Abstract：
BACKGROUND:The management of acne in adult females is problematic, with many having a history of treatment failure and some having a predisposition to androgen excess. Alternatives to oral antibiotics and combined oral contraceptives (COCs) are required. OBJECTIVE:Our aim was to conduct a hybrid systematic review of the evidence for benefits and potential harms of oral spironolactone in the management of acne in adult females. METHODS:The review was conducted according to a previously published protocol. Three reviewers independently selected relevant studies from the search results, extracted data, assessed the risk of bias, and rated the quality of the evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. RESULTS:Ten randomized controlled trials (RCTs) and 21 case series were retrieved. All trials were assessed as being at a 'high risk' of bias, and the quality of evidence was rated as low or very low for all outcomes. Apart from one crossover trial that demonstrated statistical superiority of a 200 mg daily dose versus inflamed lesions compared with placebo, data from the remaining trials were unhelpful in establishing the degree of efficacy of lower doses versus active comparators or placebo. Menstrual side effects were significantly more common with the 200 mg dose; frequency could be significantly reduced by concomitant use of a COC. Pooling of results for serum potassium supported the recent recommendation that routine monitoring is not required in this patient population. CONCLUSION:This systematic review of RCTs and case series identified evidence of limited quality to underpin the expert endorsement of spironolactone at the doses typically used (≤100 mg/day) in everyday clinical practice.
journal_name
Am J Clin Dermatoljournal_title
American journal of clinical dermatologyauthors
Layton AM,Eady EA,Whitehouse H,Del Rosso JQ,Fedorowicz Z,van Zuuren EJdoi
10.1007/s40257-016-0245-xsubject
Has Abstractpub_date
2017-04-01 00:00:00pages
169-191issue
2eissn
1175-0561issn
1179-1888pii
10.1007/s40257-016-0245-xjournal_volume
18pub_type
杂志文章,评审abstract：:After a marked decline in the number of syphilis cases in the context of AIDS prevention campaigns, a significant increase has been observed in states of the former Soviet Union since 1994. In recent years, outbreaks have also been reported in the US, Canada, and several European countries. The current epidemic in the...
journal_title：American journal of clinical dermatology
pub_type： 杂志文章,评审
doi：10.2165/00128071-200607050-00003
更新日期：2006-01-01 00:00:00
abstract：:Cutaneous reactions to tattoos are not uncommon and various histologic patterns have been reported, including lichenoid, granulomatous, eczematous, and pseudolymphomatous reactions. Such patterns may develop with highly variable delay after the tattooing procedure. We report three strikingly similar cases of a fast-oc...
journal_title：American journal of clinical dermatology
pub_type： 杂志文章
doi：10.2165/00128071-200809050-00009
更新日期：2008-01-01 00:00:00
abstract：:The etiologies of a variety of skin conditions associated with diabetes have not been fully explained. One possible etiological factor is diabetic microangiopathy, which is known to affect the eyes and kidneys in patients with diabetes. There are many mechanisms by which diabetes may cause microangiopathy. These inclu...
journal_title：American journal of clinical dermatology
pub_type： 杂志文章,评审
doi：10.2165/00128071-200506040-00003
更新日期：2005-01-01 00:00:00
abstract：:Of all the psychotropic medications currently available, the mood-stabilizing agents have the highest incidence of severe and life-threatening adverse cutaneous drug reactions (ACDRs). An exanthematous eruption in a patient treated with a mood-stabilizing agent should be viewed as possibly being the initial symptom of...
journal_title：American journal of clinical dermatology
pub_type： 杂志文章,评审
doi：10.2165/00128071-200304010-00003
更新日期：2003-01-01 00:00:00
abstract：:Melanoma is a malignancy of pigment-producing cells that is driven by a variety of genetic mutations and aberrations. In most cases, this leads to upregulation of the mitogen-activated protein kinase (MAPK) pathway through activating mutations of upstream mediators of the pathway including BRAF and NRAS. With the adve...
journal_title：American journal of clinical dermatology
pub_type： 杂志文章,评审
doi：10.1007/s40257-015-0159-z
更新日期：2016-02-01 00:00:00
abstract：:Pemphigus vulgaris (PV) is a severe chronic autoimmune blistering disease that affects the skin and mucous membranes. It is characterized by suprabasal acantholysis due to disruption of desmosomal connections between keratinocytes. Autoantibodies against desmosomal cadherins, desmoglein 3 and 1, have been shown to ind...
journal_title：American journal of clinical dermatology
pub_type： 杂志文章
doi：10.1007/s40257-020-00544-w
更新日期：2020-12-01 00:00:00
abstract：:Mycobacterial organisms have re-emerged as an important cause of infectious disease worldwide. Both tuberculosis and nontuberculous mycobacterial infections remain endemic in many parts of the world and are becoming more common in patients with iatrogenic immunosuppression and HIV infection. The nontuberculous mycobac...
journal_title：American journal of clinical dermatology
pub_type： 杂志文章,评审
doi：10.2165/00128071-200910050-00001
更新日期：2009-01-01 00:00:00
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journal_title：American journal of clinical dermatology
pub_type： 杂志文章,评审
doi：10.2165/00128071-200102040-00004
更新日期：2001-01-01 00:00:00
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journal_title：American journal of clinical dermatology
pub_type： 杂志文章,评审
doi：10.2165/11594250-000000000-00000
更新日期：2012-06-01 00:00:00
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journal_title：American journal of clinical dermatology
pub_type： 杂志文章,评审
doi：10.2165/00128071-200304070-00007
更新日期：2003-01-01 00:00:00
abstract：UNLABELLED:Topical application of the antibacterial agent metronidazole is effective in the treatment of moderate to severe rosacea, although its mechanism of action has yet to be clearly established. Metronidazole preparations (0.75 and 1% cream, 0.75% gel and 0.75% lotion) were significantly more effective than place...
journal_title：American journal of clinical dermatology
pub_type： 杂志文章,评审
doi：10.2165/00128071-200001030-00007
更新日期：2000-05-01 00:00:00
abstract：:Granuloma annulare (GA) is a chronic inflammatory disease of unknown etiology characterized by the development of plaques preferentially localized to the distal extremities. Spontaneous remission and relapses are quite common and the course of GA is not easy to predict. Moreover, most therapeutic regimens have been us...
journal_title：American journal of clinical dermatology
pub_type： 杂志文章
doi：10.2165/11311040-000000000-00000
更新日期：2010-12-01 00:00:00
abstract：:A rapidly increasing number of people visit dermatologists for the prevention and treatment of aging skin. Sun avoidance and sunscreen use are widely accepted strategies of primary prevention against photoaging. Convincing evidence shows that topical application of retinoids has an effect on reversing, at least partia...
journal_title：American journal of clinical dermatology
pub_type： 杂志文章,评审
doi：10.2165/11530210-000000000-00000
更新日期：2010-01-01 00:00:00
abstract：:Photodynamic therapy (PDT) is proposed as an effective therapy with a good safety profile for patients with actinic keratoses. PDT involves the application of a photosensitizer to dysplastic or neoplastic tissue such that when exposed to light of an appropriate wavelength, the target tissue undergoes a cytotoxic react...
journal_title：American journal of clinical dermatology
pub_type： 杂志文章,评审
doi：10.2165/00128071-200304030-00001
更新日期：2003-01-01 00:00:00
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journal_title：American journal of clinical dermatology
pub_type： 杂志文章,评审
doi：10.2165/00128071-200304110-00006
更新日期：2003-01-01 00:00:00
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journal_title：American journal of clinical dermatology
pub_type： 杂志文章,评审
doi：10.1007/s40257-015-0162-4
更新日期：2016-02-01 00:00:00
abstract：BACKGROUND:A few studies in psoriasis vulgaris patients have reported changes suggesting red blood cell (RBC) damage is linked to neutrophil activation, oxidative stress, and psoriasis worsening. OBJECTIVE:The aim of this study was to evaluate erythroid disturbances in Portuguese psoriasis vulgaris patients, before, d...
journal_title：American journal of clinical dermatology
pub_type： 杂志文章
doi：10.2165/11592110-000000000-00000
更新日期：2012-02-01 00:00:00
abstract：:Microdermabrasion is a simple, safe, office cosmetic procedure in which aluminum oxide crystals or other abrasive substances are blown onto the face, then vacuumed off, using a single handpiece. This procedure has rapidly become widely utilized for a variety of cosmetic objectives, including the improvement of photoag...
journal_title：American journal of clinical dermatology
pub_type： 杂志文章,评审
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更新日期：2005-01-01 00:00:00
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journal_title：American journal of clinical dermatology
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更新日期：2013-02-01 00:00:00
abstract：:The treatment of cutaneous T cell lymphoma (CTCL), which includes mycosis fungoides and Sezary syndrome, has been in a state of continual change over recent decades, as new therapies are constantly emerging in the search for more effective treatments for the disease. However, prognosis and survival of patients with CT...
journal_title：American journal of clinical dermatology
pub_type： 杂志文章,评审
doi：10.2165/00128071-200203030-00006
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journal_title：American journal of clinical dermatology
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journal_title：American journal of clinical dermatology
pub_type： 杂志文章,评审
doi：10.2165/00128071-200203040-00003
更新日期：2002-01-01 00:00:00
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journal_title：American journal of clinical dermatology
pub_type： 杂志文章,评审
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更新日期：2003-01-01 00:00:00
abstract：:Aging of the skin is associated with skin thinning, atrophy, dryness, wrinkling, and delayed wound healing. These undesirable aging effects are exacerbated by declining estrogen levels in postmenopausal women. With the rise in interest in long-term postmenopausal skin management, studies on the restorative benefits th...
journal_title：American journal of clinical dermatology
pub_type： 杂志文章,评审
doi：10.2165/11589180-000000000-00000
更新日期：2011-10-01 00:00:00
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journal_title：American journal of clinical dermatology
pub_type： 杂志文章,评审
doi：10.2165/11536930-000000000-00000
更新日期：2011-04-01 00:00:00
abstract：:In women, acne can be successfully treated with oral contraceptives. This article focuses on the results of clinical studies on the treatment of acne with oral contraceptives. From the literature, 12 such studies could be traced over the last 10 years. Most of the studies were multicenter, randomized, and double blind...
journal_title：American journal of clinical dermatology
pub_type： 杂志文章,评审
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更新日期：2004-01-01 00:00:00
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journal_title：American journal of clinical dermatology
pub_type： 杂志文章
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更新日期：2020-10-01 00:00:00
abstract：:Vulvar lichen sclerosus is an important skin disease that is common in women in their 50 s and beyond; however, it can also affect females of any age, including children. If not treated, it has the potential to cause significant and permanent scarring and deformity of the vulvar structure. In addition, if untreated, i...
journal_title：American journal of clinical dermatology
pub_type： 杂志文章,评审
doi：10.1007/s40257-018-0364-7
更新日期：2018-10-01 00:00:00
abstract：:Vitamin D plays a key role in skeletal and cardiovascular disorders, cancers, central nervous system diseases, reproductive diseases, infections, and autoimmune and dermatological disorders. The two main sources of vitamin D are sun exposure and oral intake, including vitamin D supplementation and dietary intake. Mult...
journal_title：American journal of clinical dermatology
pub_type： 杂志文章,评审
doi：10.1007/s40257-017-0323-8
更新日期：2018-04-01 00:00:00
abstract：BACKGROUND:Scalp psoriasis is commonly the initial presentation of psoriasis, and almost 80 % of patients with psoriasis will eventually experience it. OBJECTIVE:Although several systematic reviews and guidelines exist, an up-to-date evidence-based review including more recent progress on the use of biologics and new ...
journal_title：American journal of clinical dermatology
pub_type： 杂志文章,评审
doi：10.1007/s40257-016-0222-4
更新日期：2017-02-01 00:00:00
