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Persistant acne in adults

Robert L Rosenfield
Consensus has recently been reached by international pediatric subspecialty societies that otherwise unexplained persistent hyperandrogenic anovulation using age- and stage-appropriate standards are appropriate diagnostic criteria for polycystic ovary syndrome (PCOS) in adolescents. The purpose of this review is to summarize these recommendations and discuss their basis and implications. Anovulation is indicated by abnormal uterine bleeding, which exists when menstrual cycle length is outside the normal range or bleeding is excessive: cycles outside 19 to 90 days are always abnormal, and most are 21 to 45 days even during the first postmenarcheal year...
December 2015: Pediatrics
Muhammad M Hammami, Najla Duaiji, Ghazi Mutairi, Sabah Aklabi, Nasser Qattan, Mohei El-Din M Abouzied, Mohamed W Sous
BACKGROUND: Normalization of cortisol concentration by multikinase inhibitors have been reported in three patients with medullary thyroid cancer-related Cushing's syndrome. Aortic dissection has been reported in three patients with Cushing's syndrome. Diabetes insipidus without intrasellar metastasis, intestinal intussusception, and paraneoplastic dysautonomia have not been reported in medullary thyroid cancer. CASE PRESENTATION: An adult male with metastatic medullary thyroid cancer presented with hyperglycemia, hypernatremia, hypokalemia, hypertension, acne-like rash, and diabetes insipidus (urine volume >8 L/d, osmolality 190 mOsm/kg)...
2015: BMC Cancer
B Dréno
Acne is affecting an increasing number of adult females and so can no longer be considered as a disease of adolescence. The disease has a greater negative impact on the quality of life of adult females than their younger counterparts. Adult female acne may persist from adolescence or may have its first occurrence once adulthood has been reached. The clinical presentation and pathogenesis of adult female acne may be somewhat different to that of adolescent acne and this may require a different treatment approach...
June 2015: Journal of the European Academy of Dermatology and Venereology: JEADV
Husein Husein-ElAhmed
Acne vulgaris is a very common condition affecting up of 93% of adolescents. Although rare, this disease may persist in adulthood. In adult women with acne (those older than 25 years old), this condition is particularly relevant because of the refractory to conventional therapies, which makes acne a challenge for dermatologists in this group of patients. In order to its potential risk for chronicity and the involvement of visible anatomical sites such as face and upper torso, acne has been associated with a wide spectrum of psychological and social dysfunction such as depression, anxiety, suicidal ideation, somatization, and social inhibition...
May 2015: Dermatologic Therapy
Anne Margreet van Drooge, Charlotte Vrijman, Wietze van der Veen, Albert Wolkerstorfer
BACKGROUND: Although ablative fractional laser is the gold standard for acne scars, evidence is still lacking for other types of scars. OBJECTIVE: To evaluate the efficacy and safety of the ablative fractional 10,600-nm CO2 laser in the treatment of various scar types. MATERIALS AND METHODS: The authors performed an intraindividual single-blinded randomized controlled split-lesion trial. Adult patients received 3 laser treatments at 8-week intervals for scars existing at least 1 year...
March 2015: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
Pauliina Utriainen, Saila Laakso, Jani Liimatta, Jarmo Jääskeläinen, Raimo Voutilainen
Adrenarche refers to a maturational increase in the secretion of adrenal androgen precursors, mainly dehydroepiandrosterone (DHEA) and its sulfate (DHEAS). In premature adrenarche (PA), clinical signs of androgen action appear before the age of 8/9 years in girls/boys, concurrently with the circulating DHEA(S) concentrations above the usually low prepubertal level. The most pronounced sign of PA is the appearance of pubic/axillary hair, but also other signs of androgen effect (adult type body odor, acne/comedones, greasy hair, accelerated statural growth) are important to recognize...
2015: Hormone Research in Pædiatrics
M Ramos-e-Silva, S Ramos-e-Silva, S Carneiro
This review focuses on the subject of acne in women, a disease that is increasingly common and that can also affect men. Adult acne differs from the type of acne that occurs in teenagers, and it may persist beyond adolescence or have its onset at an older age (adult-onset acne or late acne). Acne can have a negative impact on the quality of life of patients at any age, leading to a negative body image and decrease in self-esteem, and in older patients it can result in discrimination in the workplace and in other social environments...
July 2015: British Journal of Dermatology
T van Assen, O B Boelens, P V van Eerten, M R Scheltinga, R M Roumen
BACKGROUND: Injection treatment followed by an anterior neurectomy in patients insufficiently responding to an injection regimen is successful long term in three-quarters of patients with anterior cutaneous nerve entrapment syndrome (ACNES). The efficacy of secondary surgery, including re-exploration or a posterior neurectomy in patients reporting recurrent pain after initially successful surgery or following an immediately failed anterior neurectomy is unknown. METHODS: A database of ACNES patients receiving surgery between 2004 and 2012 in the SolviMáx institution was analysed...
December 2014: World Journal of Surgery
Norma Cameli, Maria Mariano, Mirko Serio, Marco Ardigò
BACKGROUND: The therapeutic approach to the treatment of acne scars and photoaging varies according to the type of lesion. Traditional carbon dioxide (CO2 ) laser is associated with long healing times, persistent erythema, and high risk of post-inflammatory hyperpigmentation. Fractional laser technology, which involves the application of microscopic beams of pixilated light inducing focal zones of tissue injury surrounded by normal tissue, is currently used for the treatment of acne scars and photoaging...
May 2014: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
Lindsey Yeo, Anthony D Ormerod
Acne is a common skin condition in adolescents. It is not uncommon in childhood and it persists into adulthood. A broad range of acne treatments are available and have been shown to be safe and effective in adolescents and adults. However, there is limited literature regarding acne treatment in childhood and its available therapeutic options. It seems reasonable to extrapolate findings of the various studies reported on treatment of acne in the adolescent and adult age group, with the exclusion of the use of tetracycline derivatives...
April 2014: American Journal of Clinical Dermatology
E Vargas-Diez, M A Hofmann, B Bravo, G Malgazhdarova, O A Katkhanova, Y Yutskovskaya
Acne, one of the most common skin problems in dermatological practice, is a condition that affects not only adolescents but also adults. While approximately 80% of cases occurring in adulthood are persistent from teenage years, around 20% are described as 'late-onset' disease, appearing for the first time in adulthood. The disease can be triggered by hormonal changes (including a change from one contraceptive to another), or it can be induced by certain nonhormonal medications, emotional stress, and various underlying diseases such as polycystic ovary syndrome...
2014: Skin Pharmacology and Physiology
R Holzmann, K Shakery
Acne in the adult female often presents as a chronic condition that can have a considerable negative psychological, social and emotional impact on the affected individual. Estimated prevalence rates of adult female acne vary widely according to study type. Case reports and clinical examinations estimate the prevalence of clinical acne at 10-12%, while survey estimates of physiological disease states are as high as 54%. Two subtypes of adult female acne may be defined according to time of onset: 'persistent' and 'late-onset', accounting for approximately 80 and 20% of cases, respectively...
2014: Skin Pharmacology and Physiology
Daniela Scalas, Janira Roana, Paolo Boffano, Narcisa Mandras, Cesare Gallesio, Mario Amasio, Giuliana Banche, Valeria Allizond, Anna Maria Cuffini
OBJECTIVE: In this study the potential presence of bacteria in radicular cyst (RC) and keratocystic odontogenic tumour(KCOT) fluids from clinically asymptomatic patients was investigated. MATERIALS AND METHODS: Cyst fluids were collected by needle aspiration from 16 patients with asymptomatic osteolytic lesions (10 RCs and 6 KCOTs) undergoing surgery. All samples were transferred into tubes containing pre-reduced transport medium, delivered to the microbiology laboratory and processed within 1h...
November 2013: Archives of Oral Biology
Liora Lazar, Joseph Meyerovitch, Liat de Vries, Moshe Phillip, Yael Lebenthal
CONTEXT: Central precocious puberty (CPP), treated or untreated, may have implications in adulthood. OBJECTIVE: To assess the reproductive outcome and social adjustment of former CPP women between the 3rd and 5th decades of life. DESIGN: Cross-sectional study of an historical cohort. METHODS: Demographic data and gynaecological history of 214 CPP women aged 25-56 years [135 GnRH analogue (GnRHa)-treated, 18 cyproterone acetate (CyA)-treated, 61 untreated] and of 446 controls with normal puberty, matched for age and year of birth, were recorded in a structured interview...
April 2014: Clinical Endocrinology
M Rademaker, J M Wishart, N M Birchall
BACKGROUND: Despite acne persisting into adulthood in up to 50% of the population, very few therapeutic studies have been performed in this age group. OBJECTIVES: To assess the efficacy of 5 mg/day isotretinoin in adult acne. METHODS: An investigator initiated, industry-sponsored, randomized, double-blind, placebo-controlled, parallel-group clinical study of isotretinoin 5 mg/day in the treatment of low-grade adult acne for 16 weeks followed by an open-label phase of 16 weeks...
June 2014: Journal of the European Academy of Dermatology and Venereology: JEADV
T Jansen, O E Janßen, G Plewig
Acne is one of the most common skin diseases in the general population, especially among adolescents. Acne tarda (adult acne) is defined as acne that develops (late-onset acne) or continues (persistent acne) after 25 years of age. The disease is more common in women. The clinical features are quite specific: inflammatory acne in the lower facial region or macrocomedones (microcysts) spread over the face. Involvement of the trunk is much more common in men. The etiology of acne tarda is still controversial, as cosmetics, drugs, smoking, stress, diet, and endocrine abnormalities have been implicated...
April 2013: Der Hautarzt; Zeitschrift Für Dermatologie, Venerologie, und Verwandte Gebiete
Ana Laura Espinosa-de-Los-Monteros, Ernesto Sosa, Nayeli Martinez, Moisés Mercado
OBJECTIVES: Successful surgery does not always resolve all the clinical consequences of hypercortisolism in patients with Cushing's disease (CD). Our purpose was to integrally evaluate a group of CD patients cured by pituitary surgery and look for the persistence of CD symptoms, signs, and comorbidities. METHODS: We performed clinical and biochemical evaluations of 29 CD patients (2 males) cured by pituitary surgery. All patients underwent early (median 12 months) and late (median 58 months) postoperative evaluations...
March 2013: Endocrine Practice
László Ságodi, László Barkai
Polycystic ovary syndrome is a heterogeneous disorder characterized by chronic ovulatory dysfunction and hyperandrogenism. It occurs in 6-8% of the female population in the reproductive age. The syndrome may be associated with various metabolic disorders which may impair the quality of life and life expectancy of patients. The diagnosis in adults is usually established by the presence of three criteria. Polycystic ovary syndrome can be also identified in adolescent girls. Although the clinical, hormonal and metabolic features are similar to those found in adult women, it may be difficult to distinguish normal adolescents from those with polycystic ovary syndrome...
January 27, 2013: Orvosi Hetilap
B Dréno, A Layton, C C Zouboulis, J L López-Estebaranz, A Zalewska-Janowska, E Bagatin, V A Zampeli, Y Yutskovskaya, J C Harper
In the adult female, acne is a chronic condition with a substantial negative psychological, social and emotional impact. Based on time of onset, two subtypes of adult female acne are recognized: 'persistent acne' is a continuation of the disease from adolescence, while 'late-onset acne' first presents in adulthood. The morphological characteristics of adult female acne are often distinct from adolescent acne. In adults, inflammatory lesions (particularly papules, pustules and nodules) are generally more prominent on the lower chin, jawline and neck, and comedones are more often closed comedones (micro cysts)...
September 2013: Journal of the European Academy of Dermatology and Venereology: JEADV
K Bhate, H C Williams
Despite acne being an almost universal condition in younger people, relatively little is known about its epidemiology. We sought to review what is known about the distribution and causes of acne by conducting a systematic review of relevant epidemiological studies. We searched Medline and Embase to the end of November 2011. The role of Propionibacterium acnes in pathogenesis is unclear: antibiotics have a direct antimicrobial as well as an anti-inflammatory effect. Moderate-to-severe acne affects around 20% of young people and severity correlates with pubertal maturity...
March 2013: British Journal of Dermatology
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