In this letter, we have reported what to our knowledge is the first time that adult acne in women is not related to a specific subtype of C acnes because no higher frequency of phylotype or clonal complex or SLST was identified. Previous studies have shown no difference in C acnes density on the face between women with early-onset (before age 21) acne and women with late-onset acne 4 or in the densities of the 3 predominant microorganisms (Cutibacterium spp, Staphylococcus spp, and Malassezia spp) 4 and women without acne. 5 In confirmation of recently published results, we found that IA1 was the predominant phylotype associated with acne. Interestingly, the frequency of C acnes resistance was similar among the adult women and teenager groups. Limitations of this study include small sample size and the possibility that prior acne treatments may have altered the patients' microbiomes. Our results suggest that differences between acne in adult women and teenagers are more likely related to nonmicrobial factors such as hormonal skin changes, stimulation of innate immunity, or environmental factors.
APPENDIXPrevious studies focusing on adult acne in women and Cutibacterium acnes were identified by using the electronic database PubMed with the following terms: adult woman, acne, and Propionibacterium acnes or Cutibacterium acnes. Each abstract was verified to identify previous studies. On the basis of this literature search strategy, we can assume that our study is the first report showing no link between adult acne in women and a specific subtype of C acnes.
The use of NGS in clinical practice for precision diagnosis requires a quality starting material. Despite the broadly established use of formalin-fixed paraffin-embedded (FFPE) samples in molecular testing, these usually have low-quality DNA. We established a method to determine the suitability of melanoma FFPE samples for an amplicon-based NGS custom panel analysis. DNA was extracted from unstained melanoma samples and wide local excision samples. Amplicon-based libraries were constructed and tested using time and quality parameters as variables. Time elapsed from sample retrieval >7 years, a quality control value > 5.63 and a DNA integrity value < 2.05 indicated samples were not suitable. A decision tree is provided with rate of samples suitable for analysis according to the combination of these parameters.
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