tetracycline and Acne-Vulgaris

Tetracyclines are a class of broad-spectrum bacteriostatic antibiotics used to treat many infections, including methicillin-resistant Staphylococcus aureus (MRSA), acne, pelvic inflammatory disease, chlamydial infections, and a host of zoonotic infections. These drugs work by inhibiting protein synthesis in bacterial ribosomes, specifically by disallowing aminoacyl-tRNA molecules from binding to the ribosomal acceptor sites. While rare, tetracycline antibiotics, particularly minocycline and doxycycline, are associated with an increased risk of developing esophageal perforation and pseudotumor cerebri (PTC, or idiopathic intracranial hypertension). Since tetracyclines are a commonly prescribed class of medications, especially in adolescents for acne treatment, it is important for clinicians to appreciate significant side effects that can result in morbidity and mortality. This paper aims to consolidate and to emphasize current research on the association between tetracycline antibiotics and the development of esophageal perforation, and PTC. PTC is a neurological syndrome consisting of increased intracranial pressure, headache, and vision changes without evidence of the contributing source, such as mass lesion, infection, stroke, or malignancy. Esophageal perforation, while rare, can be the result of pill esophagitis. Pill-induced injuries occur when caustic medicinal pills dissolve in the esophagus rather than in the stomach. Most patients experience only self-limited pain (retrosternal burning discomfort, heartburn, dysphagia, or odynophagia), but hemorrhage, stricture, and perforation may occur. Tetracycline use can lead to pill esophagitis. In summary, clinicians should appreciate the potential risks of tetracycline compounds in clinical practice.

Topics: Acne Vulgaris; Adolescent; Anti-Bacterial Agents; Doxycycline; Esophageal Perforation; Esophagitis; Humans; Methicillin-Resistant Staphylococcus aureus; Minocycline; Pain; Pseudotumor Cerebri; Tetracycline

Tetracyclines are a broad-spectrum class of antibiotics that have unclear actions with potentially lasting effects on bone metabolism. Initially isolated from Streptomyces, tetracycline proved to be an effective treatment for Gram +/- infections. The emergence of resistant bacterial strains commanded the development of later generation agents, including minocycline, doxycycline, tigecycline, sarecycline, omadacycline, and eravacycline. In 1957, it was realized that tetracyclines act as bone fluorochrome labels due to their high affinity for the bone mineral matrix. Over the course of the next decade, researchers discerned that these compounds are retained in the bone matrix at high levels after the termination of antibiotic therapy. Studies during this period provided evidence that tetracyclines could disrupt prenatal and early postnatal skeletal development. Currently, tetracyclines are most commonly prescribed as a long-term systemic therapy for the treatment of acne in healthy adolescents and young adults. Surprisingly, the impact of tetracyclines on physiologic bone modeling/remodeling is largely unknown. This article provides an overview of the pharmacology of tetracycline drugs, summarizes current knowledge about the impact of these agents on skeletal development and homeostasis, and reviews prior work targeting tetracyclines' effects on bone cell physiology. The need for future research to elucidate unclear effects of tetracyclines on the skeleton is addressed, including drug retention/release mechanisms from the bone matrix, signaling mechanisms at bone cells, the impact of newer third generation tetracycline antibiotics, and the role of the gut-bone axis.

Topics: Acne Vulgaris; Adolescent; Anti-Bacterial Agents; Humans; Minocycline; Tetracycline

Various treatments for acne vulgaris exist, but little is known about their comparative effectiveness in relation to acne severity.. To identify best treatments for mild-to-moderate and moderate-to-severe acne, as determined by clinician-assessed morphological features.. We undertook a systematic review and network meta-analysis of randomized controlled trials (RCTs) assessing topical pharmacological, oral pharmacological, physical and combined treatments for mild-to-moderate and moderate-to-severe acne, published up to May 2020. Outcomes included percentage change in total lesion count from baseline, treatment discontinuation for any reason, and discontinuation owing to side-effects. Risk of bias was assessed using the Cochrane risk-of-bias tool and bias adjustment models. Effects for treatments with ≥ 50 observations each compared with placebo are reported below.. We included 179 RCTs with approximately 35 000 observations across 49 treatment classes. For mild-to-moderate acne, the most effective options for each treatment type were as follows: topical pharmacological - combined retinoid with benzoyl peroxide (BPO) [mean difference 26·16%, 95% credible interval (CrI) 16·75-35·36%]; physical - chemical peels, e.g. salicylic or mandelic acid (39·70%, 95% CrI 12·54-66·78%) and photochemical therapy (combined blue/red light) (35·36%, 95% CrI 17·75-53·08%). Oral pharmacological treatments (e.g. antibiotics, hormonal contraceptives) did not appear to be effective after bias adjustment. BPO and topical retinoids were less well tolerated than placebo. For moderate-to-severe acne, the most effective options for each treatment type were as follows: topical pharmacological - combined retinoid with lincosamide (clindamycin) (44·43%, 95% CrI 29·20-60·02%); oral pharmacological - isotretinoin of total cumulative dose ≥ 120 mg kg. Topical pharmacological treatment combinations, chemical peels and photochemical therapy were most effective for mild-to-moderate acne. Topical pharmacological treatment combinations, oral antibiotics combined with topical pharmacological treatments, oral isotretinoin and photodynamic therapy were most effective for moderate-to-severe acne. Further research is warranted for chemical peels, photochemical therapy and photodynamic therapy for which evidence was more limited. What is already known about this topic? Acne vulgaris is the eighth most common disease globally. Several topical, oral, physical and combined treatments for acne vulgaris exist. Network meta-analysis (NMA) synthesizes direct and indirect evidence and allows simultaneous inference for all treatments forming an evidence network. Previous NMAs have assessed a limited range of treatments for acne vulgaris and have not evaluated effectiveness of treatments for moderate-to-severe acne. What does this study add? For mild-to-moderate acne, topical treatment combinations, chemical peels, and photochemical therapy (combined blue/red light; blue light) are most effective. For moderate-to-severe acne, topical treatment combinations, oral antibiotics combined with topical treatments, oral isotretinoin and photodynamic therapy (light therapy enhanced by a photosensitizing chemical) are most effective. Based on these findings, along with further clinical and cost-effectiveness considerations, National Institute for Health and Care Excellence (NICE) guidance recommends, as first-line treatments, fixed topical treatment combinations for mild-to-moderate acne and fixed topical treatment combinations, or oral tetracyclines combined with topical treatments, for moderate-to-severe acne.

Topics: Acne Vulgaris; Anti-Bacterial Agents; Humans; Isotretinoin; Network Meta-Analysis; Tetracycline

Oral tetracyclines are the most widely prescribed systemic antibiotic for acne. Synthesis of efficacy and safety of traditional and novel oral tetracyclines is highly informative to clinical practice. We conducted a systematic search of PubMed to identify large interventional and observational studies utilizing oral tetracyclines as an acne treatment. We identified 13 articles meeting inclusion for this review, which represented 226,019 pediatric and adult acne patients. Oral tetracyclines that were included in this systematic review were sarecycline (a novel narrow-spectrum tetracycline), doxycycline, minocycline, and tetracycline. Based on shared and divergent outcome measures, different oral tetracyclines were variably effective against facial acne. Sarecycline also demonstrated efficacy in truncal acne. Members of the oral tetracycline class also differed in their ability to minimize antibiotic resistance and gut dysbiosis. J Drugs Dermatol. 2020;19:11(Suppl):s4-11.

Topics: Acne Vulgaris; Administration, Oral; Anti-Bacterial Agents; Clinical Trials as Topic; Dermatology; Doxycycline; Drug Resistance, Bacterial; Dysbiosis; Face; Gastrointestinal Microbiome; Humans; Minocycline; Observational Studies as Topic; Propionibacteriaceae; Skin; Tetracycline; Tetracyclines; Treatment Outcome

Topics: Acne Vulgaris; Administration, Oral; Animals; Anti-Bacterial Agents; Clinical Trials as Topic; Dermatologic Agents; Humans; Tetracycline; Tetracyclines

The purpose of this literature review is to evaluate the use of metformin as an adjunct therapy in the treatment of moderate-to-severe acne in those not diagnosed with polycystic ovary syndrome (PCOS) or androgen excess. The authors conducted independent literature searches. Results were limited to clinical trials and randomized controlled trials. Studies with participants diagnosed with moderateto-severe acne vulgaris taking metformin versus placebo or other active treatment were included;studies with participants diagnosed with PCOS or androgen excess were excluded. The authors found three studies consistent with the search guidelines that evaluated the effects of metformin as adjunct therapy in moderate to severe acne vulgaris. In eachstudy, metformin was an effective adjunct therapy in the treatment of moderate-to-severe acne vulgaris.

Topics: Acne Vulgaris; Adapalene; Anti-Bacterial Agents; Benzoyl Peroxide; Combined Modality Therapy; Dermatologic Agents; Drug Therapy, Combination; Humans; Lymecycline; Metformin; Tetracycline

New drugs are available for managing several common skin disorders. For psoriasis, topical corticosteroids remain the first-line therapy, but topical vitamin D3 analogs, such as calcipotriene, now have a role. They are as effective as medium-potency topical steroids but without steroid side effects, though they can induce hypercalcemia if the dose exceeds 100 g/week. For more severe cases, methotrexate has been widely used, but other drugs now also are prescribed. They include calcineurin inhibitors, such as cyclosporine, and more recently, biologic agents, such as tumor necrosis factor inhibitors. For children and pregnant women, in whom the previously discussed drugs are not appropriate, narrowband UV-B light often is the first-line treatment. For eczema, patients requiring steroid-sparing topical drugs can be treated with calcineurin inhibitors (ie, pimecrolimus or tacrolimus); between the 2, tacrolimus is the first choice for adults and children older than 2 years. When systemic management is needed, oral calcineurin inhibitors (eg, cyclosporine) are appropriate, though oral steroids often are needed for severe cases. The need for systemic management can sometimes be delayed with use of diluted bleach baths. For acne vulgaris, standard treatments with topical benzoyl peroxide and topical or systemic antibiotics are used widely, as are oral contraceptives, but oral isotretinoin is the most effective treatment.

Topics: Acne Vulgaris; Administration, Oral; Administration, Topical; Adrenal Cortex Hormones; Calcineurin Inhibitors; Child; Dermatologic Agents; Eczema; Female; Histamine Antagonists; Humans; Immunologic Factors; Infant; Middle Aged; Psoriasis; Retinoids; Skin Diseases; Tetracycline

Although topical therapies alone can be very effective for milder acne, there are often cases for which oral antibiotics are needed to control disease. Through both antibacterial and antiinflammatory effects, oral antibiotics in combination with other drugs such as retinoids and benzoyl peroxide can be highly effective in the treatment of more severe disease. Patients and their parents often have many questions regarding the safety and efficacy of long-term antibiotic use. It is important for the physician to have a thorough understanding of the antibiotics at their disposal as well as their side effects. Through careful discussion, antibiotic compliance can be optimized and side effects minimized ultimately resulting in treatment success.

Topics: Acne Vulgaris; Anti-Infective Agents; Benzoyl Peroxide; Dermatologic Agents; Drug Therapy, Combination; Humans; Macrolides; Tetracycline; Tetracycline Resistance

The etiology of acne vulgaris is complicated and characterized by two aspects, non-inflammatory and inflammatory mechanisms. The non-inflammatory aspect is represented by follicular occlusion by sebaceous materials and resultant formation of comedo. On the other hand, acne features the continuing occurrence of inflammation, which yields reddish popular or nodular lesions. Therefore, acne is not a simple infection with Propionibacterium acnes, but subsequent inflammatory changes are the nature of acne. New quinolones, macrolides and tetracyclines are used for the treatment of acne as topical or systemic drugs. Recent accumulated evidence has suggested that these drugs exert their therapeutic effects by not only bacteriocidal actions but also anti-inflammatory or anti-immunological actions. These effects include antioxidative action toward neutrophils, inhibition of cytokine/chemokine production and adhesion molecule expression by keratinocytes, and suppression of the antigen-presenting ability of Langerhans cells. Drugs possessing these anti-inflammatory capacities are clinically beneficial for the treatment of inflammatory acne.

Topics: Acne Vulgaris; Administration, Topical; Anti-Bacterial Agents; Anti-Inflammatory Agents; Clindamycin; Fluoroquinolones; Humans; Immunologic Factors; Macrolides; Propionibacterium acnes; Quinolizines; Tetracycline

Topics: Acne Vulgaris; Adapalene; Anti-Bacterial Agents; Benzoyl Peroxide; Clindamycin; Dermatologic Agents; Dicarboxylic Acids; Doxycycline; Erythromycin; Humans; Isotretinoin; Minocycline; Naphthalenes; Tetracycline; Tretinoin; Zinc

Topics: Acne Vulgaris; Adolescent; Anti-Bacterial Agents; Benzoyl Peroxide; Complementary Therapies; Diagnosis, Differential; Erythromycin; Humans; Isotretinoin; Patient Education as Topic; Retinoids; Tetracycline

Topics: Acne Vulgaris; Adapalene; Anti-Bacterial Agents; Benzoyl Peroxide; Clindamycin; Dermatologic Agents; Dicarboxylic Acids; Drug Therapy, Combination; Erythromycin; Humans; Isotretinoin; Naphthalenes; Tetracycline; Tretinoin; Zinc

Topics: Acne Vulgaris; Administration, Oral; Adolescent; Adult; Androgen Antagonists; Anti-Bacterial Agents; Anti-Inflammatory Agents; Cyproterone Acetate; Dermatologic Agents; Diagnosis, Differential; Doxycycline; Female; Humans; Isotretinoin; Keratolytic Agents; Male; Minocycline; Ointments; Prednisolone; Retinoids; Tetracycline; Time Factors

Topics: Acne Vulgaris; Anti-Bacterial Agents; Evidence-Based Medicine; Humans; Keratolytic Agents; Tetracycline; Tretinoin

Antibiotic therapy directed against Propionibacterium acnes has been a mainstay of treatment for more than 40 years. Despite years of widespread use of systemic tetracyclines and erythromycin, change in P. acnes sensitivity to antibiotics was not seen until the early 1980s. The first clinically relevant changes in P. acnes antibiotic sensitivity were found in the USA shortly after the introduction of topical formulations of erythromycin and clindamycin. By the late 1980s, P. acnes strains with very high MIC levels for erythromycin and elevated MICs for tetracycline were increasingly found in the UK and the USA. Mutations in the genes encoding the 23S and 16S subunits of ribosomal RNA were first identified in the UK and also seen in a recent survey from clinics in Europe, Japan, Australia and the USA. In addition, strains were found in which these known mutations could not be identified, indicating that as yet unidentified resistance mechanisms have evolved. These findings indicate the need to develop strategies to minimize the use of antibiotics in acne therapy.

Topics: Acne Vulgaris; Drug Resistance, Bacterial; Global Health; Gram-Positive Bacterial Infections; Humans; Propionibacterium acnes; Tetracycline

Acne vulgaris is a very common disorder, affecting virtually every adolescent at some point in time. Systemic antibacterials have been used in the treatment of acne for many years, and there are several commonly used antibacterials which have established efficacy and safety records. In recent years, the issue of antibacterials resistance has become more prominent, especially with concerns that Propionibacterium acnes can transfer antibacterials resistance to other bacteria within the resident skin flora. Commonly used antibacterials include tetracycline, doxycycline, minocycline, erythromycin (and other macrolides) and trimethoprim/sulfamethoxazole (cotrimoxazole). The choice of antibacterial should take into account efficacy, cost-effectiveness, benefit-risk ratios, patient acceptability and the potential for the development of resistance. Poor clinical response can be the result of poor compliance, inadequate duration of therapy, development of gram-negative folliculitis, resistance of P. acnes to the antibacterial(s) administered, or a high sebum excretion rate. In order to help prevent the development of resistance a number of measures should be undertaken: antibacterials are prescribed for an average of 6 months; if retreatment is required, utilize the same antibacterial; generally, antibacterials should be given for at least 2 months before considering switching due to poor therapeutic response; concomitant use of oral and topical chemically-dissimilar antibacterials should be avoided (try benzoyl peroxide and/or retinoids instead) and systemic isotretinoin should be considered if several antibacterials have been tried without success.

Topics: Acne Vulgaris; Anti-Bacterial Agents; Doxycycline; Drug Resistance, Microbial; Erythromycin; Humans; Minocycline; Practice Guidelines as Topic; Tetracycline; Trimethoprim, Sulfamethoxazole Drug Combination

Tetracyclines and isotretinoin are widely used treatments for patients with acne. Although generally safe, the use of these agents has been associated with pseudotumor cerebri and combination therapy with these agents may increase the risk for pseudotumor cerebri. A 14-year-old boy presented with headaches and bilateral visual loss secondary to papilledema. He had been treated with tetracycline and isotretinoin for acne for three weeks prior to presentation and was subsequently diagnosed as having pseudotumor cerebri. He required long-term medical therapy and eventually underwent bilateral optic nerve sheath decompression. The literature regarding pseudotumor cerebri in association with tetracyclines and isotretinoin treatment for acne is reviewed. Dermatologists should be aware of the risk of pseudotumor cerebri in patients receiving tetracycline or isotretinoin treatment for acne and should be particularly cautious about using both agents simultaneously.

Topics: Acne Vulgaris; Adolescent; Adult; Drug Therapy, Combination; Humans; Isotretinoin; Male; Pseudotumor Cerebri; Tetracycline

Fraternal twin sisters developed idiopathic intracranial hypertension (IIH) shortly after beginning tetracycline for treatment of acne. We reviewed from the literature 19 familial cases of IIH and 37 cases of IIH associated with tetracycline usage. Among the 37 combined adult and pediatric cases, 26 of 37 had resolution of signs or symptoms of IIH within hours to days of stopping the antibiotic, and rapid recurrence with reinitiation of drug occurred in 4 of 37. We suggest that these cases may be tetracycline-induced, may be related to an underlying genetic susceptibility, and support the notion of multifactorial etiologies for IIH.

Topics: Acne Vulgaris; Adult; Child; Diseases in Twins; Female; Humans; Papilledema; Pseudotumor Cerebri; Tetracycline; Twins, Dizygotic

Acne vulgaris is the clinical expression of inflammation of the pilosebaceous unit. Factors known to predispose to the development of acne include increased sebum, which is acted on by Propionobacterium acnes to generate inflammatory substances, and retention hyperkeratosis, which causes obstruction of the sebaceous follicle. Therapeutic modalities for acne include topical and systemic antibiotics, comedolytic agents (such as benzoyl peroxide and topical retinoids) and systemic retinoids. Acne scars may be treated surgically using procedures such as dermabrasion and dermal injections of bovine collagen or simple scar excision, scar punch elevation, or punch grafting.

Topics: Acne Vulgaris; Adolescent; Adult; Benzoyl Peroxide; Cicatrix; Female; Humans; Male; Office Visits; Surgery, Plastic; Tetracycline; Tretinoin

The role of laboratory monitoring in patients receiving long-term oral antibiotics for acne vulgaris has not been clearly defined.. The purpose of our study was (1) to evaluate the literature for objective evidence on the value of routine laboratory monitoring of the asymptomatic patient receiving oral antibiotics for acne and (2) to determine the utilization of laboratory monitoring of these patients by Connecticut dermatologists.. We surveyed Connecticut dermatologists by phone and inquired about the laboratory monitoring performed in patients receiving long-term oral tetracycline, minocycline, or erythromycin for acne.. Eight published studies reported a total of 777 patients who had laboratory monitoring at various frequencies while receiving oral antibiotics for acne. Only one adverse drug reaction (ADR) was detected in a patient in whom mild hyperbilirubinemia developed. Of the 75 Connecticut dermatologists who participated in our survey, 48 (64%) perform some laboratory monitoring; 29% do so routinely, and 35% under special circumstances.. Our literature review does not support routine laboratory monitoring in all patients who receive long-term oral antibiotics for acne; rarely does such screening detect an ADR and thus does not justify the cost of such testing. A relatively small proportion of Connecticut dermatologists check laboratory tests more frequently than appears necessary; in our opinion, laboratory monitoring should be limited to patients who may be at higher risk for an ADR.

Topics: Acne Vulgaris; Dermatology; Disease; Drug Monitoring; Erythromycin; Gastrointestinal Diseases; Hematopoietic System; Humans; Kidney; Liver; Long-Term Care; Minocycline; Tetracycline; Time Factors

Topics: Acne Vulgaris; Humans; Long-Term Care; Tetracycline

The management of skin disease may differ in different parts of the world, but in most countries, acne should be a most treatable disease. Acne therapy has not evolved in the most logical fashion, but this article reviews our demonstration of risk factors in the treatment of acne. Young patients, male patients, truncal acne, a marked seborrhea, and a low dose (500 mg/day or less) of tetracycline are factors associated with a poorer response and, when oral therapy is stopped, a greater relapse rate. One gram a day of tetracycline, given for 6 months, is the minimum course of oral therapy and should be given along with topical therapy. One of the most widely used topical treatments is benzoyl peroxide, and this presentation was given in honor of Dr. William Pace, who was possibly the first dermatologist to be aware of the benefit of benzoyl peroxide--a fact not adequately recorded in dermatologic history. A small number of patients do not respond well to conventional therapy, but alternative treatments should bring about a successful outcome. Alternative treatments include hormonal therapy (i.e., 2 mg cyproterone acetate plus 50 micrograms ethinyl estradiol; spironolactone, 100 mg twice daily; or isotretinoin, 1 mg/kg). The success of all these treatments bears some relationship to their effect in modulating the etiologic factors of acne: an enhanced sebum production, increased ductal cornification, abnormal bacterial colonization, and the production of inflammation. Isotretinoin is the most beneficial of all drug regimens, and this fact no doubt relates to its favorable effect on all etiologic factors.

Topics: Acne Vulgaris; Benzoyl Peroxide; Dose-Response Relationship, Drug; Erythromycin; Female; Humans; Male; Tetracycline; Tretinoin

Topics: Acne Vulgaris; Animals; Anti-Bacterial Agents; Contraceptives, Oral, Synthetic; Drug Interactions; Erythromycin; Ethinyl Estradiol; Female; Humans; Pregnancy; Tetracycline

Topics: Acne Vulgaris; Androgen Antagonists; Androgens; Benzoyl Peroxide; Cyproterone; Cyproterone Acetate; Dermatitis, Seborrheic; Drug Combinations; Erythromycin; Ethinyl Estradiol; Female; Humans; Isotretinoin; Male; Propionibacterium acnes; Sebum; Tetracycline; Tretinoin

Topics: Acne Vulgaris; Administration, Topical; Anti-Bacterial Agents; Clindamycin; Drug Resistance, Microbial; Erythromycin; Humans; Tetracycline

Topics: Acne Vulgaris; Administration, Oral; Administration, Topical; Anti-Bacterial Agents; Clindamycin; Drug Resistance, Microbial; Erythromycin; Humans; Tetracycline

Topics: Acne Vulgaris; Administration, Oral; Administration, Topical; Anti-Bacterial Agents; Chloramphenicol; Clindamycin; Drug Resistance, Microbial; Erythromycin; Humans; Sulfamethoxazole; Tetracycline; Trimethoprim

Several pathogenetic factors contribute to the development of acne vulgaris. These include genetic predisposition, hormonal influences, increasing sebaceous secretion, bacterial colonization of the follicle and keratinization defects in the follicular epithelium. Modern acne therapy can take specific forms on the basis of recent research on pathogenesis. Sebostatic therapy can be performed by the topical application of benzoyl peroxide or the systemic administration of hormones (oestrogens, antiandrogens). Local treatment with retinoic has proved optimal in achieving a comedolytic effect. Moreover, the long-term use of antibiotics--tetracyclines, erythromycin systemically or benzoyl peroxide topically--is beneficial in respect to a reduction in Propionibacterium acnes. Experiments with immunological therapy are still in the early stages. Optimum results are obtained by the rational combination of several therapeutic modalities adapted to the type of acne to be treated.

Topics: Acne Vulgaris; Androgen Antagonists; Bacterial Vaccines; Benzoyl Peroxide; Cyproterone; Erythromycin; Estrogens; gamma-Globulins; Levamisole; Propionibacterium; Tetracycline; Tretinoin

Topics: Acne Vulgaris; Adolescent; Adult; Anti-Bacterial Agents; Child; Clindamycin; Clinical Trials as Topic; Demeclocycline; Erythromycin; Fatty Acids, Nonesterified; Female; Humans; Lincomycin; Middle Aged; Placebos; Pregnancy; Propionibacterium acnes; Sulfamethoxazole; Tetracycline; Tetracyclines; Trimethoprim

Topics: Acne Vulgaris; Adolescent; Adrenal Cortex Hormones; Androgens; Animals; Anti-Bacterial Agents; Contraceptives, Oral, Synthetic; Cryosurgery; Drug Synergism; Fatty Acids, Nonesterified; Female; Hair; Humans; Keratins; Keratolytic Agents; Lipase; Male; Propionibacterium acnes; Sebaceous Glands; Sebum; Soaps; Stress, Psychological; Tetracycline; Ultraviolet Therapy; Vitamin A

Topics: Acetates; Acne Vulgaris; Adult; Animals; Biopsy; Dermatitis, Seborrheic; Diglycerides; Esters; Fatty Acids, Nonesterified; Female; Guinea Pigs; Humans; In Vitro Techniques; Lipids; Male; Middle Aged; Rabbits; Rats; Sebaceous Glands; Sebum; Skin; Squalene; Tetracycline; Triglycerides

Topics: Acne Vulgaris; Anti-Bacterial Agents; Humans; Propionibacterium acnes; Tetracycline

Topics: Acne Vulgaris; Administration, Topical; Adolescent; Adrenal Cortex Hormones; Anti-Bacterial Agents; Astringents; Cicatrix; Cosmetics; Cryosurgery; Dermatitis, Seborrheic; Diet Therapy; Diuretics; Estrogens; Humans; Immunotherapy; Progesterone; Tetracycline; Ultraviolet Rays; Vitamin A

Topics: Acne Vulgaris; Adolescent; Dermatitis, Seborrheic; Female; Glucocorticoids; Humans; Male; Puberty; Tetracycline

Topics: Acne Vulgaris; Adolescent; Adrenal Cortex Hormones; Androgens; Anti-Bacterial Agents; Contraceptives, Oral; Diet Therapy; Emulsions; Estrogens; Humans; Immunotherapy; Mestranol; Ointments; Progesterone; Radiotherapy Dosage; Suspensions; Tetracycline; Vitamins

Topics: Acids; Acne Vulgaris; Alkynes; Animals; Circadian Rhythm; Diet; Fatty Acids, Nonesterified; Folic Acid Antagonists; Humans; Lipids; Mice; Naphthalenes; Pyrimidines; Rats; Sebum; Skin; Tetracycline; Triglycerides

Topics: Acne Vulgaris; Adolescent; Adult; Age Factors; Child; Child, Preschool; Contraceptives, Oral; Dermatitis; Dermatitis, Contact; Diagnosis, Differential; Drug Eruptions; Environmental Exposure; Facial Dermatoses; Female; Humans; Infant; Infant, Newborn; Light; Lipid Metabolism; Lupus Erythematosus, Systemic; Male; Middle Aged; Pyridoxine; Rosacea; Sebaceous Glands; Sex Factors; Skin; Skin Manifestations; Tetracycline

Topics: Acne Vulgaris; Alopecia Areata; Dermatitis, Contact; Humans; Lupus Erythematosus, Systemic; Lymphatic Diseases; Methotrexate; Ointments; Photosensitivity Disorders; Porphyrias; Psoriasis; Rosacea; Skin Diseases; Steroids; Sunscreening Agents; Tetracycline; Tinea; Trichophyton; Urea; Vitiligo

Topics: Absorption; Acne Vulgaris; Bacteria; Bacteriuria; Bronchial Diseases; Chemical and Drug Induced Liver Injury; Chemical Phenomena; Chemistry; Chlortetracycline; Demeclocycline; Drug Eruptions; Humans; Infections; Kidney Diseases; Methacycline; Oxytetracycline; Protein Binding; Tetracycline; Tooth Discoloration

Topics: Acne Vulgaris; Adult; Aged; Child, Preschool; Female; Gonorrhea; Hirsutism; Humans; Ichthyosis; Infant; Male; Melphalan; Middle Aged; Psoriasis; Sarcoidosis; Skin Diseases; Skin Neoplasms; Syphilis; Tetracycline; United States

Topics: Acne Vulgaris; Adolescent; Adult; Age Factors; Diet; Emotions; Female; Humans; Male; Marriage; Pregnancy; Sunlight; Tetracycline

Topics: Acne Vulgaris; Anti-Bacterial Agents; Corynebacterium; Humans; Lipid Metabolism; Mitosporic Fungi; Pityriasis; Sebum; Skin; Staphylococcal Infections; Tetracycline

Topics: Acne Vulgaris; Child; Female; Humans; Pregnancy; Pregnancy Complications; Skin; Skin Diseases; Stomatitis, Aphthous; Tetracycline; Tooth Discoloration

Topics: 17-Ketosteroids; Acne Vulgaris; Animals; Cortisone; Dehydroepiandrosterone; Endocrinology; Estrogens; Female; Gonadal Steroid Hormones; Humans; Male; Rats; Sebaceous Glands; Skin; Testosterone; Tetracycline

Insulin, insulin-like growth factor-1 (IGF-1) and essential amino acids activate the mechanistic target of rapamycin complex 1 (mTORC1), the main nutrient-sensitive kinase. Metformin, through inhibition of mTORC1 may improve acne. A 12-week, randomized, open-labeled study evaluated the efficacy and safety of metformin as an adjunct for moderate to severe facial acne. In total, 84 patients received either oral tetracycline 250 mg bd and topical benzoyl peroxide 2.5% with or without metformin 850 mg daily. Evaluations constituted lesion counts, the Cardiff Acne Disability Index (CADI), metabolic parameters and treatment success rate (Investigators Global Assessment score of 0 or 1 or improvement of two grades). Treatment success rates were higher in the metformin group (66.7% vs. 43.2%; p = .04). The mean percentage reduction from baseline in total lesion counts at Week 12 was greater in the metformin group (71.4% vs. 65.3%; p = .278). The CADI scores showed a greater mean reduction in the metformin group (4.82 vs. 4.22; p = .451). Metformin was equally efficacious in improving acne in lean and overweight subjects. Gastrointestinal symptoms were noted in 31.7% of subjects on metformin. This study presents favorable data for metformin as an adjunct for acne treatment. Further randomized placebo-controlled studies are required.

Topics: Acne Vulgaris; Adolescent; Adult; Benzoyl Peroxide; Dermatologic Agents; Drug Therapy, Combination; Female; Humans; Hypoglycemic Agents; Male; Metformin; Prospective Studies; Severity of Illness Index; Tetracycline; Treatment Outcome; Young Adult

There is a need for new oral antibiotics for acne with improved safety profiles and targeted antibacterial spectra. Sarecycline is a novel, tetracycline-class antibiotic specifically designed for acne, offering a narrow spectrum of activity compared with currently available tetracyclines, including less activity against enteric Gram-negative bacteria. This phase 2 study evaluated the efficacy and safety of three doses of sarecycline for moderate to severe facial acne vulgaris.. In this multicenter, double-blind, placebo-controlled study, patients aged 12 to 45 years were randomized to once-daily sarecycline 0.75 mg/kg, 1.5 mg/kg, 3.0 mg/kg, or placebo. Efficacy analyses included change from baseline in inflammatory and noninflammatory lesion counts at week 12, with between-group comparisons using analysis of covariance. Safety assessments included adverse events (AEs), clinical laboratories, vital signs, electrocardiograms, and physical examinations.. Overall, 285 randomized patients received at least one dose of study drug. At week 12, sarecycline 1.5 mg/kg and 3.0 mg/kg groups demonstrated significantly reduced inflammatory lesions from baseline (52.7% and 51.8%, respectively) versus placebo (38.3%; P=0.02 and P=0.03, respectively). Sarecycline was safe and well tolerated, with similar gastrointestinal AE rates in sarecycline and placebo groups. Vertigo and photosensitivity AEs occurred in less than 1% of patients when pooling sarecycline groups; no vulvovaginal candidiasis AEs occurred. Discontinuation rates due to AEs were low. No serious AEs occurred.. Once-daily sarecycline 1.5 mg/kg significantly reduced inflammatory lesions versus placebo and was safe and well tolerated with low rates of AEs, including gastrointestinal AEs. Sarecycline 3.0 mg/kg did not result in additional efficacy versus 1.5 mg/kg. Sarecycline may represent a novel, once-daily treatment for patients with moderate to severe acne. It offers a narrow antibacterial spectrum relative to other tetracycline options, which may lead to less selective pressure on enteric Gram-negative bacteria, resulting in less disruption of commensal organisms and less potential for antibiotic resistance.

J Drugs Dermatol. 2018;17(3):333-338.

Topics: Acne Vulgaris; Administration, Oral; Adolescent; Adult; Anti-Bacterial Agents; Double-Blind Method; Drug Administration Schedule; Face; Female; Follow-Up Studies; Humans; Male; Tetracycline; Treatment Outcome; Young Adult

Topical tetracycline was the first topical antibiotic approved for the treatment of acne, its use has been limited because of the skin penetration problems of the active ingredient.. The objective of this study was to evaluate the effectiveness of a new formulation of topical tetracycline [Imex, tetracycline hydrochloride 3%, 20g] monotherapy in the treatment of mild to moderate acne vulgaris.. The sample group consisted of 87 volunteer students of both sexes with grade 1 to grade 2 acne as assessed by Investigator's Global Assessment (IGA) severity grading system. Subjects were instructed to apply topical tetracycline twice daily for 8 weeks. Subject were evaluated at baseline and at weeks 2, 4, and 8.. Of 87 subjects, 68 completed the 8-week treatment period. The mean reduction rates of opened comedones were 55.4%, closed comedones were 27.1%, papules were 24.8%, pustules were 27.3%. After 8 weeks of treatment, a statistically significant reduction was only observed in the mean counts of the papules and pustules (P < 0.001).. Tetracycline is a well-tolerated topical agent and is particularly effective in the treatment of inflammatory lesions in acne.

Topics: Acne Vulgaris; Administration, Topical; Adolescent; Adult; Anti-Infective Agents, Local; Data Interpretation, Statistical; Female; Humans; Male; Patient Compliance; Tetracycline; Young Adult

The aim of this study was to compare the clinical and microbiological effect on Propionibacterium acnes of oral tetracycline plus topical adapalene vs. oral isotretinoin in moderate to severe acne vulgaris. Male and female acne patients with moderate or severe inflammatory disease were enrolled and assigned randomly to 6 months of treatment with oral tetracycline hydrochloride plus topical adapalene, or oral isotretinoin, in a controlled, open study. After cessation of oral treatment the antibiotic-treated group received topical adapalene for the 2-month follow-up period. Clinical and microbiological assessments were performed. Skin samples for microbial identification and quantification were taken at baseline, after 2, 4 and 6 months of treatment, and 2 months after cessation of treatment. Patients treated with isotretinoin showed prolonged significant remission compared with the other group. The density of resistant propionibacteria did not change significantly in any of the groups and there was no correlation between resistant P. acnes and the clinical response in any of the regions investigated. Antibiotic treatment was found to be a good alternative to isotretinoin, regardless of the presence of antibiotic-resistant P. acnes, although isotretinoin had a better effect, with prolonged remission after treatment.

Topics: Acne Vulgaris; Adapalene; Administration, Oral; Administration, Topical; Adolescent; Adult; Anti-Bacterial Agents; Clindamycin; Dermatologic Agents; Drug Resistance, Bacterial; Drug Therapy, Combination; Female; Humans; Isotretinoin; Male; Naphthalenes; Quality of Life; Remission Induction; Sex Factors; Tetracycline; Treatment Outcome

Acne vulgaris affects a large number of young adults and often presents with facial and truncal involvement. Systemic antibiotics are used for the treatment of papulopustular and cystic lesions.. We sought to determine the efficacy and safety of azithromycin versus tetracycline in the treatment of acne vulgaris.. A randomized, investigator-blind, clinical trial was carried out for 3 months at the outpatient clinic of Emam Khomeini University Hospital, Ahwaz, Iran. A total of 290 patients with moderate to severe papulopustular acne vulgaris were allocated to two groups, azithromycin and tetracycline, for 3 months of treatment. Azithromycin 500 mg was prescribed for 3 consecutive days a week for 1 month and then 250 mg every other day for the following 2 months. Tetracycline 1 g was similarly prescribed: daily for 1 month and then 500 mg daily for the following 2 months.. Both antibiotics were effective in reducing inflammatory lesions and improving acne. Azithromycin produced a slightly higher percentage of improvement compared with tetracycline (100 cases/84.7% vs 94 cases/79.7%).. Azithromycin is a safe and effective alternative in the treatment of inflammatory acne.

Topics: Acne Vulgaris; Adolescent; Adult; Anti-Bacterial Agents; Azithromycin; Child; Female; Humans; Male; Single-Blind Method; Tetracycline; Treatment Outcome

Isotretinoin, used to treat severe acne, has been shown to induce hormonal changes, especially to reduce 5 alpha-reductase in the production of the tissue-derived dihydrotestosterone (DHT) metabolite 3 alpha-Adiol G. However, the effects of isotretinoin on other pituitary, adrenal or gonadal hormones have not been thoroughly elucidated. In the present study, isotretinoin administered at a dose of 0.5 mg/kg/day for 4 weeks caused no marked changes in the serum levels of pituitary, adrenal or gonadal hormones or 3 alpha-Adiol G in patients with severe papulopustulotic acne (n = 19). After 12 weeks of therapy, there was a decrease in the levels of the precursor androgens androstenedione, testosterone and 3 alpha-Adiol G in 6/9 patients. Acne improved after 4.5 months in all but 2 male patients, who had very low serum hormone binding globulins (SHBG) and a high free androgen index (FAI). Isotretinoin did not affect the elevated LH/FSH ratio in a patient with the polycystic ovarian syndrome (PCOS); nor did it change the high FAI or low SHBG in the male patients. For comparison, tetracycline had no effects on the serum hormonal levels of patients with mild acne (n = 19) after 7 days of treatment. This study confirms that the effects of isotretinoin on the serum hormone levels are small and unlikely to be of relevance for the resolution of acne or the suppression of sebum excretion.

Topics: Acne Vulgaris; Adolescent; Adult; Anti-Bacterial Agents; Female; Gonadal Steroid Hormones; Humans; Isotretinoin; Keratolytic Agents; Male; Oxidoreductases; Steroids; Tetracycline

Twenty patients with nodulocystic acne were randomly allocated to one of two treatment schedules: 1) Tetracycline 500 mg or 2) Tab. Gugulipid (equivalent to 25 mg guggulsterone). Both were taken twice daily for 3 months, and both produced a progressive reduction in the lesions in the majority of patients. With tetracycline, the percentage reduction in the inflammatory lesions was 65.2% as compared to 68% with gugulipid; on comparison, this difference was statistically insignificant (P > 0.05). Follow-up at 3 months showed a relapse in 4 cases on tetracyline and 2 cases on gugulipid. An interesting observation was that the patients with oily faces responded remarkably better to gugulipid.

Topics: Acne Vulgaris; Administration, Oral; Adolescent; Adult; Commiphora; Facial Dermatoses; Female; Follow-Up Studies; Humans; Male; Plant Extracts; Plant Gums; Recurrence; Sebum; Tetracycline

Antibiotic resistance of the resident cutaneous bacterial flora is a well recognized consequence of systemic antibiotic therapy. In this study, we followed the development of antibiotic resistance of coagulase-negative staphylococci (CNS), the most numerous aerobic bacteria found on the skin surface, during treatment with three topical antimicrobial agents used to treat acne vulgaris. Groups of 20 subjects received either topical erythromycin, benzoyl peroxide or a combination of the two for 16 weeks. After 12 weeks of treatment with erythromycin, the aerobic flora was dominated by S. epidermidis which was completely resistant to erythromycin. In addition there was an increase in resistance to clindamycin and tetracycline. Treatment with benzoyl peroxide and the combination of erythromycin and benzoyl peroxide resulted in a significant reduction in the number of aerobic bacteria without any change in the resistance pattern to erythromycin or other antibiotics.

Topics: Acne Vulgaris; Administration, Topical; Adolescent; Adult; Benzoyl Peroxide; Clindamycin; Coagulase; Drug Resistance, Microbial; Drug Therapy, Combination; Erythromycin; Female; Humans; Male; Staphylococcus; Staphylococcus epidermidis; Tetracycline

A proprietary topical tetracycline preparation (Topicycline) was compared with an alcohol-based 5% benzoyl-peroxide gel and with oral oxytetracycline (250 mg twice daily) using a randomized group-comparative double-blind study in 69 patients with mild to moderate acne. Facial acne grades improved significantly in all three treatment groups over the 12-week study period but chest acne grades did not change significantly and only oxytetracycline produced a significant improvement in back grade. All three treatment groups produced a significant reduction in facial inflamed and non-inflamed lesions apart from oxytetracycline which failed to produce a significant reduction in inflamed lesions. However, there were no overall significant differences between the three treatment groups either in improvement of acne grade or in reduction of inflamed and non-inflamed lesions. We conclude that topical tetracycline is as effective as either 5% benzoyl-peroxide gel or 250 mg oxytetracycline twice daily in the treatment of mild to moderate acne.

Topics: Acne Vulgaris; Administration, Oral; Administration, Topical; Adolescent; Adult; Benzoyl Peroxide; Child; Drug Administration Schedule; Female; Humans; Male; Oxytetracycline; Tetracycline

Twenty-five previously untreated acne patients were monitored throughout a 6-month course of therapy with either tetracycline or minocycline for changes in the numbers of staphylococci, propionibacteria and yeasts of the genus Malessezia on the skin surface. Antibiotic resistant staphylococci and propionibacteria were also counted. Minocycline (50 mg b.d.) produced a 10-fold greater reduction in propionibacterial numbers compared to tetracycline (500 mg b.d.) after 12 (P less than 0.02, t-test) and 24 weeks (P less than 0.05) of therapy. As treatment progressed, propionibacteria were replaced by yeasts, numbers of which were significantly increased by week 12 (P less than 0.02) in tetracycline-treated patients and by week 24 (P less than 0.01) in minocycline-treated patients. This suggests that yeasts have no role in the pathogenesis of acne but may compete with propionibacteria for the same niche. Overgrowth of antibiotic resistant staphylococci prevented any decrease in staphylococcal numbers in tetracycline-treated patients, but minocycline produced a significant and sustained reduction in staphylococcal numbers after 1 week of therapy (P less than 0.001). An increase in the number of multiply resistant (greater than or equal to 3 resistances) staphylococci occurred in 67% of tetracycline-treated and 33% of minocycline-treated patients by the end of the treatment period. There was no evidence of propionibacterial resistance in either treatment group. This study shows that minocycline has much greater antibacterial activity in vivo against both staphylococci and propionibacteria and produces less staphylococcal antibiotic resistance than tetracycline.

Topics: Acne Vulgaris; Adolescent; Female; Humans; Male; Minocycline; Propionibacterium; Skin; Staphylococcus; Tetracycline; Tetracycline Resistance; Tetracyclines; Time Factors; Yeasts

Topics: Acne Vulgaris; Administration, Topical; Clinical Trials as Topic; Dicarboxylic Acids; Drug Tolerance; Female; Humans; Male; Random Allocation; Tetracycline

In a series of investigation using 20% azelaic acid as a therapy for acne, it was found that the treatment, compared with most common therapies (benzoylperoxide, oral tetracycline) significantly reduced inflamed lesions in papulo-pustular acne. The rates of improvement obtained indicate that topical azelaic acid treatment can be considered an effective therapy for papulo-pustular acne and it compares well with other agents. Azelaic acid cream shows a progressive and significant beneficial effect and its action is more pronounced in long-term treatment.

Topics: Acne Vulgaris; Administration, Oral; Adolescent; Benzoyl Peroxide; Clinical Trials as Topic; Dermatologic Agents; Dicarboxylic Acids; Humans; Male; Ointments; Tetracycline; Time Factors

The management of skin disease may differ in different parts of the world, but in most countries, acne should be a most treatable disease. Acne therapy has not evolved in the most logical fashion, but this article reviews our demonstration of risk factors in the treatment of acne. Young patients, male patients, truncal acne, a marked seborrhea, and a low dose (500 mg/day or less) of tetracycline are factors associated with a poorer response and, when oral therapy is stopped, a greater relapse rate. One gram a day of tetracycline, given for 6 months, is the minimum course of oral therapy and should be given along with topical therapy. One of the most widely used topical treatments is benzoyl peroxide, and this presentation was given in honor of Dr. William Pace, who was possibly the first dermatologist to be aware of the benefit of benzoyl peroxide--a fact not adequately recorded in dermatologic history. A small number of patients do not respond well to conventional therapy, but alternative treatments should bring about a successful outcome. Alternative treatments include hormonal therapy (i.e., 2 mg cyproterone acetate plus 50 micrograms ethinyl estradiol; spironolactone, 100 mg twice daily; or isotretinoin, 1 mg/kg). The success of all these treatments bears some relationship to their effect in modulating the etiologic factors of acne: an enhanced sebum production, increased ductal cornification, abnormal bacterial colonization, and the production of inflammation. Isotretinoin is the most beneficial of all drug regimens, and this fact no doubt relates to its favorable effect on all etiologic factors.

Topics: Acne Vulgaris; Benzoyl Peroxide; Dose-Response Relationship, Drug; Erythromycin; Female; Humans; Male; Tetracycline; Tretinoin

Sixty patients (aged 12-30 years) were enrolled in a 12-week, double-blind, randomized study to compare the efficacy of clindamycin phosphate 1% topical solution with oral tetracycline for the treatment of moderate acne. Forty-four patients (22 in each group) were evaluable. All patients experienced significant reductions in numbers of pustules, papules and inflamed nodules, and there were no significant differences between the two groups. Both treatment regimens were well tolerated, and no systemic side-effects were reported. Topical clindamycin phosphate 1% is considered a safe and effective alternative to oral tetracycline for the treatment of moderate acne vulgaris.

Topics: Acne Vulgaris; Administration, Oral; Administration, Topical; Adolescent; Adult; Child; Clindamycin; Clinical Trials as Topic; Double-Blind Method; Female; Humans; Male; Random Allocation; Tetracycline

A clinical and bacteriological comparison of tetracycline and erythromycin was carried out in 40 patients with papulopustular acne vulgaris. Twenty patients received 250 mg of tetracycline BID and 20 received 250 mg of erythromycin BID for four months. Clinically, 19 (95%) of patients treated with tetracycline and 17 (85%) of those treated with erythromycin had improvement ranging from moderate to very good. Both drugs also reduced the microflora both in the pustules and on normal skin from the same patients. Three patients given tetracycline and one given erythromycin reported mild side effects. Thus both antimicrobial agents were effective and safe in treating acne vulgaris.

Topics: Acne Vulgaris; Adolescent; Adult; Clinical Trials as Topic; Erythromycin; Female; Humans; Male; Tetracycline

Topics: Acne Vulgaris; Administration, Oral; Administration, Topical; Clindamycin; Corynebacterium Infections; Double-Blind Method; Female; Humans; Male; Microbial Sensitivity Tests; Random Allocation; Tetracycline

The efficacy of erythromycin base (E-Mycin tablets, 333 mg) and the efficacy of tetracycline hydrochloride (Panmycin tablets) were compared in this double-blind, randomized study. Two hundred patients with moderate to moderately severe acne vulgaris were randomly assigned to the study. One hundred patients received 1 gm of erythromycin base by mouth per day for 4 weeks, followed by 333 mg/day for 8 weeks, plus placebo for tetracycline. The second group of patients received 1 gm of tetracycline by mouth per day for 4 weeks, followed by 500 mg/day for 8 weeks, plus placebo for erythromycin. Both drugs reduced acne severity to the same extent. Pustules, papules, and open comedo counts decreased significantly over the 12-week period. Seventy-seven percent of the erythromycin-treated patients and 89% of the tetracycline-treated patients stated that their acne was markedly improved or improved by week 12. Most of the side effects in patients treated with erythromycin were gastrointestinal symptoms. Among the side effects in patients treated with tetracycline were Candida vaginitis in one patient and pseudotumor cerebri in one patient.

Topics: Acne Vulgaris; Administration, Oral; Adolescent; Adult; Clinical Trials as Topic; Diarrhea; Double-Blind Method; Erythromycin; Female; Humans; Nausea; Pregnancy; Tetracycline

Topical azelaic acid and oral tetracycline were compared in a 6-month double-blind study for treatment of acne vulgaris in 45 male subjects with clinical acne. Their acne was graded, inflamed or non-inflamed, lesions were counted and the density of their skin microflora was measured. Both treatments were of benefit and produced only a few minor side-effects. Although oral tetracycline was more effective than azelaic acid, the differences were only just significant. The average reduction in numbers of cutaneous micrococcaceae and Propionibacterium sp. with azelaic acid treatment was 224 and 30-fold, respectively. In a separate group of 11 male subjects with physiological acne the effect of azelaic acid on sebum excretion rate was assessed, and little change was detected.

Topics: Acne Vulgaris; Administration, Topical; Adolescent; Adult; Clinical Trials as Topic; Dicarboxylic Acids; Double-Blind Method; Humans; Male; Skin; Tetracycline

This study consists on an eight week completely randomized investigator blind trial designed to compare the relative efficacy and tolerance of clindamycin phosphate topical solution and tetracycline in the treatment of patients with mild to moderate acne vulgaris. Patients were seen at baseline, weeks 2, 4, 6 and 8. Of the forty-five case report forms received in house, thirty-four are considered to be evaluable. Seven patients failed the entry criteria, two patients were lost to follow-up and two patients left due to lack of tolerance to the medication. All patients receiving medication were examined for both local and global tolerance indices. Within group analyses show significant improvement for both medication groups with respect to the continuous efficacy parameters: inflammatory lesions, pustules, papules and comedo counts. After adjusting for initial baseline differences, no differences between the two groups arose for these variables. The investigating physician on the average judged clindamycin phosphate to be significantly more efficacious than tetracycline trends for the patients evaluation supported these results. Throughout the study, the incidence of peeling, erythema and itching was low and similar for both groups. Two tetracycline patients did however terminate participation in the study due to itching. Significantly more patients receiving tetracycline complained of a burning sensation. No diarrhea or other side effects were recorded.

Topics: Acne Vulgaris; Administration, Topical; Adolescent; Adult; Clindamycin; Clinical Trials as Topic; Double-Blind Method; Humans; Inflammation; Random Allocation; Solutions; Tetracycline

Since the recent introduction of a drug regimen containing 2 mg of the antiandrogen cyproterone acetate and 50 micrograms ethinyl-oestradiol (Diane; oestrogen-cyproterone acetate) several uncontrolled reports have extolled the benefits of this drug. Double blind studies, however, are lacking. Sixty two patients with moderate or moderately severe acne were therefore included in a double blind trial of treatment for six months comparing tetracycline alone, oestrogen-cyproterone acetate alone, and a combination of these agents. Sebum excretion rates and bacterial counts were measured before, during, and after treatment, at the same time as a clinical assessment was made. At six months the acne (as assessed by overall grade) had improved by 68% in the antibiotic treated group and by 74% in the oestrogen-cyproterone treated group. The group given a combination of both agents improved by 82%, which was significantly better (p less than 0.025) than the improvement in the tetracycline treated patients. No significant difference was found between the groups given oestrogen-cyproterone alone and the combined treatment. The sebum excretion rate was suppressed by 25% in the patients in both groups receiving oestrogen-cyproterone but not in the group given antibiotics alone. Oestrogen-cyproterone acetate is as effective as antibiotics in treating acne in women, and adding antibiotics offers no advantage over using oestrogen-cyproterone on its own, although in this study the combination was more effective than tetracycline alone at six months.

Topics: Acne Vulgaris; Adolescent; Adult; Androgen Antagonists; Clinical Trials as Topic; Cyproterone; Cyproterone Acetate; Double-Blind Method; Drug Therapy, Combination; Ethinyl Estradiol; Female; Follow-Up Studies; Humans; Recurrence; Tetracycline

This investigation utilized an accurate photographic method and grading scale for evaluating acne in sixty-two patients. During a randomized double-blind clinical study in which half of the patients received minocycline and half, tetracycline, photographs of facial or body acne were taken at baseline and every 2 weeks over a 12-week period of therapy. In addition to on-site blinded gradings by both the investigator and the patients, separate assessments were made by two independent dermatologists utilizing the scale and the transparencies taken during the study. A reasonable agreement was found between the investigator, the patients, and the independent dermatologists, indicating the usefulness of this method. The investigator's rating of acne severity disclosed a significantly (p less than or equal to 0.05) more rapid clinical response at weeks 2 and 8 in the patients who received minocycline than in those who received tetracycline. Also, the assessment of one of the independent dermatologists showed a significantly (p = 0.024) better response to minocycline than to tetracycline at week 8 of therapy. The incidence of adverse clinical experiences was lower in the minocycline-treated group (10%) than in the tetracycline-treated group (22%).

Topics: Acne Vulgaris; Adolescent; Adult; Clinical Trials as Topic; Double-Blind Method; Female; Humans; Male; Minocycline; Photography; Tetracycline; Tetracyclines

Thirty patients with treatment-resistant cystic and conglobulate acne entered a randomized double-blind protocol, testing the efficacy of isotretinoin versus tetracycline. After 16 weeks of isotretinoin treatment, the mean number of cysts decreased by 64% and the mean sum of the longest diameters was reduced by 68%. After 16 weeks of tetracycline therapy, the total number of cysts showed a mean decrease of 52%, and the mean sum of the longest diameters decreased by 60%. The reduction in the number of cysts and the sum of their longest diameters that occurred after 16 weeks of treatment was statistically significant for each of the treatment groups, but there was no statistically significant difference between the treatment groups at the end of therapy. Eight weeks after the discontinuation of treatment in the isotretinoin group, there was an overall reduction from baseline of 82% in the cyst count and 88% in the sum of the longest diameters. In the tetracycline treatment group, the overall reduction from baseline in the cyst count was 54% and in the sum of the longest diameters, 60%. This led to a statistically significant difference in the two treatment groups at 24 weeks. All patients on isotretinoin experienced side effects that were primarily related to the integumentary system but necessitated discontinuation of the drug for a short period of time in only one patient. Long-term follow-up, 8 months after discontinuation of the study, showed a prolonged significant remission of acne in the isotretinoin group but not in the tetracycline group.

Topics: Acne Vulgaris; Adolescent; Adult; Cataract; Cheilitis; Clinical Trials as Topic; Double-Blind Method; Epistaxis; Female; Follow-Up Studies; Humans; Isomerism; Isotretinoin; Male; Random Allocation; Tetracycline; Tretinoin; Xerophthalmia; Xerostomia

The clinical effect on acne vulgaris of topical treatment with meclocycline sulfosalicylate and systemic treatment with peroral tetracycline (500 mg daily) was compared in a double-blind study of 60 patients treated for 8 weeks. The reducing effect of Meclosorb cream and tetracycline tablets on the number of closed comedones, pustules, papules and cysts was marked and not significantly different. The effect of Meclosorb on open comedones was weak and of slow onset. No side effects were registered. Topical treatment with Meclosorb is an effective and safe alternative to systemic tetracycline treatment of acne vulgaris.

Topics: Acne Vulgaris; Administration, Topical; Adolescent; Adult; Clinical Trials as Topic; Double-Blind Method; Female; Humans; Male; Middle Aged; Oxytetracycline; Random Allocation; Tetracycline

In a randomized double blind study on acne the efficacy and tolerance of a combination preparation of benzoyl peroxide and miconazole as a cream formulation was compared with those of benzoyl peroxide and oral tetracyclin. For this study, we selected patients mainly suffering from papulopustular acne of medium to high degree of severity. Efficacy and tolerance were satisfactory in both groups, and there was no statistically significant difference.

Topics: Acne Vulgaris; Administration, Topical; Adolescent; Adult; Benzoyl Peroxide; Clinical Trials as Topic; Double-Blind Method; Drug Combinations; Female; Humans; Male; Miconazole; Ointments; Peroxides; Tetracycline

A prospective evaluation of the efficacy and safety of oral ibuprofen and tetracycline hydrochloride was conducted for 8 weeks in patients with moderately severe acne. Sixty-eight patients were randomly assigned in a double-blind fashion to one of four regimens: (1) one 600 mg ibuprofen tablet plus one 250 mg tetracycline capsule four times daily; (2) one 600 mg ibuprofen tablet plus one placebo capsule four times daily; (3) one 250 mg tetracycline capsule plus one placebo tablet four times daily; and (4) one placebo tablet and one placebo capsule four times daily. Sixty patients completed the 8-week study. The mean percent improvement in the groups treated with ibuprofen and tetracycline (56% +/- 5 SE), ibuprofen alone (26% +/- 13 SE), or tetracycline alone (26% +/- 9 SE) was statistically significant. However, only the combination of ibuprofen and tetracycline therapy had an effect statistically better than the placebo response (16+ +/- 11 SE). Adverse effects were transient and were similar in all four groups.

Topics: Acne Vulgaris; Adolescent; Adult; Double-Blind Method; Drug Therapy, Combination; Female; Gastrointestinal Diseases; Humans; Ibuprofen; Male; Prospective Studies; Random Allocation; Tetracycline; Time Factors

The study comprised 49 patients suffering from acne who were treated over a period averaging 4.7 +/- 1.2 months with tetracyclines administered either orally (1000 mg daily for 5 days, then 250 mg daily) or locally (2% alcoholic solution). Randomization was carried out by means of random numbers. The percentage of pustules among the total acne efflorescences was chosen as clinical parameter for the efficacy of the antibiotic therapy. After treatment, both collectives showed the same significant decline of pustulation. The therapy was finally evaluated on a six-point scale both by the doctor and the patient. In total, there could not be detected any significant difference in the evaluation of local and oral medication.

Topics: Acne Vulgaris; Administration, Oral; Administration, Topical; Adolescent; Adult; Female; Humans; Male; Tetracycline

Eighty-seven patients with moderate to severe acne were included in an 8-week randomized double-blind study to compare the efficacies of topically applied clindamycin phosphate 1% b.i.d., oral tetracyclines 500 mg b.i.d. and placebo. Patients were examined every 2 weeks and inflammatory lesions, i.e. papules and pustules were counted in the same area at each examination. Clindamycin phosphate demonstrated a highly significant 72% decrease of inflammatory lesions, as did tetracyclines with a 57% decrease, but not placebo (12%). Clindamycin phosphate was superior to tetracycline. No significant side effects were seen, in particular, no skin side effects.

Topics: Acne Vulgaris; Administration, Oral; Administration, Topical; Adolescent; Adult; Clindamycin; Clinical Trials as Topic; Double-Blind Method; Female; Humans; Male; Tetracycline

In a double-blind study on 20 patients with acne vulgaris, 10 patients were treated with topical clindamycin and 10 patients with oral tetracycline for eight weeks. The skin and colon microflora were determined before, during and up to eight weeks after treatment. All patients improved markedly to the same extent. Topical clindamycin caused no changes in the colon flora, whereas oral tetracycline significantly suppressed the numbers of colon bacteria and four patients were colonized by new tetracycline resistant bacteria. In patients receiving tetracycline, 40% of the skin bacteria became resistant during therapy, while the corresponding figure for clindamycin was 60%. The skin flora was normalized in most patients after the treatment had stopped.

Topics: Acne Vulgaris; Administration, Topical; Adolescent; Adult; Bacteria; Clindamycin; Colon; Female; Humans; Male; Skin; Tetracycline

In a multiclinic double-blind trial, 305 patients with moderate to severe acne vulgaris were treated with oral tetracycline hydrochloride, 250 mg (N: 103), a 1% solution of clindamycin phosphate (N: 105), or placebo (N: 97) twice daily for 8 weeks. The response to treatment was evaluated by lesion counts and overall clinical improvement at 2, 4, 6, and 8 weeks. Both topical clindamycin and oral tetracycline significantly reduced papule and pustule counts compared to placebo; they were rated significantly higher than placebo on the physician's and the patient's overall evaluation at the end of the treatment period. No serious side effects were reported with any of the study medications.

Topics: Acne Vulgaris; Administration, Oral; Administration, Topical; Adolescent; Adult; Clindamycin; Clinical Trials as Topic; Double-Blind Method; Female; Humans; Male; Random Allocation; Tetracycline; Time Factors

A double-blind study was conducted to compare topical erythromycin 1.5 percent solution (Staticin solution) with oral tetracycline (250 mg) twice a day in fifty-four patients with Grades II and III acne vulgaris. Although both therapies produced a statistically significant reduction in the number and severity of the acne lesions, the topical preparation usually showed an effect earlier and to a greater degree than the oral medication. By the end of the study, some of these differences were statistically significant. After twelve weeks of treatment, topical erythromycin therapy produced a 58 percent reduction in the overall lesion count, as opposed to the 38 percent reduction produced by oral tetracycline therapy. In addition, the Propionibacterium acnes counts were reduced with erythromycin by over 90 percent and with tetracycline treatment by over 80 percent. Two patients treated with tetracycline developed vaginal candidiasis and therapy had to be discontinued. During topical treatment with erythromycin only mild adverse experiences were reported and none resulted in withdrawal from the study.

Topics: Acne Vulgaris; Administration, Oral; Administration, Topical; Adolescent; Adult; Child; Double-Blind Method; Erythromycin; Female; Humans; Male; Propionibacterium acnes; Random Allocation; Skin; Tetracycline; Time Factors

In 51 patients with acne vulgaris and 34 patients suffering from occupational oil acne the clinical effect of orally administered tetracycline was evaluated before, during and after a 3-monthly treatment (total dose of antibiotic: 1st month, 28.5 g; 2nd and 3rd months, 15.0 g). Patients treated with placebo were used as controls. Investigations of the skin fluorescence under Wood's light were performed during the treatment period. In one half of the patients with acne vulgaris and oil acne oral treatment with tetracycline had a very good clinical effect. The purpose of this investigation was the comparison of the results of the treatment of acne vulgaris and occupational oil acne with tetracycline.

Topics: Acne Vulgaris; Administration, Oral; Adult; Clinical Trials as Topic; Drug Administration Schedule; Humans; Metallurgy; Occupational Diseases; Oils; Tetracycline

The effect of 1,000 mg of tetracycline hydrochloride and 200 mg of minocycline hydrochloride on Propionibacterium acnes levels and skin-surface lipid levels was measured in 15 patients with acne. Minocycline produced a significantly greater reduction in the P acnes counts that persisted even up to three weeks after discontinuation of the minocycline therapy, in contrast to the return of P acnes to baseline counts within three weeks after discontinuation of tetracycline therapy. A similar persistence of effect for reduction of skin-surface free fatty acid levels and clinical lesions was also seen with minocycline therapy.

Topics: Acne Vulgaris; Fatty Acids, Nonesterified; Female; Humans; Lipid Metabolism; Male; Minocycline; Propionibacterium acnes; Skin; Tetracycline; Tetracyclines

Oral tetracycline hydrochloride (Amphocycline) reduced significantly (P less than 0.05) the mean free fatty acid/triglyceride (FAA/TG) ratio in hair lipid, from 1.56 to 0.47 after treatment for 4 weeks, and to 0.64 after treatment for 8 weeks in 15 young men and women undergoing treatment for acne vulgaris. In a second similar group of 16 subjects who received the same oral therapy with antibiotic but who also applied a 10% (w/v) solution of ethyl lactate twice daily to affected areas on the face, the mean FFA/TG ratio was also reduced significantly (P less than 0.05) from 1.25 to 0.61 (after 4 weeks) and to 0.64 (after 8 weeks). In a third group of 16 subjects, whose only treatment was local application of ethyl lactate solution, the mean FFA/TG ratio was essentially unchanged throughout the period of treatment from 1,15, being 1.50 and 1.22 after 4 weeks and 8 weeks, respectively.

Topics: Acne Vulgaris; Administration, Oral; Adolescent; Adult; Clinical Trials as Topic; Fatty Acids, Nonesterified; Female; Hair; Humans; Lipid Metabolism; Lipolysis; Male; Placebos; Tetracycline; Triglycerides

The comparative effectiveness of three comprehensive therapeutic programs was studied in 118 patients with mild to moderate acne vulgaris. A topical program of tretinoin, benzoyl peroxide, and water avoidance was found to be as effective as the more commonly employed program of systemic tetracycline therapy with topically applied tretinoin and better than a program using systemic tetracycline therapy with abradant cleansers. At 16 weeks of therapy for all groups, the degree of skin dryness correlated with lack of improvement. Skin dryness is established as an aggravating factor in both the pathogenesis and treatment of acne. The topical program was nonirritating, well accepted by patients, and less expensive than the other two regimens.

Topics: Acne Vulgaris; Administration, Topical; Adolescent; Adult; Benzoyl Peroxide; Climate; Clinical Trials as Topic; Female; Follow-Up Studies; Humans; Humidity; Male; Peroxides; Tetracycline; Tretinoin

An eight week double-blind study comparing 1 percent clindamycin phosphate (Cleocin T) applied topically with tetracycline 500 mg a day taken orally was conducted in fifty subjects. Topically applied 1 percent clindamycin phosphate was found to be superior to oral tetracycline at six weeks as judged by patient evaluation and reduction of papules. There was a consistent trend favoring clindamycin phosphate at the other visits but the difference was not significant. The use of topically applied 1 percent clindamycin phosphate seems to be a logical alternative to the use of oral tetracycline.

Topics: Acne Vulgaris; Administration, Oral; Administration, Topical; Clindamycin; Double-Blind Method; Drug Evaluation; Drug Therapy, Combination; Humans; Tetracycline

This double-blind controlled study investigated the effectiveness of 4% topical erythromycin liquid with 1.2% zinc acetate and 4% topical erythromycin gel with 1.2% zinc octoate applied twice daily in comparison with 250 mg of oral tetracycline twice daily and placebo. One hundred forty-nine patients began and one hundred forty-one completed the study. Three judges recorded acne measurements of severity grade, papule counts, pustule counts, comedo grades, and comedo counts without mutual consultation on visits at 0, 2, 4, 6, 8, and 10 weeks. Analysis of the reduction in the acne severity grade and papule count showed that the erythromycin/zinc liquid and gel were statistically significantly better than placebo and as effective as the oral tetracycline. Analysis of comedo grades showed that at weeks 8 and 10 the 4% topical erythromycin/zinc liquid showed a reduction statistically better than placebo.

Topics: Acne Vulgaris; Administration, Topical; Adolescent; Adult; Clinical Trials as Topic; Double-Blind Method; Drug Combinations; Erythromycin; Humans; Male; Tetracycline; Zinc

A grading system for following the clinical course of acne was devised in which overall severity of acne is evaluated on a zero to eight scale anchored to photographic standards that illustrate grades 0, 2, 4, 6, and 8. Experience with use of this system in large-scale clinical trials has shown it to be useful and reliable. Photographs taken at each visit create a permanent and regradable record of each subject's clinical status throughout the course of treatment.

Topics: Acne Vulgaris; Clinical Trials as Topic; Double-Blind Method; Humans; Photography; Placebos; Tetracycline

Forty-eight patients participated in a 3-month double-blind study to compare the effect of orally administered zinc sulphate/citrate complex and tetracycline hydrochloride in acne vulgaris. Tetracycline significantly reduced the overall grade, and the number of non-inflamed lesions, papules and pustules by the third month. It also reduced significantly the non-inflamed lesions and papules at the end of the second month. In contrast, zinc therapy only had a significant effect on the pustules at the third month. The results indicate that tetracycline is far superior to the zinc complex in patients with moderately severe acne.

Topics: Acne Vulgaris; Citrates; Clinical Trials as Topic; Double-Blind Method; Humans; Sulfates; Tetracycline; Zinc

Topics: Acne Vulgaris; Administration, Topical; Anti-Bacterial Agents; Clinical Trials as Topic; Humans; Placebos; Tetracycline

Topics: Acne Vulgaris; Administration, Oral; Administration, Topical; Adolescent; Adult; Clinical Trials as Topic; Double-Blind Method; Female; Gels; Humans; Male; Tetracycline; Tretinoin; Vitamin A

Topics: Acne Vulgaris; Adolescent; Adult; Chymotrypsin; Clinical Trials as Topic; Double-Blind Method; Drug Combinations; Female; Humans; Male; Random Allocation; Tetracycline; Trypsin

The efficacy of a lotion containing 10 p. 100 ethyl lactate was evaluated in a double-blind clinical trail during 8 weeks. Test subjects were 45 male and female patients with polymorphous juvenile acne. They were divided into three groups and received the following treatments: Group A: oral antibiotic + topical placebo lotion. Group B: oral antibiotic + topical ethyl lactate lotion. Group C: topical ethyl lactate lotion only. The lotions were applied twice daily with a swab of cotton-wool. The antibiotic doses (tetracycline hydrochloride) were decreased as the trial progressed. Patients were examined before the trial, then after 1, 2, 4, 6 and 8 weeks. At each visit, comedones, microcysts, pustules and nodules were counted on a skin surface of 9 cm2. Colour photographs were taken before and at the end of the trial and served for counting inflammatory lesions. Also, at each visit, skin lipids were sampled and analysed by I. R. spectrophotometry in order to asses the effect of the treatments on the free fatty acid/triglyceride ratio. The treatments showed similar effectiveness as regards comedones and microcysts, but only treatments A and B succeeded in reducing the number of inflamed lesions. With respect to the latter, the combined treatment B (oral antibiotic + topical ethyl lactate lotion) was more effective than treatment A (oral antibiotic + topical placebo); both treatments were more effective than treatment C (topical ethyl lactate lotion only). At the end of the trial, all three groups of patients showed significant overall improvement, but acne scores (total number of lesions) did not differ significantly between treatments. When comparing these results with literature data concerning the effects of vitamin A acid and benzoyl peroxide, it appears that ethyl lactate is slightly less effective for topical treatment of acne than vitamin A acid, but slightly more effective than benzoyl peroxide. It should be underlined that ethyl lactate is well tolerated by the skin. Analysis of sebum samples failed to yield evidence of a decrease in the free fatty acid/triglyceride ratio in skin lipids of the patients irrespective of the treatment applied.

Topics: Acne Vulgaris; Administration, Topical; Clinical Trials as Topic; Drug Therapy, Combination; Fatty Acids, Nonesterified; Female; Humans; Lactates; Male; Placebos; Skin; Tetracycline; Triglycerides

Tetracycline was compared to clindamycin as adjunctive therapy in the treatment of moderate to moderately severe acne under double-blind controlled conditions. Both antibiotics were efficacious and differences were not appreciable. Lesion counts of both comedones and pustules were reduced and clinical improvement was noted in the majority of subjects. Side effects were not a problem. The place of clindamycin in the therapeutic armamentarium of the dermatologist is discussed.

Topics: Acne Vulgaris; Adolescent; Clindamycin; Clinical Trials as Topic; Drug Evaluation; Female; Humans; Male; Tetracycline

63 patients suffering from predominantly papulo-pustular acne vulgaris were treated with 5-10% benzoyl peroxidegel over a period of 2-4 months. The skin condition showed marked improvement in 80% of the patients. Two patients developed cutaneous allergy. Benzoyl peroxide is the therapy of choice for the inflammatory form of acne vulgaris. Systemic tetracyclines need not be given concomitantly. Autoradiographic studies revealed that benzoyl peroxide also has a truly sebostatic effect.

Topics: Acne Vulgaris; Adolescent; Adult; Benzoyl Peroxide; Clinical Trials as Topic; Female; Humans; Keratosis; Male; Peroxides; Tetracycline

Topics: Acne Vulgaris; Anti-Bacterial Agents; Clinical Trials as Topic; Humans; Tetracycline; Tetracyclines

Groups of 20 males of high-school age with moderate acne were treated with oral tetracycline (500 mg/day), topical tetracycline (0.5% solution applied twice daily), or placebo for 8 weeks. The two panels treated with tetracycline showed a significant and equivalent reduction in acne severity as assessed by visual grading. The surface lipids in the panel treated with oral tetracycline showed a small but not statistically significant decrease in free fatty acid content, but the subjects receiving topical tetracycline showed no reduction in free fatty acids. Further, neither treatment was associated with a change in mass of surface lipid nor did the mass or weight percent of any component of the surface lipids change with the decrease in acne severity. These results show that acne severity can be reduced with tetracycline (both oral and topical) without any concomitant quantitative change in surface lipids.

Topics: Acne Vulgaris; Administration, Oral; Administration, Topical; Adolescent; Face; Fatty Acids, Nonesterified; Humans; Male; Skin; Tetracycline

Topics: Acne Vulgaris; Chymotrypsin; Clinical Trials as Topic; Drug Combinations; Female; Humans; Male; Tetracycline; Trypsin

A group of 135 college students with acne was evaluated in a 12-week, double-blind study comparing placebo, oral tetracycline 0.5 gm daily, and a new topical tetracycline preparation. The topical tetracycline preparation containing n-decyl methyl sulfoxide to enhance penetration, produced statistically significant improvement of acne as compared to placebo after 7, 10, and 12 weeks of treatment. Oral tetracycline, 0.5 gm daily, was statistically significantly more effective for acne than placebo after 4, 7, 10, and 12 weeks of therapy. The placebo group also had marked improvement which may have been related to sun exposure. Emotional stress produced by final examinations had no apparent effect on the patients given placebo, oral, or topical tetracycline. Side effects of the topical tetracycline included a slight yellowish discoloration of the skin in 25% of the subjects and transient stinging or tingling sensation after application in 36%.

Topics: Acne Vulgaris; Administration, Oral; Administration, Topical; Adolescent; Adult; Clinical Trials as Topic; Female; Humans; Male; Tetracycline

A group of 75 subjects with moderate or severe acne was divided by random selection into three treatment groups. One group was treated with a topically applied placebo liquid and with 500 mg of orally administered tetracycline hydrochloride daily; one group received orally administered lactose capsules and topically applied placebo liquid each day; and one group was treated with orally administered lactose capsules and with a topical preparation containing tetracycline hydrochloride and n-decylmethyl sulfoxide, an agent intended to enhance antibiotic penetration. At the conclusion of the 13-week study and at several points during the study, the conditions of the subjects receiving topically or orally administered tetracycline hydrochloride were significantly (P less than .05) more improved than the conditions of the subjects receiving lactose capsules and the topically applied placebo liquid. However, there was no significant difference between the effects of topically and orally administered tetracycline hydrochloride.

Topics: Acne Vulgaris; Administration, Oral; Administration, Topical; Adolescent; Adult; Child; Clinical Trials as Topic; Dose-Response Relationship, Drug; Female; Humans; Male; Remission, Spontaneous; Tetracycline

A double-blind prospective study was undertaken to compare low-dosage tetracycline hydrochloride and clindamycin hydrate hydrochloride in the treatment of patients with pustular acne. Clinical improvement was noted in 93.7% of those receiving tetracycline and in 92.8% of those receiving clindamycin. Of those patients who were receiving clindamycin, two patients developed diarrhea and one patient developed pseudomembranous colitis. We conclude, therefore, that clindamycin should not be used as a primary drug in the treatment of acne.

Topics: Acne Vulgaris; Adolescent; Adult; Clindamycin; Clinical Trials as Topic; Colonic Diseases, Functional; Drug Administration Schedule; Female; Humans; Male; Prospective Studies; Remission, Spontaneous; Tetracycline

This report presents the results of a 13-week study done on 300 patients with acne vulgaris treated with a tetracycline topical lotion alone. The vehicle used was an aqueous-ethanol solution containing the penetration enhancer, n-decyl methyl sulfoxide. On a 0-8 grading scale, 81% of the patients improved by one or more grade points, 57% by two or more points and 31% by three or more points. Analysis indicated that concomitant variables such as severity, age, type of acne, sex and season of the year did not alter the conclusion as to efficacy. Detailed statistical analysis indicates that the conclusion is valid that the tetracycline preparation is beneficial in the treatment of acne vulgaris. No adverse reactions were observed in the patients treated. Hemograms, blood studies and urinalyses were completed on 37 patients. No disturbing trends were uncovered.

Topics: Acne Vulgaris; Administration, Topical; Adolescent; Adult; Child; Clinical Trials as Topic; Female; Humans; Male; Tetracycline

Topics: Acne Vulgaris; Administration, Topical; Clindamycin; Clinical Trials as Topic; Erythromycin; Humans; Pharmaceutical Vehicles; Tetracycline

A double-blind, random distribution study showed that a lower than recommended dose of minocycline--50 mg twice daily--was as effective as a dose of 250 mg twice daily of tetracycline for treatment of acne vulgaris in comparable patient groups, and that minocycline produced no vestibular side effects at the lower dosage. Like tetracycline, minocycline did not produce the phototoxicity associated with demeclocycline or the life-threatening colitis associated with clindamycin. Patients in this study did not develop a resistance either to minocycline or to tetracycline. Studies of the use of minocycline in patients who have developed tetracycline resistance and long-range studies of patients on the new lower dose of minocycline are now underway.

Topics: Acne Vulgaris; Adolescent; Adult; Candidiasis, Vulvovaginal; Clinical Trials as Topic; Female; Humans; Male; Minocycline; Tetracycline; Tetracyclines; Time Factors

Various tetracyclines and erythromycins have been used rather empirically for the systemic treatment of acne vulgaris for more than a decade. It has been impossible to accurately evaluate clinically the numerous derivatives and to compare their effectiveness with other antibiotics such as clindamycin. As a substitute for this approach, this present study ranks these antibiotics, when given orally, as to their effectivensss in suppressing the fatty acids in sebum in normal volunteers. As a group, the tetracyclines were more effective than the erythromycins in decreasing the fatty acids, but clindamycin was significantly more potent than either.

Topics: Acne Vulgaris; Anti-Bacterial Agents; Chlortetracycline; Clindamycin; Clinical Trials as Topic; Demeclocycline; Erythromycin; Esters; Fatty Acids; Humans; Minocycline; Sebum; Spectrophotometry, Infrared; Tetracycline

Topics: Acne Vulgaris; Adolescent; Adult; Anti-Bacterial Agents; Child; Clindamycin; Clinical Trials as Topic; Demeclocycline; Erythromycin; Fatty Acids, Nonesterified; Female; Humans; Lincomycin; Middle Aged; Placebos; Pregnancy; Propionibacterium acnes; Sulfamethoxazole; Tetracycline; Tetracyclines; Trimethoprim

Topics: Acne Vulgaris; Ampicillin; Anti-Bacterial Agents; Carotenoids; Clindamycin; Clinical Trials as Topic; Demeclocycline; Doxycycline; Drug Evaluation; Drug Therapy, Combination; Erythromycin; Humans; Methods; Tetracycline

Topics: Acne Vulgaris; Administration, Oral; Adult; Clinical Trials as Topic; Delayed-Action Preparations; Female; Follow-Up Studies; Humans; Male; Tetracycline

Topics: Acne Vulgaris; Administration, Oral; Adolescent; Baths; Blood Transfusion, Autologous; Clinical Trials as Topic; Female; Humans; Male; Ointments; Seasons; Tetracycline; Vitamin A

Topics: Acne Vulgaris; Administration, Oral; Adolescent; Adult; Clindamycin; Clinical Trials as Topic; Female; Humans; Male; Tetracycline

Topics: Acne Vulgaris; Administration, Oral; Drug Synergism; Fatty Acids, Nonesterified; Humans; Propionibacterium acnes; Skin; Tetracycline; Time Factors; Vitamin A

Topics: Acne Vulgaris; Administration, Oral; Clinical Trials as Topic; Female; Humans; Male; Methods; Photography; Placebos; Tablets; Tetracycline; Time Factors

Topics: Acne Vulgaris; Amphotericin B; Diagnosis, Differential; Humans; Placebos; Rosacea; Tetracycline

Fifty-one patients with acne vulgaris were included in a double-blind trial to assess the therapeutic effect of 250 mg. tetracycline hydrochloride twice daily for three months. The results, assessed clinically and photographically, showed that tetracycline hydrochloride had a statistically significant beneficial effect. Hence, since it is cheap and rarely has side-effects in healthy young adults, its use is suggested, as well as local therapy, in the more severe forms of acne.

Topics: Acne Vulgaris; Adolescent; Adult; Child; Clinical Trials as Topic; Female; Humans; Male; Photography; Placebos; Statistics as Topic; Tetracycline

Topics: Acetates; Acne Vulgaris; Adolescent; Adult; Aged; Child; Female; Humans; Male; Middle Aged; Placebos; Tetracycline

Topics: Acetates; Acne Vulgaris; Anti-Bacterial Agents; Clinical Trials as Topic; Humans; Italy; Placebos; Rosacea; Tetracycline

Topics: Acne Vulgaris; Adolescent; Adult; Female; Humans; Male; Placebos; Tetracycline

Topics: Acne Vulgaris; Clinical Trials as Topic; Humans; Tetracycline

Topics: Acne Vulgaris; Adolescent; Adult; Clinical Trials as Topic; Female; Humans; Male; Novobiocin; Placebos; Tetracycline

Topics: Acne Vulgaris; Adolescent; Adult; Female; Humans; Male; Sebum; Tetracycline

Topics: Acne Vulgaris; Anti-Bacterial Agents; Ethnicity; Humans; Hyperpigmentation; Minocycline; Retrospective Studies; Tetracycline

Oral tetracyclines (TCNs) are commonly prescribed for acne, but they have been shown to increase the risk of hyperpigmentation, particularly in the setting of sun exposure.. We evaluated seasonal trends in TCN-associated hyperpigmentation incidence in addition to Google search trends for hyperpigmentation-related terms.. We performed a retrospective review of acne patients seen at Massachusetts General Brigham and Women’s Hospital between 1992 and 2022. We calculated the incidence of new hyperpigmentation diagnoses for each drug cohort. We also analyzed search volume of hyperpigmentation-related terms extracted from Google Trends.. Seasonal differences in new hyperpigmentation diagnoses were identified among acne patients prescribed doxycycline (P=0.016), with peak incidence in April. In the control group of patients who had never received a TCN, diagnoses peaked in May. There were no significant seasonal differences among patients prescribed minocycline (P=0.885). There was greater search volume for hyperpigmentation-related terms in spring and summer compared to fall and winter (P<0.001). Limitations of this study include its retrospective nature and reliance on prescription and diagnosis coding data.. Our findings support the seasonal periodicity of acne-related hyperpigmentation, underscoring the importance of photoprotection counseling for patients with acne. Additionally, doxycycline may be associated with an earlier onset of hyperpigmentation, suggesting a potential benefit of considering minocycline or other alternatives to doxycycline. J Drugs Dermatol. 2023;22(11):e9-e11    doi:10.36849/JDD.7409e.

Topics: Acne Vulgaris; Anti-Bacterial Agents; Doxycycline; Female; Humans; Hyperpigmentation; Minocycline; Retrospective Studies; Seasons; Tetracycline

Tetracycline-class drugs have been used for first-line treatment of moderate-to-severe acne and rosacea for decades. Recently, a new third generation tetracycline, sarecycline, was US FDA-approved for the treatment of moderate-to-severe acne. This narrow-spectrum tetracycline-derived antibiotic has been shown to be effective with an improved safety profile.

Topics: Acne Vulgaris; Anti-Bacterial Agents; Humans; Protein Synthesis Inhibitors; Tetracycline; Tetracyclines

Topics: Acne Vulgaris; Anti-Bacterial Agents; Dermatologists; Drug Therapy, Combination; Humans; Mineralocorticoid Receptor Antagonists; Physicians; Practice Patterns, Physicians'; Retrospective Studies; Spironolactone; Tetracycline

Intermittent inflammation of the vulval pilosebaceous units is common and usually self-limiting, but some patients experience recurrent and more troublesome symptoms. There is a scarcity of information on this problem. We describe the clinical and histological features in these patients and the response to treatment. A retrospective, observational study of 16 patients with this phenomenon of recurrent, protracted folliculocentric inflammation of the vulval pilosebaceous unit was performed. Details on the clinical features, histology and response to treatment were collected. Mean age at presentation was 32 years (range 21-45). All patients reported recurrent painful papules and pustules on the labia majora and labia minora. Nine patients reported a cyclical pattern to the development of lesions, with premenstrual exacerbation being most common. Histological examination of these lesions showed a folliculocentric microabscess formation surrounded by an acute and chronic inflammatory cell infiltrate, with a focal foreign-body granulomatous reaction. All our patients responded well to tetracycline, antiandrogenic or retinoid therapy. We propose the term 'vulval acne' for this condition and propose a stepwise approach to its management. We hope to highlight this as a common but underreported entity.

Topics: Acne Vulgaris; Adult; Angiogenesis Inhibitors; Biopsy; Disease Progression; Drug Therapy, Combination; Female; Humans; Inflammation; Middle Aged; Protein Synthesis Inhibitors; Recurrence; Retinoids; Retrospective Studies; Tetracycline; Treatment Outcome; Vulvar Diseases

The prevalence of antimicrobial-resistant Cutibacterium acnes is an important concern for the antimicrobial treatment of acne vulgaris. We hypothesized that antimicrobial treatment regimens for acne vulgaris would change following the revisions in the Japanese acne treatment guidelines, which added a statement regarding appropriate antimicrobial usage. Here, we studied the changes in antimicrobial use and antimicrobial-resistant C. acnes isolated from acne patients. A total of 127 C. acnes isolates collected from 212 patients with acne between 2013 and 2018 were used. Roxithromycin and clindamycin resistance rates were approximately 50% and 40%, respectively. In contrast, the prevalence of low doxycycline-susceptible strains (minimum inhibitory concentration [MIC] ≥8 μg/mL) in 2018 (17.4%) was 5.6-fold higher than that in 2013 (3.1%). Although the number of patients with severe and moderate acne did not change, the number of patients with a history of oral tetracycline use increased. The incidence of low doxycycline-susceptible strains was high in patients with a history of oral tetracycline use. The prevalence of strains with a 16S rRNA mutation, which confers reduced susceptibility to tetracyclines, increased by 8.6-fold (12.1%) from 2016 to 2018 in comparison with the previously revised guidelines (1.4%). Furthermore, the prevalence of low susceptibility strains with two resistance factors, 16S rRNA mutation and ribosomal S10 protein substitution, also increased. Approximately 10% of strains had the exogenous resistance gene, tet(W) (2013 to 2015, 10.1%; 2016 to 2018, 8.6%), and these strains showed different susceptibility to doxycycline dependent on the expression of tet(W) (MIC range 0.5-8 μg/mL). Our data show that the antimicrobial resistance pattern in C. acnes changes according to the trend of antimicrobial usage for acne treatment. Therefore, we should pay heed to the rapid dissemination of tetracycline resistance in C. acnes owing to acquisition of 16S rRNA mutation and tet(W).

Topics: Acne Vulgaris; Anti-Bacterial Agents; Doxycycline; Humans; Japan; Microbial Sensitivity Tests; Prevalence; Propionibacterium acnes; R Factors; RNA, Ribosomal, 16S; Tetracycline; Tetracycline Resistance

Hidradenitis suppurativa (HS) rarely affects pediatric patients. The literature on pediatric HS patients is scarce. This is a cross-sectional study based on case note review or interviews and clinical examination of 140 pediatric patients undergoing secondary or tertiary level care. Patients were predominantly female (75.5%, n = 105) with a median age of 16. 39% reported 1st-degree relative with HS. Median BMI percentile was 88, and 11% were smokers (n = 15). Median modified Sartorius score was 8.5. Notable comorbidities found were acne (32.8%, n = 45), hirsutism (19.3%, n = 27), and pilonidal cysts (16.4%, n = 23). Resorcinol (n = 27) and clindamycin (n = 25) were the most frequently used topical treatments. Patients were treated with tetracycline (n = 32), or oral clindamycin and rifampicin in combination (n = 29). Surgical excision was performed in 18 patients, deroofing in five and incision in seven patients. Obesity seemed to be prominent in the pediatric population and correlated to parent BMI, suggesting a potential for preventive measures for the family. Disease management appeared to be similar to that of adult HS, bearing in mind that the younger the patient, the milder the disease in majority of cases.

Topics: Acne Vulgaris; Administration, Cutaneous; Administration, Oral; Adolescent; Anti-Bacterial Agents; Body Mass Index; Child; Clindamycin; Comorbidity; Cross-Sectional Studies; Dermatologic Surgical Procedures; Drug Therapy, Combination; Female; Hidradenitis Suppurativa; Hirsutism; Humans; Male; Obesity; Pilonidal Sinus; Resorcinols; Rifampin; Risk Factors; Severity of Illness Index; Smoking; Tetracycline; Treatment Outcome; Young Adult

Acne vulgaris is one of the most common chronic diseases worldwide with the high prevalence ratio of about 80-85% in patients who are in puberty period. For the treatment options, many conventional dosage forms are available; however, existing limitations of systemic administration of drugs (oral antibiotics), such as adverse events and resistance, led for seek of new formulation options. In this study, liposomes containing tetracycline HCl and tretinoin were prepared by the film formation method.

Topics: Acne Vulgaris; Animals; Anti-Bacterial Agents; Biofilms; Cells, Cultured; Drug Combinations; Drug Compounding; Hydrogels; Liposomes; Mice; Microbial Sensitivity Tests; Molecular Structure; Particle Size; Staphylococcus; Tetracycline; Tretinoin

Cutibacterium acnes (or Propionibacterium acnes) is the main target for the prevention and medical treatment of acne vulgaris. The aim of this study was to evaluate the in vitro anti-C. acnes and anti-S. epidermidis properties of some marine fungi isolated from different Indian marine environments. Seventy fungal isolates were obtained from samples collected from the west coasts and Andaman Island, India. Methanol extracts of 35 isolates were screened for their antibacterial properties and 5 out of the 35 isolates displayed significant inhibition as compared with tetracycline. DNA was successfully extracted from these five fungal isolates and phylogenetic analysis was performed. The methanol extracts possessed antibacterial activity against C. acnes and S. epidermidis with MIC values ranged from 0.8 mg/mL to 1 mg/mL. SEM analysis revealed that the extract induces deleterious morphological changes in the bacterial cell membrane. This study has identified some fungi extracts with significant antibacterial activity. The extracts may have potential for development as an antibacterial agent in the treatment of acne vulgaris.

Topics: Acne Vulgaris; Anti-Bacterial Agents; Drug Evaluation, Preclinical; Fungi; Humans; Microbial Sensitivity Tests; Phylogeny; Propionibacterium acnes; Seawater; Staphylococcus epidermidis; Tetracycline

A 14-year-old girl presented with a history of left-sided headache and acute bilateral blurred vision. She had a remote history of oral tetracycline use for the treatment of acne vulgaris, which had been discontinued for 1 month. The patient was diagnosed with drug-induced intracranial hypertension (IH) and treated with oral acetazolamide with subsequent resolution of symptoms. IH, a known rare complication of the tetracycline class of antibiotics, can also have a delayed presentation after discontinuation of the medication.

Topics: Acetazolamide; Acne Vulgaris; Adolescent; Anti-Bacterial Agents; Carbonic Anhydrase Inhibitors; Female; Humans; Intracranial Hypertension; Tetracycline; Vision Disorders; Visual Acuity; Visual Field Tests; Visual Fields; Withholding Treatment

Acne affects a large proportion of the Canadian population and has psychosocial and financial consequences.. We provide cost information for treatments recommended by the Canadian acne guidelines.. Highest level recommendations were selected for 3-month usage cost.. Three-month estimated treatment costs were as follows: topical retinoids ($14.40-$73.80), benzoyl peroxide (BPO; $6.75), fixed-dose BPO-clindamycin ($40.95-$44.10) and BPO-adapalene ($73.80), oral antibiotics ($25.20 for tetracycline 250 mg qid; $52.20 and $52.74 for doxycycline 50 mg bid and 100 mg od, respectively), and hormonal therapy ($26.46-$37.80 for ethinyl estradiol [EE] 0.030 mg/drospirenone 3mg and $75.60-108.99 for EE 0.035 mg/cyproterone acetate 2 mg). Oral isotretinoin 3-month costs ranged from $393.96 to $478.80.. Awareness of costs of recommended treatments may facilitate improved outcomes by increasing procurement and adherence.

Topics: Acne Vulgaris; Adapalene; Administration, Cutaneous; Administration, Oral; Androgen Antagonists; Androstenes; Anti-Bacterial Agents; Benzoyl Peroxide; Canada; Clindamycin; Cyproterone Acetate; Dermatologic Agents; Doxycycline; Drug Combinations; Estrogens; Ethinyl Estradiol; Humans; Isotretinoin; Mineralocorticoid Receptor Antagonists; Minocycline; Practice Guidelines as Topic; Severity of Illness Index; Tetracycline

Acne vulgaris is a chronic inflammatory disease involving the pilosebaceous unit of the skin. Isotretinoin is a systemic retinoid that is often used as an effective treatment option for severe and treatment-resistant acne. Isotretinoin may also cause rheumatologic symptoms. The aim of this prospective observational study was to present followup results regarding the rheumatologic symptoms of patients who received systemic therapy for the treatment of acne (isotretinoin and tetracycline).. For inclusion in the study, all consecutive patients with acne who were aged > 18 years were evaluated by the same dermatologist. The first 42 consecutive patients were included in the isotretinoin group, and after matching for age and sex, 32 consecutive patients were included in the tetracycline group. Isotretinoin treatment was planned as an average dose of 30 mg daily and a total dose of 120-150 mg/kg for 4-6 months. The patients were administered a dose of 1 g/day of tetracycline as 2 equal doses for 3 months.. Forty-two patients diagnosed with acne vulgaris were treated with isotretinoin 20.6 ± 4.4 (male/female: 17/22), and 32 patients were treated with tetracycline 20.6 ± 2.7 (male/female: 8/24). There was no significant difference between the 2 groups with respect to age and sex. Unilateral Achilles enthesopathy developed in 3 patients, whereas both Achilles enthesopathy and unilateral sacroiliitis developed in 1 patient. Inflammatory back pain developed in 6 patients in the isotretinoin group.. To our knowledge, this was the first prospective observational study that assessed the rheumatologic symptoms of isotretinoin treatment. The spondyloarthropathy findings were identified in 23.1% of the patients who used isotretinoin.

Topics: Acne Vulgaris; Adolescent; Age Distribution; Cohort Studies; Dose-Response Relationship, Drug; Drug Administration Schedule; Female; Follow-Up Studies; Humans; Incidence; Isotretinoin; Male; Prospective Studies; Risk Assessment; Severity of Illness Index; Sex Distribution; Spondylarthropathies; Tetracycline; Young Adult

The aim of this study was to evaluate changes in nasal and oropharyngeal flora in patients with acne during treatments with tetracycline and isotretinoin. Swab specimens were taken from the right and left nasal cavities and oropharynx of 55 patients with acne and 20 healthy volunteers who were admitted to the dermatology department (Etlik Educational and Research Hospital, Ankara, Turkey) before the administration of treatment and in the third month of treatment. Study participants were divided into four groups as follows: patients with acne on topical treatment only, systemic isotretinoin, and systemic tetracycline, and the control group. Of 55 patients with acne, 18 were male and 37 were female. The mean age of the patients and the control group was 22.21 ± 4.22 and 21.95 ± 7.64, respectively. Staphylococcus aureus was isolated from the nasal flora of five patients, normal flora was suppressed in the oropharyngeal cultures of seven patients, and normal flora grew in the cultures of the other 20 patients who were on tetracycline treatment. On the other hand, normal flora grew in the nasal and oropharyngeal cultures of all the patients who were on isotretinoin treatment. Treatment options and follow-up procedures for acne vulgaris may lead to the development of bacterial resistance and damage to flora. In particular, systemic tetracycline treatment leads to changes in flora of the nose and throat in patients with acne with an increased carriage of S. aureus. Therefore, careful attention should be paid to the duration of tetracycline treatment in order to not increase the risk of disturbance of microbial flora.

Topics: Acne Vulgaris; Adolescent; Adult; Anti-Bacterial Agents; Dermatologic Agents; Female; Humans; Isotretinoin; Male; Microbiota; Nasal Cavity; Oropharynx; Severity of Illness Index; Staphylococcus aureus; Tetracycline; Young Adult

  Propionibacterium acnes is an important target in acne management. Antibiotic resistance has increased, reducing its clinical efficiency..   To study the prevalence, antimicrobial susceptibility patterns, and resistance mechanisms of P. acnes isolated from patients with acne..   Skin swabs were collected from 83 patients. Agar dilution determined the minimum inhibitory concentrations of five antibiotics. Polymerase chain reaction and DNA sequencing were used to identify mutations. Results  P. acnes was isolated in 80 of 83 patients (96%), and 27 patients had resistance to antibiotics (33.7%). The mean age was older in the antibiotic-resistant group (20.8 ± 5.8 vs. 18.3 ± 3.7, P = 0.02). Resistance to trimethoprim-sulfamethoxazole was 26.3%, erythromycin 12.5%, and clindamycin 7.5%. All clindamycin-resistant strains had cross-resistance to erythromycin, and 40% erythromycin-resistant strains had cross-resistance to trimethoprim-sulfamethoxazole. All strains were sensitive to tetracycline and doxycycline. The use of topical erythromycin or clindamycin was a risk factor to carry resistant strains (P = 0.02, P = 0.04, respectively). Resistance to trimethoprim-sulfamethoxazole was associated with acne severity (P = 0.02). Six of the 10 erythromycin-resistant strains had a mutation in the peptidyl transferase region of the 23S rRNA gene: one A2058G and five A2059G. No strain carrying mutation G2057A was found..   Resistance to trimethoprim-sulfamethoxazole was the most common pattern found, and further studies are required to clarify its resistance mechanism. A certain tetracycline resistance was expected, but interestingly all strains remained sensitive. Resistance to erythromycin and clindamycin were influenced using topical formulations. Mutation A2059G was related to high resistance to erythromycin. Antibiotic resistance is increasing, and new strategies are needed.

Topics: Acne Vulgaris; Adolescent; Adult; Age Factors; Analysis of Variance; Anti-Bacterial Agents; Clindamycin; Doxycycline; Drug Resistance, Multiple, Bacterial; Erythromycin; Female; Humans; Male; Microbial Sensitivity Tests; Mutation; Propionibacterium acnes; RNA, Ribosomal, 23S; Severity of Illness Index; Tetracycline; Trimethoprim, Sulfamethoxazole Drug Combination; Young Adult

Acne pathogenesis has recently been linked to decreased nuclear FoxO1 levels and increased mTORC1 activity. This hypothesis postulates that antiacne agents either enhance nuclear FoxO activity or inhibit mTORC1. Benzoyl peroxide (BPO), by activation of oxidative stress-inducible kinases, increases nuclear FoxO levels promoting Sestrin3-mediated AMPK activation. Furthermore, BPO-derived ROS may activate AMPK via ataxia-telangiectasia mutated. Isotretinoin and all-trans retinoic acid may stimulate FoxO gene expression. Doxycycline may enhance FoxOs nuclear retention by inhibiting the expression of exportin 1. Suppression of TNFα signalling by tetracyclines, erythromycin and other macrolides may attenuate IKKβ-TSC1-mediated mTORC1 activation. Erythromycin attenuates ERK1/2 activity and thereby increases TSC2. Azelaic acid may decrease mTORC1 by inhibiting mitochondrial respiration, increasing cellular ROS and nuclear FoxO levels. Antiandrogens may attenuate mTORC1 by suppressing mTORC2-mediated Akt/TSC2 signalling. This hypothesis unmasks a common mode of action of antiacne agents as either FoxO enhancers or mTORC1 inhibitors and thus provides a rational approach for the development of new antiacne agents.

Topics: Acne Vulgaris; AMP-Activated Protein Kinases; Benzoyl Peroxide; Dermatologic Agents; Dicarboxylic Acids; Enzyme Activation; Erythromycin; Forkhead Box Protein O1; Forkhead Transcription Factors; Humans; Isotretinoin; Mechanistic Target of Rapamycin Complex 1; Multiprotein Complexes; Oxidative Stress; Tetracycline; TOR Serine-Threonine Kinases; Up-Regulation

Topics: Acne Vulgaris; Adult; Anti-Bacterial Agents; Female; Humans; Lupus Erythematosus, Systemic; Tetracycline

The aim of this study was to develop lipid nanocarriers that combine tretinoin and tetracycline for the efficient topical delivery to treat acne vulgaris. Two different nanocarriers, nanoemulsions (NEs) and nanostructured lipid carriers (NLCs), were prepared, and we examined their average size, zeta potential, drug encapsulation percentage, and drug permeation via the skin. The antibacterial activities of the nanosystems against Staphylococcus aureus, Pseudomonas aeruginosa, and Propionibacterium acnes were evaluated by an agar diffusion assay and the amount of total protein. A ca. 200-nm particle size was achieved with the prepared nanoparticles. The size increased when incorporating a cationic surfactant. Dual-drug loading did not largely affect the size of negatively charged nanoparticles, but significantly reduced the particle size of positively charged nanocarriers. NEs and NLCs exhibited high entrapment of tretinoin which ranged 60-100%. Tetracycline mainly resided in the aqueous phase, with ca. 10% of molecules located at the particulate interface. An in vitro skin permeation study showed that NLCs enhanced tetracycline flux by about 2-times over the control solution. Tretinoin permeation was generally unaffected after nanoparticulate encapsulation. There was no significant difference in tretinoin delivery before or after tetracycline incorporation, while tetracycline permeation significantly decreased by 2-fold in the dual-drug system. Nanoparticulate loading mostly maintained the antibacterial activity of tetracycline. Negatively charged NEs and NLCs even strengthened the antibacterial ability against S. aureus compared to the control solution. This is the first report examining skin permeation and antibacterial activities of dual-drug nanocarriers for acne treatment.

Topics: Acne Vulgaris; Administration, Topical; Animals; Anti-Bacterial Agents; Drug Carriers; Emulsions; Female; Keratolytic Agents; Lipids; Mice; Mice, Inbred BALB C; Mice, Nude; Nanoparticles; Propionibacterium acnes; Pseudomonas aeruginosa; Skin; Skin Absorption; Staphylococcus aureus; Tetracycline; Tretinoin

An analytical method for the simultaneous determination of 6 antibiotics (minocycline, oxytetracycline, tetracycline hydrochloride, chlorotetracycline hydrochloride, doxycycline hydrochloride and chloramphenicol) and metronidazole in acne removal products of cosmetic was established using high performance liquid chromatography (HPLC). The drugs in the sample were extracted with methanol. The separation was performed on an Agilent ZORBAX SB-C18 column (250 mm x 4.6 mm, 5 microm) at 20 degrees C with methanol, acetonitrile and 0.002 mol/L oxalic acid solution as mobile phases with gradient elution at a flow rate of 0.8 mL/min. The detection was performed by a diode array detector (DAD) at 268 nm. The injection volume was 10 microL. The quantification was performed by external standard method. The calibration curves showed good linearity within the range of 1 - 30 mg/L with the correlation coefficients no less than 0.997 0. The detection limits were in the range of 1.1 - 1.2 microg/g. The recoveries were between 91.9% and 107.7% in three spiked levels of 5, 10 and 20 mg/L with the relative standard deviations (RSDs) of 0.13% - 1.74%. The method was used in the analysis of acne removal products, and metronidazole was found in 15% of the total test samples. The method is rapid, sensitive, accurate, effective in separation, and can be used in the determination of the six antibiotics and metronidazole in acne removal products.

Topics: Acne Vulgaris; Anti-Bacterial Agents; Anti-Infective Agents; Chromatography, High Pressure Liquid; Cosmetics; Humans; Metronidazole; Minocycline; Oxytetracycline; Tetracycline

Propionibacterium acnes plays an important role in the development of acne, and inflammatory lesions are improved by antibiotics. Long-term use of antibiotics may result in development of resistant strains and treatment failure. The aim of the present study was to investigate the isolation rate of P. acnes and to evaluate its antibiotic susceptibility to widely used antibiotics in acne in Korea. Among 46 patients, 31 P. acnes strains were cultured. Isolated P. acnes was measured for minimum inhibitory concentration (MIC) of tetracycline, doxycycline, minocycline, erythromycin and clindamycin using an Epsilometer test. Age, disease duration and previous history of antibiotic therapy for acne were compared in relation to the MIC. The mean MIC of tetracycline, minocyclines, doxycycline, clindamycin and erythromycin were all below the breakpoint of antibiotic resistance. The patients with acne vulgaris with disease duration of more than 2 years documented higher MIC values in doxycycline, erythromycin, and clindamycin than those of less than 2 years. The patients who were previously treated with topical or systemic antibiotics showed higher MIC in doxycycline. Antibiotic resistance of P. acnes is still low in Korea, but at this point, there is an increasing trend of MIC. Caution and acknowledgement of increased risk of antibiotic resistant P. acnes should be advised in acne antibiotic treatment to minimize and avoid the emergence of the resistant strain.

Topics: Acne Vulgaris; Adolescent; Adult; Anti-Bacterial Agents; Child; Clindamycin; Doxycycline; Drug Resistance, Microbial; Erythromycin; Female; Gram-Positive Bacterial Infections; Humans; In Vitro Techniques; Male; Microbial Sensitivity Tests; Minocycline; Propionibacterium acnes; Republic of Korea; Tetracycline; Young Adult

Topics: Acne Vulgaris; Anti-Bacterial Agents; Dermatologic Agents; Humans; Inflammatory Bowel Diseases; Isotretinoin; Tetracycline

The percentage of strains of Propionibacterium acnes resistant to antibiotics in acne is increasing in many countries, raising the question of the risks associated with bacterial resistance. Numerous series of cases have been published on European populations of acne patients, but at the moment we still have very few data regarding France.. The aim of this study was to evaluate the prevalence of P. acnes resistant strains to erythromycin, tetracycline, and doxycycline in a population of French acne patients.. Specimens were collected from 273 patients in 43 centers located throughout France (12 hospitals and 31 private office practices).. 75.1% of the patients were carriers of P. acnes strains resistant to erythromycin and 9.5% to tetracycline. One hundred percent of strains resistant to tetracycline were also resistant to doxycycline. There was no significant difference among the regions and between patients followed in hospital or private office.. It clearly appears that the percentage of patients with P. acnes strains resistant to erythromycin is similar to that in other countries, but lower for tetracycline or doxycycline in comparison to other European countries.

Topics: Acne Vulgaris; Adolescent; Adult; Anti-Bacterial Agents; Child; Doxycycline; Drug Resistance, Bacterial; Erythromycin; Female; France; Gram-Positive Bacterial Infections; Humans; Male; Middle Aged; Prevalence; Propionibacterium acnes; Tetracycline; Young Adult

Previous studies have shown an association between isotretinoin and inflammatory bowel disease (IBD). The majority of patients prescribed isotretinoin for their acne are previously on an extended course of antibiotics. Therefore, it is important to consider antibiotic use as a confounding variable for the development of IBD.. We performed a retrospective cohort study using The Health Improvement Network database of the United Kingdom. We identified 94,487 individuals with acne who were followed up by a general practitioner for 406,294 person-years.. >A prescription for minocycline was received by 24,085 individuals, for tetracycline/oxytetracycline by 38,603 individuals, and doxycycline by 15,032 individuals. IBD was noted in 41 individuals exposed to minocycline, 79 individuals exposed to tetracycline/oxytetracycline, 32 individuals exposed to doxycycline, and 55 (0.11%) individuals not exposed to any of these antibiotics. The hazard ratio (HR) for developing IBD for any exposure to a tetracycline antibiotic was 1.39 (1.02, 1.90). HRs for individual antibiotics were 1.19 (0.79, 1.79) for minocycline, 1.43 (1.02, 2.02) for tetracycline/oxytetracycline, and 1.63 (1.05, 2.52) for doxycycline. For ulcerative colitis, the associations (HR) were 1.10 (0.76, 1.82) for minocycline, 1.27 (0.78, 2.07) for tetracycline/oxytetracycline, and 1.06 (0.53, 2.13) for doxycycline. For Crohn's disease (CD), the associations (HR) were 1.28 (0.72, 2.30) for minocycline, 1.61 (0.995, 2.63) for tetracycline/oxytetracycline, and 2.25 (1.27 4.00) for doxycycline.. Tetracycline class antibiotics, and particularly doxycycline use may be associated with the development of IBD, particularly CD. Potential confounding by previous doxycycline exposure should be considered when assessing whether treatment with other acne medications increases the risk of IBD.

Topics: Acne Vulgaris; Chi-Square Distribution; Confounding Factors, Epidemiologic; Dermatologic Agents; Doxycycline; Drug Interactions; Female; Humans; Inflammatory Bowel Diseases; Isotretinoin; Male; Minocycline; Oxytetracycline; Proportional Hazards Models; Retrospective Studies; Risk Factors; Statistics, Nonparametric; Tetracycline; United Kingdom; Young Adult

Topics: Acne Vulgaris; Administration, Oral; Administration, Topical; Adolescent; Benzoyl Peroxide; Contraceptives, Oral, Hormonal; Dermatologic Agents; Diagnosis, Differential; Facial Dermatoses; Female; Humans; Isotretinoin; Referral and Consultation; Retinoids; Tetracycline

In a recent study, prostatectomy specimens from which Propionibacterium acnes was cultured were more likely to have inflammation than culture-negative specimens or specimens positive for other bacteria, leading the authors to hypothesize that P. acnes-mediated inflammation may contribute to prostate carcinogenesis. To indirectly explore associations between P. acnes and prostate cancer, we investigated severe acne, as measured by tetracycline use for 4 or more years, in relation to incident prostate cancer in the Health Professionals Follow-up Study. On the 1992 follow-up questionnaire, participants were asked whether they had ever used "tetracycline for at least 2 months at a time (e.g., for acne or other reason)" and their duration of use. Prostate cancer diagnoses were ascertained on each subsequent biennial questionnaire and confirmed by medical record review. Between 1992 and 2002, 2,147 cases of prostate cancer were reported among 34,629 eligible participants. Men who used tetracycline for 4 or more years had a significantly higher risk of prostate cancer (16 cases, 1,569 person-years) than men who did not use tetracycline (2,071 cases, 304,822 person-years, multivariable-adjusted RR = 1.70, 95% CI: 1.03-2.80). Although intriguing, this finding should be viewed cautiously because of the small number of exposed cases, indirect assessment of severe acne, and complex etiology of acne, which is not limited to P. acnes infection. Therefore, additional biologic and epidemiologic studies are necessary to determine and elucidate the possible role of P. acnes infection in prostate carcinogenesis.

Topics: Acne Vulgaris; Adult; Aged; Anti-Bacterial Agents; Gram-Positive Bacterial Infections; Health Personnel; Humans; Inflammation; Male; Middle Aged; Odds Ratio; Propionibacterium acnes; Prospective Studies; Prostatic Hyperplasia; Prostatic Neoplasms; Risk Assessment; Risk Factors; Surveys and Questionnaires; Tetracycline; Time Factors; United States

About two million people per year in the U.S. have acne severe enough to require treatment with antibiotics. Treatment frequently lasts for more than six months, prompting concerns about antibiotic resistance and other possible consequences of long-term antibiotic use, such as increased susceptibility to infections. This Issue Brief summarizes a large study that evaluates the risk for upper respiratory and urinary tract infections among adolescents and young adults treated with antibiotics for acne.

Topics: Acne Vulgaris; Adolescent; Adult; Anti-Bacterial Agents; Clindamycin; Erythromycin; Female; Humans; Male; Respiratory Tract Infections; Tetracycline; Tetracycline Resistance; Time

Topics: Acne Vulgaris; Adult; Anti-Bacterial Agents; Doxycycline; Drug Eruptions; Drug Therapy, Combination; Female; Humans; Hyperpigmentation; Tetracycline

Topics: Acne Vulgaris; Anti-Bacterial Agents; Clindamycin; Colony Count, Microbial; Doxycycline; Drug Resistance, Bacterial; Erythromycin; Forehead; Humans; Microbial Sensitivity Tests; Nose; Propionibacterium acnes; Skin; Tetracycline; Turkey

Topics: Acne Vulgaris; Adolescent; Anti-Bacterial Agents; Diagnosis, Differential; Female; Humans; Leg; Self Mutilation; Skin; Tetracycline

Topics: Acne Vulgaris; Adolescent; Anti-Bacterial Agents; Drug Hypersensitivity; Fever; Humans; Male; Tetracycline

Topics: Acne Vulgaris; Adolescent; Doxycycline; Esophagitis; Esophagoscopy; Female; Humans; Male; Tetracycline

Propionibacterium acnes (P. acnes), an anaerobic pathogen, plays an important role in the pathogenesis of acne and seems to initiate the inflammatory process by producing neutrophil chemotactic factors (NCF). Once neutrophils attracted by bacterial chemoattractants reach the inflamed site, they release inflammatory mediators such as lysosomal enzymes and reactive oxygen species (ROS). Previously, it has been shown that antibiotics may affect acne by means other than their anti-bacterial effects. Thus, we investigated the effect of subminimal inhibitory concentration (sub-MIC) of tetracycline and erythromycin on production of NCF and ROS. NCF was tested in vivo in a mouse model and ROS was estimated on human PMNL in vitro, by nitroblue tetrazolium dye reduction test (NBT) and cytochrome-C reduction test. Tetracycline (CS-T) and Erythromycin (CS-E) treated cultures showed a significant reduction of 35.8% and 58.3% in NCF production respectively, as compared to P. acnes stimulated cultures. Tetracycline and erythromycin at their sub-MIC also significantly inhibited release of ROS from human PMNL. Thus, tetracycline and erythromycin, besides having antibacterial activity, also have an anti-inflammatory action. These antibiotics reduce the capacity of P. acnes to produce NCF, as well decrease its ability to induce ROS from PMNL.

Topics: Acne Vulgaris; Anti-Inflammatory Agents; Chemotactic Factors; Cytochrome c Group; Dose-Response Relationship, Drug; Drug Therapy, Combination; Erythromycin; Humans; Inflammation; Neutrophils; Oxidation-Reduction; Propionibacterium acnes; Reactive Oxygen Species; Superoxides; Tetracycline; Time Factors

Topics: Abnormalities, Drug-Induced; Acne Vulgaris; Contraceptives, Oral, Hormonal; Drug Interactions; Female; Humans; Pregnancy; Tetracycline

We report on a young adolescent with benign intracranial hypertension which we attribute to the use of minocycline for acne.

Topics: Acne Vulgaris; Adolescent; Anti-Bacterial Agents; Female; Humans; Intracranial Hypertension; Tetracycline

This case report describes infection in a lumbar disc in a healthy young man with an organism of low pathogenicity. The patient was taking a prolonged course of antibiotics at the time the infection occurred.. To describe this unique case of infective spondylodiscitis.. To the authors' knowledge, spinal infection with Enterobacter agglomeranshas never been reported. This organism is a transient gut colonizer, and may have established itself secondary to the patient's prolonged ingestion of tetracycline for acne.. This 22-year-old farmer had spontaneous lumbar back pain. Radiologic investigations showed an abnormality in the L4-L5 disc region, and together with other investigations, were suggestive of infection. The diagnosis was confirmed by surgical aspiration.. Antibiotic therapy was administered, and the patient made a complete recovery. Follow-up radiographs showed a complete loss of the L4-L5 disc space with only minimal bone destruction.. A unique cause of infective lumbar discitis is presented. Several features of this case are unusual. The magnetic resonance findings were not readily diagnostic. The cultured organism is usually nonpathogenic. The infection may have been secondary to prolonged tetracycline therapy.

Topics: Acne Vulgaris; Adult; Anti-Bacterial Agents; Discitis; Enterobacter; Enterobacteriaceae Infections; Humans; Low Back Pain; Lumbar Vertebrae; Magnetic Resonance Imaging; Male; Radiography; Tetracycline; Tetracycline Resistance

Topics: Acne Vulgaris; Acute Disease; Adolescent; Drug Therapy, Combination; Humans; Isotretinoin; Male; Prednisone; Roxithromycin; Tetracycline

Tetracyclines have long been recognized as a cause of pseudotumor cerebri in adults, but the role of tetracyclines in the pediatric age group has not been well characterized in the literature and there have been few reported cases. We present 6 cases to better delineate the problem, the patient profile, the response to treatment, and the sequelae.. We retrospectively analyzed the records of all patients admitted with a diagnosis of pseudotumor cerebri who had documented usage of a tetracycline-class drug immediately before presentation at the Hospital For Sick Children in Toronto, Canada, from January 1, 1986, to March 1, 1996.. Six patients (5 female, 1 male) who met all inclusion and exclusion criteria were identified; their ages ranged from 12 to 17 years. All were being treated for acne vulgaris. Duration of use before diagnosis was as short as 2 weeks and as long as 10 months, with a mean of 4.4 months. Duration of symptoms ranged from 0.57 to 4 weeks. Symptoms included headache (6 of 6), nausea (5 of 6), and diplopia (4 of 6). All for whom height and weight data were known (5 of 6) were in the upper quartile for body mass index. Visual acuity was 6/6 in all but 1 eye of one patient (6/9) at diagnosis, and final visual acuity was 6/6 in all patients. All had normal color vision, where this was recorded (5 of 6). The only recorded field defect was enlargement of the blind spot (4 of 6). All patients responded to treatment, with loss of symptoms in 1 day to 4 weeks.. Pseudotumor cerebri as a result of tetracycline-class drugs does occur in the pediatric population. With prompt and appropriate medical treatment, long-term sequelae can almost always be avoided. Physicians who treat patients with tetracyclines need to be aware of the potential complications in children.

Topics: Acetazolamide; Acne Vulgaris; Adolescent; Anti-Bacterial Agents; Child; Dexamethasone; Diuretics; Drug Therapy, Combination; Female; Follow-Up Studies; Glucocorticoids; Humans; Magnetic Resonance Imaging; Male; Pseudotumor Cerebri; Retrospective Studies; Tetracycline; Tomography, X-Ray Computed; Visual Acuity

Follicular mucinosis can be a primary idiopathic disease or a secondary disease associated with lymphoma. When it appears in childhood or adolescence, it is usually primary and self-limited. We describe four cases of follicular mucinosis occurring in early adulthood that have had protracted courses. Each presented as an unusual acneiform eruption. Two of the cases demonstrated a clonal genetic rearrangement of the T-cell receptor within the cutaneous lymphoid infiltrate, a finding not previously reported. Although its significance is not clear, the clonal lymphocytic expansion indicates a need for continued surveillance of these patients.

Topics: Acne Vulgaris; Administration, Topical; Adult; Anti-Bacterial Agents; Anti-Inflammatory Agents; Clobetasol; Clone Cells; Diagnosis, Differential; Female; Follow-Up Studies; Gene Rearrangement, T-Lymphocyte; Glucocorticoids; Humans; Isotretinoin; Keratolytic Agents; Lymphocytes; Male; Minocycline; Mucinosis, Follicular; Receptors, Antigen, T-Cell; Tetracycline; Tretinoin

A rising percentage of tetracycline-resistant Propionibacterium acnes strains has been reported in the English literature.. We studied a population of 16 patients with acne who had been treated with oral tetracyclines during the preceding year. A bacteriological examination of a skin biopsy was obtained in all patients to determine aerobic and anaerobic flora as wells as resistance to tetracycline and minocycline.. Staphylococcus epidermidis strains were frequently resistant to tetracycline (87.5%) as well as minocycline (30%). Tetracycline-resistant Propionibacterium acnes were also observed (7%). Inversely, we were unable to evidence any minocycline-resistant Propionibacterium acnes strains.. These findings emphasize the importance of determining whether therapeutic response is related or not to the presence of resistant strains.

Topics: Acne Vulgaris; Administration, Oral; Adolescent; Adult; Anti-Bacterial Agents; Colony Count, Microbial; Female; Humans; Male; Minocycline; Prevalence; Propionibacterium acnes; Staphylococcus epidermidis; Tetracycline; Tetracycline Resistance

Topics: Acne Vulgaris; Anti-Bacterial Agents; Humans; Minocycline; Tetracycline

Topics: Acne Vulgaris; Anti-Bacterial Agents; Humans; Minocycline; Oxytetracycline; Tetracycline

A retrospective analysis of the bacterial flora of acne lesions was carried out in 320 patients. Atypical flora was isolated very rarely. The pathogenic flora was found most frequently in the Autovaccine Laboratory when the microbiological material was taken directly onto plates and the investigation was repeated several times. Atypical flora was isolated only from three cases. Propionibacterium and Staphylococcus epidermidis were found to be sensitive to the antibiotics routinely used in the treatment of acne. The highest antibacterial effect in vitro against both these species was demonstrated using rifampicin and tetracycline.

Topics: Acne Vulgaris; Humans; Microbial Sensitivity Tests; Propionibacterium; Retrospective Studies; Rifampin; Staphylococcus epidermidis; Tetracycline

Topics: Acne Vulgaris; Adolescent; Anti-Bacterial Agents; Dental Enamel; Humans; Minocycline; Tetracycline

Topics: Acne Vulgaris; Adolescent; Anti-Bacterial Agents; Drug Resistance, Microbial; Erythromycin; Humans; Microbial Sensitivity Tests; Pharyngitis; Streptococcal Infections; Streptococcus pyogenes; Tetracycline

Topics: Acne Vulgaris; Adult; Female; Humans; Minocycline; Tetracycline; Tooth Discoloration

A miniaturized sensitive bioassay was used to detect tetracycline in open comedones following topical twice daily application of 0.22% tetracycline hydrochloride for a minimum of 4 weeks to the facial skin of patients with mild to moderate acne. The lower limit of detection was 4.8 +/- 0.8 ng per comedone or per 10 microliters. Using this method, 111 of 155 open comedones from 15 patients were found to contain a detectable amount of tetracycline, ranging from 1.8 to 156.9 ng per comedone, and between 4.5 and 1140.1 ng per mg comedonal material. There was a significant effect of comedone weight on tetracycline content, with smaller comedones containing proportionately more tetracycline. The Spearman rank correlation coefficient was -0.5619 (P < 0.001). All 111 comedones in which tetracycline was detected contained sufficient drug to inhibit fully antibiotic-sensitive propionibacteria. However, conditions favourable to the selection and overgrowth of highly tetracycline-resistant strains (MIC > or = 32 micrograms/ml) prevailed in at least 18.7% (29 of 155) of the comedones tested.

Topics: Acne Vulgaris; Administration, Cutaneous; Biological Assay; Drug Administration Schedule; Humans; Propionibacterium; Sebaceous Glands; Tetracycline

Acne fulminans is an ulcerative form of acne with an acute onset and systemic symptoms. It most commonly affects adolescent boys.. Clinical and laboratory findings and treatment results of patients with acne fulminans were reviewed to obtain a better understanding of the clinical course and outcome of the disease.. Data of patients with severe acne were collected from the Dermatology Departments of Finnish hospitals during the years 1970 to 1991.. Twenty-four patients with acne fulminans are described. All patients had ulcerative acne with acute onset. In 22 patients acne was associated with high fever for at least 1 week. All patients had musculoskeletal pain. Increased uptake in bone scan or radiographic findings compatible with an infectious origin were detected in 17 patients. Eight patients were treated with antibiotics alone, but the response was poor; three patients had a relapse of musculoskeletal symptoms. Ten patients were given systemic steroids in addition to antibiotics. In this group the response was rapid, but acne and musculoskeletal symptoms tended to relapse when the steroid dosage was reduced. Four patients were treated with a combination of antibiotics, systemic steroids, and isotretinoin; all responded well, but one of these patients also had a relapse.. Musculoskeletal symptoms are common in patients with acne fulminans. Systemic steroid treatment rapidly controls the skin lesions and systemic symptoms. The duration of steroid treatment should be 2 to 4 months to avoid relapses. Therapy with isotretinoin, antibiotics, or both was often combined with steroids, but the role of these agents is still uncertain.

Topics: Acne Vulgaris; Adolescent; Adult; Anti-Bacterial Agents; Anti-Inflammatory Agents, Non-Steroidal; Blood Sedimentation; Dermatitis, Atopic; Female; Fever; Glucocorticoids; Humans; Isotretinoin; Joints; Leukocytosis; Male; Muscles; Osteolysis; Pain; Retrospective Studies; Tetracycline; Ulcer

In the present investigation, collagen synthesis and degradation were studied by measuring the carboxyterminal propeptide of type I procollagen (PICP), the aminoterminal propeptide of type III procollagen (PIIINP) and a type I collagen-specific degradation peptide (ICTP) in the sera of 43 male patients, treated for acne with isotretinoin or with tetracycline. The values were compared with those observed in 24 acne patients without treatment and in healthy controls. The treatment with isotretinoin did not seem to affect these parameters in a cross-sectional setting, whereas tetracycline treatment was associated with slightly decreased levels of ICTP. Since there were marked variations in the PICP, PIIINP and ICTP levels between individual subjects, a follow-up study, including male and female patients, others than in the first part of the study, was conducted. Two other biochemical markers of bone metabolism, osteocalcin, reflecting osteoblastic activity, and tartrate-resistant acid phosphatase (TRAP), reflecting osteoclastic activity, were also analyzed. In females, all these parameters were lower than in males. In addition, the changes in females were more pronounced; in particular, PIIINP and TRAP were significantly increased in females during retinoid treatment (p < 0.05 and p < 0.01, respectively). Importantly, no increase was found in the synthesis of type I collagen during retinoid treatment, suggesting that the commonly used retinoid dosages do not stimulate the synthesis of type I collagen in vivo.

Topics: Acne Vulgaris; Adolescent; Adult; Antineoplastic Combined Chemotherapy Protocols; Biomarkers; Collagen; Cross-Sectional Studies; Cytarabine; Daunorubicin; Female; Follow-Up Studies; Humans; Isotretinoin; Male; Osteocalcin; Peptide Fragments; Prednisolone; Procollagen; Tetracycline; Thioguanine

Administration of tetracycline to children or pregnant women is known to adversely affect the color of developing teeth. This case report suggests the possibility that discoloration from tetracycline may not be limited to tooth development in the child, but may also affect the adult dentition. When given over long periods of time in adults, the tetracycline molecule is incorporated into the continuously forming secondary dentin. It is possible that chronic sun exposure of the incorporated tetracycline may cause the formation of a reddish-purple oxidation product, resulting in discoloration of the permanent teeth.

Topics: Acne Vulgaris; Adult; Female; Humans; Tetracycline; Tooth Discoloration

Topics: Acne Vulgaris; Contraceptives, Oral; Drug Interactions; Female; Humans; Tetracycline

Biotypes 1-5 Propionibacterium acnes (P. acnes) strains were grown in the presence of 1/10 minimal inhibitory concentrations (sub-MIC) of erythromycin (EM), tetracycline (TC), clindamycin (CLDM), or minocycline (MINO) and their culture filtrates were assayed for human neutrophil chemotactic activity using Boyden chamber methods. The addition of sub-MIC of MINO to the medium strongly suppressed the neutrophil chemotactic activity of the culture filtrates of P. acnes strains of all biotypes. In contrast, with sub-MIC of EM, TC, or CLDM, the activity of the culture filtrates of P. acnes strains of biotypes 2 and 3 were suppressed but those of biotypes 1, 2, and 5 were not. These results indicate that sub-MIC of MINO is capable of decreasing the inflammatory capacity of P. acnes strains of all biotypes.

Topics: Acne Vulgaris; Anti-Bacterial Agents; Chemotactic Factors; Clindamycin; Erythromycin; Humans; Microbial Sensitivity Tests; Minocycline; Neutrophils; Propionibacterium acnes; Tetracycline

The effects of tetracycline, minocycline and erythromycin on complement activation in vitro were studied. At concentrations of 100 mg/l or less, these antibiotics did not inhibit the capacity of Propionibacterium acnes to cleave C3 in normal human serum or in serum chelated of Ca2+ allowing complement activation by the alternative pathway alone. The antibiotics had no effect (at 100 mg/l) on total haemolytic activity of complement in normal human serum. This study did not provide evidence to support the hypothesis that the efficacy of these antibiotics in the therapy of inflammatory acne vulgaris can be explained by inhibition of complement activation.

Topics: Acne Vulgaris; Cell Division; Complement Activation; Complement C3c; Erythromycin; Humans; In Vitro Techniques; Propionibacterium acnes; Tetracycline

Nowadays the existence of bearing both T and B marker lymphocytes has generally been accepted, but their role and nature is still unknown. The effect of tetracycline on lymphocytes was examined in 26 patients with different, mainly respiratory infections. Examinations were carried out on lymphocyte populations with T and B cell count using E rosette and surface immunoglobulin as a marker. It has been shown that on the lymphocytes of patients receiving tetracycline, regularly high number of D cells are found.

Topics: Acne Vulgaris; Adult; Aged; Antigens, Surface; Female; Humans; Immunophenotyping; Leukocyte Count; Lymphocyte Subsets; Middle Aged; Respiratory Tract Infections; Tetracycline; Urinary Tract Infections

Topics: Acne Vulgaris; Administration, Topical; Adolescent; Adult; Benzoyl Peroxide; Female; Gels; Humans; Tetracycline

Two young males with acne fulminans (AF) are described. In addition to severe skin lesions, they had musculoskeletal symptoms including bacteriologically negative osteolytic lesions in the clavicles. Both patients received antibiotics for suspected septic infections. The response was unsatisfactory in both patients, and combination treatment with prednisolone was started. A favourable response was observed, and a relapse occurring in the first patient was controlled by steroids alone. The possible pathomechanism of bone lesions in AF is discussed.

Topics: Acne Vulgaris; Adolescent; Drug Therapy, Combination; Humans; Male; Osteomyelitis; Prednisolone; Radionuclide Imaging; Recurrence; Tetracycline

Topics: Acne Vulgaris; Administration, Oral; Adolescent; Dermatologic Agents; Dicarboxylic Acids; Drug Evaluation; Facial Dermatoses; Humans; Ointments; Skin Diseases; Tetracycline

A superficial pustular eruption with acute onset has been reported in patients with acne vulgaris receiving systemic antibiotic treatment. In all past cases the causative micro-organism was found to be a gram-negative bacterium. This case report describes a similar clinical picture under the same circumstances, in which the bacterium incriminated was a coagulase-negative Staphylococcus.

Topics: Acne Vulgaris; Adult; Coagulase; Folliculitis; Gram-Negative Bacteria; Humans; Male; Staphylococcal Skin Infections; Staphylococcus; Tetracycline

Topics: Acne Vulgaris; Administration, Cutaneous; Administration, Oral; Adolescent; Adult; Female; Humans; Male; Tetracycline

Topics: Acne Vulgaris; Adjuvants, Immunologic; Adolescent; Adult; Humans; Tetracycline; Thymus Hormones

A female adolescent on tetracycline therapy for a dermatologic condition developed pseudotumor cerebri resulting in impaired visual acuity and papilledema. The therapy of pseudotumor cerebri is discussed.

Topics: Acne Vulgaris; Adolescent; Dexamethasone; Female; Humans; Papilledema; Pseudotumor Cerebri; Tetracycline; Vision Disorders

Regarding treatment of acne vulgaris and rosacea, there is not much difference between hospital and practice nor among practicing dermatologists. Most of the assistants performing the important physical-manual treatment have had the same training. After analytical conversation and etiologic as well as diagnostic classification, the patients undergo the following manual treatment: cleansing, astringing, removing of comedones, massage, face pack, and covering with tinted emulsion. At home, acne: cleansing, massage, skin lotion, vitamin A acid, benzoylperoxide, antibacterial therapy; in serious male cases of acne conglobata, Roaccutan. Rosacea: antiseptic (antibiotic) treatment (topically and systemically), metronidazole (Arilin); in serious male cases, Roaccutan.

Topics: Acne Vulgaris; Benzoyl Peroxide; Combined Modality Therapy; Erythromycin; Feeding Behavior; Humans; Rosacea; Tetracycline; Tretinoin

Topics: Acne Vulgaris; Adolescent; Female; Humans; Isotretinoin; Teratogens; Tetracycline; Tretinoin

Topics: Acne Vulgaris; Administration, Oral; Erythromycin; Humans; Tetracycline

The antiandrogen cyproterone acetate, which is known to suppress sebum production, but is not a standard therapy, was given in combination with tetracycline to 63 young unmarried men who had failed to respond to 6 months' tetracycline therapy alone. Fifty-seven patients responded and the mean time to clearance was 5.2 months' therapy. The main side effects were nodular sub-nipple breast swellings, which occurred in 13 cases (21%). Such side effects were reversible and cleared after 3-4 months following cessation of therapy. Eighty-eight percent of patients relapsed within 3 months of discontinuing therapy.

Topics: Acne Vulgaris; Adolescent; Adult; Cyproterone; Cyproterone Acetate; Drug Therapy, Combination; Humans; Male; Tetracycline

Pustules from 92 new cases of pustular acne and gram-negative folliculitis were cultured in aerobic medium for superimposed bacterial infection. During the treatment of 1,561 new patients with papular acne with tetracycline and topical clindamycin and antibacterial soaps, an additional 10 developed pustules. The majority showed in vitro resistance to ampicillin. The effective treatment was co-trimoxazole and topical gentamicin. A new classification of acne with practical therapeutic use is needed.

Topics: Acne Vulgaris; Adult; Ampicillin; Clindamycin; Drug Combinations; Female; Humans; Male; Penicillin Resistance; Staphylococcal Infections; Sulfamethoxazole; Suppuration; Tetracycline; Trimethoprim; Trimethoprim, Sulfamethoxazole Drug Combination

Topics: Acne Vulgaris; Administration, Topical; Adrenal Cortex Hormones; Benzoyl Peroxide; Cicatrix; Contraceptives, Oral, Hormonal; Humans; Isotretinoin; Minocycline; Propionibacterium acnes; Tetracycline; Tretinoin

The aim of the present study was to evaluate different treatment schedules in some different types of acne using a quantitative counting technique. Systemic treatment with erythromycine 0.5 g daily and topical treatment with clindamycin phosphate solution 1% was found to be optimal from the efficacy/side effect ratio. The combined treatment was tried in heat-provoked and cosmetic acne with favourable results. Doubling of erythromycine dosage could not prevent premenstrual exacerbation of acne. Diazepam 4 mg daily for two weeks followed by an antihistamine in addition to erythromycine 0.5 g daily gave relatively good results in female patients with acne excorié. In acne coexisting with pronounced seborrhoic dermatitis of the face the addition of hydrocortisone cream 1% was of benefit, although Roaccutane may here be the drug of choice. In female postpubertal acne, the effect of cyproteronacetate-etynilestradiol (Diane) was not superior to treatment with erythromycine 0.5 g daily. By treating special subtypes differently, one could be able to improve the results of acne therapy.

Topics: Acne Vulgaris; Administration, Topical; Adolescent; Adult; Androgen Antagonists; Anti-Inflammatory Agents; Benzoyl Peroxide; Clindamycin; Cyproterone; Cyproterone Acetate; Diazepam; Drug Administration Schedule; Drug Combinations; Drug Therapy, Combination; Erythromycin; Ethinyl Estradiol; Female; Humans; Hydrocortisone; Male; Sulfamethoxazole; Tetracycline; Tretinoin; Trimethoprim; Trimethoprim, Sulfamethoxazole Drug Combination

The use of topical tretinoin (Retin-A) for comedonal lesions, benzoyl peroxide for inflamed papules and pustules, and topical or oral antibiotics for more severe or widespread disease gives excellent results for the majority of patients with acne. At present, oral isotretinoin (13-cis-retinoic acid) (Accutane) should be reserved for patients with severe nodulocystic acne whose condition has not responded to an accepted therapeutic regimen. Good patient rapport and follow-up are essential in the management of this common disease.

Topics: Acne Vulgaris; Administration, Oral; Administration, Topical; Aspartate Aminotransferases; Benzoyl Peroxide; Erythromycin; Female; Humans; Isotretinoin; Tetracycline; Tretinoin; Triglycerides

A comparative clinical study on therapy of nodulocystic acne with 13-cis-retinoic acid was performed in 32 patients. 20 patients were treated with a dose of 1 mg/kg body weight daily, and 12 with a combined therapy: 0.25 mg/kg/day 13-cis-retinoic acid and 0.5 g of tetracycline daily. In both groups the therapy was carried out for 16 weeks. The effect of the combined therapy within 4 months was favourable in 75% of the cases versus 100% in the group treated with larger doses of 13-cis-retinoic acid. Thus, the time needed for clearing was longer in some patients (up to 6 months). However, the incidence of side effects was considerably lower in the group of combined therapy. In acne fulminans 13-cis-retinoic acid alone is not effective and should be combined with corticosteroids.

Topics: Acne Vulgaris; Adolescent; Adult; Drug Therapy, Combination; Female; Humans; Isotretinoin; Male; Prednisone; Tetracycline; Time Factors; Tretinoin

We have studied the effects of long-term tetracycline and erythromycin administration on the fecal flora of patients and their relatives. Tetracycline administration selects for multiply antibiotic-resistant organisms in both patients and relatives. Erythromycin exerts no such selection pressure. The mechanisms by which this may occur are discussed.

Topics: Acne Vulgaris; Adolescent; Adult; Drug Resistance, Microbial; Erythromycin; Escherichia coli; Feces; Female; Humans; Intestines; Male; Tetracycline; Time Factors

Fifty patients consulting my dermatologic practice because of facial papulopustular acne varying from grade I up to grade IV (according to Plewig and Kligman) have been treated with benzoyl peroxide and erythromycin. The more severe cases (grades III and IV) received additional treatment, such as tetracycline or cyproterone acetate internally and/or, externally, removal of comedones as well as UV-A-radiation. As a result, 68 percent of all patients showed remission in at least 70 percent of their inflammatory skin eruptions.

Topics: Acne Vulgaris; Adolescent; Adult; Androgen Antagonists; Benzoyl Peroxide; Combined Modality Therapy; Cyproterone; Cyproterone Acetate; Drug Combinations; Drug Therapy, Combination; Erythromycin; Ethinyl Estradiol; Female; Humans; Male; Peroxides; Tetracycline; Ultraviolet Therapy

The effect of zymosan-activated serum samples, obtained from patients with acne who were receiving oral tetracycline hydrochloride therapy, on the chemotaxis and random migration of autologous polymorphonuclear leukocytes (PMNLs) and PMNLs from control donors was assayed in a Sykes-Moore chamber by a double-filter technique. Cells incubated with autologous serum specimens from these patients demonstrated significant suppression of both random migration and chemotaxis, with the greatest effect seen at a dosage of 1 g daily and a significant effect found at all dosage levels. When zymosan-activated serum samples from these patients were assayed with control donor PMNLs, similar inhibitory effects were shown. Assays of control sera and PMNLs from tetracycline-treated patients with acne showed the least degree of inhibition of chemotaxis. Although the mechanism of action is unclear, tetracycline appears to have a direct effect on neutrophil movement.

Topics: Acne Vulgaris; Adolescent; Adult; Cell Movement; Cells, Cultured; Chemotactic Factors; Chemotaxis, Leukocyte; Female; Humans; Male; Neutrophils; Tetracycline; Zymosan

The intradermal injection of 140 micrograms of Propionibacterium acnes (CN 6134) into the ears of female Sprague-Dawley rats produced a chronic inflammation with formation of acneiform lesions. Inflammation was characterized by more than a doubling of ear thickness at 24 h and a peak of 3-4 times control levels at day 21. At 42 days post injection ears were still 3 times normal thickness. Histologically there was early polymorph accumulation giving way to macrophages and lymphocytes by day 7. Pilosebaceous follicles overlying the inflamed area lost their sebaceous glands and became hyperplastic cords of cells that grew down and encapsulated inflammatory loci. By day 9 many of these follicles had become secondary comedones. Three isolates of P. acnes from inflammatory acne lesions and 4 of 5 isolates from non-acne patients produced results similar to that of the strain CN 6134. In these cases the number of histologically evident secondary comedones was correlated with ear thickness. In contrast, samples of Streptococcus lactis, Escherichia coli B, and Staphylococcus epidermidis failed to produce this combination of chronic inflammation and high lesion count. Benzoyl peroxide, tetracycline, erythromycin, phenidone, naproxen, and cis and trans retinoic acid were inactive as inhibitors of P. acnes CN 6134-induced ear thickening. The corticosteroid fluocinolone acetonide produced dramatic suppression of inflammation, but upon cessation of treatment the ears returned to inflamed levels. The specificity for P. acnes, the formation of acneiform lesions, and the recalcitrance of the inflammation suggest our model is indeed relevant to acne.

Topics: Acne Vulgaris; Animals; Benzoyl Peroxide; Disease Models, Animal; Erythromycin; Female; Fluocinolone Acetonide; Inflammation; Injections, Intradermal; Naproxen; Propionibacterium acnes; Pyrazoles; Rats; Rats, Inbred Strains; Tetracycline; Tretinoin

Topics: Acne Vulgaris; Administration, Oral; Administration, Topical; Benzoyl Peroxide; Cyproterone; Cyproterone Acetate; Double-Blind Method; Erythromycin; Female; Humans; Isotretinoin; Male; Tetracycline; Tretinoin

Topics: Acne Vulgaris; Bone and Bones; Humans; Lymph Nodes; Male; Minocycline; Pigmentation; Tetracycline; Tetracyclines; Thyroid Gland

Topics: Acne Vulgaris; Administration, Topical; Clindamycin; Humans; Tetracycline

The minimal inhibitory concentration (MIC) of Propionibacterium acnes in seventy-five acne patients receiving long-term antibiotic therapy demonstrated the emergence of resistant strains. The mean MIC in thirty-three patients receiving long-term tetracycline was four to five times higher than that found in control groups of acne patients not receiving antibiotic therapy and controls free of acne. The average MIC for erythromycin was more than 100 times higher in those receiving long-term antibiotic therapy. In a second group of sixty-two patients, the clinical course and number of P. acnes were correlated with the presence of "resistant strains" defined as P. acnes with a tenfold increase in MIC to tetracycline or erythromycin. Patients with resistant strains had higher counts of P. acnes and clinically were not doing as well as those with sensitive strains.

Topics: Acne Vulgaris; Adolescent; Adult; Anti-Bacterial Agents; Bacterial Infections; Clindamycin; Drug Resistance, Microbial; Erythromycin; Female; Humans; Male; Minocycline; Propionibacterium acnes; Tetracycline

Strains of propionibacteria resistant to clindamycin or clindamycin and erythromycin were isolated from four patients with acne, three of whom were receiving clindamycin. Four strains of P. acnes and one of P. granulosum with moderate levels of tetracycline resistance were isolated from 25 patients with acne being treated with tetracycline. A similar increase in tetracycline resistance was achieved by training sensitive strains in vitro. P. acnes was sensitive to sulphonamide and trimethoprim but some strains of P. granulosum were resistant to sulphonamide. Similar reports of clindamycin and erythromycin resistance from the USA suggest resistance may be increasing in isolates from patients with acne.

Topics: Acne Vulgaris; Anti-Bacterial Agents; Clindamycin; Drug Resistance, Microbial; Erythromycin; Humans; Minocycline; Propionibacterium; Propionibacterium acnes; Sulfamethoxazole; Tetracycline; Trimethoprim

Topics: Acne Vulgaris; Adolescent; Adult; Female; Humans; Male; Middle Aged; Tetracycline; Ultraviolet Therapy

Topics: Acne Vulgaris; Administration, Topical; Adolescent; Anti-Bacterial Agents; Benzoyl Peroxide; Child; Cicatrix; Dermatologic Agents; Erythromycin; Estrogens; Humans; Sebum; Tetracycline; Tretinoin

Unpigmented and pigmented cystic epithelial inclusions were found bilaterally within the lower palpebral conjunctiva temporally of a 31-year-old man. He had a history of tetracycline/minocycline therapy for 14 years because of acne vulgaris. The cysts were studied by light and electron microscopy, histochemistry, and ultraviolet light. By light microscopy the unpigmented cysts contained faintly eosinophilic globular material that disclosed yellowish-green autofluorescence indicating the presence of tetracycline/minocycline. The pigmented cysts revealed laminated eosinophilic to brownish concretions that also showed yellowish-green autofluorescence. Autofluorescence, however, decreased with increasing brown pigmentation of the concretions. Histochemically, the pigment, which failed to show the staining characteristics of lipofuscin, melanin or iron, probably represented an oxidation product of tetracycline. By electron microscopy the cysts contained moderately electron dense amorphous material as well as degenerating epithelial cells. The epithelial cells lining the conjunctival cysts, did not contain membrane-bound, large, pigment granules within their cytoplasm as has been demonstrated in the colloid and follicular epithelium of the thyroid following minocycline therapy.

Topics: Acne Vulgaris; Adult; Conjunctiva; Conjunctival Diseases; Cysts; Cytoplasmic Granules; Drug Therapy, Combination; Epithelium; Humans; Male; Microscopy, Electron; Minocycline; Tetracycline; Tetracyclines

Topics: Acne Vulgaris; Drug Administration Schedule; Humans; Methods; Tetracycline

Topics: Acne Vulgaris; Cimetidine; Drug Interactions; Guanidines; Humans; Tetracycline

Topics: Acne Vulgaris; Adolescent; Adult; Cyproterone; Cyproterone Acetate; Drug Evaluation; Female; Humans; Male; Tetracycline; Tretinoin

Topics: Acne Vulgaris; Adolescent; Female; Humans; Muscular Diseases; Tetracycline

Topics: Acne Vulgaris; Administration, Oral; Administration, Topical; Adolescent; Adult; Clindamycin; Double-Blind Method; Female; Humans; Male; Random Allocation; Tetracycline

Topics: Acne Vulgaris; Adolescent; Anti-Bacterial Agents; Benzoyl Peroxide; Child; Contraceptives, Oral, Hormonal; Dermatologic Agents; Female; Humans; Male; Tetracycline; Tretinoin

Topics: Acne Vulgaris; Adolescent; Adult; Contraceptives, Oral; Cyproterone; Cyproterone Acetate; Drug Combinations; Drug Therapy, Combination; Ethinyl Estradiol; Female; Humans; Tetracycline

Manifestations of lithium carbonate toxicity include acneform eruptions, sinus node dysfunction, hyperparathyroidism, hypothyroidism, thyrotoxicosis, extrapyramidal side effects, and renal toxicity, which may present as nephrogenous diabetes insipidus. This report concerns a patient with a toxic reaction to lithium carbonate. The patient initially had acneform lesions, hypoglycemia, hypothyroidism, and nephrogenous diabetes insipidus. Features of lithium carbonate-induced acneform eruptions are emphasized. Renal toxicity from a lithium carbonate overdose is common, and the hazards of prescribing potentially nephrotoxic drugs to such a patient are stressed.

Topics: Acne Vulgaris; Adult; Diabetes Insipidus; Drug Interactions; Humans; Hypoglycemia; Hypothyroidism; Kidney Tubules; Lithium; Lithium Carbonate; Male; Tetracycline

Topics: Acne Vulgaris; Clindamycin; Erythromycin; Family Practice; Female; Humans; Male; Tetracycline; Tretinoin

Benign intracranial hypertension occurred in four young women taking tetracycline for acne; two were also taking vitamin A. In a fifth case a 14-year-old boy developed papilloedema after taking a short course of tetracycline for bronchitis. All symptoms disappeared soon after stopping the drugs, though in two cases the papilloedema persisted for many months. Benign intracranial hypertension should be sought in any young woman complaining of headache during treatment with tetracycline. Moreover, young women given vitamin A and tetracycline in combination for acne may be at special risk and should be kept under surveillance.

Topics: Acne Vulgaris; Adolescent; Adult; Female; Humans; Male; Papilledema; Pseudotumor Cerebri; Sex Factors; Tetracycline

The purpose of the study presented herein was to determine the safety and efficacy of minocycline in patients whose acne vulgaris failed to respond adequately to tetracycline therapy and to confirm continued improvement in tetracycline-responsive patients when minocycline was substituted for tetracycline. Thirty-six acne vulgaris patients were given oral tetracycline (250 mg four times a day) for six weeks, followed by oral minocycline (50 mg three times a day) for six weeks. An analysis of the increase or decrease in total lesion counts obtained at biweekly intervals revealed that minocycline caused statically significant improvement both in patients who did not respond to tetracycline and in patients who did respond to tetracycline. Patients who did not respond to tetracycline therapy achieved a mean decrease of 54 percent in lesions after after six weeks of minocycline treatment. In tetracycline-responsive patients, six weeks' treatment with tetracycline caused a 33.5 percent mean decrease in the lesion count. When these patients received minocycline for a subsequent six-week period, the mean lesion count decreased by an additional 60 percent. Only one patient developed a side effect: severe itching and urticaria in a minocycline-treated subject warranted discontinuance of therapy. Minocycline was a safe and effective agent in the treatment of acne both in tetracycline-resistant and in tetracycline-responsive patients.

Topics: Acne Vulgaris; Administration, Oral; Adolescent; Adult; Female; Humans; Male; Minocycline; Tetracycline; Tetracyclines; Urticaria

Topics: Acne Vulgaris; Administration, Oral; Adolescent; Female; Humans; Male; Middle Aged; Prospective Studies; Tetracycline

Topics: Acne Vulgaris; Adult; Bone and Bones; Color; Fluorescence; Humans; Male; Spectrophotometry; Tetracycline

The assumption that tetracycline HCl can cause acute pancreatitis has been accepted since reports began to appear implicating it as a cause of fatty liver in pregnancy with associated pancreatitis. It is listed as an etiologic factor for acute pancreatitis in reference articles and standard medical textbooks without good documentation of this association in the absence of fatty liver. This report describes a documented case of tetracycline HCl-induced acute pancreatitis without associated overt liver disease.

Topics: Acne Vulgaris; Acute Disease; Adolescent; Female; Humans; Pancreatitis; Tetracycline

Topics: Acne Vulgaris; Administration, Oral; Administration, Topical; Erythromycin; Humans; Tetracycline

Topics: Acne Vulgaris; Administration, Topical; Adrenal Cortex Hormones; Anti-Bacterial Agents; Benzoyl Peroxide; Contraceptives, Oral; Humans; Keratolytic Agents; Tetracycline; Tretinoin; Zinc

Yellow lunulae with yellow fluorescence under Wood's lamp examination developed in a patient treated with a high-dose tetracycline hydrochloride regimen for cystic acne after one month of therapy. The clinical findings in other causes of yellow nail pigmentation are reviewed. The Wood's lamp examination is useful in distinguishing tetracycline-induced yellow nails from other causes of yellow nail pigmentation and may be helpful in determining patient compliance with tetracycline hydrochloride regimens of 1 g or more daily.

Topics: Acne Vulgaris; Adult; Dose-Response Relationship, Drug; Humans; Male; Nail Diseases; Patient Compliance; Pigmentation Disorders; Tetracycline

Topics: Acne Vulgaris; Administration, Oral; Administration, Topical; Adolescent; Adult; Androgen Antagonists; Benzoyl Peroxide; Erythromycin; Female; Humans; Male; Tetracycline; Tretinoin

Topics: Acne Vulgaris; Administration, Topical; Anti-Bacterial Agents; Clindamycin; Erythromycin; Humans; Pharmaceutical Vehicles; Tetracycline

Tetracycline, because of its effectiveness, safety, and economy, remains the treatment of choice for chronic maintenance of uncomplicated acne. However, a certain percentage of patients with very difficult acne will not respond satisfactorily to tetracycline. The study presented herein described forty-two patients with nodulocystic acne who did not show imporvement on adequate trials of tetracycline and were switched to low-dose clindamycin. A majority of these patients then showed significant improvement with nine showing essential clearing of the condition. Two patients experienced diarrhea, but recovered immediately after the clindamycin was discontinued.

Topics: Acne Vulgaris; Adolescent; Adult; Clindamycin; Drug Resistance; Female; Humans; Male; Tetracycline

Delayed passage of irritant drugs like tetracycline hydrochloride can cause esophageal ulceration, especially when the medication is taken with only a sip of water before sleeping or by a patient with stricture or motor abnormality of the esophagus. Certain precautions should be taken when prescribing irritant drugs. Patients should be advised to take sufficient quantities of water with the medication and to avoid taking the capsules at bedtime. These drugs should not be given to patients with esophageal obstruction or motility disorders.

Topics: Acne Vulgaris; Adolescent; Adult; Esophageal Diseases; Female; Humans; Male; Skin Diseases; Tetracycline; Ulcer

Topics: Acne Vulgaris; Benzoyl Peroxide; Erythromycin; Humans; Propionibacterium acnes; Sebaceous Glands; Sebum; Tetracycline; Tretinoin

Topics: Acne Vulgaris; Adolescent; Adult; Chronic Disease; Drug Evaluation; Female; Humans; Male; Middle Aged; Tetracycline

Acne vulgaris is a common skin disorder that is socially disabling to some degree in the majority of adolescents. Effective management of this disease has two major components: a strong physician-patient relationship and a sound medical regimen. The former is necessary to foster patient compliance with the long-term therapeutic regimen required, as well as to reduce the disease's potential for emotional scarring. The rational usage of the various topical and systemic medications available will serve to decrease the frequency and severity of exacerbations as well as to minimize possible scarring. Specific recommendations as to moisturizers and cosmetics are included.

Topics: Acne Vulgaris; Benzoyl Peroxide; Cosmetics; Erythromycin; Humans; Physician-Patient Relations; Salicylates; Tetracycline; Tretinoin

Topics: Abnormalities, Drug-Induced; Acne Vulgaris; Animals; Chick Embryo; Female; Humans; Infant, Newborn; Pregnancy; Pregnancy Complications; Tetracycline

Multiple granulomata pyogenica are usually satellites of a primary lesion recently treated unsuccessfully. Disseminated pyogenic granulomas are very uncommon. In our case report, we describe a young man with six granulomata pyogenica over the chest, after treating his acne with tetracycline and vitamin A acid. In the discussion, we include infection, trauma and vitamin A acid as factors which can induce the vascular tumor in the region of a vascular dysplasia.

Topics: Acne Vulgaris; Adult; Granuloma; Humans; Male; Tetracycline; Tretinoin; Vitamin A

Topics: Acne Vulgaris; Administration, Oral; Administration, Topical; Anti-Bacterial Agents; Clindamycin; Enterocolitis, Pseudomembranous; Humans; Pharmaceutical Vehicles; Tetracycline

Topics: Acne Vulgaris; Administration, Oral; Adult; Carbon Dioxide; Female; Humans; Male; Minocycline; Oxygen; Pulmonary Eosinophilia; Radiography; Tetracycline; Tetracyclines; Urinary Tract Infections

Topics: Acne Vulgaris; Contraceptives, Oral; Humans; Resorcinols; Salicylates; Sulfur; Tetracycline; Tretinoin

Blue nodules developed in the skin of a patient with acne concomitant with the start of tetracycline therapy. When removed, these nodules were brown and histologic examination revealed a lamellate structure compatible with bone. Under ultraviolet light, these osteomas fluoresced yellow, indicating the presence of tetracycline. This suggests that tetracycline, combined with new bone formation, causes pigmentation of osteoma cutis.

Topics: Acne Vulgaris; Adult; Calcinosis; Female; Humans; Osteogenesis; Skin Diseases; Skin Pigmentation; Tetracycline

Acne fulminans is a rare disorder of male teenage patients. The disease is characterized by the sudden appearance of highly inflammatory, tender, ulcerative and crusted lesions on back, chest and face. At the onset of the disease all patients show febrile temperature, leucocytosis, increased sedimentation rate and frequently polyarthralgia. The reported case showed typical lesions and distribution, fever, leucocytosis, elevated sedimentation rate, anemia, a decrease in albumin and an increase in alpha 2-globulin. Intradermal skin tests (delayed reactivity) showed marked decrease responses. Systemic treatment with antibiotics (ampicilline, tetracycline) with concomitant topical therapy was effective.

Topics: Acne Vulgaris; Adolescent; Ampicillin; Humans; Male; Tetracycline

Ninety-one patients with acne vulgaris were selected for a two-part study primarily because the severity of disease suggested that it might be tetracycline-recalcitrant. Of the eighty-eight patients completing the first part of the study, thirty-two were judged to have tetracycline-nonresponsive acne and received 50 mg of minocycline twice daily for the next six to eight weeks. Twenty-five patients completed this second part of the study. Of these twenty-five, twenty-two experienced a 33 percent or greater reduction in the number of lesions. It is concluded that minocycline in a dosage of 50 mg twice daily is a safe and effective antibiotic for those patients with tetracycline-recalcitrant acne vulgaris.

Topics: Acne Vulgaris; Adult; Drug Resistance; Female; Humans; Minocycline; Tetracycline; Tetracyclines

Topics: Acne Vulgaris; Adolescent; Female; Humans; Pseudotumor Cerebri; Tetracycline

Many factors may be involved in the pathogenesis of acne, the most important of them lie in the sebaceous follicle, in disturbances of the cornification of the follicular channels and in the bacterial flora of the hair follicles. The latter consists of a yeast (pityrosporon ovale), coagulase-negative aerobic staphylococci and propionibacterium acnes. P. acnes is found in the depth of the follicle. It is of particular importance for the pathogenesis because it produces a lipase which releases fatty acids which stimulate the formation of comedones. Many questions are still unanswered. Presently, treatment consists of administration of estrogens or combination preparations of estrogen and progesterone (only recommended for women), of vitamin A acid and antibiotics. Tetracycline and its derivatives have proved particularly valuable for this purpose.

Topics: Acne Vulgaris; Candidiasis; Estrogens; Female; Humans; Malassezia; Male; Progesterone; Staphylococcal Infections; Tetracycline; Vitamin A

Topics: Acne Vulgaris; Drug Evaluation; Factor Analysis, Statistical; Humans; Sampling Studies; Skin Diseases; Tetracycline

One hundred five patients were treated effectively with topically applied tetracycline in an ethanol-water solution with n-decyl methyl sulfoxide, and observed for a year. Comedones and cystic lesions were least responsive to topical tetracycline. Side effects, which were minor, included yellow staining of facial skin and stinging after application. Two patients, one with juvenile diabetes and one with congenital nephritis, successfully used the preparation without adverse effects.

Topics: Acne Vulgaris; Administration, Topical; Adolescent; Adult; Child; Female; Follow-Up Studies; Humans; Male; Tetracycline

Free glycerol would be expected from biochemical considerations to be an end product of lipolysis of sebum triglycerides. Glycerol was measured in skin surface washings of acne vulgaris patients, in acne vulgaris patients treated for at least 3 mo with oral tetracycline and in control subjects. Surface glycerol in untreated acne subjects was significantly less than that expected theoretically, whereas the amounts of such glycerol in treated acne patients and in control subjects closely approached the theoretically expected values. It is suggested that glycerol may be an in vivo substrate for Propionibacterium acnes.

Topics: Acne Vulgaris; Adolescent; Adult; Female; Glycerol; Humans; Lipids; Male; Skin; Tetracycline

Topics: Acne Vulgaris; Bacterial Infections; Cellulitis; Child; Dermatitis, Exfoliative; Furunculosis; Humans; Impetigo; Infant; Infant, Newborn; Penicillins; Skin Diseases, Infectious; Staphylococcal Infections; Tetracycline; Wound Infection

Topics: Acne Vulgaris; Administration, Topical; Adolescent; Adult; Dexamethasone; Drug Resistance, Microbial; Female; Hexachlorophene; Humans; Lactates; Magnesium Sulfate; Male; Ointments; Salicylates; Tetracycline; Zinc

Topics: Acne Vulgaris; Adolescent; Adult; Benzoyl Peroxide; Chlorhexidine; Drug Therapy, Combination; Erythromycin; Female; Humans; Male; Tetracycline; Tretinoin

While there is no single treatment plan that will work for every patient, acne can be controlled and long-term scarring can be minimized. Treatment must be individualized. Remember, there may be a "flare" when intensive therapy begins. Useful treatment methods include ultraviolet light, cleansers and soaps, peeling and drying agents, benzoyl peroxide preparations, abrasive soaps and scrubs, retinoic acid and oral antibiotics. The therapeutic choice depends upon the extent and severity of the disease.

Topics: Acne Vulgaris; Adolescent; Benzoyl Peroxide; Humans; Keratolytic Agents; Soaps; Tetracycline; Tretinoin; Ultraviolet Therapy

The administration of anti-androgens brings favourable results especially in such skin diseases showing unsatisfactory therapeutic results, i.e. all severe forms of acne, seborrhoea, androgenic alopecia and hirsutism. Exact knowledge of the oestrogen and gestagen effect is essential. Also of fundamental importance is the observation and consideration of side effects besides the contraceptive efficacy and therapeutic results in dermatology.

Topics: Acne Vulgaris; Alopecia; Androgen Antagonists; Contraceptives, Oral; Contraceptives, Oral, Hormonal; Dermatitis, Seborrheic; Female; Hirsutism; Humans; Hypertrichosis; Skin Diseases; Tetracycline; Tretinoin

The patterns of drug resistance and the frequency of conjugative R plasmids in intestinal Escherichia coli from 88 patients treated for a skin disease (acne vulgaris) with low oral doses of tetracycline are reported. The proportion of patients with resistant bacteria was progressively greater in patients who received tetracycline for 1 week, 4 weeks, or longer (from 50 to 88%). No multiply drug-resistant bacteria were detected before treatment or after 1 week of treatment. After more than 4 weeks of treatment, multiply drug-resistant E. coli were isolated from about 50% of the patients. The origin and selection of R plasmid-determined multiple drug resistance are discussed.

Topics: Acne Vulgaris; Drug Resistance, Microbial; Escherichia coli; Extrachromosomal Inheritance; Feces; Humans; Plasmids; R Factors; Rosacea; Tetracycline; Time Factors

The introduction of topical antibiotics for acne vulgaris has ushered in a new era in the treatment of this troublesome disorder. Tetracycline, erythromycin, and clindamycin can now be prepared in lotion form in vehicles that are capable of carrying the antibiotic into the follicular canal, where the primary lesion of acne occurs. Topical antibiotics are practically as effective as oral antibiotics in treating acne and are particularly useful for mild papular acne of puberty and early adolescence and papular-pustular acne of adult women. Use of topical antibiotics avoids the possibility of the adverse effects of systemic therapy; the side effects from the formulations reported here are negligible. Above all, antibiotic lotions do not produce the dryness and scaling that occur with most other topical acne preparations.

Topics: Acne Vulgaris; Administration, Topical; Anti-Bacterial Agents; Clindamycin; Erythromycin; Fatty Acids, Nonesterified; Humans; Skin; Tetracycline

Topics: Acne Vulgaris; Adolescent; Adult; Anti-Bacterial Agents; Estrogens; Female; Humans; Tetracycline; Tretinoin

We have noted an incidence of vaginitis of 5 percent in women of childbearing age taking tetracycline for acne. We believe that tetracycline is a remarkably safe medication, and that the incidence of side effects from its use is low especially when instruction is given to the patient regarding its proper ingestion.

Topics: Acne Vulgaris; Adolescent; Adult; Female; Humans; Tetracycline; Vaginitis

Topics: Abnormalities, Drug-Induced; Abnormalities, Multiple; Acne Vulgaris; Adult; Female; Humans; Pregnancy; Tetracycline

Topics: Acne Vulgaris; Adolescent; Erythema Nodosum; Humans; Male; Tetracycline

Topics: Acne Vulgaris; Adolescent; Humans; Tetracycline; Zinc

Topics: Acne Vulgaris; Adolescent; Adult; Drug Therapy, Combination; Female; gamma-Globulins; Humans; Male; Recurrence; Tetracycline

A report is made on 80 male patients aged 19-25 and suffering from common acne, who were treated with vitamin A acid (Eudyna) partly as inpatients and partly as outpatients. All stages were present from acne comedonica to acne conglobata. The preparation was available in the form of cream and jelly, each containing 0.05% tretinoin. As a rule, the drug was applied once daily. At the end of the tretinoin treatment lasting for a maximum of 9 weeks, a decrease in comedones of more than 90% is reported. The tolerance of Eudyna was seen to be good to very good in more than two thirds of the patients.

Topics: Acne Vulgaris; Administration, Topical; Adult; Drug Therapy, Combination; Humans; Male; Retrospective Studies; Tetracycline; Tretinoin; Vitamin A

Topics: Acne Vulgaris; Adolescent; Adult; Female; Follow-Up Studies; Humans; Male; Tetracycline; Vitamin A; Vitamin E

Esophageal ulceration has rarely been reported secondary to medicinal agents. we have treated three patients with esophageal ulceration associated with the ingestion of tetracycline or its derivative doxycycline. In light of the strong temporal relationship between taking the capsules and the onset of the esophageal ulceration, we believe that the capsules were the cause of the ulcers. We therefore recommend an alternative agent to tetracycline or doxycycline, if possible, for patients with any esophageal obstructive element. We also recommend that patients be cautioned not to take these drugs within one hour of going to bed.

Topics: Acne Vulgaris; Adult; Antacids; Doxycycline; Esophageal Diseases; Female; Humans; Tetracycline; Ulcer; Urinary Tract Infections

Five patients manifested cutaneous changes indistinguishable from those noted in some porphyric disorders, consisting of fragility, denudation, and blister formation of sun-exposed skin. Microscopical examination showed subepidermal bulla formation and the desposition of PAS-positive, diastase-resistant material and IgG in or around the upper dermal blood vessel walls. There was also electron microscopical evidence of vascular basal lamina reduplication and the deposition of a fine fibrillar material in and around these vessels. However, no abnormal porphyrin formation was noted. All five patients had been receiving 250 mg of tetracycline hydrochloride twice a day for at least six months and had had extensive sun exposure prior to the onset of the condition. For four patients, discontinuing the medication led to complete remission, despite subsequent sun exposure; the fifth patient was much improved, but her skin was still somewhat fragile seven months later. We concluded that these cutaneous changes resulted from a low-grade photosensitization by tetracycline hydrochloride.

Topics: Acne Vulgaris; Adolescent; Adult; Erythrocytes; Female; Humans; Microscopy, Electron; Microscopy, Fluorescence; Photosensitivity Disorders; Porphyrias; Porphyrins; Skin; Sunlight; Tetracycline

Topics: Acne Vulgaris; Animals; Chick Embryo; Female; Fetus; Guinea Pigs; Humans; Infant, Newborn; Maternal-Fetal Exchange; Mice; Pregnancy; Rats; Tetracycline

Topical antibiotics were used on patients with acne vulgaris. Corynebacterium acnes organisms from open comedones were quantitated during treatment, and the progress of the disease was evaluated. Clindamycin lotion completely suppressed the growth of C acnes organisms, whereas erythromycin and tetracycline did not depress the C acnes counts. Taken as a group, these antibiotics gave a substantial improvement of the disease on the treated side as compared with paired untreated sides of the face and back.

Topics: Acne Vulgaris; Administration, Topical; Anti-Bacterial Agents; Clindamycin; Corynebacterium Infections; Drug Therapy, Combination; Erythromycin; Erythromycin Estolate; Humans; Microbial Sensitivity Tests; Propionibacterium acnes; Skin; Tetracycline

R factors are known to be the most important mechanism of antimicrobial resistance of intestinal flora. Short courses with therapeutic doses (1000 mg/day) of tetracycline select for strains containing transferable resistance factors to more than one antimicrobial agent. In this report we show that long term treatment with very low doses (100 mg/day) of tetracycline for acne vulgaris has an equally strong effect favouring establishment of resistent strains and R factors in the intestinal flora of patients.

Topics: Acne Vulgaris; Adolescent; Adult; Ampicillin; Escherichia coli; Feces; Female; Humans; Intestines; Male; Penicillin Resistance; R Factors; Streptomycin; Sulfonamides; Tetracycline

Results of blood chemistry studies using an automated multiple analysis system and blood cell counts for 325 patients receiving long-term low-dosage tetracycline hydrochloride therapy continuously for three years or longer revealed minimal changes in all but one patient. This patient developed a transient hyperbilirubinemia with mild juandice while taking 500 mg of tetracycline daily.

Topics: Acne Vulgaris; Adolescent; Adult; Aged; Blood Cell Count; Blood Chemical Analysis; Cellulitis; Child; Female; Folliculitis; Furunculosis; Humans; Male; Rosacea; Tetracycline; Time Factors

Topics: Acne Vulgaris; Humans; Tetracycline

Topics: Acne Vulgaris; Adult; Female; Humans; Male; Middle Aged; Tetracycline

Topics: Acne Vulgaris; Adult; Aged; Facial Dermatoses; Female; Humans; Male; Middle Aged; Rosacea; Tetracycline

Oral tetracycline eliminated the histochemical staining for nonspecific esterase in human sebaceous glands after two weeks of administration. This evidence offers further support for the hypothesis that the clinical benefits of tetracycline result from suppression of follicular esterase-lipases, probably those from C. acnes.

Topics: Acid Phosphatase; Acne Vulgaris; Esterases; Histocytochemistry; Humans; Male; Sebaceous Glands; Skin; Tetracycline

Topics: Acne Vulgaris; Adolescent; Humans; Injections, Intradermal; Male; Tetracycline; Triamcinolone Acetonide

The aim of all acne therapy is sebostasis and treatment of Corynebacterium acnes as well as secondary infected postular changes. After discussion of Tretinoin (Retinoic acid)-treatment it is reported about 35 cases of acne vulgaris which were treated with the combination of Hexachlorophenspiritus 1%,Silicatgel locally and Tetracycline orally. The good results of this treatment are reported. Side effects have not been observed.

Topics: Acne Vulgaris; Drug Therapy, Combination; Gels; Hexachlorophene; Humans; Silicon Dioxide; Tetracycline

Topics: Acne Vulgaris; Female; Humans; Liver Cirrhosis; Male; Tetracycline; Time Factors

Topics: Acne Vulgaris; Adolescent; Benzoates; Clindamycin; Dermabrasion; Estrogens; Fatty Acids; Female; Humans; Irritants; Peroxides; Sebaceous Glands; Sebum; Tetracycline; Vitamin A

Topics: Acne Vulgaris; Administration, Oral; Candidiasis, Vulvovaginal; Clindamycin; Colitis; Demeclocycline; Drug Evaluation; Erythromycin; Female; Humans; Minocycline; Photosensitivity Disorders; Tetracycline; Time Factors

This is the first American report, to our knowledge, of a case of acne aestivalis, which occurred in a woman with a recurrent acneform eruption in summertime. The histopathologic sequence was very similar to that found in cases of steroid acne; namely, local necrosis of the follicular epithelium was followed by the formation of a comedo. No cause was found. Treatment with tretinoin brought about regression of the lesions.

Topics: Acne Vulgaris; Administration, Oral; Administration, Topical; Adult; Biopsy; Female; Humans; Periodicity; Radiation Dosage; Seasons; Skin; Tetracycline; Tretinoin; Ultraviolet Therapy

Topics: Acne Vulgaris; Administration, Topical; Ascorbic Acid; Humans; Niacinamide; Pyridoxine; Riboflavin; Rosacea; Tetracycline

Topics: Acne Vulgaris; Administration, Oral; Female; Humans; Nitrogen; Tetracycline; Warts

Topics: Acne Vulgaris; Adolescent; Adult; Depression, Chemical; Female; Hemoglobins; Humans; Intestinal Absorption; Iron; Iron Radioisotopes; Middle Aged; Tetracycline; Time Factors; Transferrin; Whole-Body Counting

Topics: Acne Vulgaris; Adolescent; Adult; Aged; Alanine Transaminase; Alkaline Phosphatase; Bilirubin; Blood Urea Nitrogen; Child; Female; Follow-Up Studies; Humans; Kidney Function Tests; Liver Function Tests; Male; Middle Aged; Rosacea; Skin Diseases; Tetracycline; Time Factors

Topics: Acne Vulgaris; Adrenal Cortex Hormones; Adult; Blister; Contraceptives, Oral; Cosmetics; Dermatologic Agents; Drug Eruptions; Eczema; Facial Dermatoses; Female; Fusobacterium; Humans; Male; Pruritus; Rosacea; Tetracycline; Vitamin B Deficiency

Topics: Acne Vulgaris; Administration, Oral; Administration, Topical; Adolescent; Anti-Bacterial Agents; Contraceptives, Oral; Cosmetics; Diet; Drug Therapy, Combination; Erythromycin; Facial Injuries; Female; Humans; Male; Psychophysiologic Disorders; Scalp; Tetracycline; Triamcinolone Acetonide; Vitamin A

Topics: Acne Vulgaris; Adolescent; Adult; Clindamycin; Erythromycin; Female; Humans; Male; Ointments; Resorcinols; Salicylates; Tetracycline

Topics: Acne Vulgaris; Adrenal Cortex Hormones; Adrenal Glands; Adult; Androgens; Dexamethasone; Estrogens; Female; Humans; Menstruation; Metabolic Diseases; Pregnancy; Puerperal Disorders; Tetracycline

Topics: Acne Vulgaris; Administration, Topical; Coloring Agents; Cytarabine; Dermatologic Agents; Ethyl Ethers; Female; Glutaral; Herpes Simplex; Herpes Zoster; Humans; Ichthyosis; Injections, Intradermal; Injections, Intravenous; Male; Phototherapy; Skin Diseases, Infectious; Stomatitis, Aphthous; Tetracycline; Triamcinolone; Triamcinolone Acetonide; Urea; Vitamin A; Warts

Topics: Acne Vulgaris; Amphotericin B; Fatty Acids, Nonesterified; Humans; Propionibacterium acnes; Sebaceous Glands; Sebum; Skin; Tetracycline

Topics: Acne Vulgaris; Adolescent; Adult; Contraceptives, Oral; Female; Humans; Tetracycline

Topics: Acne Vulgaris; Adolescent; Female; Humans; Hyperbilirubinemia; Male; Tetracycline

Topics: Acne Vulgaris; Adolescent; Adult; Anti-Infective Agents, Local; Dimethyl Sulfoxide; Drug Combinations; Drug Therapy, Combination; Estrone; Female; Humans; Male; Tetracycline

Topics: Acne Vulgaris; Biological Availability; Clindamycin; Colitis; Drug Resistance, Microbial; Humans; Lincomycin; Staphylococcal Infections; Tetracycline

Topics: Acne Vulgaris; Estrogens; Glucocorticoids; Humans; Sulfur; Tetracycline; Vitamin A

Topics: Acne Vulgaris; Estrogens; Gentamicins; Heliotherapy; Humans; Sunlight; Tetracycline; Ultraviolet Therapy; Vitamin A

Topics: Acne Vulgaris; Adrenal Cortex Hormones; Anti-Infective Agents; Anti-Infective Agents, Local; Clindamycin; Estrogens; Fatty Acids, Nonesterified; Humans; Sebum; Soaps; Tetracycline; Ultraviolet Therapy

Topics: Acne Vulgaris; Adolescent; Adult; Ampicillin; Bacteria; Escherichia coli; Gentamicins; Humans; Long-Term Care; Male; Penicillin Resistance; Proteus; Selenium; Tetracycline

Topics: Acne Vulgaris; Administration, Topical; Adolescent; Benzoyl Peroxide; Corynebacterium Infections; Drug Therapy, Combination; Fatty Acids; Fatty Acids, Nonesterified; Humans; Peroxides; Propionibacterium acnes; Skin; Tetracycline; Tretinoin; Vitamin A

Topics: Acne Vulgaris; Adolescent; Carcinoma, Squamous Cell; Female; Humans; Immunologic Deficiency Syndromes; Palatal Neoplasms; Tetracycline

Topics: Acne Vulgaris; Acute Disease; Adolescent; Ampicillin; Anemia; Anti-Bacterial Agents; Cephalosporins; Erythromycin; Female; Fever; Follow-Up Studies; Humans; Joint Diseases; Leukemoid Reaction; Male; Nephritis; Prednisolone; Skin Diseases; Syndrome; Tetracycline; Triamcinolone

Topics: Acne Vulgaris; Adolescent; Androgens; Dermabrasion; Diet Therapy; Diuretics; Estrogens; Fatty Acids, Nonesterified; Female; Glucocorticoids; Humans; Male; Skin; Testosterone; Tetracycline; Vitamin A

Topics: Acne Vulgaris; Adolescent; Carotenoids; Cysts; Fatty Acids, Unsaturated; Hemophilia A; Hemorrhage; Humans; Male; Steroids; Tetracycline

Topics: Acne Vulgaris; Bromides; Circadian Rhythm; Crystallization; Esters; Fatty Acids, Nonesterified; Humans; Hydrocarbons; Hydrolysis; Iodides; Methods; Sebum; Spectrophotometry, Infrared; Temperature; Tetracycline; Thallium

Topics: Acne Vulgaris; Anti-Bacterial Agents; Clindamycin; Humans; Lincomycin; Tetracycline

Topics: Acne Vulgaris; Anti-Bacterial Agents; Humans; Tetracycline

Topics: Acne Vulgaris; Adolescent; Adult; Estrogens; Female; Humans; Male; Tetracycline; Vitamin A; Vitamin E

Topics: Acne Vulgaris; Administration, Oral; Adolescent; Anemia, Macrocytic; Blood Cell Count; Blood Transfusion; Bone Marrow; Female; Folic Acid; Folic Acid Deficiency; Hematocrit; Hemoglobins; Humans; Injections, Intramuscular; Schilling Test; Tetracycline

Topics: Acne Vulgaris; Bronchitis; Drug Resistance, Microbial; Furunculosis; Humans; Tetracycline

Topics: Acne Vulgaris; Adolescent; Benzoates; Color; Female; Hair; Humans; Peroxides; Pigmentation; Tetracycline

Topics: Acne Vulgaris; Adolescent; Humans; Tetracycline

A satisfactory clinical response to long-term oral tetracycline treatment was associated with a mean serum tetracycline of 1.98 mug/ml. The surface lipid showed an increased triglyceride, decreased free fatty acids, and decreased cholesterol, and the amount of keratin within the pilosebaceous duct was reduced. At this dose level there was no quantitative decrease in the bacterial flora though there was a decrease in the fatty acids. We believe that the latter was due to a direct inhibition by tetracycline on extracellular lipases.

Topics: Acne Vulgaris; Administration, Oral; Adolescent; Adult; Cholesterol; Chromatography, Thin Layer; Fatty Acids, Nonesterified; Humans; Keratins; Lipids; Micrococcus; Skin; Squalene; Staphylococcus; Tetracycline; Triglycerides

Topics: Acne Vulgaris; Clindamycin; Corticosterone; Dermabrasion; Hexachlorophene; Humans; Propionibacterium acnes; Sebaceous Glands; Sebum; Staphylococcus; Sulfur; Tetracycline; Ultraviolet Therapy; Vitamin A

Topics: Acne Vulgaris; Adolescent; Adult; Drug Resistance, Microbial; Humans; Microbial Sensitivity Tests; Propionibacterium acnes; Staphylococcus; Tetracycline

Topics: Acne Vulgaris; Contraceptives, Oral; Female; Humans; Tetracycline; Vitamin A

Topics: Acne Vulgaris; Adolescent; Candidiasis, Vulvovaginal; Female; Humans; Tetracycline; Vaginitis

Topics: Acne Vulgaris; Humans; Tetracycline

Topics: Acne Vulgaris; Adolescent; Adult; Evaluation Studies as Topic; Female; Humans; Male; Tetracycline; Time Factors; Vaginitis

Topics: Acne Vulgaris; Cyanoacrylates; Hair; Humans; Keratins; Lipids; Microscopy, Electron; Sebaceous Glands; Sebum; Tetracycline

Topics: Acne Vulgaris; Contraceptives, Oral; Diet Therapy; Dietary Fats; Emulsions; Humans; Sebaceous Glands; Skin; Tetracycline; Vitamin A

Topics: Acne Vulgaris; Adolescent; Adult; Female; Humans; Nails; Photosensitivity Disorders; Pigmentation Disorders; Tetracycline

Topics: Acne Vulgaris; Humans; Lipase; Skin Absorption; Tetracycline

Topics: Acne Vulgaris; Administration, Oral; Adolescent; Adult; Candida albicans; Candidiasis; Female; Humans; Infections; Long-Term Care; Male; Middle Aged; Surveys and Questionnaires; Tablets; Tetracycline

Topics: Acne Vulgaris; Aged; Dihydroxyphenylalanine; Fatty Acids, Nonesterified; Female; Humans; Lipid Metabolism; Lipids; Male; Middle Aged; Parkinson Disease; Sebum; Skin; Tetracycline; Time Factors

Topics: Acne Vulgaris; Drug Eruptions; Gentamicins; Germany, West; Humans; Terminology as Topic; Tetracycline; United States

Topics: Acne Vulgaris; Adolescent; Diagnosis, Differential; Gonorrhea; Humans; Male; Neisseria gonorrhoeae; Tetracycline

Topics: Acne Vulgaris; Administration, Oral; Adult; Axilla; Bacillus; Bacteria; Corynebacterium; Erythromycin; Face; Humans; Lincomycin; Male; Penicillin Resistance; Penicillins; Sarcina; Skin; Staphylococcus; Tetracycline

A lipase which hydrolyzes triglycerides (tricaprylin and trilaurin) and naphthyl laurate was obtained from the broth of Corynebacterium acnes cultures by ammonium sulfate fractionation. Ca(2+) and sodium taurocholate stimulated activity of the enzyme. Ethylenediaminetetraacetic acid (EDTA) did not inhibit activity of the Ca(2+)-activated enzyme, but lipolytic activity was inhibited by EDTA in the absence of Ca(2+). Tetracycline (10(-4)m) produced a slight inhibition of the lipase activity with 5 x 10(-5)m or less showing no effect on the lipase activity. However, complete inhibition by tetracycline at 10(-4)m was observed for Ca(2+)-activated enzyme. Tetracycline inhibition of the C. acnes lipase could be demonstrated at concentrations as low as 10(-6)m.

Topics: Acne Vulgaris; Bile Acids and Salts; Calcium; Chemical Precipitation; Chromatography, Thin Layer; Colorimetry; Corynebacterium; Edetic Acid; Enzyme Activation; Humans; Hydrolysis; Lipase; Quaternary Ammonium Compounds; Sulfates; Tetracycline; Triglycerides

Topics: Acne Vulgaris; Chemical Phenomena; Chemistry; Chlorides; Chromatography; Corynebacterium; Humans; Hydrogen-Ion Concentration; Lipase; Protein Binding; Serum Albumin, Bovine; Species Specificity; Tetracycline; Tritium

Topics: Acne Vulgaris; Administration, Oral; Benzoates; Cosmetics; Dermatologic Agents; Diet Therapy; Erythromycin; Estrogens; Female; Humans; Male; Peroxides; Resorcinols; Salicylates; Sulfur; Tetracycline; Thiosulfates

Topics: Acne Vulgaris; Adolescent; Age Factors; Androgens; Corynebacterium; Dermatitis, Contact; Dermatologic Agents; Diagnosis, Differential; Drug Eruptions; Endocrine System Diseases; Hair; Humans; Male; Psychophysiologic Disorders; Sebaceous Glands; Tetracycline; Ultraviolet Therapy

Topics: Acne Vulgaris; Adolescent; Anti-Bacterial Agents; Corynebacterium; Fatty Acids, Nonesterified; Female; Humans; Male; Skin; Staphylococcus; Tetracycline

Topics: Acne Vulgaris; Adolescent; Brain Diseases; Female; Humans; Intracranial Pressure; Papilledema; Pseudotumor Cerebri; Remission, Spontaneous; Tetracycline

Topics: Acne Vulgaris; Adrenal Glands; Adult; Depression, Chemical; Diet; Humans; Hydrocortisone; Injections, Intradermal; Male; Methods; Tetracycline; Time Factors; Triamcinolone Acetonide

Topics: Acne Vulgaris; Administration, Oral; Adult; Drug Eruptions; Humans; Male; Tetracycline

Topics: Acne Vulgaris; Dermatitis, Seborrheic; Hormones; Humans; Tetracycline; Vitamin A

Topics: 17-Ketosteroids; Acne Vulgaris; Adrenal Cortex Hormones; Anti-Bacterial Agents; Betamethasone; Dermatitis; Fludrocortisone; Humans; Hydrocortisone; Intestinal Diseases; Intestine, Small; Ointments; Prednisolone; Psoriasis; Skin Diseases; Tetracycline

Topics: Acne Vulgaris; Chromatography; Corynebacterium; Culture Media; Humans; Skin; Species Specificity; Tetracycline; Triglycerides

Topics: Acne Vulgaris; Administration, Oral; Adult; Ampicillin; Betamethasone; Cellulitis; Humans; Lincomycin; Male; Proteus; Proteus Infections; Tetracycline

Topics: Acne Vulgaris; Adolescent; Adrenal Cortex Hormones; Dermatologic Agents; Female; Humans; Male; Sebaceous Glands; Testosterone; Tetracycline

Topics: Acne Vulgaris; Adolescent; Blood Cell Count; Blood Cells; Blood Sedimentation; Erythrocytes; Female; Hemoglobins; Humans; Leukocyte Count; Leukopenia; Male; Reticulocytes; Tetracycline

Topics: Acne Vulgaris; Adolescent; Contraceptives, Oral; Dermatologic Agents; Diet Therapy; Female; Humans; Male; Tetracycline; Vitamin A

Topics: Acne Vulgaris; Adolescent; Adult; Contraceptives, Oral; Dermatologic Agents; Diet Therapy; Female; Humans; Tetracycline

Topics: Acne Vulgaris; Diet Therapy; Female; Hospital Departments; Humans; Male; Prednisolone; Tetracycline

Topics: Acne Vulgaris; Adolescent; Adult; Anti-Infective Agents, Local; Estrogens; Female; Humans; Infant; Male; Tetracycline

Topics: Acne Vulgaris; Adolescent; Corynebacterium; Dermabrasion; Diet Therapy; Female; Gonadal Steroid Hormones; Humans; Keratins; Menstruation; Temperature; Tetracycline; Ultraviolet Rays

Topics: Acne Vulgaris; Humans; Sebum; Tetracycline

Topics: Acne Vulgaris; Administration, Topical; Anti-Inflammatory Agents; Humans; Hydrocortisone; Quinolines; Rosacea; Tetracycline

Topics: Acne Vulgaris; Animals; Basement Membrane; Female; Humans; Injections, Intramuscular; Keratins; Male; Microscopy, Fluorescence; Psoriasis; Rats; Rosacea; Sebaceous Glands; Skin; Tail; Tetracycline

Topics: Acne Vulgaris; Contraceptives, Oral; Cosmetics; Drug Hypersensitivity; England; Humans; Tetracycline

Topics: Acne Vulgaris; Adolescent; Adult; Corynebacterium; Esters; Fatty Acids, Nonesterified; Humans; Male; Sebaceous Glands; Sebum; Tetracycline; Triglycerides

Topics: Acne Vulgaris; Adult; Female; Humans; Skin Diseases; Tetracycline; Yeasts

Topics: Acne Vulgaris; Humans; Skin Diseases; Tetracycline

Topics: Acne Vulgaris; Adolescent; Adult; Aged; Animals; Dermatitis; Female; Furunculosis; Humans; Lymphadenitis; Male; Microbial Sensitivity Tests; Middle Aged; Photosensitivity Disorders; Rabbits; Skin; Skin Diseases; Staphylococcus; Tetracycline; Tinea

Topics: Acne Vulgaris; Adolescent; Adult; Aged; Blister; Blood Proteins; Chemical Phenomena; Chemistry; Female; Furunculosis; Humans; Male; Microbial Sensitivity Tests; Middle Aged; Skin Diseases; Staphylococcus; Tetracycline

Topics: Acne Vulgaris; Adolescent; Adult; Animals; Child, Preschool; Eczema; Female; Furunculosis; Humans; Male; Mice; Microbial Sensitivity Tests; Skin Diseases, Infectious; Skin Ulcer; Staphylococcal Infections; Staphylococcus; Suppuration; Tetracycline

Topics: Abscess; Acne Vulgaris; Adolescent; Adult; Aged; Cellulitis; Demeclocycline; Female; Furunculosis; Humans; Male; Microbial Sensitivity Tests; Middle Aged; Skin Diseases; Staphylococcus; Tetracycline

Topics: Acne Vulgaris; Adolescent; Adult; Female; Humans; Lymecycline; Male; Tetracycline

Topics: Acne Vulgaris; Bandages; Fluocinolone Acetonide; Humans; Ointments; Tetracycline

Topics: Acne Vulgaris; Adrenal Cortex Hormones; Adult; Humans; Male; Tetracycline

Topics: Acne Vulgaris; Diet Therapy; Female; Humans; Male; Soaps; Tetracycline

Topics: Acne Vulgaris; Adrenal Cortex Hormones; Dermatologic Agents; Estrogens; Long-Term Care; Resorcinols; Rosacea; Tetracycline

Topics: Acne Vulgaris; Anti-Bacterial Agents; Antifungal Agents; Carbuncle; Chlortetracycline; Eczema; Erysipelas; Folliculitis; Furunculosis; Griseofulvin; Humans; Impetigo; Lupus Vulgaris; Paronychia; Penicillins; Scalp Dermatoses; Skin Diseases, Infectious; Tetracycline

Topics: Acne Vulgaris; Corynebacterium; Fatty Acids; Fluorescence; Humans; Photography; Tetracycline; Triglycerides

Topics: Acne Vulgaris; Adolescent; Adult; Aerosols; Cicatrix; Cysts; Female; Follow-Up Studies; Humans; Injections; Male; Tetracycline; Triamcinolone Acetonide

Topics: Acne Vulgaris; Adolescent; Adult; Child; Corynebacterium; Demeclocycline; Female; Humans; Male; Middle Aged; Penicillin V; Staphylococcus; Tetracycline

Topics: Acne Vulgaris; Adult; Black or African American; Cellulitis; Chronic Disease; Hexachlorophene; Humans; Male; Scalp Dermatoses; Staphylococcus; Tetracycline

Topics: Acne Vulgaris; Female; Humans; Tetracycline

Topics: Acne Vulgaris; Humans; Skin; Tetracycline; Time Factors

Topics: Acne Vulgaris; Adolescent; Adult; Fatty Acids; Fatty Acids, Nonesterified; Female; Humans; Male; Skin; Tetracycline

Topics: Acne Vulgaris; Gonorrhea; Humans; Oleandomycin; Pyoderma; Skin Diseases; Steroids; Syphilis; Tetracycline; Urethritis

Topics: 1-Propanol; Acne Vulgaris; Adolescent; Adult; Dermatologic Agents; Dexamethasone; Diet Therapy; Drug Synergism; Female; Hexachlorophene; Humans; Male; Salicylates; Sulfur; Tetracycline

Topics: Acne Vulgaris; Corynebacterium; Humans; In Vitro Techniques; Staphylococcus; Tetracycline

Topics: Acne Vulgaris; Female; Humans; Pregnancy; Tetracycline

Topics: Acne Vulgaris; Adult; Humans; Keratoacanthoma; Male; Methotrexate; Middle Aged; Tetracycline

Topics: Acne Vulgaris; Adolescent; Anti-Bacterial Agents; Diet; Diet Therapy; Drug Therapy; Eczema; Hexachlorophene; Humans; Immunization; Ointments; Psychotherapy; Staphylococcal Toxoid; Steroids; Sulfisoxazole; Tetracycline

Topics: Acne Vulgaris; Anti-Bacterial Agents; Diagnosis; Humans; Pharmacology; Psoriasis; Tetracycline; Ultraviolet Rays

Topics: Acne Vulgaris; Adolescent; Anti-Bacterial Agents; Demeclocycline; Drug Therapy; Humans; Placebos; Tetracycline

Topics: Acne Vulgaris; Adolescent; Adult; Chemical Phenomena; Chemistry; Child; Fatty Acids; Female; Humans; Male; Sebum; Tetracycline

Topics: Acne Vulgaris; Anti-Bacterial Agents; Demeclocycline; Humans; Tetracycline; Toxicology

Topics: Acne Vulgaris; Adolescent; Adrenal Cortex Hormones; Adrenocorticotropic Hormone; Androgens; Anti-Bacterial Agents; Drug Therapy; Estradiol; Estrogens; Folliculitis; Halogens; Hexachlorophene; Humans; Infant; Infant, Newborn; Minor Surgical Procedures; Neomycin; Penicillins; Resorcinols; Salicylates; Sebaceous Glands; Sulfur; Tetracycline; Toxicology; Triamcinolone

Topics: Acne Vulgaris; Anti-Bacterial Agents; Antibiotics, Antitubercular; Dermatologic Agents; Drug Therapy; Female; Humans; Norethynodrel; Protein Synthesis Inhibitors; Tetracycline

Topics: Acne Vulgaris; Female; Fetal Diseases; Humans; Maternal-Fetal Exchange; Pigmentation; Pigmentation Disorders; Pregnancy; Pregnancy Complications; Tetracycline; Tooth; Toxicology

A total of 120 consecutive patients with pustular and cystic acne vulgaris were selected for study. Patients were assigned a placebo and a tetracycline medication in a random method. Of the 53 patients who were given tetracycline, 45 showed some response, which was fair in 19 and excellent in 26. Of the 55 patients who received placebo, 24 showed no response while 31 showed some improvement. No side effects were reported. The difference in response between the two groups is statistically significant. It is concluded that administration of 250 mg. tetracycline four times daily, even for periods as short as two weeks, enhances the likelihood of improvement of cystic or pustular acne vulgaris.

Topics: Acne Vulgaris; Anti-Bacterial Agents; Canada; Female; Humans; Male; Probability; Tetracycline

Topics: Acne Vulgaris; Anti-Bacterial Agents; Humans; Tetracycline

Topics: Acne Vulgaris; Anti-Bacterial Agents; Antibiotics, Antitubercular; Capsules; Dermatologic Agents; Humans; Novobiocin; Phosphates; Protein Synthesis Inhibitors; Tetracycline

Topics: Acne Vulgaris; Anti-Bacterial Agents; Humans; Protein Synthesis Inhibitors; Tetracycline

Topics: Acne Vulgaris; Anti-Bacterial Agents; Humans; Protein Synthesis Inhibitors; Rosacea; Sulfacetamide; Sulfadiazine; Sulfamerazine; Sulfanilamide; Sulfanilamides; Sulfonamides; Tetracycline

Topics: Acne Vulgaris; Anti-Bacterial Agents; Emulsions; Humans; Protein Synthesis Inhibitors; Suspensions; Tetracycline

Topics: Acne Vulgaris; Anti-Bacterial Agents; Antibiotics, Antitubercular; Dermatologic Agents; Humans; Oleandomycin; Protein Synthesis Inhibitors; Tetracycline

Topics: Acne Vulgaris; Anti-Bacterial Agents; Antibiotics, Antitubercular; Dermatologic Agents; Humans; Nystatin; Protein Synthesis Inhibitors; Skin Diseases; Tetracycline

Topics: Acne Vulgaris; Anti-Bacterial Agents; Humans; Protein Synthesis Inhibitors; Tetracycline

Topics: Acne Vulgaris; Anti-Bacterial Agents; Humans; Protein Synthesis Inhibitors; Tetracycline