Acne is a common inflammatory skin disease which affects the pilosebaceous units of the skin. It can have severe psychological effects and can leave the patient with severe skin scarring. There are four well-recognized pathological factors responsible for acne which is also the target for acne therapy. In this review, different treatment options are discussed, including topical (i.e., retinoids, and antibiotics) and systemic (i.e., retinoids, antibiotics, and hormonal) treatments. Since the general public has been showing an increasing interest in more natural and generally safer treatment options, the use of complementary and alternative medicines (CAM) for treating acne was also discussed. The use of physical therapies such as comedone extraction, cryoslush therapy, cryotherapy, electrocauterization, intralesional corticosteroids and optical treatments are also mentioned. Acne has been extensively researched with regards to the disease mechanism as well as treatment options. However, due to the increasing resistance of Propionibacterium acnes towards the available antibiotics, there is a need for new treatment methods. Additionally, the lack of necessary evidence on the efficacy of CAM therapies makes it necessary for researchers to investigate these treatment options further.

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Most anti-cancer drugs are derived from natural resources such as marine, microbial and botanical sources. Cutaneous malignant melanoma is the most aggressive form of skin cancer, with a high mortality rate. Various treatments for malignant melanoma are available, but due to the development of multi-drug resistance, current or emerging chemotherapies have a relatively low success rates. This emphasizes the importance of discovering new compounds that are both safe and effective against melanoma. In vitro testing of melanoma cell lines and murine melanoma models offers the opportunity for identifying mechanisms of action of plant derived compounds and extracts. Common anti-melanoma effects of natural compounds include potentiating apoptosis, inhibiting cell proliferation and inhibiting metastasis. There are different mechanisms and pathways responsible for anti-melanoma actions of medicinal compounds such as promotion of caspase activity, inhibition of angiogenesis and inhibition of the effects of tumor promoting proteins such as PI3-K, Bcl-2, STAT3 and MMPs. This review thus aims at providing an overview of anti-cancer compounds, derived from natural sources, that are currently used in cancer chemotherapies, or that have been reported to show anti-melanoma, or anti-skin cancer activities. Phytochemicals that are discussed in this review include flavonoids, carotenoids, terpenoids, vitamins, sulforaphane, some polyphenols and crude plant extracts.

Background The associations between the extent of forced expiratory volume in 1 s (FEV₁) impairment and mortality, incident cardiovascular disease, and respiratory hospitalisations are unclear, and how these associations might vary across populations is unknown. MethodsIn this international, community-based cohort study, we prospectively enrolled adults aged 35-70 years who had no intention of moving residences for 4 years from rural and urban communities across 17 countries. A portable spirometer was used to assess FEV₁. FEV₁ values were standardised within countries for height, age, and sex, and expressed as a percentage of the country-specific predicted FEV₁ value (FEV₁%). FEV₁% was categorised as no impairment (FEV₁% ≥0 SD from country-specific mean), mild impairment (FEV₁% <0 SD to -1 SD), moderate impairment (FEV₁% <-1 SD to -2 SDs), and severe impairment (FEV₁% <-2 SDs [ie, clinically abnormal range]). Follow-up was done every 3 years to collect information on mortality, cardiovascular disease outcomes (including myocardial infarction, stroke, sudden death, or congestive heart failure), and respiratory hospitalisations (from chronic obstructive pulmonary disease, asthma, pneumonia, tuberculosis, or other pulmonary conditions). Fully adjusted hazard ratios (HRs) were calculated by multilevel Cox regression. Findings Among 126 359 adults with acceptable spirometry data available, during a median 7•8 years (IQR 5•6-9•5) of follow-up, 5488 (4•3%) deaths, 5734 (4•5%) cardiovascular disease events, and 1948 (1•5%) respiratory hospitalisation events occurred. Relative to the no impairment group, mild to severe FEV₁% impairments were associated with graded increases in mortality (HR 1•27 [95% CI 1•18-1•36] for mild, 1•74 [1•60-1•90] for moderate, and 2•54 [2•26-2•86] for severe impairment), cardiovascular disease (1•18 [1•10-1•26], 1•39 [1•28-1•51], 2•02 [1•75-2•32]), and respiratory hospitalisation (1•39 [1•24-1•56], 2•02 [1•75-2•32], 2•97 [2•45-3•60]), and this pattern persisted in subgroup analyses considering country income level and various baseline risk factors. Population-attributable risk for mortality (adjusted for age, sex, and country income) from mildly to moderately reduced FEV₁% (24•7% [22•2-27•2]) was larger than that from severely reduced FEV₁% (3•7% [2•1-5•2]) and from tobacco use (19•7% [17•2-22•3]), previous cardiovascular disease (5•5% [4•5-6•5]), and hypertension (17•1% [14•6-19•6]). Population-attributable risk for cardiovascular disease from mildly to moderately reduced FEV₁ was 17•3% (14•8-19•7), second only to the contribution of hypertension (30•1% [27•6-32•5]).Interpretation FEV₁ is an independent and generalisable predictor of mortality, cardiovascular disease, and respiratory hospitalisation, even across the clinically normal range (mild to moderate impairment).

SynopsisIt has been recognized that the vehicle in which a permeant is applied to the skin has a distinctive effect on the dermal and transdermal delivery of active ingredients. The cutaneous and percutaneous absorptions can be enhanced, e.g. by an increase in thermodynamic activity, supersaturation and penetration modifiers. Furthermore, dermal and transdermal delivery can be influenced by the interactions that may occur between the vehicle and the skin on the one hand, and interactions between the active ingredient and the skin on the other hand. Emulsions are widely used as cosmetic and pharmaceutical formulations because of their excellent solubilizing capacities for lipophilic and hydrophilic active ingredients and application acceptability. This review focuses, in particular, on the effect of emulsions on the dermal and transdermal delivery of active ingredients. It is shown that the type of emulsion (w/o vs. o/w emulsion), the droplet size, the emollient, the emulsifier as well as the surfactant organization (micelles, lyotropic liquid crystals) in the emulsion may affect the cutaneous and percutaneous absorption. Examples substantiate the fact that emulsion constituents such as emollients and emulsifiers should be selected carefully for optimal efficiency of the formulation. Moreover, to understand the influence of emulsion on dermal and transdermal delivery, the physicochemical properties of the formulation after application are considered. Ré suméOn sait que le véhicule dans lequel un perméat est appliqué sur la peau a un effet spécifique sur la libération dermique et transdermique des ingrédients actifs. Les absorptions cutanées et percutanées peuvent être augmentées, par exemple par une augmentation de l'activité thermodynamique, une super saturation ou la présence de modificateurs de pénétration. Ainsi, la libération dermique et transdermique peut être influencée par les interactions susceptibles de s'établir d'un côté entre le véhicule et la peau et de l'autre entre l'ingrédient actif et la peau. Les émulsions sont largement utilisées dans les formulations cosmétiques et pharmaceutiques du fait de leurs excellentes capacités de solubilisation des ingrédients actifs lipophiles et hydrophiles, et du fait de leur bonne tolérance. Cette revue traite, en particulier, des effets des émulsions sur la libération dermique et trans-dermique d'ingrédients actifs. On montre que le type d'émulsion (E/H par rapport à H/E), la granulomé-trie, l'émollient, les émulsifiants, autant que l'organisation des tensioactifs (micelles, cristaux liquides lyotropes) peuvent influencer l'absorption cutanée et percutanée. Des exemples justifient le fait qu'un choix soigné des constituants de l'émulsion comme les émollients et les émulsifiants peut optimiser l'efficacité de la formulation. En complément, pour comprendre l'influence de l'émulsion sur la libéra-tion dermique et transdermique, les propriétés physico-chimiques de la formulation après application sont étudiées.The effect of the vehicle on dermal and transdermal deli...

The transdermal route of administration offers an alternative pathway for systemic drug delivery with numerous advantages over conventional routes. Regrettably, the stratum corneum forms a formidable barrier that hinders the percutaneous penetration of most drugs, offering an important protection mechanism to the organism against entrance of possible dangerous exogenous molecules. Different types of penetration enhancers have shown the potential to reversibly overcome this barrier to provide effective delivery of drugs across the skin. Although certain chemical and physical skin penetration enhancers are already employed by the pharmaceutical industry in commercially available transdermal products, some skin penetration enhancers are associated with irritating and toxic effects. This emphasizes the need for the discovery of new, safe and effective skin penetration enhancers. Penetration enhancers from natural origin have become popular as they offer several benefits over their synthetic counterparts such as sustainable mass production from a renewable resource and lower cost depending on the type of extraction used. The aim of this article is to give a comprehensive summary of the results from scientific research conducted on skin penetration enhancers of natural origin. The discussions on these natural penetration enhancers have been organized into the following chemical classes: essential oils, terpenes, fatty acids and polysaccharides.

The effect of particle size of lipasomes cm the deposition of drugs into the strata of skin was evaluated using hairless mice. hamster and pig skin. fn vitro diffusion studies were performed in an attempt to find an optimum formulation for topical drug delivery as welt as to try to explain the mechanism of topica! drug delivery by fipasomes. The results indicate that an optimum particle size for optima1 drug delivery exists. The study proved that the folficular route play an important roie in determining the kinetics of drug transfer from liposomes into the skin.

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