Corporate partners of the EDF have been asked to contribute towards this work. GlaxoSmithKline plc. (GSK) and Meda AB have contributed funding for the development of the European evidence-based (S3) guideline for the treatment of acne (update 2016) through an educational grant to the EDF. Sponsors had no influence on the content of the guideline. Support was given independent of any influence on methods or results. Sponsors did not receive any information about methods, group members or likely results. The sources of the funding were not known to the experts of the guideline and were not disclosed before the finalization of the guideline. This is a short summary of the complete version of the S3 European Acne guideline, please see online appendix for full text (Document S1. Long Version) and detailed methods report (DOI: 10.1111/jdv.13783). Expiry date: 31 December 2020
MethodsIn order to weight the different recommendations, the group assigned a 'strength of recommendation'. It considered all aspects of the treatment decision, such as efficacy, safety, patient preference and the reliability of the existing body of evidence.
Strength of recommendationIn order to grade the recommendation a "standardized guideline" language was used:
Androgens affect several functions of the human skin, such as sebaceous gland growth and differentiation, hair growth, epidermal barrier homeostasis and wound healing. Their effects are mediated by binding to nuclear androgen receptors. Androgen activation and deactivation are mainly intracellular events. They differ from cell type to cell type and between cells at different locations. The major circulating androgens, dehydroepiandrosterone sulfate and androstenedione, are predominantly produced in the adrenal glands, and testosterone and 5alpha-dihydrotestosterone are mainly synthesized in the gonads. Testosterone in women and 5alpha-dihydrotestosterone in both genders are also synthesized in the skin. Skin cells express all androgen metabolizing enzymes required for the independent cutaneous synthesis of androgens and the development of hyperandrogenism-associated conditions and diseases, such as seborrhea, acne, hirsutism and androgenetic alopecia. The major thrust of drug design for the treatment of androgen-associated disorders has been directed against several levels of androgen function and metabolism. Partial effectiveness has only been achieved either by androgen depletion, inhibition of androgen metabolism or blockade of the androgen receptor.
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