Acne is associated with depression and anxiety; however, the relationship between acne and suicide is still unclear. This study is aimed to evaluate the association between acne and suicide by conducting a meta-analysis. Studies were identified by electronic searches of the PubMed and EMBASE databases from their inception through Jan 10, 2020. Two authors separately assessed the quality and extracted data from the selected studies. When the heterogeneity was significant, we used a random-effects model to calculate overall pooled risk estimates. Five studies involving a total of 2,276,798 participants were finally included in the meta-analysis; 52,075 participants had acne. Suicide was positively associated with acne in the overall analysis (odds ratio (OR) 1.50, 95% confidence interval (95% CI): 1.09–2.06, P = .004, I 2 = 74.1%). Subgroup analyses were performed for suicidal behavior groups ( P = .002, I 2 = 80.4%), suicidal ideation or thoughts groups ( P = .849, I 2 = 0.0%), International Classification of Diseases version 9 (ICD-9) groups ( P = .137, I 2 = 49.6%), non-ICD-9 groups ( P = .950, I 2 = 0.0%), American groups ( P = .311, I 2 = 2.4%), and non-American groups ( P = .943, I 2 = 0.0%). Sensitivity analyses indicated flawed results. No publication bias was detected. Acne may significantly increase suicide risk. Clinicians should actively treat acne and consider suicide screening. Further international studies with high-quality analyses are needed as more data are published. Ethical approval and patient consent are not required because this study is a literature-based study.

Background: Acute herpes zoster (AHZ) is a common skin disease caused by invasion of the varicella zoster virus into the ganglia and skin, and the severe pain is the most complaint, which can seriously disturb the normal life of patients. Fire needle plus cupping is a special acupuncture treatment, which is widely used to treat AHZ for its better analgesic effect in China although it has not been fully verified by rigorous randomized controlled trial (RCT). Methods/design: To test the effect, a three-arm randomized parallel controlled trial protocol has been designed. A total of 105 AHZ patients suffering pain will be randomly divided into three groups in an equal proportion. The interventions are fire needle plus cupping (FC) in group A, famciclovir plus gabapentin (FG) in group B, and fire needle plus cupping plus famciclovir (FCF) in group C. The length for the trial is set for a week time frame. Precisely speaking, the A group (FC) is to carry out 1 treatment per day for the total of 7 treatment sessions within 1 week period. On the other hand, the B group (FG) will take drugs orally three times a day within the trial 1 week. Meanwhile, with its combination element, the C group (FCF) is due to undertake both treatments and drugs as prescribed for A and B groups within the trial week. As an intra-trial arrangement, analgesic medication will be carefully administered for temporary pain release if the sudden intolerable pain appeared. For the primary outcome, this study is due to apply visual analogue scale to identify pain intensity relief. As the secondary outcomes are concerned, this study is aiming to focus on the issues related to changes in substance P and beta-endorphin concentrations in peripheral plasma, as well as those issues of analgesic needs, side effects, symptoms, and physical signs including pain classification, local itching, burning sensation, fever, local lymphadenopathy, skin lesion area, blisters, herpes clusters, vesicular traits, ulcers, and pimples; all these are taken into account for evaluation. For the final stage, the participants are to be followed up for postherpetic neuralgia. Discussion: The results of this trial aim to provide sufficient evidence on FC treatment over both FG and FCF treatments. It will then give a credible alternative treatment to cut down acute pain and to cure AHZ infection.

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BackgroundAcute herpes zoster (AHZ) is a common skin disease caused by invasion of the varicella-zoster virus into the ganglia and skin, and the severe pain is the most complaint, which can seriously disturb the normal life of patients. Fire needle plus cupping is a special acupuncture treatment, which is widely used to treat AHZ for its better analgesic effect in China although it has not been fully verified by rigorous randomized controlled trial (RCT). Methods/ Design To test the effect, a three-arm randomized parallel controlled trial protocol has been designed. 105 AHZ patients suffering pain will be randomly divided into three groups in an equal proportion. The interventions are fire needle plus cupping (FC) in group A , famciclovir plus gabapentin (FG) in group B and fire needle plus cupping plus famciclovir (FCF) in Group C. The length for the trial is set for a week time frame. Precisely speaking, the A group (FC ) is to carry out 1 treatment per day for the total of 7 treatment sessions within 1 week period, On the other hand, the B group (FG) will take drugs orally three times a day within the trial 1 week . Meanwhile, with its combination element, the C group (FCF) is due to undertake both treatments and drugs as prescribed for A and B groups within the trial week. As an intra-trial arrangement, analgesics medication will be carefully administered for temporary pain release if the sudden intolerable pain appeared. For the primary outcome, this study is due to apply visual analogue scale to identify pain intensity relief. As the secondary outcomes are concerned, this study is aiming to focus on the issues related to changes in substance P and beta-endorphin concentrations in peripheral plasma, as well as those issues of analgesic needs, side effects, symptoms and physical signs including pain classification, local itching, burning sensation, fever, local lymphadenopathy, skin lesion area, blisters, herpes clusters, vesicular traits, ulcers, and pimples; and all these are taking into account for evaluation. For the final stage, the participants are due to be followed up for postherpetic neuralgia. Discussion: The results of this trial aim to provide sufficient evidence on FC treatment over both FG and FCF treatments. It will then give a credible alternative treatment to cut down acute pain and to cure AHZ infection. Trial registration: The registration number is ChiCTR1800015372. Registered on 28 March 2018.

Background Herpes zoster (HZ) is a common skin disease caused by invasion of the varicella-zoster virus into the ganglia and skin. Severe pain caused by HZ seriously affects the normal life of patients; thus, pain often becomes the patient’s first complaint. Fire needle plus cupping may be effective for acute herpes zoster (AHZ), but the evidence is insufficient. Methods This is a three-arm randomized controlled trial with an observation time of 1 week. A total of 96 patients with AHZ pain are divided into three groups by stratified randomization, with 32 in each group: (a) fire needle + cupping (FC); (b) famciclovir + gabapentin (FG), famciclovir hydrochloride, 3 × 0.25 g/d orally (p.o.), with an individualized dose of gabapentin 900-3600 mg/d p.o.; and (c) fire needle + cupping + famciclovir (FCF). The above intervention lasts for 1 week, and all patients receive analgesia (nonopioid analgesics [analgin or paracetamol] and opioid analgesics [tramadol or morphine]). Groups a and c undergo 1 to 7 sessions of fire needles and cupping treatments per patient, with gabapentin and analgesic medication administered depending on the patient’s needs. The primary outcome measure is the assessment of changes in pain intensity before and after treatment (visual analogue scale ranging from 0-100 mm). Secondary outcome measures are changes in substance P and beta-endorphin concentrations in peripheral plasma before and after treatment. Quantitative scoring methods are used to evaluate the symptoms and physical signs before and after treatment, including pain classification, local itching, burning sensation, fever, local lymphadenopathy, skin lesion area, blisters, herpes clusters, vesicular traits, ulcers, and pimples. In addition, analgesic needs and side effects are evaluated. Discussion: The results of this study will be obtained by randomised controlled trial(RCT), and the outcomes will be analyzed and evaluated to prove FC may be effective for AHZ. Trial registration :The registration number is ChiCTR1800015372. Registered on 28 March 2018.