Journal of

Background and Aim: Acne vulgaris is a chronic inflammatory disease of the pilosebaceous unit. Retinoids are used as the first line therapy in acne. Systemic absorption and skin irritation including redness, pruritus and exfoliation are some of their side effects. In this study we compared the efficacy of isotretinoin 0.05% niosomal gel versus adapalen 0.1% gel in treatment of acne vulgaris.

Methods: In this randomized double blind clinical trial, 144 patients with mild to moderate acne vulgaris aged from 15 to 30 years were enrolled. The patients were randomly allocated into two groups of A, whom were treated with isotretinoin 0.05% niosomal gel and B whom were treated with adapalen 0.1% gel. The patients were evaluated for clinical reponse, decrease in the number of inflammatory and non-inflammatory lesions and side effects after 2, 4, 8, and 12 weeks of the initiation of treatment.

Results: At the end of the study the clinical responses of comedones and inflammatory lesions in isotretinoin 0.05% niosomal gel group were 68% and 79%, in comparison with 65% and 76% in the adapalen gel group,  respectively. The differences were not statistically significant. At the end of the treatment period more decrease in number of inflammatory and non-inflammatory lesions were seen in group A patients (niosomal isotretinoin) than group B (adapalen 0.1% gel) (P<0.001). Also side effect of skin redness was found more in group B (P<0.001).

Conclusion: Isotretinoin 0.05% niosomal gel has less side effects and more efficacy in the treatment of mild to moderate acne vulgaris in comparison with adapalen 0.1% gel.

Background and Aim: Acne is one of the most common diseases among young individuals. Controversial findings are reported about the effect of glycemic index (GI) and glycemic load (GL) of the diet on acne vulgaris. The aim of this study was to investigate the effect of GI and GL of diet on severity of acne.

Methods: All relevant studies on effects of GI or GL on acne published up to December 2016 were collected using PubMed, Google Scholar, Science direct, Ovid and Cochrane library.

Results: Of 714 articles in our initial research, 6 interventional and 3 case-control studies were included.
Case-control studies revealed that patients with acne vulgaris consumed diets with a higher GI rather than control group. Intervention with a low GI diet reduced lesion counts and improved the severity of acne as well as insulin sensitivity compared with those under high GI diet.

Conclusion: Overall, a diet with low GI and GL could improve acne severity and inflammatory lesions.

Background and Aim: Acne vulgaris is one of the most common skin diseases in adolescents and young adults. Although acne do not physically disable the patient, it can cause significant psychological morbidities. The disease etiology is not fully understood; however, there are several factors involved in the pathogenesis. The aim of this study is to investigate the seasonal variation of acne vulgaris in patients referred to skin clinic of Shohaday-e-Tajrish Hospital in Tehran in 2017.

Methods: This study was a cross-sectional study in patients diagnosed with acne vulgaris by a dermatologist. One-hundred three eligible patients were enrolled in the study. The severity of acne was graded as mild, moderate or severe. In addition to the demographic data, information on the acne severity and changes in the acne severity in summer and winter had been recorded.

Results: The average age of 103 acne patients was 24.68±6.77 years. Sixty-eight patients were female and 35 cases were male. Fifteen (14.6%) patients had mild acne, 55 (53.4%) cases had moderate acne and 33 (32%) subjects had severe disease. In the summer, symptoms improved in 34 (33%) patients, worsened in 18 (17.5%) patients, and remained unchanged in 51 (49.5%) cases. In winter, symptoms improved in 15 (14.6%) patients, worsened in 37 (35.9%) patients, and remained unchanged in 51 (49.5%) patients (P=0.001). There was no significant relationship between changes in the severity of acne in winter or summer with age, age of the disease onset or duration or severity of acne (P>0.05).

Conclusion: In the present study, the number of patients with acne exacerbation in winter was significantly higher than that in summer. This may highlight the important role of winter in increasing the acne severity; however, more comprehensive studies with more sample sizes are still needed in different geographical areas.

Background and Aim: Acne vulgaris is one of the most common skin disorders, affecting more than eighty percent of individuals around puberty. Because of the adverse effects on the patient’s appearance, the disease may have detrimental psychological impacts such as low self-esteem and social isolation. The aim of the present study was to evaluate factors affecting self-esteem in patients with acne vulgaris in Hamadan.

Methods: Patients with acne vulgaris referred to the  dermatology clinic of Hamadan’s Sina Hospital (as the case group), and their healthy accompanying persons (as the control group) were included in the study. After obtaining written informed consent, demographic dat

a were recorded and participants were asked to fill out a questionnaire. To assess the severity of acne, Global Acne Grading System (GAGS) was used. In addition, Coopersmith Inventory was applied to measure the self-esteem of the participants. In data were analyzed using STATA 14.0 software.

Results: Overall, 184 patients with acne and 177 controls were included in this study. The mean age of patients and controls was 17.89+3.13 and 17.72+2.94, respectively. Independent samples t-test showed that the mean Self-Esteem Index of patients was significantly lower than controls (32.04+8.29 vs. 34.85+7.73, P<0.001). The severity of acne was inversely correlated with self-esteem; one score increase in GAGS would result in 0.1 unit decrease in self-esteem index (P<0.001).

Background and Aim: Atopic dermatitis is a chronic inflammatory disease that is caused by an inflammatory process stimulated by Th2 cells. Acne vulgaris is a chronic inflammatory skin disease. It is associated with an increase in sebum secretion, unusual pilosebaceous keratinization and an increased inflammatory immune response. Propionibacterium acne can induce IL-17 production and Th1/Th17 response. The present study was designed to determine the prevalence of atopic dermatitis in patients with acne.

Methods: In this case-control study, the case group consisted of 75 individuals with acne and the control group consisted of 75 individuals without acne matched in age and gender. Both groups were interviewed for atopic dermatitis, asthma and allergic rhinitis symptoms in the past and present. 

Results: Prevalence of atopic dermatitis at present in patients who had acne was significantly lower than those who did not have acne. There was no significant difference between case and control groups in frequency of atopic dermatitis in the past and frequency of asthma and allergic rhinitis in the present and past time.

Conclusion: The inverse relationship between prevalence of acne and atopic dermatitis can be related to activation of different immune responses (Th1 versus Th2), but more studies should be done to confirm this relationship.