Search Results (1,127)

Azelaic acid (AzA), a saturated dicarboxylic acid, is indicated for the treatment of acne vulgaris, rosacea, melasma, and post-inflammatory hyperpigmentation. Its antimicrobial, anti-inflammatory, and antimelanogenic properties support its use; however, its poor aqueous solubility and limited skin permeability constrain its optimal topical delivery. This review summarizes clinical evidence and advances in formulations—including conventional vehicles, polymeric/lipid nanocarriers, and deep eutectic solvent (DES) systems—to promote more effective and well-tolerated use. Across indications, 15–20% azelaic acid (AzA) formulations produced clinically meaningful improvements with mild, transient local irritation. For acne vulgaris, reductions in inflammatory and noninflammatory lesions were comparable to those of topical retinoids/adapalene, and tolerability was superior in some studies. For rosacea, the 15% gel formulation was comparable to metronidazole in reducing papules, pustules, and erythema while maintaining negligible systemic exposure. In melasma and other dyschromias, 20% cream demonstrated efficacy similar to hydroquinone, exhibiting a favorable safety profile. Advanced delivery systems, including liposomes, niosomes/ethosomes, nanostructured lipid carriers, microemulsions, nanosponges, and DES platforms, increased AzA solubilization, cutaneous deposition, and stability. This enabled dose-sparing strategies and improved adherence. Data on AzA cocrystals and ionic salts suggest additional control over release and irritation. AzA remains a versatile and well-tolerated dermatologic agent whose performance is strongly vehicle-dependent. Rational selection and engineering of carriers, particularly DES-integrated polymeric and lipid systems, can mitigate solubility and permeability limitations, enhance skin targeting, and reduce irritation in the treatment of acne and rosacea. Full article

Polycyclic aromatic hydrocarbons (PAHs) are recognized carcinogens that enter the food chain through pre-existing environmental contamination (air, water, soil), and their formation and accumulation during food preparation and processing involve high temperatures. We established a modified QuEChERS GC-MS method that couples n-hexane-saturated acetonitrile containing 1% toluene with a freeze-out step. Compared to the previously reported ACN QuEChERS protocol, this method enhanced PAH desorption and suppressed lipid interference across four matrices. The method linearity (R² ≥ 0.99), limit of detection (LOD, from 0.03 to 0.20 μg/kg), limit of quantitation (LOQ, from 0.10 to 0.60 μg/kg), and intra-/inter-day precision (≤5.7% RSD) all satisfied AOAC criteria. The modified QuEChERS reduced solvent consumption and shortened preparation time compared to other conventional extraction methods. The developed method was applied to 302 retail food samples, and Kezuribushi was found to have the highest concentration of the 4PAHs, reaching 22.0 µg/kg. Risk assessment based on EFSA’s margin-of-exposure (MOE) approach identified grilled chicken feet (MOE = 7604) as a potential health concern, as this value falls below EFSA’s threshold of 10,000 for potential risk characterization. The validated method enables sensitive and scalable monitoring of PAHs in complex food matrices within the tested matrices and conditions. Full article

Background: Hidradenitis suppurativa (HS) is a chronic inflammatory disease with a complex immune response. Given the considerable heterogeneity of the clinical phenotype of HS, this study aimed to analyse the immunohistochemical pattern of interstitial inflammation. Methods: Immunohistochemical analysis was performed on skin samples from 49 patients with HS. The immunohistochemical markers CD3, CD4 and CD8 for T-cells, CD20 for B-cells, CD138 for plasma cells and CD30, CD56, Bcl-2 and Bcl-6 were stained on lesional skin. Results: The analysis of immune cell dominance in patients with HS revealed that 33.3% of the cohort exhibited B-cell dominance, defined as a ratio of the sum of CD20+ and CD138+ cells to CD3+ cells greater than 1, while the majority (66.7%) demonstrated T-cell dominance, defined as a ratio of CD3+ cells to the sum of CD20+ and CD138+ cells greater than 1. B-cell-dominant HS is associated with a significantly elevated probability of mammary involvement (13.3% vs. 0%; p = 0.041). T-cell-dominant HS patients tended to demonstrate a higher mean tobacco consumption, but not significantly (20 vs. 5 tobacco pack-years; p = 0.06). CD4-dominant HS patients exhibited a significantly greater involvement of the mons pubis (62.5% vs. 28.6%, p = 0.023) compared to CD8-dominant patients, who demonstrated a significantly higher number of abscesses (p = 0.027). Conclusions: For the first time, we describe the clinical and immunohistochemical characteristics of T-cell- and B-cell-dominant HS. Although HS seems to be more dominated by T-cells, a B-cell dominance was found in 33% of cases. Full article

Background/Objectives: Adapalene is a synthetic retinoid used as a treatment for acne vulgaris. In this study, we attempted to evaluate the dermal pharmacokinetics of adapalene utilizing experimental and in silico tools. Methods: We utilized three over the counter (OTC) adapalene gels to evaluate local dermal pharmacokinetics. A data-driven, robust, mechanistic dermal physiologically based pharmacokinetic (PBPK) model was developed by integrating the physicochemical properties of adapalene, the formulation attributes of the gels, and the biophysical aspects of dermal absorption. The dermal PBPK model was validated against experimental data using in vitro release studies and in vitro permeation studies with human cadaver skin. A clinical study was performed to evaluate the effects of adapalene from the three gel formulations. The impact of adapalene delivery from three gels on the stratum corneum (SC) thickness, pilosebaceous unit area, keratinocyte number, and epidermal thickness was captured using a non-invasive technique, line-field confocal optical coherence tomography (LC–OCT). These responses were evaluated using an Emax model. Results: The dermal PBPK model has successfully predicted adapalene penetration profiles across different gel formulations. The model accuracy, in predicting drug release and permeation characteristics, was confirmed using the experimental data. Clinical evaluation revealed formulation-dependent differences in adapalene’s effects on measured skin parameters, with distinct pharmacodynamic profiles observed for each gel formulation. Conclusions: The overall study gave us a detailed insight into potential effects of formulation on the dermal pharmacokinetics and pharmacodynamics of adapalene using three marketed gels. Full article

Background/Objectives: Isotretinoin is a highly effective therapy for severe acne, but its potential neuropsychiatric adverse reactions (NPsRs) have been controversial. This study evaluated EudraVigilance data from 2005 to 2025 to better understand the frequency, typology, and predictors of such events. Methods: We conducted a retrospective analysis of 33,381 individual case safety reports (ICSRs) related to isotretinoin. Using descriptive statistics, chi-square tests, and logistic regression, we assessed associations between NPsRs and variables such as age, sex, geographic region, and reporter type. Results: A total of 9793 cases (29.3%) involved at least one NPsR. Depression (31%) and suicidal ideation (8.6%) were the most frequently reported symptoms. Adolescents (12–17 years) had the highest proportion of NPsR cases, while male patients and reports submitted by non-healthcare professionals were significantly overrepresented. Reports from non-European Economic Area countries also had slightly increased odds of including NPsRs. All predictors were statistically significant in the logistic regression model, though the explained variance was modest (Nagelkerke R² = 0.065). Conclusions: Neuropsychiatric reactions remain a prominent and persistent signal in isotretinoin pharmacovigilance, particularly among younger patients and non-professional reporters. Although causality cannot be inferred from spontaneous reporting data and confounding factors like acne-related depression cannot be excluded, these findings highlight the clinical value of pre-treatment psychiatric screening, patient-centered education, and proactive mental health monitoring throughout isotretinoin therapy. Full article

Cannabidiol (CBD), a non-psychoactive phytocannabinoid derived from Cannabis sativa L., has emerged as a promising multifunctional agent in dermatology and cosmetic science. The review provides an updated synthesis of CBD’s topical therapeutic potential, challenges, and evolving regulatory frameworks. CBD exhibits diverse biological effects, including anti-inflammatory, antioxidant, antibacterial, analgesic, lipostatic, antiproliferative, moisturising, and anti-ageing properties through interactions with the skin’s endocannabinoid system (ECS), modulating CB1, CB2, TRPV channels, and PPARs. Preclinical and clinical evidence support its efficacy in managing acne, psoriasis (including scalp psoriasis), atopic and seborrheic dermatitis, and allergic contact dermatitis. CBD also relieves pruritus through neuroimmune modulation and promotes wound healing in conditions such as pyoderma gangrenosum and epidermolysis bullosa. In hair disorders such as androgenetic alopecia, it aids follicular regeneration. CBD shows promise in managing skin cancers (melanoma, squamous cell carcinoma, Kaposi sarcoma) and pigmentation disorders such as melasma and vitiligo. It enhances skin rejuvenation by reducing oxidative stress and boosting collagen and hydration. However, there are challenges regarding CBD’s physicochemical stability, skin penetration, and regulatory standardisation. As consumer demand for natural, multifunctional skincare grows, further research is essential to validate its long-term safety, efficacy, and optimal formulation strategies. Full article

Lactic acid bacteria (LAB) are a promising source of postbiotics with potential applications in the cosmetic industry; however, strains isolated from fermented vegetables are rarely studied. This study aimed to characterize the bioactivity of postbiotics produced by Lactiplantibacillus pentosus B1 isolated from fermented beetroot juice. An organic extract (ELCFS) and a lyophilizate (LLCFS) were prepared from cell free supernatant of B1 and assessed for antimicrobial activity (MIC, MBC), biofilm inhibition and eradication ability against Staphylococcus aureus, Escherichia coli, Streptococcus pyogenes and Cutibacterium acnes. Stability (temperature, time) and cytotoxicity were also examined. Metabolite composition was determined by GC-MS. MIC values were 10 g/L for ELCFS and 10–20 g/L for LLCFS. ELCFS completely inhibited biofilm formation at 10 g/L, and LLCFS at 25 g/L; partial inhibition was observed at lower concentrations (e.g., E. coli—32.99% at 1 g/L ELCFS; S. aureus and S. pyogenes—74.01% and 95.67%, respectively, at 5 g/L). Complete eradication of mature biofilm was obtained at 2.5 g/L (ELCFS) and 12.5 g/L (LLCFS), while a significant partial effect was observed from 0.04 g/L ELCFS for E. coli (29.3%) and 0.2 g/L LLCFS for S. pyogenes (23.2%). C. acnes showed the lowest sensitivity. A reduction in viability of eucaryotic cells was observed at ≥ 5 g/L ELCFS (90.32%) and 12.5—50 g/L LLCFS (55.87—89.20%). Importantly, concentrations causing partial inhibition and eradication of biofilm did not show cytotoxicity towards fibroblasts. The preparations were thermostable and retained activity over time; only incubation of ELCFS at elevated temperature significantly reduced its antimicrobial activity against the C. acnes strain. GC-MS analysis revealed five organic acids, with lactic acid dominating. The results confirm the potential of L. pentosus B1 as a source of stable, effective, and safe postbiotics for cosmetology applications. Full article

Background: The skin microbiome plays a key role in maintaining skin health, and its composition can be influenced by cosmetic treatments. This study aimed to investigate the effects of SMART DNA Therapy treatment on facial skin microbiome composition, with specific focus on changes in commensal and pathogenic bacterial populations following multi-component anti-aging intervention. Methods: This clinical study included 10 Caucasian female participants aged 28–50 years (Clinical trial registration number: 0406/2023). Each participant received three Retix.C SMART DNA THERAPY treatments at 14-day intervals over 6 weeks. The protocol included three phases: chemical peeling with ferulic acid, peptide microinjections for DNA repair, and home-care products with antioxidants. Bacterial samples were collected from forehead and cheek skin before treatment and 2 weeks after the final treatment. Samples were analyzed using bacterial culture and PCR methods. Results: After treatment, the skin microbiome showed beneficial changes with increased numbers of helpful bacteria and elimination of harmful bacteria: complete removal of Cutibacterium acnes and Staphylococcus aureus was observed, Staphylococcus epidermidis and other beneficial bacteria increased on both forehead and cheek areas. Overall bacterial diversity decreased, and participants exhibited more similar microbiome patterns after treatment. Conclusions: SMART DNA Therapy treatment successfully modified the skin microbiome by increasing protective bacteria and eliminating pathogenic species. The treatment may support skin health through microbiome modulation and the potential antioxidant effects of its active ingredients, although these were not directly assessed in this study. Full article

Antimicrobial resistance is a critical global health issue exacerbated by biofilm-associated infections that often resist conventional therapies. Photodithazine-mediated antimicrobial photodynamic therapy (PDZ-aPDT) has emerged as a promising alternative, demonstrating a broad-spectrum antimicrobial efficacy against multidrug-resistant bacteria and fungi, including those in biofilms. This systematic review evaluates the efficacy, safety, and clinical applications of PDZ-aPDT by synthesizing evidence from preclinical and clinical studies. Databases including PubMed, Embase, Scopus, and Cochrane were systematically searched, resulting in the inclusion of 13 studies for qualitative analysis. PDZ-aPDT consistently reduced the microbial burden in various models, including oral candidiasis, denture stomatitis, acne, and infections related to medical devices. Synergistic combinations with conventional antimicrobials and adjunctive therapies (e.g., DNase I) further enhanced its effectiveness. However, the evidence base remains limited by methodological variability, small sample sizes, and short follow-up periods. Future research should focus on rigorous clinical trials with standardized protocols and extended follow-up to establish definitive efficacy and safety profiles, facilitating a broader clinical implementation in combating antimicrobial resistance. Full article

Diseases such as obesity and metabolic-dysfunction-associated fatty liver disease (MAFLD) are often associated with changes in gut microbiota composition. The present study aims to investigate the relationship between the potential preventive effects of an Opuntia ficus-indica var. colorada cactus pulp extract on obesity and hepatic steatosis, and changes in gut microbiota composition, in a murine model fed a high-fat high-fructose diet. The low-dose extract was the most effective in reducing hepatic TG (−12.5%) and the weight of subcutaneous and visceral adipose tissue (−18.4% and 11.4%, respectively), while the high dose led to improved serum lipid profile (−74.2% in TG, −37.2% in total cholesterol, −50.5% in non-HDL cholesterol and +71.7% in HDL cholesterol). Opuntia extract supplementation did not prevent the dysbiosis in gut microbiota produced by the high-fat high-fructose diet. However, modifications in its composition, consistent with an increment in both Adlercreutzia muris and Cutibacterium acnes, and a reduction in Massiliimalia timonensis, were observed. It can be proposed that these changes may contribute to the extract effects against obesity and liver steatosis. Nevertheless, further research is required to establish a direct link between the anti-obesity and anti-steatotic effects and the functionality of the bacteria modified by the treatment. Full article

Background/Objectives: Acne vulgaris is a prevalent dermatological condition, yet clear, region-specific management guidelines, particularly for India’s diverse population, remain limited. Effective acne management extends beyond pharmacologic therapy, emphasizing proper skincare, patient education, and adherence strategies. This consensus aims to provide tailored, evidence-based recommendations for optimizing acne treatment in the Indian context. Methods: A panel of 14 dermatology experts with ≥15 years of experience reviewed literature, real-world clinical practices, and patient-centric factors relevant to acne management in India. Using a modified Delphi process with two virtual voting rounds, 61 statements across seven clinical domains were evaluated. Consensus was defined as ≥75% agreement. Results: Topical retinoids remain the first-line therapy, with combination regimens (benzoyl peroxide or topical antibiotics) preferred to enhance efficacy and minimize antibiotic resistance. Hormonal therapies, including combined oral contraceptives and spironolactone, are recommended for females with resistant acne. Guidance includes individualized treatment plans, baseline investigations, and selection of appropriate topical and systemic agents. Special considerations for pregnancy and lactation prioritize maternal and fetal safety. Conclusions: This expert consensus provides practical, evidence-based recommendations for acne management in India, integrating pharmacological and non-pharmacological approaches. The tailored guidance supports individualized care, antibiotic stewardship, and improved treatment adherence, aiming to enhance patient outcomes nationwide. Full article

Emerging evidence suggests a critical role of the gut microbiome in modulating systemic immune responses, with increasing relevance in dermatological diseases. Chronic spontaneous urticaria (CSU), traditionally viewed as an isolated cutaneous disorder, is now recognized as a systemic immune condition involving complex interactions between innate and adaptive immunity, mast cell dysregulation, and non-IgE-mediated pathways. This review explores the gut–skin axis as a unifying concept linking intestinal dysbiosis to inflammatory skin diseases, including atopic dermatitis, psoriasis, rosacea, and acne. Special emphasis is placed on CSU, where altered gut microbial composition, characterized by reduced diversity, depletion of short-chain fatty acid-producing bacteria, and expansion of Proteobacteria, may contribute to increased intestinal permeability, systemic immune activation via toll-like receptors, and heightened mast cell sensitivity. We discuss findings from animal models demonstrating that gut microbiota modulation can attenuate mast cell hyperreactivity and reduce urticarial symptoms. In parallel, we examine clinical evidence supporting the potential role of probiotics, prebiotics, dietary interventions, and fecal microbiota transplantation as adjunctive strategies in CSU management. Despite promising findings, challenges remain in translating microbiome research into effective therapies due to interindividual variability, the complexity of host–microbiome interactions, and a lack of standardized protocols. Future research should focus on identifying predictive microbial patterns and developing personalized microbiome-targeted interventions. Understanding the bidirectional gut–skin relationship may open new therapeutic avenues beyond symptomatic treatment, positioning the microbiome as a novel target in CSU and related inflammatory dermatoses. Full article

Infections following spinal surgery can result in potentially devastating complications. An accurate microbiological diagnosis is crucial for proper treatment. Sonication is a diagnostic method that can be beneficial in patients with acute or low-grade infections. This study aimed to assess the sensitivity and effectiveness of sonication as a method for diagnosing spinal implant infections in cases of both suspected and unsuspected infections during spinal surgical revision. We conducted a retrospective observational study that included all patients who underwent revision spinal surgery between March 2011 and October 2022. We collected the implants and surrounding tissues from these patients for microbiological analysis. The implant sonication was performed according to a previously published protocol. Patients were categorised into those undergoing surgical revision for suspected spinal implant infection (SSII) and those for non-suspected spinal implant infection (NSSII). We collected comprehensive patient data, including demographics, risk factors, Charlson Comorbidity Index (CCI), surgical details, microbiological findings, antibiotic regimens, and clinical outcomes. Sensitivity and specificity analyses were conducted on both sonicated and non-sonicated samples. A total of 158 patients met the inclusion criteria; 51 of them were diagnosed with infection during surgery revision. Patients with SSII had higher CCIs than those with NSSII. The sensitivity was significantly higher in sonicated samples (68.6%; 95% CI: 55.9–81.4%) than in non-sonicated samples (42%; 95% CI: 28.3–55.7%). The specificities were similar, with sonicated samples at 93.5% (95% CI: 88.8–98.1%) and non-sonicated samples at 99.05% (95% CI: 97.2–100.9%). Combining both methods resulted in sensitivity and specificity rates of 76% (95% CI: 64.2–87.8%) and 93.3% (95% CI: 88.2–98.1%), respectively. Methicillin-susceptible Staphylococcus aureus (MSSA) was common in SSII, whereas Cutibacterium acnes and coagulase-negative Staphylococcus (CNS) were predominant in NSSII. This study supports the routine use of implant sonication as a valuable supplementary method for peri-implant tissue cultures, especially for identifying low-grade spinal implant infections. Full article

Shedding light on Hidradenitis Suppurativa activity: a pilot study to evaluate the potential of [^99mTc]Tc-anti-TNF-alpha scintigraphy. Background/Objectives: Hidradenitis suppurativa (HS), also known as acne inversa and Verneuil’s disease, is a chronic and non-contagious auto-inflammatory disease of pilo-sebaceous units that can lead to severe complications and sequelae. The actual prevalence of HS is unknown due to diagnostic delay and/or misdiagnosis, but it is estimated to affect 0.00033–4.1% of the general population worldwide. Only severe cases are referred for imaging assessment, and the final diagnosis is mostly established on a clinical basis. Here, we present a pilot study aiming to evaluate clinically active inflammatory disease in patients with HS using [^99mTc]Tc-anti-TNF-alpha scintigraphy. Methods: Four patients (2 male, 2 female) had their HS clinical features measured through the HS-PGA and Hurley Score and compared to [^99mTc]Tc-anti-TNF-alpha scintigraphy findings. Results: Scintigraphy with [^99mTc]Tc-anti-TNF-alpha showed abnormal uptake in clinically active lesions of HS and also detected some clinically unknown potential active lesions, later confirmed by clinical reassessment after the imaging. Conclusions: Our results suggest that scintigraphy with [^99mTc]Tc-anti-TNF-alpha may be able to detect increased radiotracer uptake in most clinically identified active lesions in this pilot cohort. While promising, due to the inherent limitations of this pilot study, more studies need to be carried out to arrive at a definitive diagnostic assessment of active inflammatory disease using this method. Full article

Background and Clinical Significance: As a common inflammatory skin disorder, acne vulgaris is classically associated with sebum overproduction, follicular hyper keratinization, and Cutibacterium acnes proliferation. Emerging evidence suggests a link between severe or treatment-resistant acne and metabolic syndrome, characterized by central obesity, insulin resistance, dyslipidemia, and hypertension. This case series aims to explore the clinical overlap between acne and metabolic dysfunction and highlight the relevance of multidisciplinary evaluation. Case Presentation: Three patients with severe acne vulgaris and coexisting metabolic abnormalities were evaluated at a dermatology clinic in Oradea, Romania, between 2023 and 2024. Each patient underwent dermatologic examination, laboratory testing for metabolic and hormonal parameters, and individualized treatment. Management strategies included topical/systemic acne therapies combined with metabolic interventions (lifestyle modifications, metformin (in two cases), and lipid-lowering agents). Case 1 (female, 23) had obesity, insulin resistance, dyslipidemia, and polycystic ovary syndrome (PCOS). Case 2 (male, 19) presented with central obesity and atherogenic dyslipidemia. Case 3 (male, 18) showed insulin resistance, overweight status, and elevated inflammatory markers. All three showed suboptimal response to standard acne treatment. Adjunct metabolic management resulted in partial improvement within 3 months. One patient required isotretinoin after metabolic stabilization. Conclusions: These cases underscore the interplay between acne and metabolic dysfunction. Insulin resistance and systemic inflammation may contribute to therapeutic resistance in acne. Early recognition of metabolic syndrome features in patients with severe acne may improve treatment outcomes. Dermatologists should consider metabolic screening to guide comprehensive, multidisciplinary care. Full article