Severe Acne in Female-to-Male Transgender Patients

Turrión-Merino, Lucía; Urech-García-de-la-Vega, Marta; Miguel‐Gomez, Laura; Harto-Castaño, Antonio; Jaén‐Olasolo, Pedro

doi:10.1001/jamadermatol.2015.0761

Cited by 44 publications

(33 citation statements)

References 6 publications

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“…8,9 A two patient case series by Turrino-Merino, et al was among the first to report that transsexual men may require continuous oral isotretinoin (30mg per day) after developing severe inflammatory acne with scarring secondary to therapeutic androgen therapy. 9 The clinical side effects of testosterone-treatment were also reported by Wierckx, et al in a cohort of 50 transsexual men. 8 On prospective analysis, testosterone-induced facial acne was present in over 82% of patients after 6 months of continuous androgen therapy.…”

Section: Discussionmentioning

confidence: 99%

“…Sexual minorities, particularly individuals with gender identity disorders (GID), have unique needs, of which care providers should be aware. 9 Furthermore, despite increased recognition of GID over the past decade, there remains a paucity of literature that investigates the serious dermatologic issues related to androgen therapy in transsexual males. 10 …”

Section: Discussionmentioning

confidence: 99%

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Necrotizing Soft Tissue Infection or Sweet Syndrome

Otero¹,

Barber

Yeh

et al. 2017

A & A Case Reports

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We report a case of Necrotizing Sweet's syndrome in a 24-year-old transsexual male who presented with recurrent myonecrosis of the neck/upper chest. Upon index admission, computer tomography revealed gas and fat stranding of the sternocleidomastoid and pectoralis major muscle -- findings suggestive of a necrotizing soft tissue infection. Despite debridement procedures and intravenous antibiotic therapy, myonecrosis of the affected areas persisted. Evaluation of tissue samples by Dermatopathology revealed neutrophilic infiltration extending into the dermis and muscle necrosis, findings consistent with Necrotizing Sweet's syndrome. The initiation of IV corticosteroids, the gold standard treatment for Necrotizing Sweet's syndrome, lead to significant clinical improvement. When soft tissue infections do not respond to debridement and broad-spectrum antimicrobial coverage, perioperative care providers should consider Necrotizing Sweet's syndrome as an underlying cause. By facilitating the early diagnosis and appropriate management of unique conditions such as Necrotizing Sweet's syndrome anesthesiologists can not only play a more visible role as leaders in the emerging Perioperative Surgical Home model, but also may prevent significant patient morbidity and reduce unnecessary utilization of healthcare resources.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Necrotizing Soft Tissue Infection or Sweet Syndrome

Otero¹,

Barber

Yeh

et al. 2017

A & A Case Reports

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show abstract

“…Contrary to treatment with estrogens, there is often a significant increase in sebum production (Giltay and Gooren, 2000). In addition, severe acne has been observed in this population, especially upon initiation of the therapy (Turrion-Merino et al, 2015, Wierckx et al, 2014). Although topical agents and oral antibiotic medications remain first-line treatments for testosterone-induced acne, many transgender men ultimately require isotretinoin.…”

Section: Hormone Supplementationmentioning

confidence: 96%

Dermatologic care of the transgender patient

Ginsberg

2017

International Journal of Women's Dermatology

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Given the complexities of the transitioning process, transgender individuals may face unique dermatologic needs in addition to routine care. Exogenous hormones affect hair and sebum production, gender-confirming surgeries often require dermatologic pre- and postoperative interventions, and postoperative anatomy may show unique presentations of routine skin conditions. Aesthetic techniques that are often used for rejuvenation may have a role in facial feminization and masculinization and unfortunately are too frequently performed by nonmedical personnel with negative consequences. Ultimately, physicians should strive to make their office a more accommodating environment for transgender individuals.

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“…Female to male transsexual patients have in some cases suffered severe chronic acne after beginning testosterone supplementation [80]. Typical treatments like doxycycline and topical retinoids did not show an improvement, but oral isotretinoin led to clearance followed by a delayed recurrence of severe acne in both patients [80].…”

Section: Edible Plants and Acnementioning

confidence: 99%

“…Typical treatments like doxycycline and topical retinoids did not show an improvement, but oral isotretinoin led to clearance followed by a delayed recurrence of severe acne in both patients [80]. Another study with a larger sample size ( n = 70) showed that acne presence and severity did increase over the first six months on testosterone, but that this condition was temporary and that only ~6% of patients had acne after long-term supplementation [81].…”

Section: Edible Plants and Acnementioning

confidence: 99%

Edible Plants and Their Influence on the Gut Microbiome and Acne

Clark

Haas

Sivamani

2017

IJMS

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Acne vulgaris affects most people at some point in their lives. Due to unclear etiology, likely with multiple factors, targeted and low-risk treatments have yet to be developed. In this review, we explore the multiple causes of acne and how plant-based foods and supplements can control these. The proposed causative factors include insulin resistance, sex hormone imbalances, inflammation and microbial dysbiosis. There is an emerging body of work on the human gut microbiome and how it mediates feedback between the foods we eat and our bodies. The gut microbiome is also an important mediator of inflammation in the gut and systemically. A low-glycemic load diet, one rich in plant fibers and low in processed foods, has been linked to an improvement in acne, possibly through gut changes or attenuation of insulin levels. Though there is much interest in the human microbiome, there is much more unknown, especially along the gut-skin axis. Collectively, the evidence suggests that approaches such as plant-based foods and supplements may be a viable alternative to the current first line standard of care for moderate acne, which typically includes antibiotics. Though patient compliance with major dietary changes is likely much lower than with medications, it is a treatment avenue that warrants further study and development.

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Severe Acne in Female-to-Male Transgender Patients

Cited by 44 publications

References 6 publications

Necrotizing Soft Tissue Infection or Sweet Syndrome

Necrotizing Soft Tissue Infection or Sweet Syndrome

Dermatologic care of the transgender patient

Edible Plants and Their Influence on the Gut Microbiome and Acne

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