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OBJECTIVES: To describe the ultrasound characteristics of facial and submandibular hidradenitis suppurativa (HS) and detect acne vulgaris (AV) concomitance in these cases. METHODS: We performed a retrospective study of the ultrasound images of patients with facial HS who had been clinically evaluated by dermatologists. The reported ultrasound diagnostic criteria, severity (mSOS-HS), and activity (US-HAS) staging of HS were used to categorize the patients. The finding of fragments of hair tracts within the key lesions (dilated hair follicles, pseudocysts, fluid collections, and tunnels) was considered a pivotal sign to discriminate HS from AV. Demographic and morphological analysis of the images were considered. RESULTS: Thirty-three patients met the criteria (78.8% male/21.2% female). Of these, the mSOS- HS scoring was stage I in 51.5%, stage II in 27.3%, and stage III in 21.2%. Dilation of the hair follicles and the presence of pseudocysts, fluid collections, and tunnels were detected in the HS cases; 63.1% of pseudocysts, 62.4% of tunnels, and 46.2% of fluid collections contained fragments of hair tracts. In all HS cases, there was a key lesion(s) with fragments of hair tracts. Four (12.1%) patients showed concomitant facial HS and acne ultrasound lesions. The acne lesions were pseudocysts without inner hair tract fragments in all cases, and the SOS-Acne scoring was stage II for all of them. CONCLUSION: Facial HS can be detected on ultrasound and shows a morphology similar to that of HS in other corporal regions. In some cases, facial HS could be concomitant with AV. The subclinical ultrasonographic information can support a better management of these cases.

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INTRODUCTION: Furoxan and benzofuroxan are compounds containing an N-oxide function, known for their diverse pharmacological properties, including antimicrobial and antiinflammatory effects. This study aimed to investigate these activities using an in-house library of N-oxide compounds. METHOD: Twenty compounds were tested against both Gram-positive and Gram-negative bacteria, including Cutibacterium acnes (C. acnes), a microorganism implicated in the development of acne vulgaris. One compound, (E)-4-(3-((2-(3-hydroxybenzoyl)hydrazone)methyl)phenoxy)-3- (phenylsulfonyl)-1,2,5-oxadiazol-2-N-oxide (compound 15), exhibited selective antimicrobial activity against C. acnes, with a Minimum Inhibitory Concentration (MIC) value of 2 µg/mL. Indirect measurement of Nitric Oxide (NO) release showed that compound 15 and isosorbide dinitrate, when treated with L-cysteine, produced nitrite levels of 20.1% and 9.95%, respectively. Using a NO scavenger (PTIO) in combination with compound 15 in a culture of C. acnes resulted in reduced antimicrobial activity, indicating that NO release is part of its mechanism of action. Cytotoxicity assessments using murine macrophages showed cellular viability above 70% at concentrations up to 0.78 µg/mL. RESULTS: Measurements of Interleukin-1 beta (IL1-ß) and Tumor Necrosis Factor-alpha (TNF-α) indicated that compound 15 did not reduce the levels of these pro-inflammatory cytokines. Sustained NO production by inducible Nitric Oxide Synthase (iNOS) in macrophages or neutrophils has been found to be involved in the inflammatory process in acne vulgaris and lead to toxicity in surrounding tissues. Nitrite levels in the supernatant of murine macrophages were found to be decreased at a concentration of 0.78 µg/mL of compound 15, indicating an anti-inflammatory effect. In vivo studies were conducted using Balb/c nude mice inoculated subcutaneously with C. acnes. Cream and gel formulations of compound 15 were applied to treat the animals, along with commercially available anti-acne drugs, for 14 days. Animals treated with a cream base containing 5% of compound 15 exhibited less acanthosis with mild inflammatory infiltration compared to other groups, highlighting its anti-inflammatory properties. CONCLUSION: Similar results were observed in the benzoyl peroxide group, demonstrating that compound 15 presented comparable anti-inflammatory activity to the FDA-approved drug. These promising results suggest that compound 15 has a dual mechanism of action, with selective antimicrobial activity against C. acnes and notable anti-inflammatory properties, making it a potential prototype for developing new treatments for acne vulgaris.

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Objective: Acne is a chronic inflammatory disease that involves the pilosebaceous follicle. Its pharmacological treatment involves topical and systemic medications, but a heterogeneous group of drugs may exacerbate or induce skin lesions. The aim of this study was to identify the pharmacological management and medications related to the exacerbation of skin lesions in patients diagnosed with acne. Methods: This was a cross-sectional study that identified the outpatient medication prescription patterns of patients with acne from a dispensing database of 8.5 million members of the Colombian Health System. Sociodemographic and pharmacological variables and the identification of prescriptions that were potentially inappropriate due to the risk of worsening acne were considered. Results: A total of 21,604 patients with acne were identified. Median age was 20.8 years (interquartile range: 17.3-27.3 years), and 60.7 percent were female. Treatment mainly involved antibiotics (79.9% of patients), especially doxycycline (66.0%), and retinoids (55.7%). A total of 17.2 percent of patients had potentially inappropriate prescriptions, predominantly progestogens with androgenic properties (8.9%). Female patients (odds ratio [OR]: 3.55; 95% confidence interval [CI]:3.24-3.90) and patients with pathologies such as systemic lupus erythematosus (OR: 18.61; 95% CI: 7.23-47.93) and rheumatoid arthritis (OR: 10.80; 95% CI: 5.02-23.23) were more likely to receive inappropriate prescriptions, and the risk increased with each year of life (OR: 1.02; 95% CI: 1.02-1.03). Limitations: Access to medical records was not obtained to verify clinical characteristics of acne. Conclusion: Patients with acne are excessively treated with systemic antibiotics, counter to clinical practice guidelines. Approximately one-fifth of these patients received some potentially inappropriate medication that could exacerbate their skin lesions.

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Introducción: el acné vulgar es una enfermedad común de la piel con un gran impacto en la calidad de vida. El acné fulminans es una variante rara y severa de acné inflamatorio. Se describe en la literatura muy pocos casos de acné en pueblos étnicos. Se presenta el caso de una niña de 13 años, originaria de pueblo étnico del Paraguay, en que se observó una presentación severa de acné inflamatorio, acné fulminans. Se realiza tratamiento antibiótico asociado a prednisona, la paciente abandona el seguimiento por lo cual no se inicia el tratamiento aconsejado de Isotretinoína. Conclusiones: el caso presentado en particular corresponde a una forma severa de acné en una población con bajos reportes de esta enfermedad. Consideramos de importancia el estudio de los factores intervinientes para el desarrollo de la enfermedad.

Introduction: acne vulgaris is a common skin disease with a great impact on quality of life. Acne fulminans is a rare and severe variant of inflammatory acne. Very few cases of acne in ethnic people are described in the literature. We present the case of a 13-year-old girl, originally from an ethnic town in Paraguay, in whom a severe presentation of inflammatory acne, acne fulminans, was observed. Antibiotic treatment associated with prednisone was carried out, the patient abandoned follow-up and therefore the recommended treatment of Isotretinoin was not started. Conclusions: the case presented in particular corresponds to a severe form of acne in a population with low reports of this disease. We consider the study of the factors involved in the development of the disease to be important.

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ABSTRACT Purpose: In this prospective study, we compared ocular clinical variables in patients with acne vulgaris with those of healthy controls. These variables included tear film break-up time, meibomian gland dropout rate, and anterior chamber parameters. Methods: Our sample comprised 73 eyes from 73 patients with acne vulgaris and 67 eyes from 67 healthy controls. All participants underwent a non-invasive first tear film break-up time test and the average tear film break-up time was evaluated. Meibography was used to identify any meibomian gland dropout. The parameters of the cornea and anterior chamber were measured using Scheimpflug topography imaging. Finally, the ocular surface disease index questionnaire was administered to score each participant on their subjective experience of ocular complaints. Results: The noninvasive first tear film break-up time values of the acne vulgaris Group and the control Group were 4.7 ± 2.8 and 6.4 ± 3.5 sec, respectively. There was a significant difference between the groups (p=0.016). The number of eyes with tear break-up at any time during the measurement period was also significantly higher in the acne Group (p=0.018). In the acne vulgaris Group, the mean meibomian gland dropout rates were 33.21 ± 15.5% in the upper lids and 45.4 ± 14.5% in the lower lids. In the control group, these rates were 15.7 ± 6.9% and 21 ± 9.7% respectively. Dropout was significantly higher in the acne group for both the upper and lower lids (p=0.000). Conclusion: We found impaired tear stability in patients with acne vulgaris and a high rate of meibomian gland dropout. These glands play a key role in tear stability and their dropout is likely to result in evaporative dry eye. Measurement of the variables in this study allows objective diagnosis of this condition using a non-invasive, dye-free methodology, with minimum contact.

RESUMO Objetivo: Neste estudo prospectivo, pacientes com acne vulgaris e indivíduos saudáveis do grupo controle foram comparados em relação ao tempo de ruptura do filme lacrimal, taxa de abandono de glândulas meibomianas e parâmetros da câmara anterior, usando o tempo de ruptura do filme lacrimal topográfico não invasivo, meibografia não invasiva e fotografia de Scheimpflug, respectivamente. Métodos: Setenta e três olhos de 73 pacientes com acne vulgaris e 67 olhos de 67 indivíduos saudáveis foram incluídos. Todos os participantes submetidos ao primeiro tempo de ruptura do filme lacrimal não-invasivo e ao tempo médio de ruptura do filme lacrimal não-invasivo foram avaliados pelo uso do tempo de ruptura do filme lacrimal; perda de glândulas meibomianas foram avaliadas por meibografia; os parâmetros da córnea e da câmara anterior foram medidos por fotografia de Scheimpflug; e, finalmente, as queixas oculares subjetivas foram pontuadas com o uso do questionário do Indice de doenças de superfície ocular. Resultados: Os valores do tempo de ruptura do primeiro filme lacrimal não-invasivo do Grupo com acne vulgaris e do Grupo controle foram 4,7 ± 2,8 e 6,4 ± 3,5 segundos, respectivamente, refererindo-se a uma diferença significativa entre os valores dos grupos (p=0,016). Qualitativamente, o número de olhos com ruptura lacrimal a qualquer momento durante o período de medição foi significativamente maior no grupo de pacientes. (p=0,018). No Grupo com acne vulgaris, a perda de glândulas meibomianas nas pálpebras superiores foi de 33,21 ± 15,5% e nas pálpebras inferiores foi de 45,4 ± 14,5%; por outro lado, no Grupo controle foi de 15,7 ± 6,9% e 21 ± 9,7% respectivamente; ambos os casos referem-se a uma diferença significativa entre os grupos (p=0,000). Conclusão: Encontramos estabilidade comprometida do filme lacrimal em pacientes com acne vulgaris. No entanto, o comprometimento foi de grau muito menor, em comparação com a taxa de perda das glândulas meibomianas que desempenham um papel fundamental na estabilidade do filme lacrimal. Esta condição pode ser documentada de forma objetiva - uma metodologia parcialmente sem contato, totalmente não-invasiva e livre de corantes.

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SUMMARY OBJECTIVE: Isotretinoin is the only medication against all the factors involved in acne vulgaris pathogenesis. The aim of our study was to verify whether patients with acne vulgaris receiving isotretinoin therapy exhibit elevated anger levels and to observe the correlation between age, temperament traits, and anger. METHODS: The study group comprised a sum of 100 cases, involving 50 individuals with acne vulgaris-required high-dose retinol therapy and 50 controls who did not start any medication. RESULTS: Our study showed that anger levels increased with drug use. A positive correlation between cyclothymic temperament, the anxiety-related behavior subdimension, and the introvert and passive-aggressive subdimension of interpersonal anger reactions has been recognized. In addition, a positive one was observed between hyperthymic temperament and the introvert subdimension, which is one of the anger-related thoughts and interpersonal anger reactions. CONCLUSION: This study elucidates anger dimensions such as anger-related thoughts, behaviors, and reactions in individuals who received retinol treatment for acne vulgaris. In addition to anger and its dimensions, temperament was also investigated. Although several studies have investigated the relationship between acne vulgaris and psychiatric symptoms, to the best of our knowledge, no research has been reported in the English-language literature regarding the relationship between anger dimensions and temperament after retinol treatment that might make our study an original and valuable contribution to the literature.

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Introducción: El acné vulgar es la enfermedad más frecuente en adolescentes y adultos jóvenes; constituye un estado obstructivo e inflamatorio crónico de folículos pilosebáceos, caracterizado por la formación de lesiones inflamatorias. Objetivo: Identificar los factores de riesgo y las comorbilidades asociados al acné vulgar de grados I y II y su impacto psicosocial. Métodos: Se realizó un estudio observacional, descriptivo y transversal de 50 pacientes con acné vulgar de grados I y II, atendidos en el Hospital General Docente Dr. Juan Bruno Zayas Alfonso de Santiago de Cuba, desde enero de 2018 hasta igual periodo de 2020. Se valoraron los factores de riesgo y las comorbilidades asociados a la dermatosis, así como el tiempo de aparición de estos. Resultados: En la serie predominaron el grupo etario de 18-24 años de edad y el sexo femenino (60,0 %, respectivamente), la ansiedad (58,0 %), el estado seborreico de la piel y los hábitos tóxicos (44,0 % en cada caso). También primaron el nivel de escolaridad de técnico medio y el color de la piel mestizo (60,0 % cada uno), el estado civil acompañado (44,0 %), la procedencia urbana (88,0 %), los afectados con evolución de la enfermedad entre 4 a 12 meses, sin antecedentes patológicos familiares de esta, y los trastornos endocrinos como las comorbilidades asociadas a la dermatosis. Conclusiones: Una buena parte de los pacientes presentaron, como factores de riesgo, algún episodio emocional de ansiedad y estado seborreico de la piel relacionado con el acné, los cuales estuvieron asociados a comorbilidades endocrinometabólicas.

Introduction: Common acne is the most frequent disease in adolescents and young adults; it constitutes a chronic obstructive and inflammatory state of pilosebaceous follicles, characterized by the formation of inflammatory lesions. Objective: To identify the risk factors and comorbidities associated to grade I and II common acne and its psychosocial impact. Methods: An observational, descriptive and cross-sectional study of 50 patients with grade I-II common acne was carried out; they were assisted at Dr. Juan Bruno Zayas Alfonso Teaching General Hospital in Santiago de Cuba, from January, 2018 to the same period in 2020. The risk factors and comorbidities associated with the dermatoses were valued, as well as the onset time of them. Results: In the series there was a prevalence of the 18-24 age group and the female sex (60.0%, respectively), the anxiety (58.0%), seborrheic state of the skin and toxic habits (44.0% each one). Also, the school level of technician and mixed race (60.0% each one), accompanied as marital status (44.0%), the urban origin (88.0%), as well as those affected with evolution of the disease between 4 to 12 months, without family pathological history, as well as endocrine disorders as the comorbidities associated with the dermatoses. Conclusions: A great part of the patients presented, as risk factors, some emotional event of anxiety and seborrheic state of the skin related to the acne, which were associated with endocrine-metabolic comorbidities.

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BACKGROUND: The contribution of insulin to acne is that it stimulates the synthesis of androgenic hormones, which are important in the development of excess sebum, hyperkeratinization, and sebaceous gland cell growth. OBJECTIVE: To ascertain whether the lipid profile abnomalies seen in acne vulgaris are genetically induced, we also seek to establish a link between insulin resistance and lipid profiles. METHODS: An analytical cross-sectional study with case-control design research investigation of 72 individuals with acne vulgaris and 72 healthy volunteers was carried out. Both groups' medical histories were taken, as were the severity and duration of the disease among acne sufferers, as well as demographic data. Anthropometry tests were performed on both groups, including their weights, height, and circumference of waist, as well as the profile of lipids, blood glucose levels after a fast, insulin levels during fasting, resistance to insulin, and Apo B-48 folding change. RESULTS: Severe acne vulgaris patients showed significantly increased TG, TC, LDL-C, blood glucose levels after a fast, fasting insulin, and resistance to insulin levels. P = 0.005 showed that Apo B-48 expression increased in patients compared to healthy people. Apo B-48 folding change and insulin resistance were found to have a substantial positive simple linear association. Acne vulgaris, whether mild, moderate, or severe, has a significant positive linear connection with insulin resistance. CONCLUSION: Acne patients had an abnormal in lipid profile. Acne individuals with severe form are more inclined to acquire resistance to insulin as well as higher glucose and insulin levels. Apo B-48 gene expression is elevated in acne individuals with severe form who have lipid abnormalities. This illustrating the importance of genetic variables in acne, insulin resistance, lipid profile modifications as well as Isotretinoin, a standard acne medication, can also cause lipid irregularities.

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ABSTRACT Purpose: To investigate ocular surface and meibomian glands in patients with treatment-naive acne vulgaris. Methods: The Ocular Surface Disease Index (OSDI) questionnaire, invasive tear film breakup time, fluorescein staining of the ocular surface, and Schirmer II test were performed for all subjects. Total eyelid and meibomian gland secretion scores were assessed. Non-contact meibography was performed with the Sirius corneal topographic device. Results: The right eyes of 35 patients with acne vulgaris and 35 healthy volunteers were included the study. While the OSDI and staining scores were significantly higher in the acne group than in the control group (p=0.01 and p=0.003, respectively), the invasive tear film breakup time and Schirmer measurements were significantly lower in the acne group (p=0.000 and p=0.003, respectively). The total eyelid and meibomian gland secretion scores were also higher in the acne group than in the control group (p=0.003 and p=0.000, respectively). On the morphological evaluation of the meibomian glands, the thickening, thinning, tortuosity, and presence of ghost areas were statistically significantly more common in the acne vulgaris group than in the control group (p=0.000, p=0.001, p=0.05, and p=0.006, respectively). The percentage of the meibomian gland loss area was significantly high in the acne vulgaris group on both upper and lower meibography. The meibomian gland loss area positively correlated with total eyelid and meibomian gland secretion scores. Conclusion: Acne vulgaris may have a predisposition to meibomian gland dysfunction and ocular surface damage. Early recognition of meibomian gland and ocular surface alterations seems important, especially in acne vulgaris cases for which oral isotretinoin treatment is planned.

RESUMO Objetivo: Todos os indivíduos responderam ao questionário Ocular Surface Disease Index (OSDI) e tiveram avaliados o tempo de ruptura do filme lacrimal pelo método invasivo, a coloração da superfície ocular com fluoresceína e o teste de Schirmer II. Foram ainda avaliados o escore palpebral total e o de secreção das glândulas meibomianas. Foi realizada meibografia sem contato com um dispositivo topográfico corneano Sirius. Métodos: Todos os indivíduos responderam ao questionário Ocular Surface Disease Index (OSDI) e tiveram avaliados o tempo de ruptura do filme lacrimal pelo método invasivo, a coloração da superfície ocular com fluoresceína e o teste de Schirmer II. Foram ainda avaliados o escore palpebral total e o de secreção das glândulas meibomianas. Foi realizada meibografia sem contato com um dispositivo topográfico corneano Sirius. Resultados: Foram incluídos no estudo os olhos direitos de 35 voluntários com acne vulgar e 35 saudáveis. Os escores do Ocular Surface Disease Index e da coloração foram significativamente maiores no grupo com acne em comparação com o grupo controle (p=0,01 e p=0,003, respectivamente), mas o tempo de ruptura do filme lacrimal pelo método invasivo e as medidas do teste de Schirmer II foram significativamente menores (p=0,000 e p=0,003, respectivamente). O escore palpebral total e o escore de secreção das glândulas meibomianas também foram maiores no grupo com acne que no grupo controle (p=0,003 e p=0,000). Na avaliação morfológica das glândulas meibomianas, o espessamento, o afinamento, a tortuosidade e a presença de áreas fantasmas nas glândulas foram mais comuns no grupo acne vulgar que no grupo controle, com significância estatística (p=0,000, p=0,001, p=0,05 e p=0,006 respectivamente). A porcentagem da área de perdas das glândulas meibomianas foi significativamente mais alta no grupo com acne vulgar, tanto na meibografia superior quanto na inferior. A área de perda das glândulas meibomianas demonstrou uma correlação positiva com o escore palpebral total e com o escore de secreção das glândulas meibomianas. Conclusão: A acne vulgar pode levar a uma predisposição para a disfunção das glândulas meibomianas e para danos na superfície ocular. Parece ser importante reconhecer precocemente as alterações das glândulas meibomianas e da superfície ocular, especialmente nos casos de acne vulgar para os quais se planeja o tratamento oral com isotretinoína.

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The burden of disease associated with acne vulgaris has continued to increase over time in the world population. This continued growth suggests that there is an unmet dermatologic need for this condition worldwide. Potential sequelae of acne, such as scarring, depigmentation, and marked emotional and psychological problems (e.g., low self-esteem), can lead to significant morbidity. The purpose of this study was to investigate whether dietary supplementation with magnesium, phosphate, omega 6 (linoleic acid calcium salt - C18:2 fatty acid Ca salt), and omega 7 (palmitoleic acid calcium salt - C16:1 fatty acid Ca salt) would help patients with acne vulgaris, and to compare with isotretinoin (13-cis retinoic acid). Magnesium has anti-inflammatory properties. Linoleic and palmitoleic acids have bactericidal activity against Staphylococcus aureus and Cutibacterium acnes (formerly known as Propionibacterium acnes). A single-blind randomized study was conducted in which 257 patients were treated with the above dietary supplementation (group A) and 275 patients with isotretinoin (group B) for 6 months. All patients in group A (100%) reported complete regression of symptoms after 6 months of treatment. On the other hand, 187 subjects (68%) in group B reported complete resolution of symptoms during the same period. The difference between the groups (p < 0.05) was statistically significant. The study was approved by the CEP/CONEP. This natural formulation promotes regression and/or cure of acne vulgaris symptoms and has better results than drugs (such as isotretinoin), without significant side effects.

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