Although acne is not an infectious disease, oral antibiotics have remained a mainstay of treatment over the last 40 years. The anti-inflammatory properties of oral antibiotics, particularly the tetracyclines, are efficacious in treating inflammatory acne lesions. Common prescribing practices in Dermatology exert significant selection pressure on bacteria, contributing to the development of antibiotic resistance. Antibiotic use for acne not only promotes resistance in Propionibacterium acnes, but also affects other host bacteria with pathogenic potential. This review will summarize the commonly used treatments for acne vulgaris, and how they should be combined as rational treatment. The indications for using oral antibiotics in acne will be highlighted. Strategies described in the literature to conserve the utility of oral antibiotics will be summarized. These include limiting the duration of antibiotic therapy, concomitant use of a topical non-antibiotic agent, use of subantimicrobial dose doxycycline, and the introduction of topical dapsone.

There is a lack of real‐world data on the use of omalizumab in treatment‐refractory chronic spontaneous urticaria (CSU). A single‐centre retrospective cohort study was performed to assess the efficacy and safety of omalizumab for treatment‐refractory CSU. The overall response rate of 67% is comparable with that reported in the literature. Disease control and sustained remission can be achieved with omalizumab, even in patients with treatment‐resistant CSU.

Introduction: Cutaneous T-cell lymphomas (CTCLs) represent a rare group of primary cutaneous lymphomas. Pruritus is common in patients with CTCL and is severe and intractable in the subtypes Sézary syndrome (SS) and folliculotropic mycosis fungoides (MF). Materials and methods: We conducted a systematic review on interventions demonstrating efficacy in reducing pruritus in patients with CTCL. The primary aim of our study was to identify disease-directed and itch-directed therapies effective in reducing CTCL-associated pruritus. Our secondary aim was to outline various tools used to quantify itch in clinical studies. Results: Our study identified multiple disease-directed therapies effective in reducing CTCL-associated pruritus. Most evidence supported the use of histone deacetylase inhibitors. For the agents romidepsin, vorinostat, and quisinostat, reduction in pruritus was achieved in both disease responders and nonresponders. Various therapies were effective in managing pruritus associated with SS and folliculotropic MF. Vorinostat is effective in reducing pruritus in patients with SS. Extracorporeal photophoresis, total skin electron beam therapy, and romidepsin are effective in reducing pruritus in patients with folliculotropic MF. The antiemetic aprepitant is an effective targeted treatment of CTCL-associated pruritus. Aprepitant demonstrated efficacy in reducing pruritus in patients with all stages of MF, including patients with SS. Lignocaine administered via continuous subcutaneous infusion is effective in reducing pruritus in patients with advanced-stage MF, including patients with SS. The most frequently used tools to quantify itch were the Visual Analogue Scale and Numerical Rating Scale. Definitions of a significant reduction in pruritus were extremely varied between studies. Discussion: To our knowledge, this is the first systematic review specifically addressing the management of itch in patients with CTCL. Patients with all stages of CTCL were represented across included studies, including patients with folliculotropic MF and SS. A wide range of treatment options were identified, including options appropriate for patients with end-stage disease.

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