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Cutis is a peer-reviewed clinical journal for the dermatologist, allergist, and general practitioner published monthly since 1965. Concise clinical articles present the practical side of dermatology, helping physicians to improve patient care. Cutis is referenced in Index Medicus/MEDLINE and is written and edited by industry leaders.
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A peer-reviewed, indexed journal for dermatologists with original research, image quizzes, cases and reviews, and columns.
Debunking Acne Myths: Do Patients Need to Worry About Acne After Adolescence?
Myth: Acne only occurs in teenagers
Acne typically is associated with teenagers and puberty, and many adult patients may not be aware that acne can persist beyond adolescence or even develop for the first time in adulthood. As the prevalence of adults with acne increases, it is important to educate this population about factors associated with postadolescent acne development and let them know that effective treatments are available.
There are 2 types of adult acne: persistent acne, which refers to adolescent acne that continues beyond 25 years of age, and late-onset acne, which develops for the first time after 25 years of age. Adult acne generally is mild to moderate in severity and may be refractory to treatment. Unlike adolescent acne, which is more prominent in adolescent boys and manifests as the more severe forms of the disease, adult acne primarily affects women and is more inflammatory in nature, making these patients more susceptible to scarring. In one study, acne prevalence among 1055 adult participants (age range, 20–60 years) was estimated at 61.5%; however, only 36.8% were aware of their condition and only 25% sought treatment. The most commonly affected area was the malar region, which differs from acne seen in teenagers. In addition to the cheeks, adult acne generally is more prominent on the lower chin, jawline, and neck, and lesions more commonly present as closed comedones.
Fluctuating hormone levels are a common cause of adult acne, particularly in women during menses or pregnancy, menopause, or perimenopause; women also may experience breakouts after starting or discontinuing birth control pills. Acne flare-ups in adults also have been linked to chronic stress, family history, hair and skin care products, medication side effects, undiagnosed medical conditions, steroid use, increased calorie intake, whole and fat-reduced milk consumption, and tobacco smoking. Adult acne also has been found to be associated with other dermatologic conditions including hirsutism, alopecia, and seborrhea.
Early diagnosis and treatment of adult acne is crucial to ensure good cosmetic outcomes and minimize disease burden. When treating adult acne, particularly in women, dermatologists should consider a variety of factors that set this condition apart from adolescent acne, including the predisposition of older skin to irritation, possible slow response to treatment, a high likelihood of good adherence to treatment, and the psychosocial impact of acne in the adult population. In adult women, it also is important to consider whether patients are of childbearing age when selecting a treatment. Patients also should be encouraged to read the labels on their personal care products to ensure they are noncomedogenic and will not clog pores.
Adult acne. American Academy of Dermatology website. https://www.aad.org/public/diseases/acne-and-rosacea/adult-acne. Accessed January 9, 2018.
Dréno B, Layton A, Zouboulis CC, et al. Adult female acne: a new paradigm [published online January 10, 2013]. J Eur Acad Dermatol Venereol. 2013;27:1063-1070.
Khunger N, Kumar C. A clinic-epidemiological study of adult acne: is it different from adolescent acne? Indian J Dermatol Venereol Leprol. 2012;78:335-341.
Semedo D, Ladeiro F, Ruivo M, et al. Adult acne: prevalence and portrayal in primary healthcare patients, in the Great Porto Area, Portugal [published online September 30, 2016]. Acta Med Port. 2016;29:507-513.
Myth: Acne only occurs in teenagers
Acne typically is associated with teenagers and puberty, and many adult patients may not be aware that acne can persist beyond adolescence or even develop for the first time in adulthood. As the prevalence of adults with acne increases, it is important to educate this population about factors associated with postadolescent acne development and let them know that effective treatments are available.
There are 2 types of adult acne: persistent acne, which refers to adolescent acne that continues beyond 25 years of age, and late-onset acne, which develops for the first time after 25 years of age. Adult acne generally is mild to moderate in severity and may be refractory to treatment. Unlike adolescent acne, which is more prominent in adolescent boys and manifests as the more severe forms of the disease, adult acne primarily affects women and is more inflammatory in nature, making these patients more susceptible to scarring. In one study, acne prevalence among 1055 adult participants (age range, 20–60 years) was estimated at 61.5%; however, only 36.8% were aware of their condition and only 25% sought treatment. The most commonly affected area was the malar region, which differs from acne seen in teenagers. In addition to the cheeks, adult acne generally is more prominent on the lower chin, jawline, and neck, and lesions more commonly present as closed comedones.
Fluctuating hormone levels are a common cause of adult acne, particularly in women during menses or pregnancy, menopause, or perimenopause; women also may experience breakouts after starting or discontinuing birth control pills. Acne flare-ups in adults also have been linked to chronic stress, family history, hair and skin care products, medication side effects, undiagnosed medical conditions, steroid use, increased calorie intake, whole and fat-reduced milk consumption, and tobacco smoking. Adult acne also has been found to be associated with other dermatologic conditions including hirsutism, alopecia, and seborrhea.
Early diagnosis and treatment of adult acne is crucial to ensure good cosmetic outcomes and minimize disease burden. When treating adult acne, particularly in women, dermatologists should consider a variety of factors that set this condition apart from adolescent acne, including the predisposition of older skin to irritation, possible slow response to treatment, a high likelihood of good adherence to treatment, and the psychosocial impact of acne in the adult population. In adult women, it also is important to consider whether patients are of childbearing age when selecting a treatment. Patients also should be encouraged to read the labels on their personal care products to ensure they are noncomedogenic and will not clog pores.
Myth: Acne only occurs in teenagers
Acne typically is associated with teenagers and puberty, and many adult patients may not be aware that acne can persist beyond adolescence or even develop for the first time in adulthood. As the prevalence of adults with acne increases, it is important to educate this population about factors associated with postadolescent acne development and let them know that effective treatments are available.
There are 2 types of adult acne: persistent acne, which refers to adolescent acne that continues beyond 25 years of age, and late-onset acne, which develops for the first time after 25 years of age. Adult acne generally is mild to moderate in severity and may be refractory to treatment. Unlike adolescent acne, which is more prominent in adolescent boys and manifests as the more severe forms of the disease, adult acne primarily affects women and is more inflammatory in nature, making these patients more susceptible to scarring. In one study, acne prevalence among 1055 adult participants (age range, 20–60 years) was estimated at 61.5%; however, only 36.8% were aware of their condition and only 25% sought treatment. The most commonly affected area was the malar region, which differs from acne seen in teenagers. In addition to the cheeks, adult acne generally is more prominent on the lower chin, jawline, and neck, and lesions more commonly present as closed comedones.
Fluctuating hormone levels are a common cause of adult acne, particularly in women during menses or pregnancy, menopause, or perimenopause; women also may experience breakouts after starting or discontinuing birth control pills. Acne flare-ups in adults also have been linked to chronic stress, family history, hair and skin care products, medication side effects, undiagnosed medical conditions, steroid use, increased calorie intake, whole and fat-reduced milk consumption, and tobacco smoking. Adult acne also has been found to be associated with other dermatologic conditions including hirsutism, alopecia, and seborrhea.
Early diagnosis and treatment of adult acne is crucial to ensure good cosmetic outcomes and minimize disease burden. When treating adult acne, particularly in women, dermatologists should consider a variety of factors that set this condition apart from adolescent acne, including the predisposition of older skin to irritation, possible slow response to treatment, a high likelihood of good adherence to treatment, and the psychosocial impact of acne in the adult population. In adult women, it also is important to consider whether patients are of childbearing age when selecting a treatment. Patients also should be encouraged to read the labels on their personal care products to ensure they are noncomedogenic and will not clog pores.
Adult acne. American Academy of Dermatology website. https://www.aad.org/public/diseases/acne-and-rosacea/adult-acne. Accessed January 9, 2018.
Dréno B, Layton A, Zouboulis CC, et al. Adult female acne: a new paradigm [published online January 10, 2013]. J Eur Acad Dermatol Venereol. 2013;27:1063-1070.
Khunger N, Kumar C. A clinic-epidemiological study of adult acne: is it different from adolescent acne? Indian J Dermatol Venereol Leprol. 2012;78:335-341.
Semedo D, Ladeiro F, Ruivo M, et al. Adult acne: prevalence and portrayal in primary healthcare patients, in the Great Porto Area, Portugal [published online September 30, 2016]. Acta Med Port. 2016;29:507-513.
Adult acne. American Academy of Dermatology website. https://www.aad.org/public/diseases/acne-and-rosacea/adult-acne. Accessed January 9, 2018.
Dréno B, Layton A, Zouboulis CC, et al. Adult female acne: a new paradigm [published online January 10, 2013]. J Eur Acad Dermatol Venereol. 2013;27:1063-1070.
Khunger N, Kumar C. A clinic-epidemiological study of adult acne: is it different from adolescent acne? Indian J Dermatol Venereol Leprol. 2012;78:335-341.
Semedo D, Ladeiro F, Ruivo M, et al. Adult acne: prevalence and portrayal in primary healthcare patients, in the Great Porto Area, Portugal [published online September 30, 2016]. Acta Med Port. 2016;29:507-513.
A Peek at Our January 2018 Issue
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
NIH Undiagnosed Diseases Network to Offer Grand Rounds Webinar Series
The NIH Undiagnosed Diseases Network (UDN) will launch a webinar series on March 8, 2018 (1–2 p.m. ET) that will feature descriptions of clinical phenotype and diagnostic evaluations of UDN patients. Webinar participants will be able to ask questions and offer insights on the presented cases. Registration is free but required using this link. This activity has been approved for free AMA PRA Category 1 Credit. Contact UDN_Convener@hsm.harvard.edu with questions.
The NIH Undiagnosed Diseases Network (UDN) will launch a webinar series on March 8, 2018 (1–2 p.m. ET) that will feature descriptions of clinical phenotype and diagnostic evaluations of UDN patients. Webinar participants will be able to ask questions and offer insights on the presented cases. Registration is free but required using this link. This activity has been approved for free AMA PRA Category 1 Credit. Contact UDN_Convener@hsm.harvard.edu with questions.
The NIH Undiagnosed Diseases Network (UDN) will launch a webinar series on March 8, 2018 (1–2 p.m. ET) that will feature descriptions of clinical phenotype and diagnostic evaluations of UDN patients. Webinar participants will be able to ask questions and offer insights on the presented cases. Registration is free but required using this link. This activity has been approved for free AMA PRA Category 1 Credit. Contact UDN_Convener@hsm.harvard.edu with questions.
FDA Issues Guidance for More Efficient Approach to Drug Development for Rare Pediatric Diseases
The Food and Drug Administration (FDA) has released a draft guidance describing a possible new approach for companies to collaborate and test multiple drug products in the same clinical trials. Public comment is welcomed.
FDA also has issued a guidance on clarification of orphan designation of drugs and biologics for pediatric subpopulations of common diseases.
The Food and Drug Administration (FDA) has released a draft guidance describing a possible new approach for companies to collaborate and test multiple drug products in the same clinical trials. Public comment is welcomed.
FDA also has issued a guidance on clarification of orphan designation of drugs and biologics for pediatric subpopulations of common diseases.
The Food and Drug Administration (FDA) has released a draft guidance describing a possible new approach for companies to collaborate and test multiple drug products in the same clinical trials. Public comment is welcomed.
FDA also has issued a guidance on clarification of orphan designation of drugs and biologics for pediatric subpopulations of common diseases.
NORD Provides Update on Tax Cuts and Jobs Act
The Tax Cuts and Jobs Act passed by Congress and signed into law by President Trump includes a reduction of the Orphan Drug Tax Credit (ODTC), a repeal of the Affordable Care Act’s individual mandate, and a temporary bolstering of the Medical Expense Deduction. While NORD supports the temporary strengthening of the Medical Expense Deduction, it opposed the repeal of the individual mandate and the reduction of the ODTC. Thanks to the work of rare disease advocates joining NORD in support for the ODTC, the tax credit was not repealed entirely, as was initially suggested, but rather was cut in half. NORD is grateful for the support it received on this issue and will continue to work to preserve the important orphan drug incentives in 2018.
The Tax Cuts and Jobs Act passed by Congress and signed into law by President Trump includes a reduction of the Orphan Drug Tax Credit (ODTC), a repeal of the Affordable Care Act’s individual mandate, and a temporary bolstering of the Medical Expense Deduction. While NORD supports the temporary strengthening of the Medical Expense Deduction, it opposed the repeal of the individual mandate and the reduction of the ODTC. Thanks to the work of rare disease advocates joining NORD in support for the ODTC, the tax credit was not repealed entirely, as was initially suggested, but rather was cut in half. NORD is grateful for the support it received on this issue and will continue to work to preserve the important orphan drug incentives in 2018.
The Tax Cuts and Jobs Act passed by Congress and signed into law by President Trump includes a reduction of the Orphan Drug Tax Credit (ODTC), a repeal of the Affordable Care Act’s individual mandate, and a temporary bolstering of the Medical Expense Deduction. While NORD supports the temporary strengthening of the Medical Expense Deduction, it opposed the repeal of the individual mandate and the reduction of the ODTC. Thanks to the work of rare disease advocates joining NORD in support for the ODTC, the tax credit was not repealed entirely, as was initially suggested, but rather was cut in half. NORD is grateful for the support it received on this issue and will continue to work to preserve the important orphan drug incentives in 2018.
NORD Launches Year-Long 35th Anniversary Observance
2018 marks the 35th anniversary of the Orphan Drug Act (ODA) and of NORD. The ODA was signed into law by President Ronald Reagan on January 4, 1983. Exactly four months later, NORD was formally established by the patient organization leaders who had provided advocacy for the ODA. The ODA provides critically important financial incentives to encourage development of treatments for rare diseases. Major events during the anniversary year will include NORD’s Rare Impact Awards in May and Rare Summit in October. Visit the NORD website often this year for information about those and other anniversary activities.
2018 marks the 35th anniversary of the Orphan Drug Act (ODA) and of NORD. The ODA was signed into law by President Ronald Reagan on January 4, 1983. Exactly four months later, NORD was formally established by the patient organization leaders who had provided advocacy for the ODA. The ODA provides critically important financial incentives to encourage development of treatments for rare diseases. Major events during the anniversary year will include NORD’s Rare Impact Awards in May and Rare Summit in October. Visit the NORD website often this year for information about those and other anniversary activities.
2018 marks the 35th anniversary of the Orphan Drug Act (ODA) and of NORD. The ODA was signed into law by President Ronald Reagan on January 4, 1983. Exactly four months later, NORD was formally established by the patient organization leaders who had provided advocacy for the ODA. The ODA provides critically important financial incentives to encourage development of treatments for rare diseases. Major events during the anniversary year will include NORD’s Rare Impact Awards in May and Rare Summit in October. Visit the NORD website often this year for information about those and other anniversary activities.
Visit NORD’s Website to Learn About Current or Future Research Funding Opportunities
NORD research grant opportunities are posted throughout the year as funds become available for research on specific rare diseases. Researchers should visit the website periodically to learn whether any new requests for proposals (RFPs) have been posted. Information about the NORD Research Program and current RFPs may be found here.
NORD research grant opportunities are posted throughout the year as funds become available for research on specific rare diseases. Researchers should visit the website periodically to learn whether any new requests for proposals (RFPs) have been posted. Information about the NORD Research Program and current RFPs may be found here.
NORD research grant opportunities are posted throughout the year as funds become available for research on specific rare diseases. Researchers should visit the website periodically to learn whether any new requests for proposals (RFPs) have been posted. Information about the NORD Research Program and current RFPs may be found here.
NORD Awards Five Research Grants
NORD has awarded research grants to the following scientists and institutions:
- Arun Pradhan, PhD, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
- J. Silvio Gutkind, PhD, University of California, San Diego, California
- D. Scott Merrell, PhD, Uniformed Services University of the Health Sciences, Bethesda, Maryland
- Marc Pocard, MD, PhD, Institut national de la santé et de la recherche médicale (Inserm), Paris
- Traci L. Testerman, PhD, University of South Carolina School of Medicine, Columbia, South Carolina
These grants are for studies of alveolar capillary dysplasia with misalignment of the pulmonary veins (with support from the David Ashwell Foundation, Alveolar Capillary Dysplasia Association and William Akers Jr. and Georgia O. Akers Private Foundation) and appendix cancer pseudomyxoma peritonei (with support from the Appendix Cancer Pseudomyxoma Peritonei Research Foundation).
NORD has awarded research grants to the following scientists and institutions:
- Arun Pradhan, PhD, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
- J. Silvio Gutkind, PhD, University of California, San Diego, California
- D. Scott Merrell, PhD, Uniformed Services University of the Health Sciences, Bethesda, Maryland
- Marc Pocard, MD, PhD, Institut national de la santé et de la recherche médicale (Inserm), Paris
- Traci L. Testerman, PhD, University of South Carolina School of Medicine, Columbia, South Carolina
These grants are for studies of alveolar capillary dysplasia with misalignment of the pulmonary veins (with support from the David Ashwell Foundation, Alveolar Capillary Dysplasia Association and William Akers Jr. and Georgia O. Akers Private Foundation) and appendix cancer pseudomyxoma peritonei (with support from the Appendix Cancer Pseudomyxoma Peritonei Research Foundation).
NORD has awarded research grants to the following scientists and institutions:
- Arun Pradhan, PhD, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
- J. Silvio Gutkind, PhD, University of California, San Diego, California
- D. Scott Merrell, PhD, Uniformed Services University of the Health Sciences, Bethesda, Maryland
- Marc Pocard, MD, PhD, Institut national de la santé et de la recherche médicale (Inserm), Paris
- Traci L. Testerman, PhD, University of South Carolina School of Medicine, Columbia, South Carolina
These grants are for studies of alveolar capillary dysplasia with misalignment of the pulmonary veins (with support from the David Ashwell Foundation, Alveolar Capillary Dysplasia Association and William Akers Jr. and Georgia O. Akers Private Foundation) and appendix cancer pseudomyxoma peritonei (with support from the Appendix Cancer Pseudomyxoma Peritonei Research Foundation).
January 12 Is Deadline for Rare Impact Awards Nominations
Nominate a colleague, patient, caregiver, or organization for a NORD Rare Impact Award online by January 12, 2018. These awards honor individuals or organizations for improving the lives of those affected by rare diseases. The awards are presented at NORD’s Rare Impact Awards event in Washington, DC in May. Over the years, those honored have included members of Congress, senior officials from FDA and NIH, clinicians, researchers, medical societies, patient organizations, and others whose work has had a beneficial impact on the community. More info.
Nominate a colleague, patient, caregiver, or organization for a NORD Rare Impact Award online by January 12, 2018. These awards honor individuals or organizations for improving the lives of those affected by rare diseases. The awards are presented at NORD’s Rare Impact Awards event in Washington, DC in May. Over the years, those honored have included members of Congress, senior officials from FDA and NIH, clinicians, researchers, medical societies, patient organizations, and others whose work has had a beneficial impact on the community. More info.
Nominate a colleague, patient, caregiver, or organization for a NORD Rare Impact Award online by January 12, 2018. These awards honor individuals or organizations for improving the lives of those affected by rare diseases. The awards are presented at NORD’s Rare Impact Awards event in Washington, DC in May. Over the years, those honored have included members of Congress, senior officials from FDA and NIH, clinicians, researchers, medical societies, patient organizations, and others whose work has had a beneficial impact on the community. More info.
Join 7,000 Miles Campaign to Support Programs for Rare Disease Patients
In anticipation of “Rare Disease Day” on February 28, 2018, NORD will be hosting a “7,000 Miles Campaign” for everyone interested in showing support for rare disease patients. The campaign will run from February 1 through February 28, and the goal will be for participants to walk, run, or cycle 7,000 miles during that time period. Funds raised will support NORD’s programs of advocacy, education, research, and patient services. Everyone seeking to improve the lives of rare disease patients is invited to participate and to share information about the campaign with others. More info.
In anticipation of “Rare Disease Day” on February 28, 2018, NORD will be hosting a “7,000 Miles Campaign” for everyone interested in showing support for rare disease patients. The campaign will run from February 1 through February 28, and the goal will be for participants to walk, run, or cycle 7,000 miles during that time period. Funds raised will support NORD’s programs of advocacy, education, research, and patient services. Everyone seeking to improve the lives of rare disease patients is invited to participate and to share information about the campaign with others. More info.
In anticipation of “Rare Disease Day” on February 28, 2018, NORD will be hosting a “7,000 Miles Campaign” for everyone interested in showing support for rare disease patients. The campaign will run from February 1 through February 28, and the goal will be for participants to walk, run, or cycle 7,000 miles during that time period. Funds raised will support NORD’s programs of advocacy, education, research, and patient services. Everyone seeking to improve the lives of rare disease patients is invited to participate and to share information about the campaign with others. More info.