A move towards a holistic approach for patients with acne may be in hold for the future
COVID-19 pandemic: consensus guidelines for preferred practices in an aesthetic clinic
In response to the COVID-19 global pandemic, strict infection control policies are now in place. These measures are expected to stay in place for the foreseeable future.
Most of the procedures provided in medical aesthetics clinics are carried out on a one-to-one basis, either by a physician, nurse or therapist. In these situations, it is important to have guidelines detailing the infection control measures for aesthetic clinics.
Recently, an online meeting was carried out with a group of international experts in the field of aesthetic medicine who have vast experience in running aesthetic clinics. The aim of this meeting was to provide a set of consensus guidelines to protect clinic staff and patients from SARS-CoV-2 infection.
These guidelines consisted of protocols for scheduling of patients, patient evaluation, triaging and for safety precautions regarding the various procedures. The procedures were categorised into low-risk, moderate risk, and high-risk, based on the probability of transmission of SARS-CoV-2 virus from the patient to the physician, nurse or therapist.
The authors have stated that these guidelines are not intended to be complete or exhaustive but to help provide sound infection control measures for aesthetic practices. Guidelines regarding safety measures and use of personal protective equipment will vary from country to country, and, in all cases, local government guidelines should also be followed to stop COVID-19 infection in aesthetic clinics.
Truncal acne, what do we know?
In dermatological practice, truncal acne is often overlooked. It is important to identify the disease early so as to introduce treatment on time and to prevent it from deteriorating and resulting in physical and psychological sequelae.
This review aimed to provide an overview of what is known about truncal acne, its prevalence, aetiology and physiopathology, how severity is determined, how it differs from other skin conditions and treatment options.
To carry out this review, the authors reviewed literature on truncal acne published up to 2019 by looking at PubMed, and chose to include 76 articles in the study.
The authors found that there is very little information available about truncal acne.
They also found that specific acne severity grading systems and quality of life questionnaires, as well as a specific treatments, are still lacking.
The authors suggest that making these improvements would help clinicians to effectively assess truncal acne by selecting suitable treatment options and improving patients' quality of life. In conclusion, the authors have said that more knowledge and research is required to treat truncal acne more efficiently.
Acne treatments: future trajectories
There is a need for new and effective acne treatments for long-term administration for recalcitrant or relapsing acne. The authors of this study found that current acne treatments available pose several limitations.
The authors found that new data about the loss of diversity of microbiota in acne provides evidence for the possible use of oral or topical probiotics.
Another therapeutic approach to modulate the microbiota could be topical formulation of C. acnes bacteriophages to target specifically the pathogenic ‘acnegenic’ C. acnes phylotypes. Insulin-sensitising agents, such as metformin, myo-inositol and d-chiro-inositol, are promising.
Limited studies are available regarding this and there is much heterogeneity in the methods that assess acne efficacy outcomes.
The authors feel that a move towards a holistic approach for patients with acne is the future. Clinicians must take into account both internal and external factors, such as pollution, stress, family history of acne, age, smoking habits and diet, and tackling quality of life and the psychological effect of acne.
Hydroxychloroquine in dermatology: new perspectives on an old drug
Hydroxychloroquine is an old drug that has been widely used as an immunomodulatory agent and which has little side effects. The use of this particular drug has increased throughout the years.
The aim of this paper was to review this drug, which included recently updated prescribing recommendations and a summary of its clinical dermatological application.
The authors advise that a maximum daily dose of 5.0 mg/kg based on actual body weight and no greater than 400 mg is recommended to reduce the risk of retinopathy. It is advised that annual screening follows a baseline ophthalmologic assessment after the use of this drug. Closer monitoring is advised should existing retinopathy be present.
The authors found that hydroxychloroquine is now considered to be used safely in pregnancy, and regular glucose-6-phosphate dehydrogenase (G6PD) deficiency testing is not required. Smoking can significantly decrease its effectiveness, although the reason is still unclear. Hydroxychloroquine also appears to show antineoplastic and cardioprotective benefits.
Following hyaluronic acid injections, it is relatively rare to have a delayed reaction, and they may be a result of influenza-like illness
Antibiotic resistance in acne: changes, consequences and concerns
A major concern in dermatology is antibiotic resistance in treating acne. This was first noticed in the 1970s, and has increasingly become a concern since the 1980s.
Antibiotic resistance rates and types have since shown great variations in different regions and countries.
The resistance to topical erythromycin and clindamycin continues to be a global issue. Resistance to newer antibiotics like azithromycin and clarithromycin has also been increasing.
According to the authors, the results of antibiotic resistance may include failing to treat acne, the disturbance of skin microbiota, local and systemic induction of opportunistic pathogens and dissemination of resistant strains to both healthcare professionals and the general population.
Delayed hypersensitivity reaction to hyaluronic acid dermal filler following influenza-like illness
In the aesthetics industry, it is relatively rare to have a delayed reaction following hyaluronic acid injections. Delayed reactions can be due to infectious or immune-mediated origins, and can be triggered by an influenza-like illness.
The aim of this paper was to look at possible adverse events from influenza-like illness following dermal filler injection.
The authors of this study have reported on 14 cases of delayed hypersensitivity reaction to several brands of hyaluronic acid dermal filler following influenza-like illness.