Publications by authors named "J Piquero-Martin"

Background: Acne pathophysiology includes a complex interaction among inflammatory mediators, hyperseborrhea, alteration of keratinization and follicular colonization by Propionibacterium acnes.

Aims: To describe the impact of the exposome on acne and how photoprotection can improve outcomes.

Methods: A narrative review of the literature was carried out; searches with Google Scholar and Pubmed from January 1992 to November 2022 were performed.

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Acne vulgaris affects more than 80% of adolescents and young adults and forms a substantial proportion of the dermatologist's and general practitioner's caseload. Severity of symptoms varies but may result in facial scarring and psychological repercussions. Oral isotretinoin is highly effective but can only be prescribed by specialists.

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Scientific advances are continually improving the knowledge of acne and contributing to the refinement of treatment options; it is important for clinicians to regularly update their practice patterns to reflect current standards. The Global Alliance to Improve Outcomes in Acne is an international group of dermatologists with an interest in acne research and education that has been meeting regularly since 2001. As a group, we have continuously evaluated the literature on acne.

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Trichotillomania represents a chronic disorder in which patients traumatically remove their own hair in a bizarre pattern. Like obsessive-compulsive disorder, the hair-pulling behavior is recognized as senseless and undesirable, but is performed in response to several emotions and affects, such as increasing anxiety, or unconscious conflicts with a resultant tension relief. The condition may be episodic, but is usually chronic and difficult to treat.

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Systemic treatment is required in patients with moderate-to-severe acne, especially when acne scars start to occur. Antibiotics with anti-inflammatory properties, such as tetracyclines (oxytetracycline, tetracycline chloride, doxycycline, minocycline and limecycline) and macrolide antibiotics (erythromycin and azithromycin) are the agents of choice for papulopustular acne, even though the emerging resistant bacterial strains are minimizing their effect, especially regarding erythromycin. Systemic antibiotics should be administered during a period of 8-12 weeks.

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