MIN Zhongsheng's Clinical Experience in Delayed Post-adolescent Acne / 浙江中医药大学学报

[Objective] To explore the clinical experience of Professor MIN Zhongsheng treatment in delayed post -adolescent acne. [Methods] Through studying with Professor MIN, collecting clinical medical cases, representing academic views of others, discussing clinical experience of Professor MIN, treatment in delayed post -adolescent acne from the pathogenesis, explanation of the prescription was presented, and a classic case was cited as an evidence. [Results] Ancient doctors considered that wind, cold, heat and wet were the external cause, while the weakness of vital Qi and blood heat were the internal cause. It led to stasis, when body was infected with wind-cold damp pathogen. Professor MIN considers that the etiology of this disease contains two aspects, one is endocrine disorder, the other is metal facts. He also thinks that deficiency of energy is the root cause and blood stagnation is the clinical manifestation. He also regards tonifying Yin of liver and kidney,cleating away heat and toxin, removing blood stasis as treatment. In the classic case, Professor MIN used Rubus idaeus L, Eclipta prostrata as monarch drugs to tonify Yin of liver and kidney; used Hedyotis diffusa, Taraxacum mongolicum, Citrus reticulata Blanco, Salvia miltiorrhiza as minister drugs to clear away heat and toxin, and remove blood stasis. The patient of delayed post-adolescent acne became much better after the treatment.[Conclusion]The therapeutic method put emphases on tonifying Yin of liver and kidney, then clearing away heat and toxin. Removing blood stasis is the key of the treatment.

Relationship between clinical types and related risk factors in female patients with post-adolescent acne / 中华皮肤科杂志

Objective To investigate the relationship between clinical types and related risk factors in female patients with post-adolescent acne.Methods Female outpatients with post-adolescent acne aged more than 25 years were enrolled from Department of Dermatology of Renji Hospital between January and October 2016.A questionnaire survey was conducted to investigate related risk factors for post-adolescent acne in the females.Skin lesions and clinical types were evaluated by dermatologists.Statistical analysis was carried out by t test for comparison of means between two groups and by chi-square test for comparison of ratios.Results A total of 312 female patients with post-adolescent acne completed the survey,including 268 (85.9％) with mild to moderate acne and 44 (14.1％) with severe acne,241 (77.2％) with persistent acne and 71 (22.8％) with late-onset acne,or 102 (32.7％) with comedonal post-adolescent acne (CPAA) and 210 (67.3％) with papular post-adolescent acne (PPAA).Survey on related risk factors showed that 121 patients reported seasonal factors and 59 (18.9％) patients became worse in summer,and spicy,sweet and fried foods can aggravate the condition in 131 (42％),93 (29.8％) and 85 (27.2％) patients respectively.Other risk factors such as premenstrual period (62.8％,196/312),psychological factors (51.6％,161/312) and exogenous chemical exposures (43.6％,136/312) were complained of by the patients.Furthermore,premenstrual period,diet and constipation were found to be more associated with PPAA compared with CPAA (x2 =4.523,4.068,3.910,respectively,all P ＜ 0.05).Exogenous chemical exposures,such as the use of cosmetics,exposure to polluted air environment and occupational hazards,were more associated with CPAA compared with PPAA,as well as with late-onset acne compared with persistent acne (x2 =6.579,9.057,both P ＜ 0.05).In addition,premenstrual exacerbation occurred more frequently in patients with persistent acne compared with those with late-onset ache (x2 =4.512,P ＜ 0.05).Conclusions The risk factors for the occurrence of female post-adolescent acne are very complex.Premenstrual exacerbation plays a major role in the aggravation of papular and persistent post-adolescent acne,diet and constipation are more associated with PPAA,and exogenous chemical exposures are still be considered in the aggravation of comedonal and late-onset post-adolescent acne.Thus,clinical types should be considered in the diagnosis and treatment of post-adolescent acne in females.

Clinical Manifestation and Elevated Serum Insulin-like Growth Factor-1 (IGF-1) Levels with Post-adolescent Acne / 대한피부과학회지

BACKGROUND: Acne has been recognized as a common disorder amongst adolescents but recent studies have documented increased prevalence of post-adolescent acne. OBJECTIVE: The purpose of this study was to demonstrate insulin resistance in post-adolescent acne by examining insulin, insulin like growth factor-1 (IGF-1), and insulin like growth factor binding protein-3 (IGFBP-3) compared to those in normal controls. METHODS: Twenty-eight patients with acne between 25 and 45 years and 10 control individuals were studied. We classified the post-adolescent acne into persistent and late-onset types according to onset ages. We compared clinical features and the levels of fasting insulin, IGF-1, and IGFBP-3 in persistent and late-onset type of post-adolescent acne. RESULTS: Among the post-adolescent group, there were few patients of metabolic syndrome. But, the mean serum levels of IGF-1 were significantly increased in post-adolescent acne compared to those in controls. Mean serum levels of IGFBP-3 were decreased in post-adolescent acne. Compared to persistent type, late-onset type showed more inflammatory acne lesions. Increased fasting insulin, IGF-1, and decreased IGFBP-3 in late-onset type compared to those in persistent type were observed. CONCLUSION: Results of this study indicate that insulin resistance could have a role in pathogenesis of post-adolescent acne.

The Study of Post-adolescent Acne in Nurses / 대한피부과학회지

BACKGROUND: Acne is usually considered a disorder of adolescence, and a number of studies have examined the prevalence of this condition in the adolescent population. However, prevalence of acnes in patients over the age of 25 years has significantly increased. There are relatively few data on the prevalence of acne in the adult population, especially in Korea. Also, although many researches have been conducted into the etiology of this disease, much substantial myth still abounds with the treatment and cause of this condition. OBJECTIVE: This study was carried out to investigate the prevalence of acne in adult women, and to compare adolescent acne with post-adolescent acne in nurses. METHODS: We analyzed the answers from 504 nurses, who work in the St. Mary's Hospital, to questions about the acne. RESULTS: 1. Prevalence of post-adolescent acne was 36% in nurses of above the age of 25. Their mean age of onset of acne was 17.4 years. 2. The forehead and cheeks were the most common predilection sites in both groups. However, the jaw and perioral area were more common in the post-adolescent group than the adolescent group (p<0.05). 3. Positive family history of acne was more common in the post-adolescent group than the adolescent group (p<0.05). 4. Stress was the most important factor to aggravate acne in both groups. Menstrual cycle was related to aggravation of acne in the majority of nurses. However, both stress and menstrual cycle were more related to the post-adolescent group than the adolescent group (p<0.05). 5. Nurses are occupied medical care. Nevertheless, a considerable percentage of them showed wrong actions and incorrect recognition about the acne. CONCLUSION: Prevalence of post-adolescent acne in nurses was relatively high compared with previous data and most of post-adolescent acne was persistent acne.

A Comparative Study between Adolescent Acne and Post-adolescent Acne

BACKGROUND: The prevalence of patients over the age of 25 years with acne has significantly increased over the past 10 years. Several etiologic factors such as genetic factor, hyperandrogenism, stress, and cosmetics have been studied. OBJECTIVES: The purpose of this study is to evaluate the differences between adolescent acne and post-adolescent acne, based on the clinical features, asoociated diseased and aggravating factors of 327 acne patients. METHODS: 327 consective patients, first visited to our hospital with clinical facial acne between March 2000 and February 2001, were enrolled. 220 adolescent patients(AP) were under the age of 25 and post-adolescent patients(PP) were over age of 25. RESULTS: 1. In the face, cheeks and forehead in adolescents, chin and cheeks in post-adolescents were predilection sites. The predominant type was a comedonal type in adolescents and a papulopustular type in post-adolescents(P<0.05). Severity of inflammatory type was not different between two groups. Familial factors were important in both groups, but more frequently found in post-adolescents with persistent acne(P<0.05). 2. Rosacea, chloasma, and hyperandrogenic features such as hirsutism and androgenetic alopecia were more frequently observed in post-adolescents. Seborrheic and atopic dermatitis were more frequent in adolescents. Four patients had all the features of chloasma, acne, rosacea, seborrheic dermatitis and hirsutism. 3. Aggravation by weason especially summer, sweating, stress, and cosmetics was more frequent in adolescents. In PP, acne was more frequently aggravated by sunlight, foods and menstrual period. CONCLUSION: Post-adolescent acne was mainly a papulopustular type predominantly located on the chin and cheeks with mild to moderated severity, and family history and hyperandrogenism were strong etiologic factors in persistent acne. Aggravating factors were not significantly different between two group, which suggested cosmetics and stress might not be important in post adolescent acne.