S2k – Guideline on the Therapy of Acne

Nast, Alexander; Bayerl, Christiane; Borelli, Claudia; Degitz, Klaus; Dirschka, Thomas; Erdmann, R.; Fluhr, Joachim W.; Gieler, Uwe; Hartwig, Roland; Meigel, Eva‐Maria; Möller, Siegfried; Ochsendorf, Falk; Rabe, T.; Rzany, Berthold; Sammain, Adel; Schink, Susanne; Zouboulis, Christos C.; Gollnick, Harald

doi:10.1111/j.1610-0387.2010.07466.supp.x

Cited by 23 publications

(44 citation statements)

References 318 publications

(422 reference statements)

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“…Existing data from different countries vary, possibly due to differences in sun exposure patterns, pigmentary characteristics, and/or different MC1R allelic frequencies in diverse study populations (3,4). This is a case-control study aiming to investigate the association of MC1R gene variants and pigmentary characteristics with the risk of BCC in a Southern European population in Greece.…”

Section: Questions Addressedmentioning

confidence: 99%

Inhibition of retinoic acid catabolism by minocycline: evidence for a novel mode of action?

Regen

Hildebrand

Bret

et al. 2015

Experimental Dermatology

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Hsp90 forms a complex with MMP-12 as well as with MMP-2, but not MMP-9, in sera of EBA patients, implicating that these two basement-degrading factors are client proteins of Hsp90 and that their activity is dependent on its chaperone function. A close interaction between MMPs and Hsp90 secreted by cancer cells has been previously described in the context of tumor cell invasion and metastasis formation, and there is evidence that disruption of such Hsp90-MMP complexes by pharmacological Hsp90 blockade can inhibit the protease-dependent mechanism of tissue destruction by malignant cells that shares some similarity with the processes of blister formation in EBA (7,8). These findings might therefore have direct translational implications for the management of patients with EBA and related diseases.It has been previously shown that leukocyte-driven dermalepidermal separation in the ex vivo EBA model can be induced by serum from EBA patients with either the inflammatory or mechanobullous variant and that protease inhibitors can abrogate this effect regardless of the phenotype (5,6). While only sera of inflammatory EBA were used in the cryosection assay of this study, our co-immunoprecipitation experiments revealed that Hsp90-MMP complex formation can be found in both types of EBA. This suggests that Hsp90 inhibition may also be effective in mechanobullous EBA, although it remains speculative until a specific model for this disease subtype will be developed in the future.In summary, our findings add to the knowledge of the multimodal anti-inflammatory effects of Hsp90 blockade and implicate that Hsp90 is closely involved in the effector mechanisms of neutrophil-driven autoantibody-induced tissue damage, thus being a relevant therapeutic target in patients with neutrophilmediated autoimmune diseases such as inflammatory types of EBA. AcknowledgementsThis work was supported by Deutsche Forschungsgemeinschaft (DFG) Excellence Cluster 'Inflammation at Interfaces' (EXC 306/2) and DFG KA 3438/1-1 as well as grants from the Medical Faculty of the University of L€ ubeck (E16-2012, E22-2013, and Focus Program 'Autoimmunity'). Author contributionMK, ST, TL, and RJL conceived and designed the experiments. ST, LH, CU, and MH performed the experiments. MK, ST, TL, RJL, DZ, and US analysed the data and provided reagents/materials/analysis tools. MK and ST wrote the paper. Conflict of interestsThe authors have declared no conflicting interests. Supporting InformationAdditional supporting data may be found in the supplementary information of this article. Figure S1. Cell viability. Data S1. Supplementary methods.

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Section: Questions Addressedmentioning

confidence: 99%

Inhibition of retinoic acid catabolism by minocycline: evidence for a novel mode of action?

Regen

Hildebrand

Bret

et al. 2015

Experimental Dermatology

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“…In this context, the S2k guidelines initially recommend systemic glucocorticoid treatment to avoid scar formation, even though there are no corresponding studies [ 34 ] (Table 2 ).…”

Section: Selection Of the Appropriate Agentmentioning

confidence: 99%

“…The following recommendations may improve adherence [ 34,41 ] . It has been shown that treatment simplifi cation, consideration of patients' preferences, good patient-physician communication, and repeated consultations improve adherence, whereas technical interventions, such as automated text messages, are ineffective [ 40 ] .…”

Section: Patient Managementmentioning

confidence: 99%

“…25 % (girls) of adolescents with severe acne have suicidal ideations, which is signifi cantly higher than corresponding fi gures in a control group (6 % and 12 %, respectively) [ 5 ] . It is therefore recommended to assess and document patients' psychological distress at fi rst presentation, for example, using the Dermatology Life Quality Index (DLQI) [ 34 ] . If there are indications of common comorbidities, such as depression, social anxiety, body dysmorphic, or obsessive-compulsive disorders, appropriate psychotherapeutic interventions must be initiated [ 34 ] .…”

Section: Patient Managementmentioning

confidence: 99%

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Acne

Degitz

Ochsendorf

2017

J Deutsche Derma Gesell

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Summary Acne is a chronic disease with a high prevalence among adolescents. Key pathogenetic factors (and their clinical correlates) are increased sebum production (seborrhea), follicular hyperkeratosis (comedones), and perifollicular inflammation (papules and pustules). The disease is modulated by a variety of endogenous (androgens, IGF‐1, neuroendocrine factors) and exogenous (Propionibacterium acnes, diet, friction, ingredients of medical or cosmetic topical products) triggers. Acne is associated with high morbidity, and even mild manifestations may potentially cause considerable impairment in quality of life. Effective topical and systemic treatments are available. Optimal therapeutic results require continuous patient management over the course of the entire treatment period as well as adjustment of treatment modalities based on symptoms and disease severity.

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“…It occurs primarily in adolescents and young adults, with a predominant facial involvement. [3][4][5][6] Although a fast onset of visible treatment success can be crucial to ensure an adolescent's adherence, none of the existing guidelines or systematic reviews takes the aspect of the time until onset of action (TOA) of acne treatments into account. 1 Medication adherence is critical to acne management and essential for treatment success.…”

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confidence: 99%

Systematic review on the rapidity of the onset of action of topical treatments in the therapy of mild-to-moderate acne vulgaris

et al. 2014

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The time until a patient achieves a relevant improvement during the treatment of a skin disease is important for selecting a therapy, but has been largely neglected in reviews and guidelines. The aim of this systematic review was to determine the time until the onset of action (TOA) of topical acne treatments. The primary outcome was the TOA defined as the time until a 25% reduction in the mean number of inflammatory lesions had been achieved. A systematic literature search in Medline and Embase was carried out. Clinical trials that evaluated head-to-head comparisons of treatments in patients suffering from mild-to-moderate papulopustular acne were included. Abstract and full-text screening and data extraction were done independently by two investigators. With respect to inflammatory lesions, different concentrations of benzoyl peroxide (BPO) or adapalene did not seem to influence the TOA. BPO seemed to act more quickly than isotretinoin and tretinoin. Adapalene showed a shorter TOA than isotretinoin. Conflicting results were seen when comparing adapalene with tretinoin, with a tendency for adapalene to be faster. Clindamycin/BPO seemed to act more quickly than adapalene. Inconsistent results were seen for the comparison of clindamycin/BPO and BPO alone with a slight indication of a shorter TOA for clindamycin/BPO. Adapalene/BPO and clindamycin/BPO showed comparable TOA. When interpreting the data, the different study designs and the limited study quality need to be taken into account. Further research is needed to identify treatments that offer an early onset of action and possibly help to optimize patients' adherence. TOA should be considered as an additional outcome in acne trials.

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S2k – Guideline on the Therapy of Acne

Cited by 23 publications

References 318 publications

Inhibition of retinoic acid catabolism by minocycline: evidence for a novel mode of action?

Inhibition of retinoic acid catabolism by minocycline: evidence for a novel mode of action?

Acne

Systematic review on the rapidity of the onset of action of topical treatments in the therapy of mild-to-moderate acne vulgaris

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