Eligibility Criteria Related to Hormone Therapy in Acne Clinical Trials: A Systematic Review

DeGrazia, Taryn; Rolader, Robin; Thiboutot, Diane; Yeung, Howa

doi:10.1016/j.jid.2020.05.086

Cited by 4 publications

(3 citation statements)

References 4 publications

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“…Individuals receiving hormonal therapy were excluded from the study because the use of exogenous hormones in a pivotal trial would represent a confounding variable that could affect the results obtained. Indeed, a recent evaluation of 86 acne studies showed 37 studies (43%) had exclusion criteria associated with hormone therapy …”

mentioning

confidence: 58%

Potential Role for Topical Antiandrogens in the Management of Acne Among Patients Receiving Masculinizing Hormone Therapy—Reply

Thiboutot

Cartwright²,

Mazzetti³

2020

JAMA Dermatol

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similarly worsened, as intrapulmonary shunting increased from 40.5% to 55.6%. Daratumumab was therefore discontinued. Regrettably, the patient died of complications of TEMPI syndrome within a year.Discussion | TEMPI syndrome is a multisystem disease with early cutaneous findings and potentially life-threatening pulmonary compromise. 1 Progression to intrapulmonary shunting and hypoxemia can often be avoided with proper treatment, which may result in a more indolent course. 2 Therefore, early recognition of symptoms and establishing the diagnosis is key. 2 Dermatologists can play an important role in diagnosis by recognizing cutaneous findings, which are often an initial presenting symptom. 1 Telangiectasias were reported in 12 of 15 published cases according to a 2018 review and usually affect the face, chest, and back. 1,3 In this patient, they were most notable on the chest and back, along with the lips, where their atypical presentation resembled angiomas or venous lakes (Figure). Relatively similar mucocutaneous findings, although less pronounced, were observed by Schroyens et al. 4 While this patient's lip lesions were not biopsied, we believe they represent telangiectasias given their established association with the disease. 1 Because of the prevalence of telangiectasias in TEMPI syndrome, the disease has been recognized as a monoclonal gammopathy of cutaneous significance, and telangiectasias have been proposed as a major diagnostic criterion. 1,5 Their presence, when concurrent with other TEMPI findings, should raise clinical suspicion for this novel disorder and prompt appropriate referral.The pathogenesis of telangiectasias in TEMPI syndrome remains poorly understood, 5 although a few hypotheses exist. One suggests that the same angiogenic process drives the cutaneous findings and intrapulmonary shunting, as evidenced by the resolution of both symptoms in the same time frame with treatment. 1 Another speculates that hypoxia leads to telangiectasias by causing dilation of superficial capillaries or through induction of hypoxia-inducible factor 1α, a transcription factor that regulates angiogenesis. 3,6 While the exact mechanism remains unclear, this patient's clinical course with concurrent worsening telangiectasias and pulmonary status supports the hypothesis that the 2 share a pathophysiologic association.We present a case of TEMPI syndrome with classic and atypical cutaneous findings, which dermatologists should be familiar with for timely diagnosis. To our knowledge, this case represents the first that was refractory to daratumumab and highlights the need for additional therapies.

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confidence: 58%

Potential Role for Topical Antiandrogens in the Management of Acne Among Patients Receiving Masculinizing Hormone Therapy—Reply

Thiboutot

Cartwright²,

Mazzetti³

2020

JAMA Dermatol

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“…Clascoterone reduces inflammatory and non-inflammatory facial acne with minimal adverse effects or safety concerns [ 44 ]. While clinical trials for clascoterone, like most acne clinical trials [ 45 ], did not specifically include any transgender participants or document hormone therapy use of its participants, the use of topical antiandrogens in transmasculine patients has been proposed as a targeted treatment for reducing the unwanted testosterone action in the skin [ 46 ]. Future research should examine the safety of topical androgens, including the potential systemic effects of clascoterone on serum testosterone level, as well as their acceptability by transmasculine patients and hormone providers.…”

Section: Treatment Planmentioning

confidence: 99%

Treating Acne in Transgender Persons Receiving Testosterone: A Practical Guide

et al. 2022

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Transgender persons who undergo masculinizing hormone therapy experience a wide array of dermatologic effects as they initiate and maintain testosterone therapy. Acne is one of the most common adverse effects for many transmasculine patients receiving testosterone. Acne can worsen body image and mental health, with significant impact on quality of life in transgender patients. Specific training and awareness are needed for a clinically and culturally competent encounter while providing care for the transgender patient. This article provides a practical guide for the treatment of testosterone-induced acne in transmasculine patients. Recommendations on creating a welcoming clinical setting, taking a gender-inclusive history, and conducting a patient-centered physical examination relevant to acne care are provided. Assessment of reproductive potential and the appropriate contraceptive methods before prescribing acne treatment with teratogenic potential in transmasculine patients are examined. Interactions between acne treatments with gender-affirming therapies are explored. For patients with severe or treatment-refractory acne, indications, contraindications, and barriers to isotretinoin prescription, such as the US iPLEDGE program, are examined. Multidisciplinary approaches to acne care, involving mental health, reproductive health, gender-affirming hormone therapy and surgeries, are adopted to guide isotretinoin treatment.

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“…Estrogens may also play a role in lesion recuperation and anti-inflammatory methods via their complicated interplay with IGF-1 [57][58][59]. According to a standardized evaluation of over 1,000 researches, cases with acne vulgaris were reduced serum estrogen degrees than controls [60]. It indicates that estrogen can also play a role in the acne's pathogenesis [61].…”

Section: Estrogensmentioning

confidence: 99%

Endocrine Disorders and Hormonal Therapy for Adolescent Acne

Assawaruangsin¹

2022

ijcsrr

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Acne vulgaris is a worldwide disease which is mostly found in teenagers. This has a crucial impact on their life’s quality, particularly when endocrine disorders have been implicated. Current consideration regarding antibiotic stewardship, failing with antibiotic utilization, and the improvement of antibiotic-resistant Propionibacterium acnes, there are many treatment alternatives for pimple therapy have been acknowledged. A following analysis investigates hormonal treatments for the therapy of acne vulgaris.

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Eligibility Criteria Related to Hormone Therapy in Acne Clinical Trials: A Systematic Review

Abstract: N, suppresses IL-17-mediated skin inflammation and is genetically associated with psoriasis.

Cited by 4 publications

References 4 publications

Potential Role for Topical Antiandrogens in the Management of Acne Among Patients Receiving Masculinizing Hormone Therapy—Reply

Potential Role for Topical Antiandrogens in the Management of Acne Among Patients Receiving Masculinizing Hormone Therapy—Reply

Treating Acne in Transgender Persons Receiving Testosterone: A Practical Guide

Endocrine Disorders and Hormonal Therapy for Adolescent Acne

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