The term “Alternative Medicine” encompasses many forms, and elicits at least as many opinions. This authoritative, objective set is in tune with the subjects that matter to students and researchers, presenting four volumes of current, unbiased information on alternative and complementary medical practices. Covering all aspects of the subject—Therapies, Conditions/Diseases, Herbs/Plants and People—the “Gale Encyclopedia of Alternative Medicine” identifies 150 types of alternative medicine being practiced today, including reflexology, acupressure, acupuncture, chelation therapy, kinesiology, yoga, chiropractic, Feldenkrais, polarity therapy, detoxification, naturopathy, Chinese medicine, biofeedback, Ayurveda and osteopathy. For the practitioner or interested patient, there are current training requirements, listings of organizations, as well as descriptions of treatments.

Acne is no longer just a teenage affliction. In fact, dermatologists often refer to it as a woman's disease, and drugstore shelves are filled with acne products specifically geared toward adult women. But how do you choose from the overwhelming selection of treatments? Which products are appropriate to use as you grow older, become pregnant, or enter menopause? How can you work with a dermatologist to get the most out of prescription acne medications?

Lydia Preston answers all of these questions and more, with up-to-date information drawn from her years of reporting on dermatology, as well as her own long personal experience with acne. In Breaking Out, she shares the wisdom of dozens of doctors and scientists who have devoted their careers to studying and treating acne, including:

Guidelines for buying and using over-the-counter products Treatment for acne scars Emergency acne remedies and camouflage tips Alternative treatments, including herbal remedies, acupuncture, dietary approaches, and ways to unlock the mind-skin connection

No one has to live with acne or its consequences. Breaking Out is an invaluable guide to understanding and combating acne that women of all ages can turn to with confidence.

Author: Lydia Preston, Tina Alster
Paperback: 256 pages
Company: Touchstone (2004-06-29) (2004-06-29)
ISBN: 0743236238
List Price: $17.95
Amazon Price: $0.01
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The Clear Skin Diet is designed to help those who suffer from acne to understand:

Modern research shows:

The Clear Skin Diet introduces the acne diet and lifestyle. Dietary requirements for protecting the skin are listed - along with suggested food supplements when they cannot be easily met - and summarized, as well as mind-body medical interventions that can influence acne hormones and lessen their impact. Also included are 50 acne-preventive recipes, along with information on how one can locate the ingredients that are not readily available in most grocery stores.

Author: Alan C. Logan, Valori Treloar
Hardcover: 304 pages ISBN13: 9781581825749, Condition: New, Notes: BRAND NEW FROM PUBLISHER! 100% Satisfaction Guarantee. Tracking provided on most orders. Buy with Confidence! Millions of books sold!
Company: Cumberland House (2007-09-01)
ISBN: 1581825749
List Price: $22.95
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Healthy, delicious, and simple, the Paleo Diet is the diet we were designed to eat. If you want to lose weight-up to 75 pounds in six months-or if you want to attain optimal health, The Paleo Diet will work wonders. Dr. Loren Cordain demonstrates how, by eating your fill of satisfying and delicious lean meats and fish, fresh fruits, snacks, and non-starchy vegetables, you can lose weight and prevent and treat heart disease, cancer, osteoporosis, metabolic syndrome, and many other illnesses.Breakthrough nutrition program based on eating the foods we were genetically designed to eat-lean meats and fish and other foods that made up the diet of our Paleolithic ancestorsThis revised edition features new weight-loss material and recipes plus the latest information drawn from breaking Paleolithic researchSix weeks of Paleo meal plans to jumpstart a healthy and enjoyable new way of eating as well as dozens of recipesThis bestselling guide written by the world's leading expert on Paleolithic eating has been adopted as a bible of the CrossFit movement

The Paleo Diet is the only diet proven by nature to fight disease, provide maximum energy, and keep you naturally thin, strong, and active-while enjoying every satisfying and delicious bite.

Author: Loren Cordain
Paperback: 288 pages ISBN13: 9780470913024, Condition: New, Notes: BRAND NEW FROM PUBLISHER! 100% Satisfaction Guarantee. Tracking provided on most orders. Buy with Confidence! Millions of books sold!
Company: Wiley (2010-12-07)
ISBN: 0470913029
List Price: $14.95
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"ACNE RX" Finally, an effective treatment for clearing acne that works. Dr.Fulton's research has resulted in a treatment, which is so simple, so effective that no one ever again need accept and live with acne or endure the physical and emotional scars it leaves.

Once you understand what acne is you'll be taught other factors that will influence the treatment schedule most suitable to your acne condition.

You'll also learn the startling effect the seasons, sunlight, geography and the calendar have on acne; how stress and hormones can aggravate acne; what can be done about removing the physical scars acne causes and also how to deal with the psychological scars.

James E Fulton, Jr.M.D. Ph.D. is the co developer of Retin A® and the developer of Benzoyl Peroxide. Dr. Fulton continually pioneers new developments in skin care and has been an impiration in bringing new methods and standards to physicians worldwide.

Author: James E. Fulton
Paperback: 311 pages Let's Bury the Acne Myths:, Chocolate causes acne, Sexual frustration causes acne, Acne is only a teenage diseace, Acne scars will disappear with time
Company: James E Fulton MD Phd (2001-10-10)
ISBN: 0971281009
List Price: $21.95
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Acne is no longer just a teenage affliction. In fact, dermatologists often refer to it as a woman's disease, and drugstore shelves are filled with acne products specifically geared toward adult women. But how do you choose from the overwhelming selection of treatments? Which products are appropriate to use as you grow older, become pregnant, or enter menopause? How can you work with a dermatologist to get the most out of prescription acne medications?

Lydia Preston answers all of these questions and more, with up-to-date information drawn from her years of reporting on dermatology, as well as her own long personal experience with acne. In Breaking Out, she shares the wisdom of dozens of doctors and scientists who have devoted their careers to studying and treating acne, including:

Guidelines for buying and using over-the-counter products Treatment for acne scars Emergency acne remedies and camouflage tips Alternative treatments, including herbal remedies, acupuncture, dietary approaches, and ways to unlock the mind-skin connection

No one has to live with acne or its consequences. Breaking Out is an invaluable guide to understanding and combating acne that women of all ages can turn to with confidence.

Author: Lydia Preston, Tina Alster
Paperback: 256 pages
Company: Touchstone (2004-06-29) (2004-06-29)
ISBN: 0743236238
List Price: $17.95
Amazon Price: $0.01
Used Price: $0.01

Mymensingh Med J. 2012 Jan; 21(1): 60-5
Anwary SA, Alfazzaman M, Bari N, Islam MR

The polycystic ovary syndrome (PCOS) is a clinical diagnosis. During one year period, 50 women suffering from PCOS were treated with either 850 mg/twice daily or 500 mg/thrice daily along with clomiphene citrate and/or letrozole, with advice for exercise and dietary therapy. Diagnosis of the PCOS patients was made by the presence of two out of the following three criteria: (a) oligo and/or anovulation, (b) hyperandrogenism (clinical and/or biochemical), and (c) polycystic ovaries, with the exclusion of other aetiologies. The mean±SD age of our patients was 26.74±3.85 years, BMI 26.64±2.64 kg/m2, pulse 80.56±4.61 b/min, systolic blood pressure 113.80±4.40 mmHg and diastolic blood pressure 76.10±4.77 mmHg, duration of marriage 6.19±3.20 years, and parity was 43(86%) nulliparous and 7(14%) primiparous. Oligomenorrhoea was present in 100%, hypomenorrhoea in 38%, secondary amenorrhoea in 28% and acne in 70% women. Results showed that 92% women followed advice on exercise and dietary therapy, in maximum number of women progesterone level was 31.40 nmol/L (66%), weight loss was 2 kg (44%), menstrual cycle regular (90%) and pregnancy test negative (90%). Only in 5 cases (10%) pregnancy test was positive.

J Pediatr Endocrinol Metab. 2011; 24(11-12): 1055-7
Jain V, Chen M

We report hyperandrogenism with severe acne, hirsutism and alopecia in a set of non-obese triplet sisters presenting at an early age. Interestingly, one of the triplets had hyperthyroidism and had significantly lower androgen level as well as hirsutism compared to her sisters. Treatment of hyperthyroidism with radioiodine ablation led to significant elevation of androgen levels and worsening of hirsutism suggesting that hyperthyroidism masks the biochemical and clinical expression of hyperandrogenism in susceptible females.

Phytomedicine. 2012 Feb 1;
Coenye T, Brackman G, Rigole P, De Witte E, Honraet K, Rossel B, Nelis HJ

Propionibacterium acnes is a Gram-positive bacterium that plays an important role in the pathogenesis of acne vulgaris. This organism is capable of biofilm formation and the decreased antimicrobial susceptibility of biofilm-associated cells may hamper efficient treatment. In addition, the prolonged use of systemic antibiotic therapy is likely to lead to the development and spread of antimicrobial resistance. In the present study we investigated whether P. acnes biofilms could be eradicated by plant extracts or their active compounds, and whether other mechanisms besides killing of biofilm cells could be involved. Out of 119 plant extracts investigated, we identified five with potent antibiofilm activity against P. acnes (extracts from Epimedium brevicornum, Malus pumila, Polygonum cuspidatum, Rhodiola crenulata and Dolichos lablab). We subsequently identified icariin, resveratrol and salidroside as active compounds in three of these extracts. Extracts from E. brevicornum and P. cuspidatum, as well as their active compounds (icariin and resveratrol, respectively) showed marked antibiofilm activity when used in subinhibitory concentrations, indicating that killing of microbial cells is not their only mode of action.

J Dermatol Sci. 2011 Nov 20;
Choi JJ, Park MY, Lee HJ, Yoon DY, Lim Y, Hyun JW, Zouboulis CC, Jin M

BACKGROUND: Tumor necrosis factor-alpha (TNF-α) is an important pathophysiologic factor involved in the development of acne. However, its role is unclear. OBJECTIVE: To explore the lipogenic effect by TNF-α and possible molecular mechanisms in sebocyte. METHODS: Using SZ95 human sebocytes, lipid formation by TNF-α was assessed by Oil Red O, Nile Red staining and thin layer chromatography (TLC). Expression of lipogenic genes and activation of mitogen-activated protein kinase as well as Akt were examined by real-time polymerase chain reaction and/or Western blot analysis. Activation of peroxisome proliferator-activated receptor (PPAR) was evaluated by luciferase assay using PPAR response element containing reporter plasmids. Involvement of c-Jun N-terminal kinase (JNK) and Akt in TNF-α-induced lipogenesis was investigated by molecule specific small interfering RNA and inhibitors. RESULTS: TNF-α treatment significantly increased formation of lipid droplets in accordance with up-regulated expression of FAS and activation of SREBP-1, but not PPARs. Suppression of phosphorylated JNK by the JNK inhibitor SP600125 greatly diminished TNF-α-induced expression of FAS and SREBP-1. TNF-α could not induce both expression of lipogenic proteins and lipid synthesis when Akt expression was attenuated with siRNA. CONCLUSIONS: TNF-α induces lipogenesis in SZ95 human sebocytes through the JNK and phosphoinositide-3-kinase/Akt pathways. These results will be valuable in developing therapeutic strategies for control of seborrhea and acne.

J Sex Med. 2012 Feb 3;
Davis SR, Braunstein GD

Introduction.  Hypoactive sexual desire disorder (HSDD) is a common problem in postmenopausal women, but in the absence of an approved medical treatment in the United States, off-label testosterone use is widespread. Large, randomized controlled studies have demonstrated that transdermal testosterone improves sexual function and activity in postmenopausal women and has favorable short-term safety. However, a longer-term safety profile of testosterone must be established before a testosterone product for women is approved. Aim.  To review current knowledge of the efficacy and safety of transdermal testosterone based on presentations at a satellite symposium during the 2011 annual meeting of the International Society for the Study of Women's Sexual Health. Methods.  Pertinent information included in the presentations was augmented with relevant articles from the peer-reviewed literature. Main Outcome Measures.  The rationale for testosterone therapy and results from phase III and other clinical studies with the testosterone patch in postmenopausal women with HSDD and findings from studies investigating the cardiovascular, breast, and endometrial effects of testosterone therapy. Results.  Randomized, double-blind, placebo-controlled studies have established the efficacy of the transdermal testosterone patch for relieving symptoms of HSDD in surgically and naturally menopausal women with and without concomitant estrogen or estrogen/progestin therapy. The main side effects reported in clinical trials were increased hair growth and acne. Available safety data for testosterone, although not conclusive, were reassuring with respect to cardiovascular, breast, and endometrial outcomes. Interim data from a long-term phase III safety trial of a testosterone gel demonstrate a continued low rate of cardiovascular events and breast cancer in postmenopausal women at increased cardiovascular risk. Conclusion.  Transdermal testosterone appears to be an effective and safe therapy for postmenopausal women with HSDD. Davis SR and Braunstein GD. Efficacy and safety of testosterone in the management of hypoactive sexual desire disorder in postmenopausal women. J Sex Med **;**:**-**.

J Drugs Dermatol. 2012 Jan; 11(1): 20
Gottschalk RW

Br J Dermatol. 2012 Feb 1;
Ong MW, Bashir S

This review investigates the effectiveness of ablative and non-ablative Fractional Photothermolysis (FP) lasers for treating facial acne scars. 26 studies (13=ablative FP; 13=non-ablative FP) published between year-2003 to January 2011 were reviewed. Quantitative and qualitative data from each article were examined and analysed. 4 studies were split-face randomised controlled studies (RCTs). Whilst the data analysed where all clinically relevant and significant, there were some methodological differences between the studies. Outcomes included subjective and objective assessment of scar appearance, pre- and postoperative treatment, side effects and pain scores. A small number of studies used 3D Optical Profiling Imaging and histology for objective assessment. Even allowing for methodological variability, ablative FP seems to have an improvement range of 26-83% whereas non-ablative FP demonstrates an improvement range of 26-50%. Patients who undergo ablative FP laser experience erythema for 3-14 days and it resolves by 12 weeks, whereas patients who opt for the non-ablative FP laser experience erythema between 1-3 days and this resolves within a week. A higher proportion of patients (up to 92.3%) who undertake ablative FP experience post inflammatory hyperpigmentation (PIH) than those who have non-ablative FP (up to 13%). The maximum duration of PIH in ablative FP is up to 6 months whereas in non-ablative FP it lasts up to 1 week. Ablative FP and the procedure can be relatively uncomfortable in comparison to non-ablative FP. Ablative pain score range from 5.90-8.10 (scale 1-10) and the non-ablative FP pain score range from 3.90-5.66 (scale 1-10).

ANZ J Surg. 2011 Sep; 81(9): 642-3
Reichardt LF, Pitak-Arnnop P, Hemprich A, Dhanuthai K, Pausch NC

Anticancer Agents Med Chem. 2012 Jan 31;
Schmitt F, Juillerat-Jeanneret L

In human pathologies, therapeutic treatments are often limited by the lack of selectivity of drugs and their elevated effective concentrations. Targeting these agents to a defined tissue could enhance their selectivity and then diminish their side effects when compared to drugs that accumulate in the entire body. Targeting could also improve treatment efficiency by allowing a localized high concentration of the agents. Based on the different behaviors and patterns of expression between diseased and normal cells, strategies for targeting can be explored. For example, receptors, proteases or trans-membrane carriers could be different or differently expressed. Many therapeutic procedures rely on this fact, including photodynamic therapy (PDT). PDT is already used in the treatment of some cancers, of inflammatory diseases and others diseases such as age-related macular degeneration or acne. PDT relies on the activation of a photosensitizer (PS) by visible light which results in the production of cytotoxic reactive oxygen species. In PDT, the general distribution of PS to the whole body leads to generalized photosensitization and poor acceptance of treatments by patients. One way to avoid these effects is to improve the targeting of PSs to diseased tissues using modification of PS with peptides or proteins that will target specific receptors or enzymes. PSs could also be functionalized with non-proteic ligands such as organometalics to achieve targeted and/or combined therapies. Alternatively, PSs could be encapsulated in nanoparticles bearing targeting agents which will decrease concentration of free circulating PS and improve photodynamic efficiency. These different approaches will be discussed in the present review with an emphasis on the use of peptides and proteins.

Dermatol Clin. 2012 Apr; 30(2): 293-300
Barnes LE, Levender MM, Fleischer AB, Feldman SR

Acne vulgaris affects most adolescents and two-thirds of adults and is associated with substantial psychosocial burden. Health-related quality of life (HRQOL) for patients with acne is an important factor of patient care, and several dermatologic and acne-specific measures have been created to assist in acne research, management, and care. This review describes several skin disease and acne-specific HRQOL measures and their applications in clinical care or research. The ideal HRQOL measure for the management of patients with acne is a concise questionnaire that places minimal burden on respondents and allows physicians to track improvement in HRQOL with successful treatment.

Br J Dermatol. 2012 Jan 27;
Lebrun-Vignes B, Kreft-Jais C, Castot A, Chosidow O,

Background:  The question of quantitative and qualitative differences between adverse drug reactions (ADRs) to cyclines was raised many years ago, especially for minocycline and doxycycline. Objectives:  To assess and compare cycline-related ADRs according to sales figures in France through a national survey. Methods:  ADR data were collected from the French Pharmacovigilance Database (FPD), marketing authorization holders (MAH) and literature. Sales analyses were based on MAH data provided annually to the French Drugs Agency. Results:  Among cyclines available in France, doxycycline and minocycline are the most frequently used. However, their sales decreased between 1995 and 2007, more sharply for minocycline than doxycycline. According to the FPD, based on MAH data and published reports, minocycline-associated ADRs were more serious and were reported more frequently than for the other cyclines. Minocycline and doxycycline ADR patterns differed: gastrointestinal disorders (especially esophageal lesions) predominated with doxycycline, while intracranial hypertension and hepatic disorders were primarily reported with minocycline. Autoimmune disorders, drug reaction with eosinophilia and systemic symptoms (DRESS) and other hypersensitivity reactions were also more frequent with minocycline. ADRs reported with lymecycline and metacycline were essentially cutaneous and gastrointestinal disorders. Conclusions:  In the absence of markedly better efficacy against the various cycline indications, the minocycline benefit/risk ratio was clearly lower than that of doxycycline, and possibly those of lymecycline and metacycline. In light of these findings, minocycline should no longer be considered first-line therapy for inflammatory skin disorders, especially acne.

Hepatogastroenterology. 2012 Jan 26; 59(116):
Shi M, Ji J, Wu J, Ma T, Liu Y, Zhou CF, Su Y, Ye ZB, Zhang J, Zhu ZG

Background/Aims: To assess efficacy and safety of cetuximab with FOLFOX4 as first-line treatment for advanced gastric cancer. Methodology: Cetuximab was administered at 400mg/m2 followed by 250mg/m2 weekly, or 500mg/m2 every 2 weeks. FOLFOX4 regimen was given every 2 weeks (oxaliplatin 85mg/m2, LFA 200mg/m2, 5-FU 400mg/m2 bolus and 600mg/m2 22-hour continuous infusion), for a maximum of 12 cycles, or until the occurrence of untolerated toxicities or disease progression. Results: Twenty-five patients enrolled from April 2007 to September 2010. With the median treatment of six cycles, patients with complete response, partial response, stable disease and progressive disease were 0, 9, 12 and 4, respectively, according to RECIST criteria. ORR and DCR were 36.0% (95% CI=17%-55%) and 84.0% (95% CI=70%-98%), respectively. The median PFS was 6.5 months (95% CI=5.0-8.0 months) and median OS was 10.6 months (95% CI=4.4-16.7 months). Grade 3-4 toxicities including leucopenia (24%), neutropenia (16%), febrile neutropenia (16%), acne-like rash (16%), sensory neuropathy (8%), diarrhea (4%), nausea and vomiting (4%), asthenia (4%) as well as stomatitis (4%) were observed. Conclusions: The combination of cetuximab and FOLFOX4 is active and well tolerated as the 1st line treatment for advanced gastric cancer. Grade 3-4 toxicities were uncommon. Large scale clinical trial is necessary to get more evidence to identify its efficacy. The potential predictive biomarkers for this regimen in treating advanced gastric cancer need to be further identified.

An Bras Dermatol. 2011 Dec; 86(6): 1113-21
Tejada Cdos S, Mendoza-Sassi RA, Almeida HL, Figueiredo PN, Tejada VF

Skin diseases are extremely frequent and may affect quality of life; therefore, it is important to assess it and identify which factors are associated with it.To assess quality of life and its associated factors in dermatological patients.A cross-sectional study involving a sample of 548 patients seen at the Dermatology Outpatient Clinic of Sistema Único de Saúde (the Brazilian National Public Health System), University Hospital, Federal University of Rio Grande do Sul (RS). Information related to socio-demographic data, medical consultation and quality of life was collected by means of the Dermatology Life Quality Index.A median of 7 and a mean of 7.7 (SD = 5.0) were obtained with the Dermatology Life Quality Index. The skin diseases with higher scores on the Dermatology Life Quality Index were psoriasis (median = 15.5), vitiligo (median = 13), atopic dermatitis (median = 12) and acne (median = 10). With respect to factors associated with quality of life, it was found that younger, single patients with a low income, one skin disease and longer disease duration presented poorer quality of life.The assessment of the impact of dermatoses on patients' quality of life is important for clinical management. It is essential to detect patients at higher risk of experiencing worse quality of life in order to treat them in a more integrated way.

J Drugs Dermatol. 2012 Feb 1; 11(2): 174-80
Tan J, Stein Gold L, Schlessinger J, Brodell R, Jones T, Cruz A, Kerrouche N, Jarratt M

Few long-term treatment regimens for severe acne vulgaris have been investigated in clinical trials. Data were combined from two consecutive, randomized, double-blind, controlled studies to evaluate the efficacy, safety and subject satisfaction of four nine-month regimens in severe acne vulgaris treatment. Subjects were first randomized to receive doxycycline (DCN) and adapalene 0.1% - benzoyl peroxide 2.5% (A/BPO) or vehicle once daily for 12 weeks. Subjects who had at least 50% global improvement were subsequently randomized to receive A/BPO or its vehicle once daily for 24 weeks. Over nine months, there were four regimens: A/BPO and DCN followed by A/BPO, vehicle and DCN followed by A/BPO, A/BPO and DCN followed by vehicle, and vehicle and DCN followed by vehicle. Among the four regimens, A/BPO and DCN followed by A/BPO led to the highest percentage of subjects rated "clear" or "almost clear" (50.0% vs. 40.4%, 26.2% and 25.0%, respectively), biggest reduction in total lesion counts (76% vs. 70%, 51% and 47%, respectively) and greatest subject satisfaction (85.0% vs. 75.5%, 63.3% and 52.4%, respectively) at week 36. It provided a faster onset of action compared to groups started with vehicle and DCN (P

Int J Cosmet Sci. 2012 Jan 23;
Patil V, Bandivadekar A, Debjani D

Lipases play an important role in pathogenesis of acne by hydrolyzing sebum triglycerides and releasing irritating free fatty acids in the pilosebaceous follicles. Lipase is a strong chemotactic and proinflammatory antigen. Therefore, lipase has generated a high interest as a pharmacological target for antiacne drugs. The aim of this study was to identify inhibitory effects of plant extracts on the lipase activity of Propionibacterium acnes. Colorimetric microassay was used to determine lipase activity. Extracts from Terminalia chebula and Embelia ribes showed lower IC(50) value (1 μg mL(-1) ) for lipase inhibition as compared to Vitex negundo and Picrorhiza kurroa (19 μg mL(-1) and 47 μg mL(-1) , respectively). The active component responsible for lipase inhibition was isolated. This study reports for the first time the novel antilipase activity of chebulagic acid (IC(50) : 60 μM) with MIC value of 12.5 μg mL(-1) against P. acnes. The inhibitory potential of plant extracts was further confirmed by plate assay. The organism was grown in the presence of subinhibitory concentrations of extracts from P. kurroa, V. negundo, T. chebula, E. ribes and antibiotics such as clindamycin and tetracycline. Extract from T. chebula showed significant inhibition of lipase activity and number of P. acnes. © 2012 The Authors ICS © 2012 Society of Cosmetic Scientists and the Société Française de Cosmétologie.

Am J Clin Dermatol. 2012 Jan 23;
Gamble R, Dunn J, Dawson A, Petersen B, McLaughlin L, Small A, Kindle S, Dellavalle RP

Topical antimicrobial treatment is indicated for mild to moderate acne vulgaris. Our literature review includes searches of Ovid, MEDLINE, EMBASE, and the databases of the Cochrane Library. A detailed search strategy is included. All searches were limited to controlled trials and systematic reviews. No year limits were applied to the searches, but we focused on trials, guidelines, and reviews published since 2004, the year that the last review of topical antimicrobials was published in this journal. Several controlled trials demonstrate that benzoyl peroxide, topical antibiotics, and topical retinoids used in combination provide the greatest efficacy and safety profile for the treatment of mild to moderate acne, but there are few trials directly comparing different combinations of these topical therapies with one another. Additionally, robust studies comparing cost and efficacy of generic combinations of the above agents with proprietary fixed-dose combination therapies that may increase compliance are also lacking. Although they have not been extensively studied, alternative agents including dapsone, salicylic acid, azelaic acid, and zinc are safe and efficacious when combined with traditional therapies.

Dermatoendocrinol. 2011 Oct; 3(4): 220-9
Youssef DA, Miller CW, El-Abbassi AM, Cutchins DC, Cutchins C, Grant WB, Peiris AN

Evidence exists that vitamin D has a potential antimicrobial activity and its deficiency has deleterious effects on general well-being and longevity. Vitamin D may reduce the risk of infection through multiple mechanisms. Vitamin D boosts innate immunity by modulating production of anti-microbial peptides (AMPs) and cytokine response. Vitamin D and its analogues via these mechanisms are playing an increasing role in the management of atopic dermatitis, psoriasis, vitiligo, acne and rosacea. Vitamin D may reduce susceptibility to infection in patients with atopic dermatitis and the ability to regulate local immune and inflammatory responses offers exciting potential for understanding and treating chronic inflammatory dermatitides. Moreover, B and T cell activation as well as boosting the activity of monocytes and macrophages also contribute to a potent systemic anti-microbial effect. The direct invasion by pathogenic organisms may be minimized at sites such as the respiratory tract by enhancing clearance of invading organisms. A vitamin D replete state appears to benefit most infections, with the possible noteworthy exception of Leishmaniasis. Antibiotics remain an expensive option and misuse of these agents results in significant antibiotic resistance and contributes to escalating health care costs. Vitamin D constitutes an inexpensive prophylactic option and possibly therapeutic product either by itself or as a synergistic agent to traditional antimicrobial agents. This review outlines the specific antimicrobial properties of vitamin D in combating a wide range of organisms. We discuss the possible mechanisms by which vitamin D may have a therapeutic role in managing a variety of infections.

J Clin Microbiol. 2012 Jan 18;
Kilian M, Scholz C, Lomholt HB

Propionibacterium acnes is a commensal of human skin but is also implicated in the pathogenesis of acne vulgaris and in biofilm-associated infections of medical devices and endophthalmitis, and in infections of bone and dental root canals. Recent studies associate P. acnes with prostate cancer. As the species includes evolutionary lineages with distinct association with health and disease, there is a need for a high-resolution typing scheme. Recently, two MLST schemes were reported, one based on nine and one based on seven housekeeping genes. In the present study, the two schemes were compared with reference to a phylogenetic tree based on 78 P. acnes genomes and their gene contents. Further support for a basically clonal population structure of P. acnes and a scenario of global spread of epidemic clones of P. acnes was obtained. Compared with the Belfast scheme, the Aarhus MLST scheme (http://pacnes.mlst.net/) based on nine genes offers significantly enhanced resolution and phylogenetic inferences more concordant with analyses based on a comprehensive sampling of the entire genomes, their gene contents, and their putative pathogenic potential.

Skinmed. 2011 Nov-Dec; 9(6): 360-5
Surjana D, Damian DL

Nicotinamide (the amide form of vitamin B3) has been used in dermatology for more than 40 years for a diverse range of conditions including acne, rosacea, autoimmune bullous dermatoses, and now the treatment and prevention of photoaging and photoimmunosuppression. The broad clinical effects of nicotinamide may be explained by its role as a cellular energy precursor, a modulator of inflammatory cytokines, and an inhibitor of the nuclear enzyme poly(adenosine diphosphate-ribose) polymerase-1, which plays a significant role in DNA repair, maintenance ofgenomic stability, and cellular response to injury including inflammation and apoptosis. This review outlines the use of nicotinamide for inflammatory dermatoses and photoaging and focuses on its emerging role in photoprotection.

Curr Pharm Biotechnol. 2012 Jan 17;
Zampeli VA, Makrantonaki E, Tzellos T, Zouboulis CC

The human sebaceous gland is a microscopic branched type multiacinar gland been present everywhere on the body except on the palms and soles, whereas they are sparsely located on the dorsum of hands and feet. Several medical conditions are related with sebaceous gland pathology, such as acne, sebaceous hyperplasia, sebaceous adenoma and sebaceous carcinoma. Acne is a common, complex, chronic disorder of the human pilosebaceous unit that mostly occurs in adolescence and young adulthood. The sebaceous gland plays an exquisite role in the initiation of the disease. The multifactorial nature of the pathogenesis of acne includes increased sebum production, alteration of the quality of sebum lipids, inflammatory processes, interaction with neuropeptides and dysregulation of the hormone microenvironment, follicular hyperkeratinization and inflammation maintained by Propionbacterium acnes products within the follicle. On the other hand, the sebaceous gland, as a major and critical compartment of human skin, is also affected through ageing, both intrinsic and extrinsic, which lead to distinct clinical and histological changes. Intrinsic ageing of the sebaceous gland is determined primarily by genetic factors and hormonal status, with androgens playing a major role. A clinical manifestation associated with intrinsic ageing changes is skin xerosis. Extrinsic ageing of human sebaceous gland is mainly caused by accumulating UV irradiation, especially UVA. Photoageing of sebaceous gland is expressed with a wide spectrum of benign and malignant sebaceous tumours, such as sebaceous hyperplasia, sebaceous carcinoma and Muir-Torre syndrome. This review will focus on the pathogenesis of the most common sebaceous gland diseases and their molecular pathways which may represent future pharmaceutical targets.