F. William Danby

Acne

Causes and Practical Management

• Gebundenes Buch

Produktbeschreibung

Learn to accurately diagnose, prevent and treat all three acnes using both traditional and novel approaches to understanding the causes and selecting the most effective treatments.

Acne vulgaris is an extremely common condition. It is troublesome to manage, often persisting into middle age. Exact causes are becoming clear and include several hormonal stimulants, some triggered by the Western diet, and a pathogen ignored for decades. Acnes rosacea and inversa (hidradenitis suppurativa) are discussed from entirely new viewpoints.

Acne: Causes and Practical Management will provide readers at all levels with a practical, well-illustrated approach to fully understanding these disorders; a faster and more cost-effective management regimen and the rationales for their prevention.

In full colour throughout and with over 200 excellent clinical images, key highlights include:
Full coverage of all acne presentations - acne vulgaris, acne rosacea and acne inversa (hidradenitis suppurativa)
An integrated view of the causes of the varied and overlapping acnes
Preventive, novel and curative approaches to treatment
Medical, surgical, and dietary components of management, fully integrated
Highly practical focus on prevention, treatment and prophylaxis based on emerging pathogenetic concepts
Brought to you by one of the world's leading authorities on the subject, Acne: Causes and Practical Management will be a valuable re-education for the dermatologist and all those who treat or suffer from these three conditions.

Produktdetails

• Verlag: Wiley & Sons
• Artikelnr. des Verlages: 1A118232770
• 1. Auflage
• Seitenzahl: 256
• Erscheinungstermin: 9. Februar 2015
• Englisch
• Abmessung: 260mm x 208mm x 18mm
• Gewicht: 773g
• ISBN-13: 9781118232774
• ISBN-10: 1118232771
• Artikelnr.: 40783259

Autorenporträt

F. William Danby, MD, FRCPC is Adjunct Assistant Professor of Dermatology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA.

Inhaltsangabe

Preface ix Practical acne therapy xii Genetics xii Diet xii Hormones xii
Stress xiii Comedones (plugs in pores) xiii Blemishes--a brief catalogue
xiv Nodules xv Scars and sinuses xvi Support xvii Introduction xviii
Nomenclature xix The three acnes and grading xx Acne vulgaris xx Acne
rosacea xxii Acne inversa (hidradenitis suppurativa) xxiii Grading the
three acnes xxvi Acne vulgaris xxvi Acne rosacea xxvi Acne inversa
(hidradenitis suppurativa) xxvi 1 The three acnes and their impact 1 1.1
Acne vulgaris 1 1.1.1 Terminology 1 1.1.2 The starting point 3 1.2 Acne
rosacea 3 1.2.1 The "pimply" part 4 1.2.2 The "redness" part 4 1.2.3 The
third part the firm fibrosis 6 1.2.4 Part four--ocular rosacea 7 1.2.5
Putting it all together 7 1.2.6 The inflammatory epiphenomena in acne
rosacea 8 1.2.7 The "acne rosacea" versus "rosacea" controversy 12 1.2.8
Summary 12 1.3 Acne inversa (formerly hidradenitis suppurativa) 12 1.3.1
Before the rupture where and why? 15 1.3.2 After the rupture what next? 15
1.3.3 So what invaders are important in acne inversa? 15 1.3.4 What makes
this disease behave so much worse than acne vulgaris? 18 1.3.5 So what can
one possibly do to settle down all this inflammation? 21 1.3.6 So how do
you get rid of all this material? 25 1.3.7 What does the future offer? 25
1.4 The psychology of acne 26 1.4.1 Acne as a stress 26 1.4.2 Acne and
self-image 27 1.4.3 Isotretinoin therapy and the psyche 27 1.4.4 The
isotretinoin-depression question 28 1.4.5 Isotretinoin in perspective 29 2
The folliculopilosebaceous unit--the normal FPSU 31 2.1 Anatomy 31 2.2
Genetics 31 2.2.1 Acne vulgaris 31 2.2.2 Acne rosacea 34 2.2.3 Acne
inversa/hidradenitis suppurativa (AI/HS) 34 2.2.4 The scottish twins 34 2.3
Epigenetics 35 2.3.1 The farmer's boys 36 2.4 Embryology 36 2.5 Histology
38 2.5.1 Onwards and downwards 38 2.5.2 What is going on inside the FPSU?
40 2.6 Physiology 42 2.6.1 Hair first 42 2.6.2 Oil second 42 2.6.3 Last but
definitely not least: the follicle 43 2.6.4 Looking deeper 44 2.7
Biochemistry 44 2.8 Hormones enzymes receptors and the intracrine system 45
2.8.1 The intracrine system 48 2.9 FoxO1 and mTORC1 49 2.9.1 The next step
50 2.9.2 The broad view 51 3 Pathogenetic mechanisms summarized 54 3.1 Acne
vulgaris 54 3.2 Acne rosacea 56 3.3 Acne inversa/hidradenitis suppurativa
(AI/HS) 57 3.4 Other variants 60 3.4.1 Malassezia folliculitis 60 3.4.2
Eosinophilic pustular folliculitis (ofuji's disease) 62 3.4.3 Dissecting
terminal folliculitis 63 3.4.4 Acne keloidalis 63 3.4.5 Epidermal growth
factor receptor (EGFR) inhibitor eruption 64 3.4.6 Acné excoriée des jeunes
filles 65 4 The acne hormones 67 4.1 The endogenous hormones 67 4.1.1
Androgens and their sources 67 4.1.2 Estrogens and their sources 68 4.1.3
Progesterone and the progesteroids 68 4.1.4 Insulin 69 4.1.5 Growth hormone
and insulin-like growth factor-1 72 4.2 The exogenous hormones 72 4.2.1
Anabolic steroids 72 4.2.1.1 Mothers' milk 72 4.2.1.2 Muscle makers 74
4.2.2 Oral contraceptive hormones 74 4.2.2.1 Oral estrogens 74 4.2.2.2 Oral
progestins 75 4.2.2.3 Extended cycles 75 4.2.3 Other exogenous birth
control hormones 77 4.2.3.1 Implants 77 4.2.3.2 Intrauterine devices 78
4.2.3.3 Intravaginal devices 78 4.2.3.4 Topicals: the patches 78 4.2.3.5
Intramuscular (depot) injections 78 4.2.4 Dietary sources of hormones 78
4.2.4.1 The impact of diet on acne 80 4.2.4.2 Carbohydrate load versus
dairy load 83 5 Exogenous acnegens and acneform eruptions 87 5.1 Chemicals
and medications 87 5.2 Endocrine imitators and disruptors 87 5.2.1
Environmental contamination 88 5.3 Foods 88 5.3.1 Iodine and bromine 89
5.3.2 Chocolate 89 5.3.3 Casein and whey 90 5.4 Photodamage glycation and
the acne and aging processes 91 5.5 Smoking and nicotine 91 6 Follicular
flora fauna and fuzz 93 6.1 Propionibacterium acnes (P. acnes) 93 6.1.1
Normal role of P. acnes 94 6.1.2 Pathogenic role of P. acnes 94 6.2
Malassezia species 95 6.2.1 Normal role 95 6.2.2 Immunogenicity 97 6.2.3
Pruritogenicity 98 6.2.4 Malassezia in the acnes 98 6.3 Staph strep and
Gram-negative organisms 99 6.4 Demodex 99 6.5 Vellus hairs 101 7 The
inflammatory response 103 7.1 Innate immunity 103 7.2 Adaptive (acquired)
immunity 104 7.3 Inflammation as the primary acnegen 104 7.4 Mediators
cellular and humoral and neuroimmunology 105 7.5 Allergy (shared antigens)
106 7.6 Inflammation pigment and PIH 106 7.7 Inflammation and scarring 107
8 Management 109 8.1 Prevention 109 8.2 General principles of management
111 8.3 Diet 111 8.3.1 Dairy 112 8.3.1.1 The deli-planning heiress 114
8.3.1.2 The pharmaceutical executive 115 8.3.2 Carbohydrates glycemic load
and hyperinsulinemia 115 8.3.3 The paleolithic diet 116 8.3.4 High-fructose
corn syrup (HFCS) 116 8.3.5 Metformin 116 8.3.6 Synthesis and summary 117
8.4 Comedolytics and other topicals 117 8.4.1 Standard topical comedolytics
118 8.4.1.1 Retinoids 118 8.4.1.2 Benzoyl peroxide 119 8.4.1.3 Salicylic
acid 120 8.4.1.4 Alpha and beta-hydroxy acids 120 8.4.2 Unclassified
topicals 120 8.4.2.1 Azelaic acid 120 8.4.2.2 Sulfur 121 8.4.2.3 Zinc
compounds 121 8.4.2.4 Resorcinol 121 8.4.3 Systemic comedolytics 121
8.4.3.1 Vitamin A 121 8.4.3.2 Isotretinoin 121 8.4.3.3 Acitretin 127
8.4.3.4 Summary 128 8.5 Anti-inflammatories and antimicrobials 128 8.5.1
Antibiotics as anti-inflammatories 128 8.5.1.1 In acne vulgaris 128 8.5.1.2
In acne rosacea 129 8.5.1.3 In acne inversa 129 8.5.1.4 In dissecting
terminal folliculitis (DTF) and acne keloidalis 129 8.5.2 Antibiotics as
antibiotics 130 8.5.3 Ketoconazole ivermectin and crotamiton 130 8.5.3.1 In
acne vulgaris 132 8.5.3.2 In acne rosacea 133 8.5.3.3 In acne
inversa/hidradenitis suppurativa and dissecting folliculitis and cellulitis
135 8.5.4 Steroids 135 8.5.4.1 The marine 136 8.5.5 Nonsteroidal
anti-inflammatory drugs (NSAIDs) and biologics 137 8.5.6 Phototherapy 137
8.5.7 Post-inflammatory hyperpigmentation 138 8.5.7.1 Prognosis 141 8.6
Hormone manipulations and therapy 141 8.6.1 Birth control pill selection
141 8.6.1.1 Estrogens 142 8.6.1.2 Progestins 143 8.6.2 Androgen receptor
blockade 143 8.6.2.1 Spironolactone 144 8.6.2.2 Cyproterone acetate 146
8.6.2.3 Flutamide 146 8.6.2.4 Drospirenone 146 8.6.2.5 Topical androgen
blockers 147 8.6.3 Dihydrotestosterone minimization 147 8.6.3.1 Finasteride
147 8.6.3.2 Dutasteride 147 8.6.3.3 Diet 148 8.6.4 Phototherapy-hormone
interactions 149 8.7 Surgery 150 8.7.1 Acne vulgaris 150 8.7.1.1 Acne
surgery for patients 150 8.7.1.2 Acne surgery for physicians 151 8.7.2 Acne
rosacea 152 8.7.3 Acne inversa/hidradenitis suppurativa 153 8.7.3.1
Mini-unroofing by punch biopsy 153 8.7.3.2 Unroofing 154 8.7.3.3 Wide
surgical excision 157 8.7.3.4 Healing options 158 8.8 Lights and lasers 162
8.8.1 Light and other radiation in acne 162 8.8.1.1 Radiation's targets 163
8.8.1.2 Light as a practical acne therapy 164 8.8.2 Lasers 165 9 Acne in
pregnancy 171 9.1 Epidemiology 171 9.2 Pathogenesis 172 9.3 Team up with
mother nature 173 9.4 Targeting therapy 173 9.4.1 Clinical manifestations
173 9.4.2 Pathology 173 9.4.3 Diagnostic evaluation 173 9.4.4 Overview and
general approach to treatment 174 9.4.5 Milk and pregnancy 174 9.4.6 Active
therapy 175 9.4.6.1 Avoidance of harm 175 9.4.6.2 Lesion-directed therapy
177 9.4.6.3 Nonprescription topicals 177 9.4.6.4 Antimicrobials 177 9.4.6.5
Combination topicals 178 9.4.6.6 Anti-inflammatories 178 9.4.6.7 Hormone
blockers 178 9.4.6.8 Procedural therapies 179 9.5 Discussion 179 9.6
Summary and conclusion 179 10 Putting it all together 182 10.1 Lifestyle
choices and the acnes 182 10.1.1 The "processed cheese queen" 184 10.2
Therapeutic choices and the acnes 184 10.2.1 Acne vulgaris 184 10.2.2 Acne
rosacea 185 10.2.3 Acne inversa/hidradenitis suppurativa 185 10.3
Conclusion 186 11 Appendices 187 11.1 Appendix A: the rosacea
"classification and staging" controversy 187 11.2 Appendix B: the dairy
versus carbohydrate controversy 189 12 The handouts 193 12.1 Acne 194 12.2
The "zero-dairy" diet 197 12.3 The risks and benefits of isotretinoin 199
12.4 The paleo diet 204 12.5 Acne inversa/hidradenitis suppurativa (AI/HS)
209 12.6 Yasmin/Ocella/Zarah or Yaz/Gianvi extended cycle for acne therapy
213 Index 215