Acne Vulgaris Clinical Trial
Official title:
A Monocentric, Single-Blind, Randomized, Placebo-Controlled Study of the Safety and Efficacy of the Topical Drug Acnase Creme in the Treatment of Acne Vulgaris I and II
The objective of this study is to establish the safety in use of the topical drug Acnase Creme and its effectiveness in treatment of acne grade I (comedones) and II (comedones, papules, pustules).
The acne is a common dermatosis in dermatological practice, affects more than 80% of the
population during the second and third decades of life. It is found worldwide, with no
evidence of racial or ethnic differences that influence the susceptibility to its
development. However there is influence of genetic factors, hormones, the use of certain
drugs that may have previous or aggravate the disease.
It is an inflammatory disease of the follicle polissebáceo, which consists of large
sebaceous glands, multiacinares, rudimentary hair follicle and a channel comprising a
acro-infundibulum in its upper portion and an infra-infundibulum in the dermal portion.
This is a benign condition, self-limited, but can cause serious psychological problems or
disfiguring scars, which can persist for the rest of life.
The initial change is a disorder of follicular epithelial differentiation, during which the
cornea cells (keratinocytes) which are the follicle polissebáceo are excessively released in
the lumen. The result of this event is the appearance of the precursor, microcomedão, from
which the lesions of acne are developed (closed comedones, open comedones, papules, pustules
and nodules). The dilation of the follicular infundibulum with the material produces a
corneal comedão closed. This is the first clinically visible lesions of acne. As
hyperkeratosis extends to the upper infundibulum, extended its opening, it formed the
comedão open.
The pathogenesis of acne is complex and understood only in part. The follicular occlusion
with adherent keratinocytes and activation of hormone secretion resulting in the formation
of sebaceous microcomedão. Studies suggest that free fatty acids intrafoliculares control
inflammation through chemotactic properties on leukocytes, monocytes and neutrophils. The
free fatty acids may provide the primary stimulus for the retention hyperkeratosis
follicularis. Moreover, tallow provides a favorable substrate for the proliferation of
Propiniobacterium acnes (P. acnes). Studies suggest that P. acnes, a microaerophilic
bacterium (almost anaerobic), Gram-positive, has a lipase able to hydrolyze triglycerides in
sebum into free fatty acids. Therefore, these pathogens play critical role in the generation
of inflammatory lesions. The P. acnes produces proteases and neuroaminidases, which may
increase the permeability of the follicular epithelium. Also produce a chemotactic factor of
low molecular weight that selects the polymorphonuclear leukocytes. In the process of
phagocytosis of bacteria are released hydrolases, which break the integrity of the
follicular wall. Subsequently, the content intrafolicular - fragments of keratin, fat, hair,
and P. acnes - is expelled to the dermis.
If surface aggregation of neutrophils, as was a wheal, and with the presence of purulent
secretion, a pustule. With the infiltration of inflammation deep and extensive, a nodule or
cyst is produced.
Clinically, the eruption acnéica is located predominantly in the face (90%) and to a lesser
extent, in the back (60%) and chest (15%). As young man, mainly affects the face, while in
older, the back.
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Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Subject), Primary Purpose: Treatment
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