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BackgroundTreatment for both facial and truncal acne has not sufficiently been studied.ObjectivesTo evaluate the long-term safety and efficacy of trifarotene in both facial and truncal acne.MethodsIn a multicentre, open-label, 52-week study, patients with moderate facial and truncal acne received trifarotene 50 μg/g cream (trifarotene). Assessments included local tolerability, safety, investigator and physician's global assessments (IGA, PGA) and quality of life (QOL). A validated QOL questionnaire was completed by the patient at Baseline, Week 12, 26 and 52/ET.ResultsOf 453 patients enrolled, 342 (75.5%) completed the study. Trifarotene-related treatment-emergent adverse events (TEAEs) were reported in 12.6% of patients, and none was serious. Most related TEAEs were cutaneous and occurred during the first 3 months. Signs and symptoms of local tolerability were mostly mild or moderate and severe signs, and symptoms were reported for 2.2% to 7.1% of patients for the face and 2.5% to 5.4% for the trunk. Local irritation increased during the first week of treatment on the face and up to Weeks 2 to 4 on the trunk with both decreasing thereafter. At Week 12, IGA and PGA success rates were 26.6% and 38.6%, respectively. Success rates increased to 65.1% and 66.9%, respectively at Week 52. Overall success (both IGA and PGA success in the same patient) was 57.9% at Week 52. At Week 52 visit, 92/171 (53.8%) patients who had completed their assessments had scores from 0 to 1 (i.e. no effect of acne on their QOL) vs. 47/208 (22.6%) patients at Baseline visit.ConclusionIn this 52-week study, trifarotene was safe, well tolerated and effective in moderate facial and truncal acne.

Background: Acne vulgaris commonly affects adults, adolescents, and preadolescents aged 9 years or older., Objective: The objective of this study was to provide evidence-based recommendations for the management of acne., Methods: A work group conducted a systematic review and applied the Grading of Recommendations, Assessment, Development, and Evaluation approach for assessing the certainty of evidence and formulating and grading recommendations., Results: This guideline presents 18 evidence-based recommendations and 5 good practice statements. Strong recommendations are made for benzoyl peroxide, topical retinoids, topical antibiotics, and oral doxycycline. Oral isotretinoin is strongly recommended for acne that is severe, causing psychosocial burden or scarring, or failing standard oral or topical therapy. Conditional recommendations are made for topical clascoterone, salicylic acid, and azelaic acid, as well as for oral minocycline, sarecycline, combined oral contraceptive pills, and spironolactone. Combining topical therapies with multiple mechanisms of action, limiting systemic antibiotic use, combining systemic antibiotics with topical therapies, and adding intralesional corticosteroid injections for larger acne lesions are recommended as good practice statements., Limitations: Analysis is based on the best available evidence at the time of the systematic review., Conclusions: These guidelines provide evidence-based recommendations for the management of acne vulgaris., Competing Interests: Conflicts of interest Rachel V.S. Reynolds, MD, Carol E. Cheng, MD, Kelly Druby, Megha M. Tollefson, MD, and Jung Min Han, PharmD, MS, have no relationships to disclose. Howa Yeung, MD, MS, serves as an investigator for American Acne & Rosacea Society, Department of Veterans Affairs, and National Institutes of Health receiving grants and research funding; as an independent contractor for American Academy of Dermatology and Journal of the American Medical Association receiving fees; as a speaker/faculty educator for Dermatology Digest receiving honoraria. Fran Cook-Bolden, MD, serves as an advisory board member for AbbVie, Dermavant Sciences, Inc., Galderma Global, Novartis, Ortho Dermatologics, and Pfizer Inc. receiving honoraria; as an investigator for Arcutis Biotherapeutics receiving grant and research funding; as a speaker for Galderma Laboratories, LP, Journey Medical Corporation, and Ortho Dermatologics receiving honoraria; as others for Topix Pharmaceuticals, Inc. receiving other financial benefit. Seemal R. Desai, MD, serves an advisory board member for Foundation for Research & Education of Dermatology receiving fees; as a consultant for AbbVie, Allergan, Inc, Almirall, Amgen, Apogee, Avita, Ballature Beauty, Beiersdorf, Inc., Bristol-Myers Squibb, Candela Corporation, Cassiopea S.p.A., Castle Biosciences, Cutera, Inc., Dermavant Sciences, Dermira, Eli Lilly and Company, EPI Health, Ferndale Laboratories, Inc., Foamix, Galderma Laboratories, LP, Gore Range Capital, Hyphens Pharma, Incyte Corporation, Janssen Pharmaceuticals, Inc, Johnson and Johnson, Leo Pharma Inc., L'Oreal USA Inc., Lyceum Health, Ortho Dermatologics, Pfizer Inc., Revision Skincare, Sanofi/Regeneron, Scientis, Skin Science Advisors, UCB, Verrica Pharmaceuticals Inc., and VYNE Therapeutics receiving fees, honoraria, and/or stock options; as an investigator for AOBiome, LLC, Atacama Therapeutics, Dermavant Sciences, Incyte Corporation, and SkinMedica, Inc. receiving grants and research funding; as a speaker for AbbVie, Dermira, Galderma Laboratories, LP., and Pfizer Inc. receiving fees; as a stockholder for Gore Range Capital; as other role for Medscape receiving fees. Esther E. Freeman, MD, PhD, serves as an investigator for International League of Dermatologic Societies and National Institutes of Health receiving grants and research funding; as an author for UptoDate, Inc. and British Journal of Dermatology, receiving honoraria or salary; as a speaker for Harvard University. Jonette E. Keri, MD, PhD, serves as an advisory board member for Ortho Dermatologics receiving honoraria; as a consultant for Almirall receiving fees; as an investigator for Galderma USA receiving grants and research funding; as a speaker for Foamix Pharmaceuticals Ltd and VYNE Therapeutics receiving honoraria. Linda F. Stein Gold, MD, serves as an advisory board member for AbbVie, Almirall, Aqua, Dermavant Sciences, Foamix, Galderma Laboratories, L.P., GlaxoSmithKline, Incyte Corporation, La Roche-Posay Laboratorie Pharmaceutique, LEO Pharma, US, Lilly ICOS LLC, Merz Pharmaceuticals, LLC, Pfizer Inc., Promius Pharmaceuticals, Sanofi/Regeneron, Taro Pharm, and Valeant Pharmaceuticals International receiving honoraria; as a consultant for AnaptysBio, BMS, Botanix Pharmaceuticals, Cutera, Inc., Incyte Corporation, Janssen Scientific Affairs, LLC, Sol-Gel Technologies, Taro Pharm, The Acne Store, and UCB receiving honoraria or grants and research funding; as an investigator for AbbVie, Allergan, Inc., AnaptysBio, Galderma Laboratories, L.P., Leo Pharma Inc., Novartis Pharmaceuticals Corp., Pfizer Inc., Topica, and Valeant Pharmaceuticals International receiving grants and research funding; as a speaker for Actavis, Almirall, BMS, Dermira, Pfizer Inc., Sanofi/Regeneron, Sun Pharmaceutical Industries Ltd., and VYNE Therapeutics receiving honoraria. Jerry K. L. Tan, MD, serves as an advisory board member for Abbott Laboratories, Cutera, Inc., Galderma Laboratories, L.P, and Sun Pharmaceutical Industries Ltd receiving honoraria or grants and research funding; as a consultant for Bausch Health, Boots, Galderma Research & Development, LLC, and Loreal Research and Innovation receiving honoraria; as an independent contractor for Norvatis receiving fees; as an investigator for Allergan, AnaptysBio, Cutera, Inc., Eli Lilly and Co., Galderma Laboratories, L.P, Lilly ICOS LLC, Pfizer, and UCB for receiving grants and research funding; as a speaker for Bausch Health, LEO Laboratories Ltd (LEO Pharma), and Vichy Laboratories receiving honoraria. Jonathan S. Weiss, MD, serves as an advisory board member for Bristol-Myers Squibb, Dermavant Sciences, Foamix, Galderma Laboratories, L.P., Incyte Corporation, Novartis, and UCB receiving honoraria; as a consultant for Arcutis, Inc., Biofrontera, Cutera, Inc., Leo Pharma Inc, Ortho Dermatologics, and UCB receiving fees or honoraria; as an investigator for AbbVie, Bausch Health, Biofrontera, Bristol-Myers Squibb, Cutera, Inc., Dermavant Sciences, Foamix, Galderma Laboratories, L.P., LEO Pharma, Mindera, Moberg Pharma North, America LLC, Novartis, Palvella Therapeutics, and Verrica Pharmaceuticals Inc receiving grants and research funding; as a speaker for AbbVie, Arcutis, Inc., Galderma Laboratories, L.P., Ortho Dermatologics, Regeneron, and Sanofi Genzyme receiving honoraria. Peggy A. Wu, MD, serves as others for UptoDate, Inc. receiving honoraria. Andrea L. Zaenglein, MD, serves as a consultant for Church & Dwight Co., Inc. and UCB receiving fees or honoraria; as an investigator for AbbVie, Arcutis Biotherapeutics, Biofrontera AG, Galderma Laboratories, L.P., and Incyte Corporation receiving grants and research funding. John S. Barbieri, MD, MBA serves as investigator for National Institutes of Health and National Psoriasis Foundation receiving grants and research funding., (Copyright © 2024 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.)

Background: While topical retinoids are a mainstay of acne treatment, acne can manifest differently in various skin types. The objective of these post hoc analyses from two pooled phase 3 studies was to examine efficacy and safety of tazarotene 0.045% and quality of life improvements in self-identified Caucasian adults with moderate-to-severe acne., Methods: In two phase 3, double-blind, 12-week studies (NCT03168334; NCT03168321), participants aged ≥9 years with moderate-to-severe acne were randomized (1:1) to tazarotene 0.045% lotion or vehicle lotion (N=1,614); a subset of adults (≥18 years) who self-reported Caucasian (White) race (n=645) were examined. Coprimary endpoints were inflammatory/noninflammatory lesion counts and treatment (endpoint) success (≥2-grade reduction from baseline in Evaluator's Global Severity Score and a score of 0 [clear] or 1 [almost clear]). Quality of life, treatment-emergent adverse events (TEAEs), and cutaneous safety/tolerability were also assessed., Results: At week 12, tazarotene lotion significantly reduced lesion counts by ~60% (least-squares mean percent changes from baseline, tazarotene vs vehicle: inflammatory, -61.2% vs -51.1%; noninflammatory, -59.7% vs -49.3%; P<0.001, both). Significantly more participants achieved treatment success with tazarotene lotion versus vehicle (P<0.001). Numerical improvements in quality-of-life domains were observed from baseline to week 12. Most TEAEs were unrelated to treatment, and rates of moderate-to-severe erythema decreased from baseline to week 12 with tazarotene treatment., Conclusions: Tazarotene 0.045% lotion was efficacious and well tolerated over 12 weeks and led to quality-of-life improvements in Caucasian adults with moderate-to-severe acne. These results, along with those from patients with skin of color, demonstrate that once daily tazarotene 0.045% lotion is an effective and well-tolerated treatment option regardless of race or skin color.J Drugs Dermatol. 2022;21(10):1061-1069. doi:10.36849/JDD.6834.

Introduction: Half of the individuals with facial acne develop truncal acne, but the impact of combined facial and truncal acne (CA) on patients' quality of life is poorly researched., Methods: A 60-min interview of 30 participants with CA was conducted that formed the basis for a cross-sectional survey of 694 adolescents and adults with CA., Results: The main themes identified from the qualitative interviews among CA subjects included acceptability to self and others, social functioning and emotional wellbeing. Feelings of embarrassment, self-consciousness and low confidence were experienced often or all the time by over 50% of participants, and were more frequent in those who perceived their acne to be out of control (P = 0.003). Half of patients reported feeling stigmatised because of their CA, and 65.4% believed that others associated their truncal acne with unhealthy or unhygienic habits. Perceived stigma was associated with more feelings of embarrassment (P = 0.005), self-consciousness (P = 0.034) and low self-confidence (P = 0.017). Overall, 64% participants reported that CA interfered with daily life, 46.4% often or always avoided social interaction, 48.6% were often concerned about talking to unfamiliar people and 47.4% were uncomfortable showing affection. Further, 32% and 24.4% participants ≥ 16 years old avoided dating or having romantic/intimate relationships because of their facial and truncal acne, respectively. Social and leisure activities were more frequently negatively impacted among those with perceived uncontrolled CA than among those with controlled CA. Avoiding undressing in front of spouse/partner/friends/relatives was more commonly reported by participants with perceived uncontrolled truncal acne than by those with controlled truncal acne (90.5% versus 80.6%, P = 0.031)., Conclusion: CA is associated with considerable psychological morbidity, with several exacerbating (e.g. perceived stigma) and attenuating factors (e.g. acne being perceived as being under control) that should be accounted for in CA management., (© 2022. The Author(s).)

Background: Females aged ≥25 years may have acne with different etiology, presentation, burden, and treatment response than females 18–24 years. This post hoc analysis investigated efficacy and safety of tazarotene 0.045% lotion in females ≥18 years or ≥25 years of age., Methods: In two phase 3 double-blind studies, participants 9 years of age and older with moderate-to-severe acne were randomized (1:1) to once-daily tazarotene 0.045% lotion or vehicle lotion for 12 weeks. Pooled data were analyzed for females aged ≥18 years (n=744) or ≥25 years (n=335). Assessments included inflammatory/noninflammatory lesion counts, treatment success (≥2-grade reduction from baseline in Evaluator’s Global Severity Score and score of 0 [clear] or 1 [almost clear]), Acne-Specific Quality of Life (Acne-QoL) questionnaire, treatment-emergent adverse events (TEAEs) and cutaneous safety/tolerability., Results: At week 12, tazarotene-treated females in both age groups had greater reductions from baseline versus vehicle in inflammatory (≥18 years: 60.6% vs 53.7% [P<0.01]; ≥25 years: 60.9% vs 57.3% [P>0.05]) and noninflammatory lesions (59.0% vs 48.4% and 61.1% vs 48.8%; P<0.01, both). Rates of treatment success were greater with tazarotene versus vehicle; this difference was significant for females ≥18 years. Acne-QoL improvements were similar across age groups and generally greater with tazarotene than vehicle. TEAEs were mostly mild to moderate in severity. No age-related trends for safety or tolerability were observed., Conclusions: Tazarotene 0.045% lotion demonstrated comparable efficacy, improvement in quality of life, and safety in adult females aged ≥18 or ≥25 years with moderate-to-severe acne. This cosmetically elegant lotion is a well-studied and important treatment option for all patients, particularly adult females. J Drugs Dermatol. 2022;21(5):587-595. doi:10.36849/JDD.6876.

Background: Acne affects more than 80% of adolescents and young adults, who most often develop acne scars. Supporting data on the effect of acne scars on patient's health-related quality of life (HRQOL) are limited., Objective: The aim was to determine how the severity of acne scars impacts the HRQOL of afflicted individuals., Methods: In this population-based cross-sectional study, 723 adults with facial acne scars but without active acne lesions self-completed the Self-assessment of Clinical Acne-Related Scars (SCARS) questionnaire formulated to investigate degree of acne scarring. The Facial Acne Scar Quality of Life (FASQoL), Dermatology Life Quality Index (DLQI), and Dysmorphic Concern Questionnaire (DCQ) were completed to assess the attitude of these patients toward their scars and the impact of scarring on their HRQOL., Results: The mean (standard error) DLQI score for facial acne scars was 6.26 (0.22). Acne scars were considered a 'very large' or 'extremely large' concern by 19.3% of participants with mild scars as compared to 20.1% and 34.0% of participants with moderate and severe/very severe scars, respectively (P = 0.003). Higher FASQoL scores were associated with increased severity of scarring (P = 0.001). In total, 16.9% of participants had clinical features of dysmorphia (i.e., DCQ > 13). DCQ scores were significantly higher among participants with more severe scarring (mean DCQ score of 8.04 [0.28], 8.40 [0.18], and 10.13 [0.08] among participants with mild, moderate, and severe/very severe acne scars, respectively; P = 0.001). Most commonly reported signs of emotional distress were self-consciousness (68.0%) and worry about scars not going away (74.8%)., Conclusions: This study highlights the significant psychosocial impact of atrophic acne scars in the form of embarrassment and self-consciousness. Individuals with mild scars also expressed significant impact on quality of life that increased with aggravation of scar severity. Patient-reported outcomes provide an insight into the physical, functional, and psychological impact of acne scarring from the patient's perspective., (© 2021. The Author(s).)

Background: Most people with acne are at risk of developing acne scars, but the impact of these scars on patients' quality of life is poorly researched., Objective: To assess the perspective of patients with acne scars and the impact of these scars on their emotional well-being and social functioning., Methods: A 60-minute interview of 30 adults with acne scars informed and contextualized the development of a cross-sectional survey of 723 adults with atrophic acne scars., Results: The main themes identified in the qualitative interviews included acceptability to self and others, social functioning, and emotional well-being. In the cross-sectional survey, 31.6%, 49.6%, and 18.8% of the participants had mild, moderate, and severe/very severe acne scarring. The survey revealed that 25.7% of the participants felt less attractive, 27.5% were embarrassed or self-conscious because of their scars, 8.3% reported being verbally and/or physically abused because of their scars on a regular basis, and 15.9% felt that they were unfairly dismissed from work. In addition, 37.5% of the participants believed that their scars affected people's perceptions about them, and 19.7% of the participants were very bothered about hiding their scars daily. Moreover, 35.5% of the participants avoided public appearances, and 43.2% felt that their scars had negatively impacted their relationships., Limitations: The temporal evaluation of the impact was not estimated., Conclusion: Even mild atrophic acne scarring can evoke substantial emotional, social, and functional concerns., Competing Interests: Dr Tan has acted as a consultant for and/or received grants/honoraria from Bausch, 10.13039/501100009754Galderma, 10.13039/100004319Pfizer, Almirall, Boots/10.13039/100005153Walgreens, Botanix, Cipher, 10.13039/501100009754Galderma, Novan, 10.13039/100004336Novartis, Promius, 10.13039/501100004296SUN, and Vichy. Dr Beissert has acted as an advisor for AbbVie Deutschland GmbH & Co, Actelion Pharmaceuticals GmbH, Allmirall-Hermal GmbH, Amgen GmbH, Celgene GmbH, Galderma Laboratorium GmbH, Janssen-Cilag GmbH, Leo Pharma GmbH, Lilly Deutschland GmbH, Menlo Therapeutics, MSD Sharp & Dohme GmbH, Novartis Pharma GmbH, Pfizer Pharma GmbH, Sanofi-Aventis Deutschland GmbH, and UCB Pharma GmbH and has received speaker honorarium from Novartis Pharma GmbH, AbbVie, MSD, Pfizer, Janssen-Cilag, Roche-Posay, Actelion, GSK, BMS, Celgene, Allmirall, and Hexal-Sandoz. Dr Cook-Bolden has acted as an advisor, consultant, investigator, and/or speaker and has received grants/honoraria from Almirall, Cassiopea, Foamix Pharmaceuticals, 10.13039/501100009754Galderma, and Ortho Dermatologics. Dr Chavda is an employee of Galderma. Dr Harper has acted as an advisor, consultant, and/or speaker and has received honoraria from Almirall, BioPharmX, Cassiopeia, Cutanea, Cutera, Dermira, EPI Health, Galderma, LaRoche-Posay, Ortho Dermatologics, Sol-Gel Technologies, Sun, and Vyne. Dr Hebert has acted as an advisor, consultant, investigator, and/or speaker and has received grants/honoraria from 10.13039/100007819Allergan, Cassiopea, 10.13039/501100009754Galderma, GSK, La Roche-Posay, Novan, Ortho Dermatologics, Ortho Dermatologics, 10.13039/100009857Regeneron 10.13039/100004339Sanofi, and Vyne. Dr Lain has acted as an advisor, consultant, investigator, and/or speaker and has received grants/honoraria from 10.13039/100006483AbbVie, Aclaris Therapeutics Inc, 10.13039/100007819Allergan Inc, Almirall, 10.13039/100004325AstraZeneca, Athenix, Biopelle Inc, BioPharmX, Biorasi LLC, BMS, Brickell Biotech Inc, Cassiopea SpA, 10.13039/100006436Celgene, Cellceutix, ChemoCentryx, Cutanea Life Sciences, Demira, Dow Pharmaceutical Sciences Inc, Dr Reddy's Laboratory, 10.13039/100004312Eli Lilly and Company, Gage Development Company LLC, Galderma Laboratories L.P., 10.13039/501100009754Galderma, Hovione, Kadmon Corporation LLC, La Roche-Posay, Leo Pharma, 10.13039/501100004628MedImmune, Menlo Therapeutics, Moleculin LLC, Neothetics, Nielsen Holdings N.V, 10.13039/100004336Novartis, Othro Dermatologics, 10.13039/100004319Pfizer Inc, Promius Pharma LLC, Sebacia Inc, Sienna Labs Inc, SkinCeuticals LLC, Sol-Gel Technologies, 10.13039/100011110UCB, and Valeant Pharmaceuticals North America LLC. Dr Layton has acted as an advisor, consultant, investigator, and/or speaker and has received grants/honoraria from 10.13039/501100009754Galderma, GSK, L'Oreal, La Roche-Posay, Origimm, Leo Pharma, and Proctor & Gamble. Dr Rocha has acted as an advisor and/or speaker and has received honoraria from Eucerin, Galderma, Johnson & Johnson, and Leo Pharma. Dr Weiss has acted as an advisor, consultant, investigator, and/or speaker and has received grants/honoraria from Almirall, Bausch, Cassiopea, Cutera, EPI Health, Foamix, 10.13039/501100009754Galderma, and Ortho Dermatologics. Dr Dréno has acted as an advisor, consultant, and/or speaker and has received honoraria from BMS, Galderma, La Roche-Posay, Merck Serono, Pierre Fabre, and Sanofi., (© 2021 by the American Academy of Dermatology, Inc. Published by Elsevier Inc.)

Background: Acne confers an increased risk of physical, psychiatric, and psychosocial sequelae, potentially affecting multiple dimensions of health-related quality of life (HRQoL). Morbidity associated with truncal acne is poorly understood., Objective: To determine how severity and location of acne lesions impact the HRQoL of those who suffer from it., Methods: A total of 694 subjects with combined facial and truncal acne (F+T) and 615 with facial acne only (F) participated in an online, international survey. Participants self-graded the severity of their acne at different anatomical locations and completed the dermatology life quality index (DLQI)., Results: The F+T participants were twice as likely to report "very large" to "extremely large" impact on HRQoL (ie, DLQI > 10 and children's DLQI [CDLQI] > 12) as compared with the F participants (DLQI: odds ratio [OR] 1.61 [95% confidence interval {CI} 1.02-2.54]; CDLQI: OR 1.86 [95% CI 1.10-3.14]). The impact of acne on HRQoL increased with increasing acne severity on the face (DLQI and CDLQI P values = .001 and .017, respectively), chest ( P  = .003; P  = .008), and back ( P  = .001; P  = .028)., Limitations: Temporal evaluation of acne impact was not estimated., Conclusions: Facial and truncal acne was associated with a greater impact on HRQoL than facial acne alone. Increasing severity of truncal acne increases the adverse impact on HRQoL irrespective of the severity of facial acne., Competing Interests: Dr Tan has acted as a consultant for and/or received grants/honoraria from Bausch, 10.13039/501100009754Galderma, 10.13039/100004319Pfizer, Almirall, Boots/10.13039/100005153Walgreens, Botanix, Cipher, 10.13039/501100009754Galderma, Novan, 10.13039/100004336Novartis, Promius, 10.13039/501100004296Sun, Vichy. Dr Chavda is an employee of Galderma. Dr Beissert, Dr Cook-Bolden, Dr Harper, Dr Hebert, Dr Lain, Dr Layton, Dr Weiss, and Pr Dréno have acted as investigators and consultants for Galderma. Dr Rocha has acted as an advisor and/or speaker and received honoraria from Eucerin, Galderma, Johnson&Johnson and Leo Pharm., (© 2021 by the American Academy of Dermatology, Inc. Published by Elsevier Inc.)

In 2017, a National Rosacea Society Expert Committee developed and published an updated classification of rosacea to reflect current insights into rosacea pathogenesis, pathophysiology, and management. These developments suggest that a multivariate disease process underlies the various clinical manifestations of the disorder. The new system is consequently based on phenotypes that link to this process, providing clear parameters for research and diagnosis as well as encouraging clinicians to assess and treat the disorder as it may occur in each individual. Meanwhile, a range of therapies has become available for rosacea, and their roles have been increasingly defined in clinical practice as the disorder has become more widely recognized. This update is intended to provide a comprehensive summary of management options, including expert evaluations, to serve as a guide for tailoring treatment and care on an individual basis to achieve optimal patient outcomes., (Copyright © 2020 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.)

Background: Acne vulgaris (acne) is highly prevalent in the Hispanic population as it is in other racial/ethnic groups. While nuances in the presentation, quality-of-life impact, and approach to therapy of acne have been reported in various racial ethnic groups and skin types, data on the Hispanic population are limited, and yet they are the fastest growing population in the United States. Potential for irritation, dryness, and pigmentary alteration (due to acne and/or treatment) are key concerns in the management of acne in Hispanic populations. Evaluation of the efficacy and tolerability of topical therapies in this growing segment of the population is therefore important. Methods: A post-hoc analysis of efficacy and cutaneous tolerability in 136 Hispanic subjects receiving clindamycin phosphate 1.2%/benzoyl peroxide (BP) 3.75% gel or vehicle from a 12-week, multicenter, double-blind study of 498 subjects with moderate-to-severe acne. Data was compared to that seen in the non-Hispanic population in the Phase 3 study. Results: Mean reductions in inflammatory and noninflammatory lesions (63.6% and 54.3%, respectively) were significantly greater with clindamycin phosphate 1.2%/BP 3.75% gel versus vehicle ( P =0.001 and 0.008, respectively) and numerically greater than the reductions seen in the non-Hispanic population. Treatment success, a 2-grade reduction in severity from baseline (36.5%), was also greater than vehicle at Week 12. Cutaneous tolerability was excellent with all mean scores less than or equal to 0.2 at Week 12 (where 1=mild). No subjects discontinued due to adverse events. Conclusion: Clindamycin phosphate 1.2%/BP 3.75% gel was well tolerated and efficacious in the Hispanic population. Compared with the general population, Hispanic acne subjects were not found to be more susceptible to cutaneous irritation from treatment with clindamycin phosphate 1.2%/BP 3.75% gel., Competing Interests: Disclosure:Dr. Alexis is an Advisory Board member for Galderma, Allergan, Novan L’Oreal, and Foamix and an Investigator for Allergan, Galderma, Novan, and BiopharmX. Dr. Cook-Bolden was a principle investigator in the Phase 3 clinical study and an advisor to Valeant Pharmaceuticals North America, LLC. Dr. Lin is an employee of Valeant Pharmaceuticals.

As the pathophysiology of acne is complex and multifactorial, the continued influx of new basic science and clinical information requires careful analysis before drawing conclusions about what truly contributes to the development and progression of this chronic disease. Our objective is to review the latest evidence and highlight a number of important perspectives on the pathophysiology of acne. An improved understanding of acne pathogenesis should lead to more rational therapy and a better understanding of the role of P acnes opens new perspectives for the development of new treatments and management. Further research may be directed at targeting receptors, adhesion molecules, cytokines, chemokines or other pro-inflammatory targets implicated in the activation of immune detection and response (i.e., toll-like receptors [TLRs], protease-activated receptors [PARs]) that appear to contribute to the pathophysiology of acne. Therapeutic options that reduce the need for topical and/or oral antibiotic therapy for acne are welcome as bacterial resistance to antibiotics is a clinically relevant concern both in the United States and globally.

It is well known that the setting of clinical trials for registration studies do not necessarily represent efficacy seen in clinical practice, where physicians have the flexibility to select, combine, and change the acne treatment prescription. In this phase 4, open-label, multicenter, community-based study, 544 patients who were dissatisfied with their current acne treatment received tretinoin gel microsphere (TGM) 0.04% or 0.1% in a pump dispenser for 12 weeks. Patients were allowed the use of up to 2 other concurrent acne therapies, not including other retinoids. A total of 361 patients received TGM 0.04% and 183 received TGM 0.1%. Compliance was high (defined as 75% to 100% of prescribed doses taken) for approximately 95% of patients in both groups at every evaluation. At week 12, the mean modified Global Acne Grade score (mGAGs) and the investigator global evaluation (IGE) demonstrated significant (P<.0001) improvement from baseline for both concentrations, with 72% having at least moderate improvement. In approximately 25% of patients, acne was assessed as cleared or almost cleared. Most side effects were characteristic of topical retinoids. These results indicate TGM in a pump dispenser as an effective, well-tolerated acne treatment that is associated with a high rate of compliance.

Acne vulgaris can affect adolescents at a time of profound physical, social, and psychological change. The negative impact of acne on self-image and self-confidence can be severe, leading to potential psychiatric problems and limiting social interactions, even in adults. Adherence is necessary for successful treatment of acne, and patient satisfaction is crucial for adherence. The Measuring Acne Outcomes in a Real-World Experience (MORE) trial enrolled 1979 subjects who used combination acne treatments, all containing adapalene gel 0.1%. Among other measures, subjects were surveyed regarding their satisfaction with treatment. Adherence to treatment protocol was high throughout the study (94.5% and 88.0% at weeks 6 and 12, respectively, determined by self-report, and 93.7% and 80.3%, respectively, determined by filled prescriptions). Of the subjects who completed preference surveys, more than 70% rated adapalene gel 0.1% as much superior or superior to other acne treatments; more than 85% of subjects were very satisfied or satisfied with adapalene gel 0.1% to treat their acne; and more than 85% of subjects reported feeling more confident or positive after using this treatment. About 75% of subjects planned to continue using adapalene gel 0.1% and/or use it in the future if they needed acne treatment, and close to 75% of subjects indicated that they would recommend this treatment to a friend. The high level of patient satisfaction with adapalene gel 0.1% as an acne treatment is likely to translate into a high level of adherence to treatment, including maintenance treatment, and a major improvement in quality of life (QOL) for patients with acne.

In the past few years, increasing attention has been given to skin disease in individuals with skin of color (also termed ethnic skin, racial skin, black skin, or pigmented skin). We will attempt to identify those individuals with skin of color. We use this article as an introduction to a recurring series that will address cutaneous disease affecting these individuals.

Background: The use of imiquimod 5% cream for the treatment of superficial basal cell carcinoma (BCC) has been described. Its clinical efficacy was first shown in a study in patients with biopsy-proven superficial and nodular BCC., Objective: To evaluate the efficacy of topical imiquimod in a patient with multiple superficial BCCs unresponsive to topical 5-fluorouracil and to review the literature on this treatment modality for BCCs., Results: After 12 weeks of topical imiqmod, the patient's lesions had resolved. The patient was evaluated three months after discontinuation of treatment. There was no clinical evidence of any recurrent tumor., Conclusion: Imiquimod 5% cream appears to be effective for multiple, superficial BCCs unresponsive to other modalities.

Keloidal scars are abnormal scars of uncertain etiology with a predilection for certain racial groups. Although many articles have been published on the management of these scars, there are no definitive treatment protocols. Our objective was to examine the scientific quality of the literature on therapy for keloidal scars. There are many problems with the study designs of existing keloidal scar research. These include lack of consistent disease definitions and outcome measures, inadequate follow-up, and inconsistent therapeutic interventions. Suggestions are given for future studies.

In the 21st century, individuals with skin of color, including those of Hispanic, Asian, and African American descent, will account for more than half of the US population. Consequently, those individuals will constitute a significant patient population for the dermatology community. Dermatologists in major metropolitan centers as well as those in rural communities need to meet the diagnostic and therapeutic challenges posed by these patients by becoming familiar with dermatologic disease prevalence and presentation in skin of color. Commonly occurring cutaneous diseases, such as acne vulgaris, display histological and clinical differences in people with skin of color compared with Caucasians (whites). Additionally, the response to therapeutic agents may vary in people with skin of color. This article reviews data derived from a survey of skin of color patients with acne vulgaris seen at the Skin of Color Center, Department of Dermatology, St. Luke's-Roosevelt Hospital, in New York City. This information should help clinicians in their diagnosis and treatment of acne vulgaris for these patients.