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Attuali trattamenti dell’acne: Farmaci, luci, laser e un nuovo laser Nd:YAG da 1064nm a 650 microsecondi.

Dott.Michael Gold, MD, Dott. David J. Goldberg, MD, JD, Dott. Mark Nestor, MD, PhD Journal of Cosmetic Dermatology, Settembre 2017, Volume 16, 3° Edizione

Sommario Il trattamento dell acne, in particolare se grave, rimane per i dermatologi una grande sfida. Le terapie comprendono retinoidi, antibiotici, ormoni, luci, laser e varie combinazioni di queste modalità. L’acne è attualmente considerata una condizione cronica, piuttosto che adolescenziale. Il trattamento appropriato dipende dal paziente e dalla gravità della malattia. Lo scopo di questo studio era quello di rivedere le terapie attuali per acne di tutti i livelli di gravità e di presentare il laser da 1064nm e 650 microsecondi per il trattamento dell’acne.

1 | INTRODUZIONE L’acne vulgaris è la ragione più frequente, per cui le persone si rivolgono al dermatologo.1 L’acne colpisce dall’85 al 90% degli adolecenti,2 bambini tra i 7 e 12 anni,3 adulti, uomini e donne, comprese le persone di colore.4,5 Tra gli adulti che hanno l’acne, il 64% ha da 20 a 30 anni, e il 43% da 30 a 40. La sua presenza è maggiore tra le donne rispetto agli uomini.68 Gollnick et al.9 e la Global Alliance to Improve Outcomes in Acne10 hanno suggerito che l’acne debba essere considerata una malattia cronica piuttosto che un semplice disturbo autolimitante degli adolescenti”. Questa asserzione si basa sulle caratteristiche note di una malattia cronica: Lunga durata, ricorrenza o ricaduta, comparsa lenta o eventi acuti ed effetti negativi sulla qualità della vita. L’acne persiste in età adulta anche fino al 50% dei pazienti interessati e ha conseguenze negative, come ansia e depressione, isolamento sociale, cicatrici e iperpigmentazione persistente.10 2 | PATOGENESI DELL’ACNE L’acne è una malattia multifattoriale dell’unità pilosebacea. Quattro sono i fattori patogeni a cui si attribuisce lo sviluppo delle lesioni da acne: Sovrapproduzione di sebo legata agli androgeni, colonizzazione del dotto pilosebaceo da parte del propionibacterium acnes, cheratinizzazione abnorme del follicolo e secrezione di mediatori infiammatori nella pelle.8 Il primo stadio è lo sviluppo di un microcomedone nell’unità pilosebacea. Si tratta di un tappo, che si forma a causa dell’aumento di produzione di sebo e di cheratinociti che rivestono il follicolo del pelo. Il risultato dell’accumulo di sebo e di cheratinociti è la formazione di comedoni visibili, più grandi. Nello stesso tempo, il P.acnes colonizza il dotto pilosebaceo, attivando il rilascio di mediatori infiammatori nel tessuto circostante ed una risposta da parte delle cellule immunocompetenti, contribuendo ulteriormente allo sviluppo di comedoni.8,11 L’acne si presenta più frequentemente sul viso, sul collo, sulla schiena e sul petto, tutte zone con molte unità pilosebacee.12,13

3 | TRATTAMENTO DELL’ACNE Le tradizionali monoterapie per l’acne, lieve o moderata, sono i retinoidi topici e gli agenti antimicrobici, come gli antibiotici e il perossido di benzoile (BPO).

3.1 | I Retinoids Members of the Global Alliance10 dichiarano che occorrerebbe considerare i retinoidi come base del trattamento di tutti i pazienti sofferenti di acne, tranne quelli con la forma più grave della malattia. I retinoidi topici, ad esempio tretinoina, tazarotene, adapalene, aiutano a normalizzare la differenziazione abnorme e

Gold MGoldberg DJNestor MSAttuali trattamenti dell’acne: Farmaci, luci, laser e un nuovo laser Nd:YAG da 1064nm a 650 microsecondiJ Cosmet Dermatol2017;16:303318https://doi.org/10.1111/jocd.12367

Table of Contents

Hyperpigmentation

Photos Courtesy of Cheryl Burgess, MD.

Photos Courtesy of Jennifer Parker-Porter, MD.

Learn more about treating hyperpigmentation today.

Vascular Lesions

Photos Courtesy of Dr. Guilia Kasimova.

Photos Courtesy of Michael Gold, MD.

Learn more about treating vascular lesions today.

Rosacea / Redness

Photos Courtesy of Yelena Kipervas, DO.

Photos Courtesy of Dr. Nabil Fakih.

Learn more about treating rosacea and redness today.

Hair Removal

Photos Courtesy of Dr. Andrew Nnadi.

Photos Courtesy of Steik Spa.

Learn more about treating hair removal today.

PFB

Photos Courtesy of Dr. Michelle Henry.

Photos Courtesy of Wendy Roberts, MD.

Learn more about treating PFB today.

Scars

Photos Courtesy of Dr. William Watfa.

Photos Courtesy of Bradley Bloom, MD.

Learn more about treating scars today.

Autoimmune Disorders

Photos Courtesy of Dr. Passeron.

Photos Courtesy of Dr. Sakhiya.

Learn more about treating autoimmune disorders today.

Skin Rejuvenation

Photos Courtesy of Catie Cutler, LE.

Photos Courtesy of Chesahna Kindred, MD.

Learn more about skin rejuvenation today.

Acne

Photos Courtesy of Michael Gold, MD.

Photos Courtesy of Michael Gold, MD.

Learn more about treating acne today.

Staff Accountant / Junior Accountant

Aerolase Corporation, a leading aesthetic laser innovator, seeks a Staff Accountant / Junior Accountant. Having made the Inc. 5000 list as one of the world’s fastest growing private companies as well as annual best-in-class product awards, Aerolase has transformed the market with products that provide uniquely tolerable treatments to the patients and exceptionally high ROI for the practitioners. The company offers competitive and an exciting high-growth company culture.

Staff Accountant / Junior Accountant

• Provide support to the Controller and the management team
• Maintain day-to-day financial accounting functions, including A/P, A/R, expense tracking
• Support the month-end close process, ensuring accurate and timely monthly, quarterly, and year-end financial statements.
• Uploading annual budget and tracking actual to budget variances
• Use of financial reporting software
• Support external auditors and other required outside reporting requirements
• Participation in quarterly inventory reconciliations
• Assist team with projects such as policy creation, system implementation, client support etc.

• Some experience with and strong understanding of the monthly close process and technical accounting
• Detailed oriented, with ability to see the big picture
• Self-starter who can work independently and employ time management skills to meet deadlines.
• Knowledge of MS Excel (V-lookup, formulas, pivot tables).
• Strong interpersonal and communication skills
• Sound judgment and problem-solving skills

• Bachelor’s or master’s degree in Accounting a MUST, good understanding of GAAP
• 1-3 years’ experience in an accounting function (including internship)
• General Ledger/Operational Accounting experience
• Knowledge of Quickbooks or other reporting software a plus (more the better)
• Industry experience a plus

Senior Accountant

Aerolase Corporation, a leading aesthetic laser innovator, seeks a Senior Accountant. Having made the Inc. 5000 list as one of the world’s fastest growing private companies as well as annual best-in-class product awards, Aerolase has transformed the market with products that provide uniquely tolerable treatments to the patients and exceptionally high ROI for the practitioners. The company offers competitive and an exciting high-growth company culture.

Senior Accountant:

• Provide support to the Controller and the management team
• Own day-to-day financial accounting functions, including A/P, A/R, expense tracking
• Assist in establishing and maintaining policies & procedures in accordance with GAAP and Aerolase policy
• Key contributor to the month-end close process, ensuring accurate and timely monthly, quarterly, and year-end financial statements.
• Assist in the preparation of management reports – (cash management, various projections, month end reporting package)
• Involvement with the annual budget process
• Use of financial reporting software
• Support external auditors and other required outside reporting requirements
• Prepare and submit payroll
• Participation in quarterly inventory reconciliation to the perpetual
• Ad hoc projects

• Strong knowledge of the monthly close process and technical accounting

• Detailed oriented, with ability to see the big picture

• Experience in continuous improvement and accounting best practices

• Self-starter who can work independently and employ time management skills to meet deadlines.

• System savvy – ability to learn new financial software

• Intermediate knowledge of MS Excel (V-lookup, formulas, pivot tables).

• Global consolidations experience a plus

• Strong interpersonal and communication skills

• Sound judgment and problem-solving skills

• Bachelor’s or master’s degree in Accounting a MUST, good understanding of GAAP

• 3+ years’ experience working as a staff/senior accountant

• General Ledger/Operational Accounting experience a must

• Extensive knowledge of Quickbooks and other reporting software

• Prior involvement with system implementation

• Prior public accounting experience (any size firm) a plus

• Industry experience a plus

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