocial factors. Methods: 114 HS patients (53.1% females; mean age 36.6 ± 13.1 years) were enrolled. Severity of the disease was measured using Hurley staging and International HS Score System (IHS4). Instruments utilized: Satisfaction with Life Scale (SWLS); Coping-Orientation to Problems-Experienced Inventory (Brief COPE); HS Quality of Life Scale (HiSQoL); Patient Health Questionnaire-9 (PHQ-9); Generalized Anxiety Disorder-7 (GAD-7); General Health Questionnaire (GHQ-28). Results: SWL was low in 31.6% of HS patients. No relation was found between SWL and Hurley staging and IHS4. SWL correlated with GHQ-28 (r = −0.579 p < 0.001), PHQ-9 (r = −0.603 p < 0.001), GAD-7 (r = −0.579 p < 0.001), and HiSQoL (r = −0.449 p < 0.001). Problem-focused coping strategies were most commonly used, followed by emotion-focused coping and avoiding coping strategies. Significant differences were found between the following coping strategies and SWL: self-distraction (p = 0.013), behavioral-disengagement (p = 0.001), denial (p = 0.003), venting (p = 0.019), and self-blame (p = 0.001). Conclusions: HS patients present low SWL which correlates with psychosocial burden. Reducing anxiety–depression comorbidity and encouraging optimal coping strategies may be of great importance in holistic approach to HS patients. Full article
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10 pages, 1839 KiB  
Article
Prospective Evaluation of a Topical Botanical Skin Care Regimen on Mild to Moderate Facial and Truncal Acne and Mood
by Yvonne Nong, Nimrit Gahoonia, Julianne Rizzo, Waqas Burney, Raja K. Sivamani and Jessica Maloh
J. Clin. Med. 2023, 12(4), 1484; https://doi.org/10.3390/jcm12041484 - 13 Feb 2023
Cited by 2 | Viewed by 2967
Abstract
Acne vulgaris is a common inflammatory condition that can be associated with profound psychosocial impacts. Conventional treatment includes topical retinoids, benzoyl peroxide, and antimicrobials, and some may cause irritation and skin dryness. In this 8-week open-label study, we examined the effects of a [...] Read more.
Acne vulgaris is a common inflammatory condition that can be associated with profound psychosocial impacts. Conventional treatment includes topical retinoids, benzoyl peroxide, and antimicrobials, and some may cause irritation and skin dryness. In this 8-week open-label study, we examined the effects of a botanical skin care regimen (Codex Labs Shaant Balancing regimen) on mild to moderate facial and truncal acne. Twenty-four male and female subjects between the ages of 12 and 45 years were assessed for eligibility, 20 were enrolled, and 15 completed all study visits. Facial and truncal acne lesion counts, skin hydration, sebum excretion rate, and mood were assessed at baseline, week 4, and week 8. Total facial lesion counts (inflammatory and non-inflammatory lesions) decreased by 20.5% at week 4 (p = 0.06) and by 25.2% at week 8 (p < 0.05). Inflammatory lesion counts on the trunk were found to decrease at week 8 relative to baseline by 48% (p < 0.05). Forehead sebum excretion rate decreased by 40% at week 4 (p = 0.07) and 22% at week 8 (p = 0.08), and cheek skin hydration increased by 27.6% at week 4 (p = 0.14) and 65% at week 8 (p = 0.10). Participants also experienced significant improvement in components of a positive effect, such as feeling “strong” and “inspired”, and a decrease in negative effects, such as feeling “irritable.” Overall, the botanical skin care regimen was found to be well-tolerated. Our study suggests that a botanical skin care regimen may reduce facial and truncal acne lesion counts, increase skin hydration, reduce sebum production, and augment positive effects and moods in those with mild to moderate facial and truncal acne. Full article
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11 pages, 1670 KiB  
Article
Efficacy of Hydrogen Purification and Cosmetic Acids in the Treatment of Acne Vulgaris: A Preliminary Report
by Karolina Chilicka, Monika Rusztowicz, Aleksandra M. Rogowska, Renata Szyguła, Binnaz Asanova and Danuta Nowicka
J. Clin. Med. 2022, 11(21), 6269; https://doi.org/10.3390/jcm11216269 - 25 Oct 2022
Cited by 19 | Viewed by 4068
Abstract
Acne and skin lesions that appear in its course deteriorate the quality of life of patients, cause depression and the emergence of suicidal thoughts. Cosmetic treatments can have a positive effect on improving skin condition by cleaning up skin eruptions, thus improving the [...] Read more.
Acne and skin lesions that appear in its course deteriorate the quality of life of patients, cause depression and the emergence of suicidal thoughts. Cosmetic treatments can have a positive effect on improving skin condition by cleaning up skin eruptions, thus improving the well-being of affected people. Hydrogen purification is a treatment that uses alkaline water generated by a device, which reduces sebum from the surface of the epidermis. This is a novel treatment that has recently been introduced to beauty salons. On the other hand, cosmetic acids have been used for many years for treating people with acne vulgaris and give spectacular results in terms of improving the skin condition. In this study, skin condition was evaluated with a Derma Unit SSC 3 device. The Global Acne Grading System (GAGS) was used to check acne severity. Twenty-four women aged 19–21 years (M = 20.13, SD = 0.80) diagnosed with mild acne vulgaris and a high sebum level participated in the study. Group A underwent a hydrogen purification treatment using an H2jet manipulator, which ejected alkaline water from the manipulator under pressure. Group B underwent a hydrogen purification treatment with the use of a phytic, pyruvic, lactic and ferulic acids at 40% mixture (pH 1.4). A series of four treatments was performed at 14-day intervals in both groups. Skin parameters were measured before and 30 days after the series of treatment. Very good results were obtained in both groups. The skin eruptions in patients were reduced and we also observed lower amounts of sebum on the surface of the epidermis, and an improvement in skin hydration. However, in group B, the results were better than in group A. The study showed that the synergy of the treatments produced much better effects than those obtained by completing the hydrogen purification treatment alone. Full article
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9 pages, 1069 KiB  
Article
A Split Face Comparative Study to Evaluate the Efficacy of 40% Pyruvic Acid vs. Microdermabrasion with 40% Pyruvic Acid on Biomechanical Skin Parameters in the Treatment of Acne Vulgaris
by Monika Rusztowicz, Karolina Chilicka, Renata Szyguła, Wiktoria Odrzywołek, Antoniya Yanakieva, Binnaz Asanova and Sławomir Wilczyński
J. Clin. Med. 2022, 11(20), 6079; https://doi.org/10.3390/jcm11206079 - 14 Oct 2022
Cited by 4 | Viewed by 1807
Abstract
The synergy of cosmetic acids, with their keratolytic and antibacterial properties, with the mechanical exfoliation of the epidermis brings faster and better treatment results. The aim of the study was to compare the effects of using only pyruvic acid and the synergy of [...] Read more.
The synergy of cosmetic acids, with their keratolytic and antibacterial properties, with the mechanical exfoliation of the epidermis brings faster and better treatment results. The aim of the study was to compare the effects of using only pyruvic acid and the synergy of microdermabrasion and chemical exfoliation. In total, 14 women diagnosed with acne took part in the study. Two areas were marked on the participants’ faces: the right side (microdermabrasion treatment and a preparation containing pyruvic acid 40%) and the left side (preparation containing pyruvic acid 40%) without mechanical exfoliation. A series of four treatments was performed at 2-week intervals. Skin parameters such as stratum corneum hydration and sebum secretion were measured. Before the treatments, all patients had moderate acne according to GAGS (Min: 19, Max: 22, Md: 20), and after the treatments, it decreased to mild acne according to GAGS (Min: 13, Max: 17, Md: 140). On the right side of the face, there was a statistically significant reduction in sebum secretion in all the examined areas of the face and increase in the hydration of the stratum corneum. On the left side of the face, the differences were also observed in the decrease of sebum value and increase of hydration level; however, they were smaller than on the right side. The use of microdermabrasion in combination with pyruvic acid led to better results in the case of increased hydration and reduction of sebum secretion than using only pyruvic acid treatment. Full article
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10 pages, 1358 KiB  
Article
Efficacy of Oxybrasion in the Treatment of Acne Vulgaris: A Preliminary Report
by Karolina Chilicka, Aleksandra M. Rogowska, Renata Szyguła, Monika Rusztowicz and Danuta Nowicka
J. Clin. Med. 2022, 11(13), 3824; https://doi.org/10.3390/jcm11133824 - 1 Jul 2022
Cited by 20 | Viewed by 4843
Abstract
There are many cosmetic methods to reduce skin eruptions in people with acne vulgaris. As oxybrasion is a safe method of exfoliating dead epidermis, our objective was to investigate its effectiveness in young women with acne vulgaris. The Global Acne Grading System (GAGS) [...] Read more.
There are many cosmetic methods to reduce skin eruptions in people with acne vulgaris. As oxybrasion is a safe method of exfoliating dead epidermis, our objective was to investigate its effectiveness in young women with acne vulgaris. The Global Acne Grading System (GAGS) and Derma Unit SSC 3 device (Sebumeter SM 815, Corneometer CM 825) were used to assess acne vulgaris and skin properties. Twenty-four women aged 19–21 years (M = 19.50, SD = 0.66) with diagnosed mild acne vulgaris and a high level of sebum (more than 100 μg/cm2) participated in the study. Women on any dermatological treatment within the last 12 months and/or hormonal contraception were excluded. Probands were randomly assigned to two equal groups. Group A (experimental) was oxybrased with 0.9% sodium chloride solution simultaneously with compressed oxygen. Group B (placebo) was the group treated with non-carbonated mineral water and oxygen from the device (not pure). A series of five treatments was performed at 10-day intervals. Skin parameters were measured before and 30 days after the end of treatment. As a result, in group A (experimental), skin hydration and GAGS improved, while sebum on the epidermis was reduced. No side effects were noted. We concluded that oxybrasion is effective in women with acne and safe, as it improved skin parameters; however, further research is needed. Full article
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Review

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10 pages, 270 KiB  
Review
Skincare in Rosacea from the Cosmetologist’s Perspective: A Narrative Review
by Danuta Nowicka, Karolina Chilicka, Iwona Dzieńdziora-Urbińska and Renata Szyguła
J. Clin. Med. 2023, 12(1), 115; https://doi.org/10.3390/jcm12010115 - 23 Dec 2022
Cited by 6 | Viewed by 4168
Abstract
Rosacea is a common skin disease that affects about 5% of the general population. Its symptoms include telangiectasia, persistent erythema, burning/stinging sensation, dry skin sensation, and pruritus. It is characterized by a chronic course with frequent exacerbation. It often coexists with anxiety and [...] Read more.
Rosacea is a common skin disease that affects about 5% of the general population. Its symptoms include telangiectasia, persistent erythema, burning/stinging sensation, dry skin sensation, and pruritus. It is characterized by a chronic course with frequent exacerbation. It often coexists with anxiety and depression, reducing the quality of life of affected patients. The etiopathogenesis of rosacea is complex and not fully elucidated; hence, there is no causative effective treatment. In this review, we highlight the role of a cosmetologist in the treatment of rosacea and the maintenance of remission. As part of medical treatment, patients are advised to introduce lifestyle changes and use proper skin care; a cosmetologist can help educate patients affected with rosacea, create effective home care programs for skin care, and support them with treatments in beauty salons. Proper skin care is essential, including the use of dermocosmetics, cleansing of the skin, and frequent visits to beauty salons for tailored apparatus procedures. A cosmetologist is more accessible to patients and can help implement healthy daily habits, including skin care and eating habits, as well as support and mediate good communication between the patient and the patient’s treating physician, thereby improving compliance and ensuring long-term satisfactory outcomes. Full article
18 pages, 3002 KiB  
Review
Revisiting the Role of Local Cryotherapy for Acne Treatment: A Review and Update
by Nark-Kyoung Rho
J. Clin. Med. 2023, 12(1), 26; https://doi.org/10.3390/jcm12010026 - 20 Dec 2022
Cited by 3 | Viewed by 3813
Abstract
Acne vulgaris is a well-recognized condition among adolescents and adults that adversely affects their quality of life. Local cryotherapy has long been reported to be effective in treating acne vulgaris, inducing a more rapid involution of acne than topical medications. However, the use [...] Read more.
Acne vulgaris is a well-recognized condition among adolescents and adults that adversely affects their quality of life. Local cryotherapy has long been reported to be effective in treating acne vulgaris, inducing a more rapid involution of acne than topical medications. However, the use of cryotherapy has been limited for acne treatment due to several drawbacks, including procedural pain and pigmentary alterations. Currently, newer cryotherapy devices are gaining attention in dermatology due to their ability to monitor and precisely control the target temperature. In this narrative review, a brief history and the latest update on acne cryotherapy will be presented. Additionally, a special emphasis is placed on the role of cryotherapy, alone or in combination with intralesional steroid injections for nodulocystic acne. Full article
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9 pages, 266 KiB  
Review
Acne Vulgaris—Novel Treatment Options and Factors Affecting Therapy Adherence: A Narrative Review
by Aleksandra Tobiasz, Danuta Nowicka and Jacek C. Szepietowski
J. Clin. Med. 2022, 11(24), 7535; https://doi.org/10.3390/jcm11247535 - 19 Dec 2022
Cited by 11 | Viewed by 5687
Abstract
Acne vulgaris is an extremely common skin condition, affecting a large population of adolescents, but at the same time, remaining a quite common issue in the group of adult patients. Its complex pathogenesis includes increased sebum secretion, impaired follicular keratinization, colonization of sebaceous [...] Read more.
Acne vulgaris is an extremely common skin condition, affecting a large population of adolescents, but at the same time, remaining a quite common issue in the group of adult patients. Its complex pathogenesis includes increased sebum secretion, impaired follicular keratinization, colonization of sebaceous glands with Cutibacterium acne bacteria, and the development of inflammation in pilosebaceous units. Although there are many methods of treatment available targeting the mechanisms mentioned above, a large percentage of patients remain undertreated or non-compliant with treatment. Ineffective treatment results in the formation of acne scars, which has a major impact on the well-being and quality of life of the patients. The aim of this publication was a review of available evidence on widely used and novel methods of topical and systemic treatment of acne, additionally including current literature-based analysis of factors affecting patients’ compliance. The strengths and limitations of novel substances for treating acne were discussed. We conclude that an effective acne treatment remains a challenge. A better understanding of current treatment options and factors affecting patients’ compliance could be a helpful tool in choosing a proper treatment option. Full article
27 pages, 474 KiB  
Review
Current Medical and Surgical Treatment of Hidradenitis Suppurativa—A Comprehensive Review
by Lennart Ocker, Nessr Abu Rached, Caroline Seifert, Christina Scheel and Falk G. Bechara
J. Clin. Med. 2022, 11(23), 7240; https://doi.org/10.3390/jcm11237240 - 6 Dec 2022
Cited by 26 | Viewed by 4840
Abstract
Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease presenting with recurrent inflammatory lesions in intertriginous body regions. HS has a pronounced impact on patients’ quality of life and is associated with a variety of comorbidities. Treatment of HS is often complex, requiring [...] Read more.
Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease presenting with recurrent inflammatory lesions in intertriginous body regions. HS has a pronounced impact on patients’ quality of life and is associated with a variety of comorbidities. Treatment of HS is often complex, requiring an individual approach with medical and surgical treatments available. However, especially in moderate-to-severe HS, there is an urgent need for new treatment approaches. In recent years, increased research has led to the identification of new potential therapeutic targets. This review aims to give a comprehensive and practical overview of current treatment options for HS. Furthermore, the clinically most advanced novel treatment approaches will be discussed. Full article
14 pages, 562 KiB  
Review
Truncal Acne: An Overview
by Yu Ri Woo and Hei Sung Kim
J. Clin. Med. 2022, 11(13), 3660; https://doi.org/10.3390/jcm11133660 - 24 Jun 2022
Cited by 7 | Viewed by 7752
Abstract
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 [...] Read more.
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. Full article
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13 pages, 293 KiB  
Review
Methods for the Improvement of Acne Scars Used in Dermatology and Cosmetology: A Review
by Karolina Chilicka, Monika Rusztowicz, Renata Szyguła and Danuta Nowicka
J. Clin. Med. 2022, 11(10), 2744; https://doi.org/10.3390/jcm11102744 - 12 May 2022
Cited by 20 | Viewed by 13082
Abstract
Acne vulgaris is a chronic skin disease that, depending on its course, is characterized by the occurrence of various skin eruptions such as open and closed comedones, pustules, papules, and cysts. Incorrectly selected treatment or the presence of severe acne vulgaris can lead [...] Read more.
Acne vulgaris is a chronic skin disease that, depending on its course, is characterized by the occurrence of various skin eruptions such as open and closed comedones, pustules, papules, and cysts. Incorrectly selected treatment or the presence of severe acne vulgaris can lead to the formation of atrophic scars. In this review, we summarize current knowledge on acne scars and methods for their improvement. There are three types of atrophic scars: icepick, rolling, and boxcar. They are of different depths and widths and have different cross-sections. Scars can combine to form clusters. If acne scars are located on the face, they can reduce the patient’s quality of life, leading to isolation and depression. There are multiple effective modalities to treat acne scars. Ablative lasers, radiofrequency, micro-needling, and pilings with trichloroacetic acid have very good treatment results. Contemporary dermatology and cosmetology use treatments that cause minimal side effects, so the patient can return to daily functioning shortly after treatment. Proper dermatological treatment and skincare, as well as the rapid implementation of cosmetological treatments, will certainly achieve satisfactory results in reducing atrophic scars. Full article
10 pages, 666 KiB  
Review
The Role of Skin Immune System in Acne
by Ewelina Firlej, Wioleta Kowalska, Karolina Szymaszek, Jacek Roliński and Joanna Bartosińska
J. Clin. Med. 2022, 11(6), 1579; https://doi.org/10.3390/jcm11061579 - 13 Mar 2022
Cited by 29 | Viewed by 13447
Abstract
Acne vulgaris is a skin disease that often occurs in adolescence and in young adulthood. The main pathogenic factors are hyperkeratinization, obstruction of sebaceous glands, stimulation of sebaceous gland secretion by androgens, and bacterial colonization of sebaceous units by Cutibacterium acnes, which [...] Read more.
Acne vulgaris is a skin disease that often occurs in adolescence and in young adulthood. The main pathogenic factors are hyperkeratinization, obstruction of sebaceous glands, stimulation of sebaceous gland secretion by androgens, and bacterial colonization of sebaceous units by Cutibacterium acnes, which promotes inflammation. Little is known about the role of skin immune cells in the development of acne lesions. The aim of the study was to try to understand the role of skin immune cells in the course of acne. Recent studies have shown that there are at least four major pathways by which Cutibacterium acnes interacts with the innate immune system to induce inflammation: through TLRs, activating inflammasomes, inducing the production of matrix metalloproteinases (MMPs), and stimulating antimicrobial peptide (AMP) activity. Cells of adaptive immune response, mainly Th1 and Th17 lymphocytes, also play an important role in the pathogenesis of acne. It is worth emphasizing that understanding the role of the skin’s immune cells in the pathogenesis of acne may, in the future, contribute to the application of modern therapeutic strategies that would avoid addiction to antibiotics, which would alleviate the spectrum of resistance that is now evident and a current threat. Full article
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