Effects of Lactobacillus plantarum CJLP55 on Clinical Improvement, Skin Condition and Urine Bacterial Extracellular Vesicles in Patients with Acne Vulgaris: A Randomized, Double-Blind, Placebo-Controlled Study

Lactobacillus plantarum CJLP55 has anti-pathogenic bacterial and anti-inflammatory activities in vitro. We investigated the dietary effect of CJLP55 supplement in patients with acne vulgaris, a prevalent inflammatory skin condition. Subjects ingested CJLP55 or placebo (n = 14 per group) supplements for 12 weeks in this double-blind, placebo-controlled randomized study. Acne lesion count and grade, skin sebum, hydration, pH and surface lipids were assessed. Metagenomic DNA analysis was performed on urine extracellular vesicles (EV), which indirectly reflect systemic bacterial flora. Compared to the placebo supplement, CJLP55 supplement improved acne lesion count and grade, decreased sebum triglycerides (TG), and increased hydration and ceramide 2, the major ceramide species that maintains the epidermal lipid barrier for hydration. In addition, CJLP55 supplement decreased the prevalence of Proteobacteria and increased Firmicutes, which were correlated with decreased TG, the major skin surface lipid of sebum origin. CJLP55 supplement further decreased the Bacteroidetes:Firmicutes ratio, a relevant marker of bacterial dysbiosis. No differences in skin pH, other skin surface lipids or urine bacterial EV phylum were noted between CJLP55 and placebo supplements. Dietary Lactobacillus plantarum CJLP55 was beneficial to clinical state, skin sebum, and hydration and urine bacterial EV phylum flora in patients with acne vulgaris.

A Double-Blinded, Randomized, Vehicle-Controlled Study of the Efficacy of Moisturizer Containing Licochalcone A, Decanediol, L-Carnitine, and Salicylic Acid for Prevention of Acne Relapse in Asian Population

Many topical agents are available for treating the acute phase of acne; however, few agents have been proven beneficial during the maintenance phase. Objective. To evaluate the efficacy and safety of moisturizer containing licochalcone A, 1,2-decanediol, L-carnitine, and salicylic acid during the maintenance phase of mild to moderate acne in Thai patients. Methods. One hundred and ten patients with mild to moderate acne vulgaris were initially treated with a fixed combination of adapalene 0.1%/benzoyl peroxide 2.5% gel once daily for 8 weeks. Fifty patients who achieved at least 50% reduction in lesion counts or at least a 2-grade improvement in the Investigator’s Global Assessment (IGA) grade from baseline were enrolled in the maintenance phase, which was an investigator-masked, left-right comparison, randomized, controlled, intraindividual study. Moisturizers with and without the active study ingredients were applied twice a day to each side of the face, respectively, for 12 weeks. Assessments included acne lesion counts, acne severity by IGA scoring, skin bioengineering measurements, and skin tolerability as assessed by both patient and physician. Results. The treatment group had a significant reduction in the mean counts of noninflammatory, inflammatory, and total lesions compared to the vehicle group at week 12 and also between baseline and week 12. There was no significant difference in the mean scores for skin dryness, stinging/burning, or pruritus at any time point between groups. Conclusions. Moisturizer containing licochalcone A, 1,2-decanediol, L-carnitine, and salicylic acid reduced acne lesions and prevented the development of new lesions during the maintenance phase. This trial is registered with ClinicalTrials.gov registration no. NCT04002024.

The Chitosan-Sodium Alginate Submicro Particles Loading Herbal of Ethanolic Exract of Leaves Senna Alata. L for Curing of Bacterial Infection on Skin

Mardiyanto 1*, Indah Solihah 1, and Thio Gunawan Jaya 1 1Department of Pharmacy Faculty of Science Sriwijaya University *Corresponding Author : [email protected] This research was performed to detect the activity of the optimum formula of chitosan and sodium alginate submicro particles loading of the ethanol extract of leaves ketepeng cina (Senna alata L.) to P. acne growth. Submicro manufactured particles was used three variations of the formula from three of volume used of calcium chloride (CaCl2): 20, 40, and 100 mL based on ionic gelation method. The results obtained of %EE in formulas 1, 2 and 3 were 78.56%, 81.71%, and 77.48%. Formula 2 with a value of % EE of 81.71% was used as an optimum formula which indicates that the particles are well protected by chitosan and sodium alginate polymers so as to prevent particle damage during the homogenization process. The results of the diameter measurements showed that the optimal formula enters in the submicro particle range with the value obtained is 525,9455 nm. The submicro formula of chitosan alginate particles loading the ketepeng cina leaf ethanol extract was barely homogeneous which based on the results obtained by the PSA was 0.433 of PDI. The zeta potential value was +3.5 mV. The results of X-ray diffraction analysis or X ̶ Ray Diffraction produce a pattern shaped amorph with the resulting peak does not have a wide distance and pattern. In vivo testing using ketepeng cina leaf extract as submicro was decreased the P. acne lesion faster than using only ketepeng cina leaf extract because the submicro particle preparation has a small particle that is below to 600 nm making it easier to penetrate the skin pores to reach the target. The results of the analysis of the curing of many lesions on the skin of mice have a significance value of homogeneity. The one-way ANOVA test of < 0.05 was a significant effect of the test group on the decreasing in the number of lesions on the skin of the mouse.

Minocycline Topical Foam: A New Drug for the Treatment of Acne

Objective: To review the safety and efficacy of minocycline 4% topical foam for the treatment of moderate to severe acne vulgaris in adults and pediatric patients aged 9 years and older. Data Sources: A literature search through PubMed and EMBASE was conducted using the following keywords: FMX101, minocycline, foam, and acne. Study Selection and Data Extraction: Articles selected included those describing preclinical and clinical studies of pharmacokinetics, efficacy, or safety of topical minocycline foam. Data Synthesis: Minocycline 4% topical foam was shown in a preclinical study to effectively deliver minocycline to the pilosebaceous unit, with little penetration beyond the stratum corneum. This was consistent with a phase 1 pharmacokinetic study of the foam, which yielded a significantly reduced systemic exposure of minocycline compared with oral minocycline. In phase 2 and phase 3 clinical trials, the foam significantly reduced acne lesion counts and Investigator’s Global Assessment scores of acne severity compared with placebo. The foam has a good safety profile, with headache, mild erythema, hyperpigmentation, and mild dryness among the most common adverse effects. Relevance to Patient Care and Clinical Practice: Topical antibiotics have been a mainstay of acne therapy with the benefit of less systemic exposure compared with oral antibiotics. However, the development of bacterial resistance has reduced their use, thereby reducing options for many patients with acne. Minocycline 4% topical foam is a safe and effective alternative, which may help restore this important therapeutic approach for treating acne vulgaris.

The Role of Digital Fluorescence in Acne Vulgaris: Correlation of Ultraviolet Red Fluorescence with the Severity of Acne Vulgaris

Background. Colonization of Propionibacterium acnes (P. acnes) and increased sebum production play important roles in the pathogenesis of acne vulgaris. Severity of acne vulgaris correlates with the lesion counts both noninflammatory and inflammatory. Digital fluorescence has been found useful in pathogenesis investigation and treatment evaluation. Ultraviolet-induced red fluorescence (UVRF) was found to be correlated with sebum and porphyrin production that can be synthesized by P. acnes. Therefore, UVRF assessment could be useful for the evaluation of the degree and extent of acne vulgaris. Objective. To evaluate the correlation of UVRF with the severity of acne vulgaris using the digital fluorescence tool. Methods. Forty-five patients were diagnosed with mild-to-severe acne vulgaris according to Lehmann classification. Lesion counts both noninflammatory and inflammatory and UVRF assessment using Visiopor PP34 camera were done to all participants in 5 divided facial areas (forehead, nose, right and left cheeks, and chin). Clinical assessment for each patient was done by 3 dermatologists. Determination of correlation between UVRF with acne lesion counts was done using Pearson test and with acne severity using Spearman test. Results. From 45 participants, majority had moderate acne (64.4%), followed by severe (24.5%) and mild acne (11.1%). Mean number of UVRF spots was 39.98 ± 11.45 and percentage area covered with UVRF was 4.39 ± 1.72. There was no correlation found between acne lesion counts, including noninflammatory and inflammatory with the number and percentage area covered with UVRF spots. Severity grade of acne vulgaris was found to be uncorrelated with the number of UVRF spots (r = 0.27, p=0.073) and percentage area covered with UVRF spots (r = 0.173, p=0.256). Conclusion. The severity of acne vulgaris has no correlation with spot counts and percentage area covered with UVRF. Digital fluorescence might be helpful in investigating further of the interrelated pathogenesis factors of acne.

Analysis of segmentation methods for acne vulgaris images. Proposal of a new methodology applied to fluorescence images

Acne vulgaris is one of the most common human pathologies worldwide. Its prevalence causes a high healthcare expenditure. Acne healthcare costs and effects on individuals' quality of life lead to the need of analysing current acne evaluation, treatment and monitoring methods. One of the most common ones is manual lesion counting by a dermatologist. However, this technique has several limitations, such as time spent. That is the reason why the development of new computer-assisted techniques are needed in order to automatically count the acne lesions. Nonetheless, the first step is automatic acne lesion detection on the skin of patients. The aim of this work is to propose a new methodology to solve the acne images segmentation problem, so that the implementation of a system for automatic counting is possible. The results would be a decrease in both time spent and diagnosis errors. With this objective, after doing a systematic review on the state of the art of acne images segmentation methods, fluorescence images of the face of acne patients are obtained. This image modality enhances visualization of the acne lesions. Finally, using the fluorescence images, a segmentation algorithm is implemented in MATLAB.