Management of severe acne

Abstract

SummaryAcne is the most common skin disease, affecting up to 95% of adolescents. Severe episodes of acne can cause considerable physical and psychological scarring, and overexpression of transforming growth factor-b can lead to formation of hypertrophic scars and keloids. The severity of acne in adolescence is associated with a positive history of severe acne in first-degree relatives, especially the mother. In most cases acne is a chronic disease, and it is often a component of systemic diseases or syndromes. All forms of severe acne require systemic treatment. The available options include oral antibiotics, hormonal antiandrogens for female patients and oral isotretinoin, as well as other combination treatments. Oral isotretinoin is the only drug available that affects all four pathogenic factors of acne. However, due to possible serious side-effects, a European directive states that oral isotretinoin should be used only as a second-line therapy in cases of severe, nodular and conglobate acne. The pharmaceutical quality of generic isotretinoin products and the obtainability of isotretinoin through e-pharmacies without prescription raise new therapeutic problems. New anti-inflammatory compounds, such as the 5-lipoxygenase inhibitor zileuton, may replace systemic antibiotics in the future, especially under the scope of antibiotic resistance prevention. This review looks into the various options and latest approaches, and factors to consider, when combating severe acne.

Large scale survey to describe acne management in Brazilian clinical practice

“…Furthermore, it has been suggested that some patients may experience depression while using oral isotretinoin, but studies have not shown a decisive relationship. 7,14,15 The development of bacterial resistance and ensuing recommendations from health authorities has limited the use of local and systematic antibiotics, favoring their use within the framework of combined therapy regimens. 16,17 Nevertheless, in 12% of cases, only one local or systematic antibiotic has been noted to be prescribed by European dermatologists, which contradicts the published recommendations and indicates that dermatologists should not use antibiotics alone.…”

Aktivitas Antibakteri Ekstrak Etanol Dari Lima Tanaman Terhadap Bakteri Staphylococcus Epidermidis Dengan Metode Mikrodilusi M7 – A6CLSI

“…Bakteri tersebut ikut serta dalam patogenesis jerawat dengan menghasilkan lipase, yang memecahkan asam lemak bebas dari lipid kulit 5 . Asam lemak ini dapat menimbulkan radang jaringan dan ikut menyebabkan jerawat 6 . Populasi bakteri penyebab jerawat tersebut dapat diturunkan dengan memberikan suatu zat antibakteri seperti tetrasiklin, kloramfenikol dan amoksisilin 7 .…”

“…Pada penggunaannya obat jerawat yang ada di pasaran memiliki efek samping yang lebih besar daripada obat jerawat yang berasal dari alam 13 , misalnya efek samping yang diakibatkan dari antibiotik yang digunakan pada produk anti jerawat yang ada di pasaran yaitu reaksi alergi yang diakibatkan oleh antibiotik dengan melibatkan sistem imun tubuh hospes. Selain itu efek samping yang ditimbulkan yaitu reaksi hipersensitifitas 6 , adanya ketergantungan obat yang terjadi karena interaksi suatu obat dengan organisme hidup 7 , ada suatu senyawa yaitu Isotretinoin yang digunakan untuk mengobati jerawat yang berat 13 , psoriasis dan kelainan kulit lainnya bisa menyebabkan cacat bawaan 14 . Yang paling sering terjadi adalah kelainan jantung, telinga yang kecil dan hidrosefalus (kepala yang besar) 15 .…”

Suppressed Serum Prolactin Levels under Topical Treatment with Isoretinoin

“…Adverse effects of isotretinoin are well defined being the major limiting factor for its usage. Next to mucocutanous changes, teratogenicity as well as psychiatric and endocrinological side effects have been reported [1].…”