Main Article Content
Pulsed light, subjective, objective, clinical trial, facial acne, vulgaris, Iraqi patients
The Intense pulse light (IPL) therapy has three mechanisms of action in acne vulgaris; photo-chemical, photo-immunological and photo-thermal. In this clinical trial forty seven patients with facial inflammatory acne lesion , their ages ranged from 15 to 40 years were enrolled. Patients included in two groups, 20 patients in group A treated with IPL for 3 sessions; 3 weeks apart, and 27 patients in group B treated with BPO 2.5% gel daily at night for 9 weeks. Follow up at 3 weeks after the end treatment. The effect of treatment was evaluated objectively according to total lesion counting and digital photographic assessment and subjectively according to the patients satisfaction. IPL is effective and well tolerated method in the treatment of inflammatory facial acne like BPO. Therefore, the IPL can be used as standard therapy for Inflammatory acne vulgaris.
2. Alison M. Layton, E. Anne Eady and Christos C. Zouboulis. Acne . In:. Christopher E. M. Griffiths, Jonathan Barker , Tanya Bleiker . Robert Chalmers & Daniel Creamer (eds). Rook's Text Book of Dermatology, 9th Edition , Blackwell Scientific Publication 2016; 90:1-16.
3. Lynn DD, Umari T, Dunnick CA, Dellavalle RP. The epidemiology of acne vulgaris in late adolescence. Adolesc Health Med Ther. 2016;7:13-25.
4. Goh C., Cheng C., Agak G., Zaenglein AL, Graber EM, Thiboutot DM, & Kim J. Acneiform disorders. In: Kang S, Amagai M, Bruckner AL, Enk AH, Margolis MJ, Mcmichael PJ, Orringer MS (eds). Fitzpatrick’s detmatology, 9th Ed. McGraw Hill 2019;1,78:1391-1407.
5. Bhate K, Williams HC. Epidemiology of acne vulgaris. Br J Dermatol. 2013;168:474-485.
6. Bataille V, et al.The infuence of genetics and environmental factors in the pathogenesis of acne: A twin study of acne in women. J Invest Dermatol. 2002;119:1317-1322.
7. Zaenglein AL, Thiboutot DM. Acne vulgaris. In: Bolognia JL, Schaffer JV, Cerroni L(eds.). Dermatology, 4th edition. Mosby Elsevier 2018;1,36:588-601.
8. Jeremy AHT, Holland DB, Roberts SG , et al. informatory events are involved in acne lesion initiation. J Invest Dermatol. 2003;121:20–7.16.
9. Habif TP. Acne and related disorder. In clinical Dermatology: Acolor Guide to Diagnosis and Therapy, 5th ed. Edinburgh, UK, Mosby 2010; 7: 217–247.
10. Cantatore-Francis JL, Glick SA. Childhood acne: evaluation and management. Dermatol Ther. 2006;19:202-209.
11. Chen W, Thiboutot D, Zouboulis CC. Cutaneous androgen metabolism: basic research and clinical perspectives. Journal of investigative dermatology, 2002;119(5):992-1007.
12. Lai JJ, et al. The role of androgen and androgen receptor in skin-related disorders. Archives of dermatological research, 2012;304(7):499-510.
13. Abdel-Fattah NS, Shaheen MA, Ebrahim AA, El Okda ES. Tissue and blood superoxide dismutase activities and malondialdehyde levels in different clinical severities of acne vulgaris. Br J Dermatol. 2008;159:1086–91.21.
14. Tanghetti EA. The role of inflammation in the pathology of acne. The Journal of clinical and aesthetic dermatology 2013; 6(9): 27.
15. Chronnell CM, Ghali LR, Ali RS, et al. Human beta defensin-1 and -2 expression in human pilosebaceous units: upregulation in acne vulgaris lesions. J Invest Dermatol. 2001;117:1120–1125.
16. Nakatsuji T, Kao MC, Zhang L, et al. Sebum free fatty acids enhance the innate immune defense of human sebocytes by upregulating beta-defensin-2 expression. J Invest Dermatol. 2010;130:985–994.
17. Nagy I, Pivarcsi A, Koreck A, et al. Distinct strains of Propionibacterium acnes induce selective human beta-defensin-2 and interleukin-8 expression in human keratinocytes through toll-like receptors. J Invest Dermatol. 2005;124:931–938.
18. Segre JA. What does it take to satisfy Koch’s postulates two centuries later? Microbial genomics and P. acnes. J Invest Dermatol. 2013;133(9):2141–2.23.
19. Lheure C, Grange PA, et al. TLR-2 recognizes Propionibacterium acnes CAMP factor 1 from highly inflammatory strains. PLoS ONE 2016;11:e0167237.26.
20. Kim J, Ochoa MT, Krutzik SR, et al. Activation of toll-like receptor 2 in acne triggers inflammatory cytokine responses. J Immunol. 2002;169:1535–41.27.
21. Jalian HR, Liu PT, Kanchanapoomi M, et al. All-trans retinoic acid shifts Propionibacterium acnes-induced matrix degradation expression profile toward matrix preservation in human monocytes. J Invest Dermatol. 2008;128:2777–82.28.
22. Qin M, Pirouz A, Kim MH, et al. P. acnes Induces IL-1β secretion via the NLRP3 inflammasome in human monocytes. J Invest Dermatol. 2014;134:381–8.30.
23. Kistowska M, Meier B, et al. P.acnes promotes Th17 and Th17/Th1 responses in acne patients. J Invest Dermatol. 2015;135:110–18.31.
24. Kumaresan M, Srinivas C R. Efficacy of IPL in treatment of acne vulgaris: Comparison of single-and burst-pulse mode in IPL. Indian journal of dermatology 2010; 55(4): 370-2.
25. Liu PT, Phan J, et al. CD209(+) macrophages mediate host defense against P. acnes. J Immunol 2008;180:4919–23.31a.