In vivo monitoring of topical therapy for acne with reflectance confocal microscopy.
BACKGROUND
Acne vulgaris is a common disease of the pilosebaceous unit. The aim of the study was to evaluate compartment-specific treatment action through the microscopic non-invasive imaging of skin changes.


METHODS
Mild-moderate acne patients, that were prescribed a topical anti-acne product, were followed by clinical and reflectance confocal microscopy (RCM) imaging every 14 days to 6 weeks. Mean and standard deviation of the scores were analyzed for each time point.


RESULTS
After 2 weeks, the RCM count of papules/pustules and the RCM scores of exocytosis and dermal inflammation, decreased substantially. After 4 weeks, the RCM number of comedos was reduced. After 6 weeks, the number of regular follicles increased, while the infundibula with thickened bright border decreased significantly.


CONCLUSIONS
The progressive reduction in the clinical scores was correlated with the improvement of the RCM parameters. RCM study of acne skin showed a different timing for inflammatory and hyperkeratotic components to achieve a significant reduction during topical therapy with the association of retinoid and antibacterial molecules. The microscopic changes observed showed the regularization of the skin and the improvement of acne related features. RCM may represent a useful tool for the objective assessment of treatment efficacy and individual response evaluation.
Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy.
M
M
Manfredini
Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy.
M
M
Greco
Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy.
F
F
Farnetani
Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy.
G
G
Mazzaglia
Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy.
S
S
Ciardo
Department of Dermatology, University of Ferrara, Ferrara, Italy.
V
V
Bettoli
Department of Dermatology, University of Ferrara, Ferrara, Italy.
A
A
Virgili
Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy.
G
G
Pellacani
D000152:Acne Vulgaris / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology*; D000279:Administration, Cutaneous; D000293:Adolescent; D000328:Adult; D046169:Dermoscopy / Q000379:methods; D016903:Drug Monitoring / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D018613:Microscopy, Confocal / Q000379:methods*; D008857:Microscopy, Interference / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D063465:Skin Cream / Q000008:administration & dosage*; D016896:Treatment Outcome; D055815:Young Adult
acne; noninvasive; reflectance confocal microscopy; topical therapy