Medicine by Alexandros G. Sfakianakis,Αλέξανδρος Γ. Σφακιανάκης

Acne vulgaris is a highly heritable trait.
Genetic loci are associated with multiple biological processes and systems.
Monogenic disorders with acne and acne‐like manifestations identify sebaceous gland development and tissue remodelling as key mechanisms in acne pathogenesis.

What does this study add?

We comprehensively review the available literature to catalogue the human genetic variation associated with acne vulgaris.
We contextualize the genetic data with underlying disease mechanisms for better understanding of acne pathogenesis.

Linked Editorial: Van Steensel. Br J Dermatol 2019; 181:647–648.

Homeostasis of the sebaceous gland and mechanisms of acne pathogenesis

R.W. Clayton, K. Göbel, C.M. Niessen, R. Paus, M.A.M. van Steensel, X. Lim

Pages: 677-690 | First Published: 06 May 2019

What's already known about this topic?

Sebaceous glands (SGs) are skin appendages that synthesize lipids (sebum).
Several skin diseases, including acne, feature abnormal SGs.
Androgens are essential for both SG maintenance and acne.
Retinoids and oestrogens, which can be used to treat acne effectively, cause dramatic SG involution.

What does this study add?

We synthesize both historical and current literature and generate testable hypotheses regarding SG homeostasis and acne pathogenesis.
We present an up‐to‐date model of the cellular and molecular mechanisms that underpin SG homeostasis.
We discuss evidence supporting a model of comedo formation where the progenitor cells that contribute to the SG and infundibulum differentiate abnormally.

Linked Editorial: Van Steensel. Br J Dermatol 2019; 181:647–648.

The role of the skin microbiota in acne pathophysiology

S. Ramasamy, E. Barnard, T.L. Dawson Jr, H. Li

Pages: 691-699 | First Published: 24 July 2019

What's already known about this topic?

Acne is among the most common skin disorders, but little is known about its aetiology.
While a role for the skin microbiome is postulated, its involvement remains unclear.

What does this study add?

This review outlines what is known about the role of skin microbes in acne.
This article describes the use of multiple methodologies for sampling and analysis of microbiology in acne studies.
Positives and negatives of each methodology are reviewed and key needs are defined.

Linked Editorial: Van Steensel. Br J Dermatol 2019; 181:647–648.
Linked Comment: Ochsendorf. Br J Dermatol 2019; 181:657–658.

Assessing effectiveness in acne clinical trials: steps towards a core outcome measure set

D.M. Thiboutot, A.M. Layton, M.‐M. Chren, E.A. Eady, J. Tan

Pages: 700-706 | First Published: 19 April 2019

What's already known about this topic?

In 2017, a core set of outcomes to measure in all future acne trials was proposed by the Acne Core Outcomes Research Network (ACORN) following a multistep consensus‐based process that involved patients, clinicians, trial investigators and trial sponsors from around the globe.
The next step is to identify or, where necessary, develop validated instruments and standardized methods to measure each outcome in the core set.

What does this study add?

The processes ACORN will adopt until full validation of the core outcome measure set are described.
An analysis of the main challenges in devising a core outcome measure set for international adoption is presented.
Pros and cons of relying on patient‐reported outcome measures are discussed, especially in relation to global severity rating.
Advances in automated acne assessment are outlined. Their relevance to the longevity of core outcome sets is highlighted.

What are the clinical implications of this work?

Use of a fully validated core outcome measure set, compliant with regulatory standards and universally adopted in acne clinical trials, will standardize measurement of the most important clinical outcomes and thereby facilitate pooling of data from small trials and meta‐analyses.

Linked Editorial: Van Steensel. Br J Dermatol 2019; 181:647–648.

REVIEW ARTICLE

Open Access

Understanding economic evidence for the prevention and treatment of atopic eczema

T.H. Sach, E. McManus, N.J. Levell

Pages: 707-716 | First Published: 28 January 2019

What's already known about this topic?

Resources available for health care are limited and their efficient allocation should be informed by robust economic evidence about value for money.
The scale and quality of economic evidence available for atopic eczema has not previously been examined.

What does this study add?

By comparison with the considerable clinical evidence for interventions to prevent and treat eczema, there is limited economic evidence available.
The economic evidence available is limited in scope with regard to the types and range of interventions evaluated.
The quality of future economic studies could be improved by greater collaboration between economists and clinicians.

Plain language summary available online

Evidence‐Based Dermatology
CRITICALLY APPRAISED RESEARCH PAPER

Suicidality and risk of suicidality in psoriasis: a critical appraisal of two systematic reviews and meta‐analyses

U. Matterne, S.E. Baumeister, C.J. Apfelbacher

Pages: 717-721 | First Published: 10 May 2019

20 of 88 articles shown

Medicine by Alexandros G. Sfakianakis,Αλέξανδρος Γ. Σφακιανάκης

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Τετάρτη 2 Οκτωβρίου 2019

Issue Information

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What does acne genetics teach us about disease pathogenesis?

Homeostasis of the sebaceous gland and mechanisms of acne pathogenesis

The role of the skin microbiota in acne pathophysiology

Assessing effectiveness in acne clinical trials: steps towards a core outcome measure set

Understanding economic evidence for the prevention and treatment of atopic eczema

Suicidality and risk of suicidality in psoriasis: a critical appraisal of two systematic reviews and meta‐analyses

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