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A case of facial burn due to the misuse of garlic face mask for acne

Hisham A, Mohamed Sukur S, Basiron N

Australas J Dermatol, 2018 Nov;59(4):336-337.
PMID: 29377074 DOI: 10.1111/ajd.12789
Matched MeSH terms: Acne Vulgaris/drug therapy*
A prospective study of a monophasic oral contraceptive containing 30 mcg ethinyl oestradiol and 150 mcg desogestrel (Marvelon)

Ismail MT

Malays J Reprod Health, 1994 Jun;12(1):43-8.
PMID: 12320338

PIP: Marvelon, a monophasic oral contraceptive (OC) containing 30 mcg of ethinyl estradiol and 150 mcg of desogestrel, has been available to Malaysian women through the national family planning program since 1982. To assess the safety, effectiveness, and side effects associated with this OC, 247 women who requested the pill were enrolled in a multicenter prospective study that included follow-up after the first, third, and sixth cycles of use. 81% of participants had never used any form of contraception before Marvelon. 194 women (79%) completed the 6-month study. There were no pregnancies recorded. Although women reported a slightly increased incidence of nausea, breast tenderness, and headache in the first treatment cycle, these side effects had abated by the end of the third cycle. After six cycles, mean body weight had decreased by an average of 0.4 kg. Both systolic and diastolic blood pressure were unaffected. An unexpected finding was a decrease in the severity of acne with continuous use of Marvelon. Although both spotting and breakthrough bleeding increased slightly in the first two cycles, irregular bleeding returned to pretreatment levels by the third cycle. The length of the withdrawal bleed in the pill-free week was reduced. The incidence of irregular bleeding and other side effects was substantially lower in this sample of Malaysian women than in Asian and Caucasian Marvelon users surveyed in other studies.

Matched MeSH terms: Acne Vulgaris*
A simple pharmacopoeia for out-station skin clinics

Pettit JHS

Trop Doct, 1977 Jul;7(3):107-10.
PMID: 142324
Matched MeSH terms: Acne Vulgaris/drug therapy
A systematic review of benzoyl peroxide for acne vulgaris

Mohd Nor NH, Aziz Z

J Dermatolog Treat, 2013 Oct;24(5):377-86.
PMID: 22658322 DOI: 10.3109/09546634.2012.699179

OBJECTIVE: Comparative trials of benzoyl peroxide (BPO) have yielded contradictory results on its effectiveness for acne vulgaris. The aim of the study was to synthesise the evidence for the effectiveness of BPO-containing topical products for facial acne vulgaris.
DESIGN: Systematic review.
METHODS: The Cochrane Central Register of Controlled trials, Cochrane Library, MEDLINE and other relevant databases were searched without publication date or language restriction.
RESULTS: We identified 22 trials involving 2212 participants; 12 trials compared BPO as single agent while the other 10 trials compared BPO in combination products. All trials reported lesion count as the outcome measure but only five trials provided numerical data. However, pooling of data from these trials was inappropriate due to variations between trials in terms of acne severity, comparator used and trial duration. Overall the study quality was fair but most studies had some bias particularly in method of random generation and allocation concealment. Although the results provide some evidence that BPO reduces acne-lesion count, the available evidence is not robust enough for firm conclusions.
CONCLUSIONS: There is no high quality evidence that topical BPO improves facial acne vulgaris, and further research is needed.

Matched MeSH terms: Acne Vulgaris/drug therapy*
Fulltext Acne analysis, grading and computational assessment methods: an overview

Ramli R, Malik AS, Hani AF, Jamil A

Skin Res Technol, 2012 Feb;18(1):1-14.
PMID: 21605170 DOI: 10.1111/j.1600-0846.2011.00542.x

INTRODUCTION: This paper presents a comprehensive review of acne grading and measurement. Acne is a chronic disorder of the pilosebaceous units, with excess sebum production, follicular epidermal hyperproliferation, inflammation and Propionibacterium acnes activity. Most patients are affected with acne vulgaris, which is the prevalent type of acne. Acne vulgaris consists of comedones (whitehead and blackhead), papules, pustules, nodules and cysts.
OBJECTIVES: To review and identify the issues for acne vulgaris grading and computational assessment methods. To determine the future direction for addressing the identified issues.
METHODS: There are two main methods of assessment for acne severity grading, namely, lesion counting and comparison of patient with a photographic standard. For the computational assessment method, the emphasis is on computational imaging techniques.
RESULTS: Current acne grading methods are very time consuming and tedious. Generally, they rely on approximation for counting lesions and hence the assessment is quite subjective, with both inter and intra-observer variability. It is important to accurately assess acne grade to evaluate its severity as this influences treatment selection and assessment of response to therapy. This will further help in better disease management and more efficacious treatment.
CONCLUSION: Semi-automated or automated methods based on computational imaging techniques should be devised for acne grade assessment.

Matched MeSH terms: Acne Vulgaris/classification*; Acne Vulgaris/diagnosis*
Fulltext Acne disability, self management and help-seeking behaviour among medical students

Leelavathi M, Tan HC, Puah JWD, Apipi M, Sohami AE, Mahat NF

Medicine & Health, 2015;10(1):1-9.
MyJurnal

Acne can affect personal appearance and impair quality of life. A cross sectional study, over a period of 12 months was conducted among medical students at Universiti Kebangsaan Malaysia to evaluate the disability, self management and help-seeking behaviour of medical students for acne. A total of 361 students were selected using stratified cluster random sampling. Acne was graded using the Comprehensive Acne Severity Score (CASS) while acne disability was assessed using the Cardiff Acne Disability Index (CADI). Acne self management and helpseeking behaviour was assessed using the acne management questionnaire. Mean CADI score was 3.35 + 2.39, with mostly mild (83.8%, n=206) and moderate (14.6%, n=36) levels of impairment. Female students and those from the nonMalay ethnic group demonstrated higher disability (3.76 + 2.24, p=0.006 and 3.79 + 2.59, p=0.018, respectively). Although the majority of students (87.4%, n=215) knew that acne can be treated, they preferred to discuss their acne problems with friends (54.1%, n=133) rather than consulting a physician (9.3%, n=23). Most of them also practiced non-evidence based measures for their acne. The results of the present study shows that young adults tend to have mild grades of acne severity and disability. However, efforts are needed to enhance their knowledge on evidence based management of acne and modify their help seeking behavior. This would help reduce complications such as permanent scars and improve quality of life, as acne is a treatable dermatological disorder.
Keywords: acne vulgaris, medical, disability, quality of life, students, severity, self care

Matched MeSH terms: Acne Vulgaris
Fulltext Acne fulminans with dapsone induced haemolysis: a case report

Ismail R

Med J Malaysia, 1987 Jun;42(2):124-6.
PMID: 2971861

Acne is one of the most common disorders affecting mankind. Although acne does not cause death, it however produces a lot of discomfort, disfigurement and psychological trauma, particularly in teenagers. Acne vulgaris is a chronic condition involving the pilosebaceous unit of the skin. It is characterised by the presence of comedones, inflammatory papules, pustules or cysts, and eventually by scarring. The end result of acne varies from hyperpigmentation, slight pitting, to extremely disfiguring scars that may develop into keloids. Acne fulminans is a rare disorder and is characterised by sudden explosive appearance of highly inflammatory, tender, crusted, ulcerated lesions involving the back, chest and face. It is one of the most scarring acute dermatologic disorders of young people. A case of acne fulminans in a young female who developed haemolysis due to dapsone is reported here.

Matched MeSH terms: Acne Vulgaris/drug therapy*
Acne prevalence, severity and risk factors among medical students in Malaysia

Muthupalaniappen L, Tan HC, Puah JW, Apipi M, Sohaimi AE, Mahat NF, et al.

Clin Ter, 2014;165(4):187-92.
PMID: 25203331 DOI: 10.7417/CT.2014.1731

BACKGROUND AND AIMS: Acne is a common skin disorder which can cause physical scaring and impact the quality of life. The aim of this study is to determine the prevalence, severity and the risk factors for developing acne among medical students in Universiti Kebangsaan Malaysia (UKM).
MATERIALS AND METHODS: A cross sectional study among UKM medical students from academic year 1 to 5 was conducted from July 2011 to May 2012. A total of 361 students were selected by stratified cluster sampling method. Baseline data of the students, risk factors, height and weight were recorded. Acne severity was graded using the Comprehensive Acne Severity Scale (CASS).
RESULTS: The prevalence of acne among medical students is 68.1% (n=246). Males and females were almost equally affected (1:1.1). Majority students with acne were graded as almost clear (55.7%, n=137), mild (35.0%, n=86), moderate (7.7%, n=19), and severe (1.6%, n=4). More than half of them had developed acne scars (59.0%, n= 213). Males were found to be at higher risk of developing acne compared to females (p<0.05, OR=4.734; 95%CL=2.726-8.222). They are also at higher risk of developing moderate and severe grades of acne compared to females (p=0.001). The odds for developing acne was higher when mother (p=0.029; OR=1.752; 95%CL=1.058-2.902) or father (p=0.027; OR=1.852; 95%CL=1.072-3.201) had acne. When both parents were affected by acne the odds of developing acne was 3 times. (p=0.025; OR=3.056; 95%CL=1.153-8.094).
CONCLUSIONS: This study shows that the prevalence of acne among medical students is high. Hence, it is important to identify those at risk and provide optimal treatment to prevent scarring and possible low self esteem among these future doctors.
KEYWORDS: acne vulgaris; medical; prevalence; risk factors; severity; students

Matched MeSH terms: Acne Vulgaris*
Acne vulgaris

Chew SS

Family Practitioner, 1982;5:27-30.

Matched MeSH terms: Acne Vulgaris
Fulltext Acne vulgaris and its association with dietary intake: a Malaysian perspective

Suppiah TSS, Sundram TKM, Tan ESS, Lee CK, Bustami NA, Tan CK

Asia Pac J Clin Nutr, 2018 10 3;27(5):1141-1145.
PMID: 30272862 DOI: 10.6133/apjcn.072018.01

BACKGROUND AND OBJECTIVES: Acne vulgaris is a common skin condition among adolescents and young adults. Its relationship with the dietary intake is highly debatable and equivocal. This study aimed to identify the association between acne vulgaris and dietary intake among Malaysians.
METHODS AND STUDY DESIGN: A case-control study was conducted involving 57 acne vulgaris patients and 57 age-, gender- and ethnicity-matched controls. All participants were aged 14 and above. The Comprehensive Acne Severity Scale (CASS) was used to categorise patients (grades 2 to 5) and controls (grades 0 to 1). Information such as the demographics, family history, smoking habits and dietary intake were collected using a self-administered questionnaire.
RESULTS: In the patient arm, the gender ratio of male to female was 1.5:1. 43 patients (75.4%) had a family history of acne vulgaris. No significant association was found for acne in patients with a history of smoking. Milk consumption was significantly higher in patients (63.2%, n=36) versus controls (43.9%, n=25), (OR=2.19, p<0.05). In addition, chocolate consumption was also significantly higher in patients (43.9%, n=25) versus controls (24.6%, n=14), (OR=2.4, p<0.05). No significant association was found with the intakes of sweets, potatoes, chips, nuts, yoghurt, ice-cream or carbonated drinks.
CONCLUSIONS: Dietary intake of milk and chocolate may play a role in acne vulgaris. Prospective cohort and intervention studies are recommended to explore whether a causal relationship might obtain.

Matched MeSH terms: Acne Vulgaris
Fulltext Acne vulgaris in a family practitioner's clinic

Goh CS

Med J Malaysia, 1981 Jun;36(2):87-8.
PMID: 6211594
Matched MeSH terms: Acne Vulgaris/drug therapy*
Acne vulgarism treatment using ultra-short laser pulse generated by micro- and nano-ring resonator system

Jalil MA, Phelawan J, Aziz MS, Saktioto T, Ong CT, Yupapin PP

Artif Cells Nanomed Biotechnol, 2013 Apr;41(2):92-7.
PMID: 22991968 DOI: 10.3109/10731199.2012.700519

Acne vulgaris is adebilitating dermatologic disease, and is conventionally treated by laser therapy using a microring resonator system. An evolving understanding of laser-tissue interactions involving Propioni bacterium acneproducing porphyrins, and the development of lasers to target the sebaceous glands, has led to the development of an escalating number of laser light for acne treatment. The results show that the full width at half maximum of the proposed laser pulse of 0.15 nm can be generated using a microring resonator system. The power of the laser is 200 W and the wavelength laser is 1,032 nm, which is proposed as a treatment of acne vulgaris diseases.

Matched MeSH terms: Acne Vulgaris/radiotherapy*
Anti-acne, anti-dandruff and anti-breast cancer efficacy of green synthesised silver nanoparticles using Coriandrum sativum leaf extract

Sathishkumar P, Preethi J, Vijayan R, Mohd Yusoff AR, Ameen F, Suresh S, et al.

J. Photochem. Photobiol. B, Biol., 2016 Oct;163:69-76.
PMID: 27541567 DOI: 10.1016/j.jphotobiol.2016.08.005

In this present investigation, AgNPs were green synthesised using Coriandrum sativum leaf extract. The physicochemical properties of AgNPs were characterised using UV-visible spectrophotometer, field emission scanning microscopy/energy dispersive X-ray (FESEM/EDX), Fourier transformed infrared spectroscopy (FT-IR), X-ray diffraction (XRD) and Brunauer-Emmett-Teller (BET) analysis. Further, in vitro anti-acne, anti-dandruff and anti-breast cancer efficacy of green synthesised AgNPs were assessed against Propionibacterium acnes MTCC 1951, Malassezia furfur MTCC 1374 and human breast adenocarcinoma (MCF-7) cell line, respectively. The flavonoids present in the plant extract were responsible for the AgNPs synthesis. The green synthesised nanoparticles size was found to be ≈37nm. The BET analysis result shows that the surface area of the synthesised AgNPs was found to be 33.72m(2)g(-1). The minimal inhibitory concentration (MIC) of AgNPs for acne causative agent P. acnes and dandruff causative agent M. furfur was found to be at 3.1 and 25μgmL(-1), respectively. The half maximal inhibitory concentration (IC50) value of the AgNPs for MCF-7 cells was calculated as 30.5μgmL(-1) and complete inhibition was observed at a concentration of 100μgmL(-1). Finally, our results proved that green synthesised AgNPs using C. sativum have great potential in biomedical applications such as anti-acne, anti-dandruff and anti-breast cancer treatment.

Matched MeSH terms: Acne Vulgaris/drug therapy*; Acne Vulgaris/microbiology
Fulltext Cardiff acne disability index in Sarawak, Malaysia

Yap FBB

Ann Dermatol, 2012 May;24(2):158-61.
PMID: 22577265 DOI: 10.5021/ad.2012.24.2.158

BACKGROUND: Acne is considered a cosmetic nuisance in Malaysia since no insurance coverage is provided for its treatment. Its psychological impact is unknown.
OBJECTIVE: The aim of this study is to determine the impact of acne on quality of life and its relationship with severity.
METHODS: A cross-sectional study using the Cardiff acne disability index (CADI) and Global Acne Grading System for acne severity grading was done in three government-run dermatology clinics in Sarawak, Malaysia.
RESULTS: The study cohort of 200 patients had a mean CADI score of 5.1. Most of the patients (59.5%) had mild CADI impairment, with the domain of feelings most affected. Patients with a family income <1,000 United States Dollor/month had a higher mean CADI (mean 5.5 vs. 4.4; p=0.04). Females, indigenous groups, and patients with tertiary education tended to have more severe CADI impairment (p>0.05). The correlation between CADI and mild acne severity was low (Pearson correlation coefficient=0.35; p<0.001) but became insignificant for moderate and severe acne.
CONCLUSION:
Acne impairment in Sarawak was moderate and must be addressed. It should be viewed as a psychologically disabling disease requiring optimal management and resource allocation.
KEYWORDS: Acne vulgaris; Disability; Quality of life

Study site: Dermatology Departments of Sarawak General Hospital

Matched MeSH terms: Acne Vulgaris*
Fulltext Comparison of antimicrobial activity of crude extracts of piper betle, aloe vera, solanum lycopersicum, cinnamomum zeylanicum and cucumis sativus against acne inducing bacteria

Aiza Izyani Aminuddin, Siti Suraiya, Ruzilawati Abu Bakar

Asian Journal of Medicine and Biomedicine, 2018;2(1):0-0.
MyJurnal

Acne vulgaris is a typical skin disorder among adolescence, causing inflammation of pilosebaceous follicle
which characterized by comedones, papules, pustules, cysts, nodules and often scars in face, neck, upper trunk
and arms. Propionibacterium acnes and Staphylococcus epidermidis have been recognized that play as a major
role in acne formation. This study was conducted to compare the antimicrobial activity of five plant extracts
namely Piper betle, Aloe vera, Solanum lycopersicum, Cinnamomum zeylanicum and Cucumis sativus against P.
acnes and S. epidermidis. The well diffusion assay was used to determine the sensitivity of the samples, while
the liquid dilution method was used for the determination of the minimal inhibition concentration (MIC). The
result showed a remarkable antibacterial activity of Piper betle extract compared to other plant extracts and
Doxycycline (positive control) against both of acne-inducing bacteria, P. acnes and S. epidermidis.

Matched MeSH terms: Acne Vulgaris
Fulltext Do adolescents attending Bandar Mas primary care clinic consult health professionals for their common health problems?

Khairani O, Zaiton S, Faridah MN

Med J Malaysia, 2005 Jun;60(2):134-9.
PMID: 16114152

The aims of the study were to determine the prevalence of the common health problems namely acne, overweight, smoking and depressive symptoms among adolescents attending a primary healthcare clinic, whether they seek treatment for these problems and the reasons for not consulting health professionals. It was a clinic-based, crosssectional study. All adolescents aged 13 to 20 years who attended the clinic during the study period were included in the study. The respondents were given self-administered questionnaires and their weights were measured to assess if they had the above disorders. A total of 215 adolescents were included in the study. The proportion of adolescents who had acne were 70.7%, overweight 8.9%, smoking 41.9% and depressive symptoms 9.8%. Only 25% of those who had acne, 47% of those who were overweight, 9.5% who had depressive symptoms and none of those who smoked had ever sought treatment for these problems. The common reasons given for not consulting the health professionals were 'did not consider it as a problem', 'shy' and 'thought there was no treatment available'. The majority of the adolescents who attended the clinic did not consult health professionals the above common health problems. It is important to educate them on these disorders and encourage health-seeking behaviour in adolescents.

Matched MeSH terms: Acne Vulgaris
Efficacy and safety of Jessner's solution peel in comparison with salicylic acid 30% peel in the management of patients with acne vulgaris and postacne hyperpigmentation with skin of color: a randomized, double-blinded, split-face, controlled trial

How KN, Lim PY, Wan Ahmad Kammal WSL, Shamsudin N

Int J Dermatol, 2020 Jul;59(7):804-812.
PMID: 32447767 DOI: 10.1111/ijd.14948

OBJECTIVE: Antibiotics and retinoids have been used for acne vulgaris for decades. Though effective, each has its own drawbacks. Chemical peels have been used for treatment of acne vulgaris with inadequate clinical evidence. We sought to determine the efficacy and safety of Jessner's solution (JS) in comparison with salicylic acid (SA) 30% in the management of acne vulgaris and postacne hyperpigmentation in patients with colored skin.
METHODS: A total of 36 subjects (94.5% Fitzpatick Type IV-V) were recruited in this randomized double-blinded, split-face, controlled trial. Each side of the face was randomly assigned for treatment with either JS or SA. Subjects were treated once fortnightly for a total of three sessions. Lesion counting, Michaelsson acne score (MAS), photographs, and postacne hyperpigmentation index (PAHPI) were used to objectively assess the improvement. Complications were assessed during each visit. Statistical analysis was conducted using SPSS v22.0. Significance was set at P = 0.05.
RESULTS: At the end of therapy, significant reduction in inflammatory, noninflammatory lesions, MAS, and PAHPI scores (P

Matched MeSH terms: Acne Vulgaris/complications; Acne Vulgaris/drug therapy*
Fulltext Efficacy and safety of azithromycin in moderate acne vulgaris

Navedur Rehman, Chin Chwen Ch’ng, Thavin Kumar Mathana Sundram, Eugenie Sin Sing Tan, Chew Kek Lee, Chung Keat Tan3

Malaysian Journal of Medicine and Health Sciences, 2020;16(2):69-74.
MyJurnal

Introduction: Acne vulgaris is a chronic inflammatory dermatosis caused by Propionibacterium acnes. Clinicians are constantly attempting to discover the best antibiotic regimes in treating acne vulgaris. This study compares two regimens in terms of efficacy, tolerability, compliance and recurrence rate to make recommendation on which is the best regime. Methods: An open-labelled prospective randomized investigator-blinded interventional study was carried on moderate acne vulgaris patients. Patients were assigned to treatment arm at enrolment followed by fol- low-up and maintenance visits. Demographic data were collected at enrolment and questionnaire enquiring acne condition, general health and quality of life impairment were filled at every visit followed by blinded dermatologist assessment. Antibiotic tablets were provided based on assigned arm until follow-up 3. Results: 26 mild acne vulgaris patients aged 17 to 29 years were recruited. Physician assessment based on GAGS and photo assessment analysis showed an overall significant change (p0.05) were found between regimens. Similarly, patient self-perceived assessment and CADI assessment also showed overall significant changes (p

Matched MeSH terms: Acne Vulgaris
Fulltext Efficacy and safety of superficial chemical peeling in treatment of active acne vulgaris

Al-Talib H, Al-Khateeb A, Hameed A, Murugaiah C

An Bras Dermatol, 2017 5 26;92(2):212-216.
PMID: 28538881 DOI: 10.1590/abd1806-4841.20175273

Acne vulgaris is an extremely common condition affecting the pilosebaceous unit of the skin and characterized by presence of comedones, papules, pustules, nodules, cysts, which might result in permanent scars. Acne vulgaris commonly involve adolescents and young age groups. Active acne vulgaris is usually associated with several complications like hyper or hypopigmentation, scar formation and skin disfigurement. Previous studies have targeted the efficiency and safety of local and systemic agents in the treatment of active acne vulgaris. Superficial chemical peeling is a skin-wounding procedure which might cause some potentially undesirable adverse events. This study was conducted to review the efficacy and safety of superficial chemical peeling in the treatment of active acne vulgaris. It is a structured review of an earlier seven articles meeting the inclusion and exclusion criteria. The clinical assessments were based on pretreatment and post-treatment comparisons and the role of superficial chemical peeling in reduction of papules, pustules and comedones in active acne vulgaris. This study showed that almost all patients tolerated well the chemical peeling procedures despite a mild discomfort, burning, irritation and erythema have been reported; also the incidence of major adverse events was very low and easily manageable. In conclusion, chemical peeling with glycolic acid is a well-tolerated and safe treatment modality in active acne vulgaris while salicylic acid peels is a more convenient for treatment of darker skin patients and it showed significant and earlier improvement than glycolic acid.

Matched MeSH terms: Acne Vulgaris/therapy*
Frequency and characteristics of acne-related post-inflammatory hyperpigmentation

Abad-Casintahan F, Chow SK, Goh CL, Kubba R, Hayashi N, Noppakun N, et al.

J Dermatol, 2016 Jul;43(7):826-8.
PMID: 26813513 DOI: 10.1111/1346-8138.13263

In patients with darker skin types (Fitzpatrick phototypes III-VI), acne is often accompanied by post-inflammatory hyperpigmentation (PIH). Further, acne-related pigmentation can pose a greater concern for the patient than the acne lesions. There has been little formal study of this acne-related PIH. Recently, the Asian Acne Board - an international group of dermatologists with interest in acne research - made a preliminary evaluation of the frequency and characteristics of PIH in seven Asian countries. A total of 324 sequential acne subjects were evaluated for the presence of PIH. The majority (80.2%) of subjects had mild to moderate acne and there were more females than males (63.0% vs 37.0%). In this population of patients consulting a dermatologist for acne, 58.2% (188/324) had PIH. The results also showed that pigmentation problems are often long lasting: at least 1 year for more than half of subjects and 5 years or longer in 22.3%. In accordance with our clinical experience, patients reported that PIH is quite bothersome, often as bothersome or more so than the acne itself and sometimes more problematic. Excoriation was commonly reported by patients, and may represent a modifiable risk factor that could potentially be improved by patient education.

Matched MeSH terms: Acne Vulgaris/complications*; Acne Vulgaris/epidemiology

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