Postinflammatory hyperpigmentation (PIH) and postinflammatory erythema (PIE) in acne vulgaris are important and refractory complications for patients with acne vulgaris. To clarify the effects of 2% isostearyl-L-ascor...Postinflammatory hyperpigmentation (PIH) and postinflammatory erythema (PIE) in acne vulgaris are important and refractory complications for patients with acne vulgaris. To clarify the effects of 2% isostearyl-L-ascorbic acid (ISAA) against PIH and PIE in acne vulgaris, a clinical pilot study with topical 2% ISAA gel was performed in 25 acne patients with PIH and PIE. Topical ISAA gel was applied on the whole face with PIH and PIE in acne vulgaris twice a day for 3 months. Regarding PIH and PIE, investigator’s global improvement rating (IGIR) was evaluated in 7-point scales according to the reduced area of PIH and PIE before and after the study. Remarkable improvement in PIH was observed in 7 patients (28.0%) and in PIE in 12 (48%) of the 25 patients. No adverse reactions were observed during the treatment. Topical ISAA application can be an alternative, non-invasive available treatment for PIH and PIE in acne vulgaris.展开更多
A 20-year-old man presented with for 6-month history of facial acne. He had erythema and red papules on the face secondary to BPO-induced contact dermatitis. He was administered topical corticosteroid. Contact dermati...A 20-year-old man presented with for 6-month history of facial acne. He had erythema and red papules on the face secondary to BPO-induced contact dermatitis. He was administered topical corticosteroid. Contact dermatitis improved with this treatment, and he had red papules, comedones, prominent postinflammatory hyperpigmentation (PIH), postinflammatory erythema (PIE), erosions and erythema associated with acne vulgaris. He was subsequently treated with oral minocycline 100 mg/d and topical adapalene and ozenoxacin lotion once daily for 3 months. The inflammatory lesions and comedo subsided;however, PIH, PIE, atrophic scar and erosion persisted. During 3 months, the patient underwent chemical peeling using 20% glycolic acid (GA) and subsequent vitamin C iontophoresis twice at 1-month intervals. He showed almost disappearance of red papules and comedones but persistent PIH, PIE and erosion after 3 months of treatment. He was thereafter prescribed topical glyceryl-octyl-ascorbic acid/ascorbyl 2-phosphate 6-palmitate/DL-a-tocopherol phosphate complex for local application twice daily for 3 months. After 7 months of treatment, PIH, PIE, erosion and atrophic scar faded significantly with only trace residual erosions, atrophic scar and PIH. Subsequently, he was prescribed local application of 2% isostearyl-L-ascorbic acid gel vitamin C gel twice daily for 3 months. After 15 months, PIH, PIE, erosion and atrophic scar disappeared completely with significant improvement. Comprehensive sequential therapy resulted in significant improvement. It is suggested that medical treatment using systemic and topical antimicrobials and topical adapalene reduces inflammatory lesions and comedones initially. Subsequent chemical peeling using GA and vitamin C iontophoresis could improve PIH. These synergistic effects might have contributed to the significant improvement observed in this case. Comprehensive sequential treatment using chemical peeling, vitamin C iontophoresis and topical vitamin C can be a useful treatment strategy for PIH in acne vulgaris.展开更多
BACKGROUND Inflammatory bowel disease(IBD)patients with post-inflammatory polyps(PIPs)may carry an increased risk of colorectal neoplasia(CRN)including dysplasia and cancer.Current guidelines recommend active colonosc...BACKGROUND Inflammatory bowel disease(IBD)patients with post-inflammatory polyps(PIPs)may carry an increased risk of colorectal neoplasia(CRN)including dysplasia and cancer.Current guidelines recommend active colonoscopy follow-up for these patients.However,the evidence for guidelines is still poor.In addition,some recent high-quality reports present a different view,which challenges the current guidelines.We hypothesize that IBD patients with PIPs are at increased risk of CRN.AIM To evaluate the risk of CRN in IBD patients with and without PIPs.METHODS A systematic search of PubMed,Embase,Cochrane Library,and Web of Science was performed to identify studies that compared the risk of CRN in IBD patients with and without PIPs.In addition,we screened the reference lists and citation indices of the included studies.Quality assessment was performed using the Newcastle–Ottawa Scale.Pooled odds ratio(OR)was calculated using the random-effects model to explore the final pooled effect size of the included studies and determine whether PIPs increase the risk of CRN.Sensitivity analysis,subgroup analysis,and assessment of publication bias were performed to examine the sources of heterogeneity.RESULTS Twelve studies with 5819 IBD patients,including 1281(22.01%)with PIPs,were considered eligible for this meta-analysis.We found that IBD patients with PIPs were at an increased risk of CRN as compared to those without PIPs[OR 2.01;95%confidence interval(CI):1.43–2.83].The results were similar when colorectal cancer was used as the study endpoint(OR 2.57;95%CI:1.69–3.91).Furthermore,the risk of CRN was still increased(OR 1.80;95%CI:1.12–2.91)when restricted to ulcerative colitis patients.Heterogeneity was high among the included studies(I^(2)=75%).Subgroup analysis revealed that the high heterogeneity was due to the study design.Sensitivity analysis showed that the main statistical outcomes did not essentially change after excluding any one of the included studies.No significant publication bias was found in the funnel plots.CONCLUSION IBD patients with PIPs have an increased risk of CRN as compared with those without PIPs,which support the current guidelines.However,a high-quality randomized controlled trial is warranted.展开更多
文摘Postinflammatory hyperpigmentation (PIH) and postinflammatory erythema (PIE) in acne vulgaris are important and refractory complications for patients with acne vulgaris. To clarify the effects of 2% isostearyl-L-ascorbic acid (ISAA) against PIH and PIE in acne vulgaris, a clinical pilot study with topical 2% ISAA gel was performed in 25 acne patients with PIH and PIE. Topical ISAA gel was applied on the whole face with PIH and PIE in acne vulgaris twice a day for 3 months. Regarding PIH and PIE, investigator’s global improvement rating (IGIR) was evaluated in 7-point scales according to the reduced area of PIH and PIE before and after the study. Remarkable improvement in PIH was observed in 7 patients (28.0%) and in PIE in 12 (48%) of the 25 patients. No adverse reactions were observed during the treatment. Topical ISAA application can be an alternative, non-invasive available treatment for PIH and PIE in acne vulgaris.
文摘A 20-year-old man presented with for 6-month history of facial acne. He had erythema and red papules on the face secondary to BPO-induced contact dermatitis. He was administered topical corticosteroid. Contact dermatitis improved with this treatment, and he had red papules, comedones, prominent postinflammatory hyperpigmentation (PIH), postinflammatory erythema (PIE), erosions and erythema associated with acne vulgaris. He was subsequently treated with oral minocycline 100 mg/d and topical adapalene and ozenoxacin lotion once daily for 3 months. The inflammatory lesions and comedo subsided;however, PIH, PIE, atrophic scar and erosion persisted. During 3 months, the patient underwent chemical peeling using 20% glycolic acid (GA) and subsequent vitamin C iontophoresis twice at 1-month intervals. He showed almost disappearance of red papules and comedones but persistent PIH, PIE and erosion after 3 months of treatment. He was thereafter prescribed topical glyceryl-octyl-ascorbic acid/ascorbyl 2-phosphate 6-palmitate/DL-a-tocopherol phosphate complex for local application twice daily for 3 months. After 7 months of treatment, PIH, PIE, erosion and atrophic scar faded significantly with only trace residual erosions, atrophic scar and PIH. Subsequently, he was prescribed local application of 2% isostearyl-L-ascorbic acid gel vitamin C gel twice daily for 3 months. After 15 months, PIH, PIE, erosion and atrophic scar disappeared completely with significant improvement. Comprehensive sequential therapy resulted in significant improvement. It is suggested that medical treatment using systemic and topical antimicrobials and topical adapalene reduces inflammatory lesions and comedones initially. Subsequent chemical peeling using GA and vitamin C iontophoresis could improve PIH. These synergistic effects might have contributed to the significant improvement observed in this case. Comprehensive sequential treatment using chemical peeling, vitamin C iontophoresis and topical vitamin C can be a useful treatment strategy for PIH in acne vulgaris.
基金The National Key R&D Program of China,No.2017YFC1308800National Natural Science Foundation of China,No.81970482+3 种基金Natural Science Foundation of Guangdong Province,China,No.2019A1515011313Sun Yat-Sen University 5010 Project,No.2010012the Fundamental Research Funds for the Central Universities,No.19ykpy05National Key Clinical Discipline.
文摘BACKGROUND Inflammatory bowel disease(IBD)patients with post-inflammatory polyps(PIPs)may carry an increased risk of colorectal neoplasia(CRN)including dysplasia and cancer.Current guidelines recommend active colonoscopy follow-up for these patients.However,the evidence for guidelines is still poor.In addition,some recent high-quality reports present a different view,which challenges the current guidelines.We hypothesize that IBD patients with PIPs are at increased risk of CRN.AIM To evaluate the risk of CRN in IBD patients with and without PIPs.METHODS A systematic search of PubMed,Embase,Cochrane Library,and Web of Science was performed to identify studies that compared the risk of CRN in IBD patients with and without PIPs.In addition,we screened the reference lists and citation indices of the included studies.Quality assessment was performed using the Newcastle–Ottawa Scale.Pooled odds ratio(OR)was calculated using the random-effects model to explore the final pooled effect size of the included studies and determine whether PIPs increase the risk of CRN.Sensitivity analysis,subgroup analysis,and assessment of publication bias were performed to examine the sources of heterogeneity.RESULTS Twelve studies with 5819 IBD patients,including 1281(22.01%)with PIPs,were considered eligible for this meta-analysis.We found that IBD patients with PIPs were at an increased risk of CRN as compared to those without PIPs[OR 2.01;95%confidence interval(CI):1.43–2.83].The results were similar when colorectal cancer was used as the study endpoint(OR 2.57;95%CI:1.69–3.91).Furthermore,the risk of CRN was still increased(OR 1.80;95%CI:1.12–2.91)when restricted to ulcerative colitis patients.Heterogeneity was high among the included studies(I^(2)=75%).Subgroup analysis revealed that the high heterogeneity was due to the study design.Sensitivity analysis showed that the main statistical outcomes did not essentially change after excluding any one of the included studies.No significant publication bias was found in the funnel plots.CONCLUSION IBD patients with PIPs have an increased risk of CRN as compared with those without PIPs,which support the current guidelines.However,a high-quality randomized controlled trial is warranted.
