Qualitative and Quantitative Changes in Cutaneous Bacteria Associated with Systemic Isotretinoin Therapy for Acne Conglobata

Leyden, James J.; McGinley, Kenneth J.; Foglia, Arlene N.

doi:10.1111/1523-1747.ep12285658

Cited by 76 publications

(56 citation statements)

References 10 publications

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“…Alternatively, the overactivated lipid catabolism observed in Scd1 mutants might lead to a shorter half-life of the injected lipids and could explain this discrepancy. Nevertheless, we noted that humans treated for acne problems with retinoids (which induce atrophy of the sebaceous glands) can suffer recurrent S. aureus skin infections as a side effect (10). Infections of the eye with gram-positive bacteria have also been noted in such patients (4).…”

Section: Discussionmentioning

confidence: 99%

A Toll-Like Receptor 2-Responsive Lipid Effector Pathway Protects Mammals against Skin Infections with Gram-Positive Bacteria

et al. 2005

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Section: Discussionmentioning

confidence: 99%

A Toll-Like Receptor 2-Responsive Lipid Effector Pathway Protects Mammals against Skin Infections with Gram-Positive Bacteria

et al. 2005

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“…It is possible that the dramatic increase in NGAL released in response to 13-cis RA targets P. acnes as well as inducing apoptosis in the sebaceous gland (17, 48). 13-cis RA reduces the numbers of P. acnes bacteria on the surface of the skin from acne patients (49,50). This is thought to result from decreased sebum that acts as a nutrient source for P. acnes.…”

Section: Figurementioning

confidence: 99%

Neutrophil gelatinase–associated lipocalin mediates 13-cis retinoic acid–induced apoptosis of human sebaceous gland cells

Nelson¹,

Zhao²,

Gilliland³

et al. 2008

J. Clin. Invest.

131

141

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13-cis retinoic acid (13-cis RA; also known as isotretinoin) is the most potent agent available for treatment of acne. It is known that the drug induces apoptosis in cells cultured from human sebaceous glands, but its mechanism of action has not been determined. In this study, skin biopsies were taken from 7 patients with acne prior to and at 1 week of treatment with 13-cis RA. TUNEL staining confirmed that 13-cis RA induced apoptosis in sebaceous glands. Transcriptional profiling of patient skin and cultured human sebaceous gland cells (SEB-1 sebocytes) indicated that lipocalin 2 was among the genes most highly upregulated by 13-cis RA. Lipocalin 2 encodes neutrophil gelatinase-associated lipocalin (NGAL), which functions in innate immune defense and induces apoptosis of murine B lymphocytes. Increased immunolocalization of NGAL was noted in patients' sebaceous glands following treatment with 13-cis RA, and recombinant NGAL induced apoptosis in SEB-1 sebocytes. Furthermore, apoptosis in response to 13-cis RA was inhibited in the presence of siRNA to lipocalin 2. These data indicate that NGAL mediates the apoptotic effect of 13-cis RA and suggest that agents that selectively induce NGAL expression in sebaceous glands might represent therapeutic alternatives to the use of 13-cis RA to treat individuals with acne.

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“…S aureus colonization of the anterior nares and of http://www.jabfm.org/ normal skin before isotretinoin treatment exists in less than 10% of isolates. 4,6 During isotretinoin treatment, however, up to 70% of patients have S aureus colonization of the anterior nares, and 50% have colonization of the skin. 4,6 Isotretinoin results in the reduction of Gram-negative bacteria as a result of the marked dryness of the skin and mucous membranes.…”

Section: Discussionmentioning

confidence: 99%

“…4,6 During isotretinoin treatment, however, up to 70% of patients have S aureus colonization of the anterior nares, and 50% have colonization of the skin. 4,6 Isotretinoin results in the reduction of Gram-negative bacteria as a result of the marked dryness of the skin and mucous membranes. This change in microenvironment and skin barrier function seems to predispose the patient to S aureus colonization.…”

Section: Discussionmentioning

confidence: 99%

“…3 Infectious complications from isotretinoin are rare. However, increased S aureus colonization of the nasal mucosa and skin is well established, 4 and cases of S aureus infection associated with isotretinoin therapy are reported. 5,6 Isotretinoin should be recognized as a risk factor for developing infections such as septic bursitis after percutaneous injection.…”

mentioning

confidence: 99%

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Subacromial/Subdeltoid Septic Bursitis Associated with Isotretinoin Therapy and Corticosteroid Injection

Drezner

Sennett

2004

The Journal of the American Board of Family Medicine

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Qualitative and Quantitative Changes in Cutaneous Bacteria Associated with Systemic Isotretinoin Therapy for Acne Conglobata

Cited by 76 publications

References 10 publications

A Toll-Like Receptor 2-Responsive Lipid Effector Pathway Protects Mammals against Skin Infections with Gram-Positive Bacteria

A Toll-Like Receptor 2-Responsive Lipid Effector Pathway Protects Mammals against Skin Infections with Gram-Positive Bacteria

Neutrophil gelatinase–associated lipocalin mediates 13-cis retinoic acid–induced apoptosis of human sebaceous gland cells

Subacromial/Subdeltoid Septic Bursitis Associated with Isotretinoin Therapy and Corticosteroid Injection

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