AARS Hot Topics - September 1, 2017 Issue


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This is a semi-monthly compilation of peer-review literature and online updates in acne and rosacea covering industry press, new medical research and what patients and your peers are talking about in patient counseling tips.

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Industry News

  • Novartis has appointed a senior retail expert to the new post of chief digital officer, following a similar move by GlaxoSmithKline last month, underscoring how drug makers are grappling with the impact of new technology. Pharmaceutical companies face a range of challenges from the digital world as mobile apps offer patients new ways to monitor their health and online communications with prescribers and consumers become routine.
  • To celebrate the launch of their new Limited Edition Deep Cleansing Pore Strips, Bioré® Skincare is partnering with Girl Up™, a United Nations Foundation campaign. Girl Up mobilizes girls and women across the globe to raise awareness and funds for United Nations programs that help adolescent girls in need.
  • It’s go big or go home for the newly re-branded Valeant Ortho Dermatologic division. At the 2017 American Academy of Dermatology in New York City, the company officially launched Siliq (brodalumab) for psoriasis and announced their new name change.

New Medical Research

  • Dermo-cosmetics were found to aid in restoration of fragile skin caused by the acne topical retinoid treatment adapalene 0.1% gel, by reducing transepidermal water loss and improving skin hydration, as well as reducing the side-effects such as skin irritation that are frequently associated with topical retinoids. Additionally, dermo-cosmetic products were found to accelerate wound closure following skin damage in a laser ablation model and reduced the duration of post-procedural side-effects such as itching and burning.
  • Different bacterial compositions were investigated using NGS and traditional anaerobic and aerobic blood culturing. Our NGS analysis provided a previously unreported characterization of the bacterial composition in peripheral blood from HS patients and healthy controls. Overall, our data demonstrated that HS patients do not have a different bacterial composition in their peripheral blood than healthy controls.
  • A new study included 35 patients with a mean age of 24.7±6.8 years. There was a significant improvement in the degree of scar severity before and after treatment on both sides. Regarding patient's satisfaction grades there was a significant improvement after both treatment modalities with insignificant differences between both treatment modalities. Both microneedling and microneedling in combined with PRP showed satisfactory results.
  • Cosmetological treatments are aimed at improving the condition of the skin and reduction or subsiding of acne skin changes. The treatment significantly improved the general quality of life of patients with acne vulgaris and their skin condition, which was evaluated by the Hellgren-Vincent scale. It was proven that therapy performed in cosmetological clinics may become an integral part of or complete dermatological treatment.
  • In a recent study the concomitant administration of isotretinoin (0.5 mg/kg bw/d, 0.25-0-0.25) and prednisolone 30 mg/d (10-10-10) is able to resolve systemic signs and markedly improve skin lesions in 65% of the patients at one month.
  • Treatment of HS can be challenging. The options available include antimicrobials, immunosuppressants, hormonal therapies, lasers, and surgery. The authors report the largest series of children with HS treated with finasteride. The results support the use of finasteride as monotherapy for the treatment of this disease in children. Further studies are necessary to fully understand the role of this drug in the management of this disease.
  • Despite the preference of rhinophyma and otophyma to the male gender, their occurrence in females needs to be considers in the differential diagnosis of dermatoses of head and neck. Early diagnosis and appropriate medical treatment improve outcome and help to avoid surgery.
  • After only one session of treatment with the CO2 laser and the topical treatment, a complete healing of the nodulocystic acne lesions was observed with minimal secondary effects. The microcystic acne showed great improvement. No other topical or oral treatment was needed. This treatment could be a safe and effective treatment for nodulocystic acne lesions and microcystic acne when other treatments fail. More studies should be performed to confirm our results.
  • Clindamycin-BP 3.75% gel demonstrates continued improvement in symptoms of moderate acne over 24 weeks, with good tolerability, demonstrating a clinical benefit of continued clindamycin-BP 3.75% gel as a maintenance therapy for acne in adult female patients.

Clinical Reviews

  • Recent research has shed some new light on the involvement of the sebaceous gland, as well as on the pro-inflammatory activity of the cutaneous microbiome. This article aims to provide an update on the involvement of the sebaceous gland, the innate immunity and the cutaneous microbiome, how all of these factors promote acne and to illustrate their links with current and future treatments.
  • This was a retrospective study of all patients treated with the fractional CO2 laser for facial acne scarring between January 2, 2008, and December 31, 2010, at the National Skin Centre, Singapore. The study demonstrated the efficacy and safety of a fractional CO2 laser in the treatment of acne scars in Asian. Future studies are required to establish optimum treatment parameters and achieve better clinical results.
  • While treatment of active acne with lasers has been successful, many studies are limited by small patient number and lack of control populations and comparison to standard therapies for active acne. Laser therapies are increasingly becoming part of or an adjunct to the medical treatment of active acne and are a useful.
  • Rosacea fulminans is a rare inflammatory condition of the central face marked by the abrupt onset of erythematous coalescing papules, pustules, nodules, and draining sinuses. Due to infrequent reporting in the literature, the pathophysiology, classification, and nomenclature of this condition remain controversial. This comprehensive review evaluated a total of 135 cases of rosacea fulminans for clinical and histopathologic features and reported treatment strategies.
  • Home optical devices are mostly used without medical practitioner supervision. As home devices usually deliver less energy per session than with professional treatments, it is important that consumers are given realistic expectations of post-treatment outcomes. Patients may use home devices without disclosure to their physician and it is important as healthcare professionals to be aware of the existence of these devices, how to use the devices properly (including what diseases can be treated and which skin types are considered safe for use), as well as any adverse effects that may occur. New research endeavors are being completed to explore the used of home devices for the treatment of chronic inflammatory diseases such as psoriasis.
  • The treatment of acne during pregnancy is often limited by the potential toxicities that are posed to the fetus by the most common and effective acne therapies. As with all dermatoses during pregnancy, the treatment of acne vulgaris in this population requires a thorough understanding of the risks and benefits that are inherent to each treatment. We report on a case of a 30-year-old pregnant patient with severe acne conglobata who showed significant improvement with a combination treatment of topical modalities, oral metronidazole, and low dose prednisone during pregnancy. We also review the literature and present an approach for the care of these patients.

Patient Counseling / Communication

  • Among outpatient visits for acne in the United States, racial disparities exist in the likelihood of seeing a dermatologist and receiving treatment. Treatment disparities are less common when care is provided by a dermatologist. More research is needed to better understand the causes of disparities in acne management and other dermatological conditions.
  • The association between hidradenitis suppurativa (HS) and some diseases is becoming relevant in recent years. Providing appropriate management of HS from an early stage requires to include prompt diagnosis and treatment of concomitant diseases and to prevent any potential comorbidity. This approach should consider the adverse events of the drugs used to treat HS potentially related to the onset of comorbidity.