Andreas Katsambas’s research while affiliated with Agricultural University of Athens and other places

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Publications (433)


New and emerging non-antibiotic pharmacological treatments for acne
The Microbiome and Acne: Perspectives for Treatment
  • Literature Review
  • Full-text available

January 2024

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242 Reads

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14 Citations

Dermatology and Therapy

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Andreas Katsambas

The skin microbiome consists of the microorganisms populating the human skin. Cutibacterium acnes (C. acnes, formerly named Propionibacterium acnes) is recognized as a key factor in acne development, regulating inflammatory and immune pathways. Dysbiosis has been described as the imbalance in skin microbiome homeostasis and may play a role in acne pathogenesis. Microbial interference has been shown to be a contributor to healthy skin homeostasis and staphylococcal strains may exclude acne-associated C. acnes phylotypes. In this review we present an update on the skin microbiome in acne and discuss how current acne treatments such as benzoyl peroxide, orally administered isotretinoin, and antibiotics may affect the skin microbiome homeostasis. We highlight the collateral damage of acne antibiotics on the skin microbiome, including the risk of antimicrobial resistance and the dysregulation of the microbiome equilibrium that may occur even with short-term antibiotic courses. Consequently, the interest is shifting towards new non-antibiotic pharmacological acne treatments. Orally administered spironolactone is an emerging off-label treatment for adult female patients and topical peroxisome proliferator-activated receptor gamma (PPARγ) modulation is being studied for patients with acne. The potential application of topical or oral probiotics, bacteriotherapy, and phage therapy for acne are further promising areas of future research.

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Hirsutism and Hypertrichosis

October 2023

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37 Reads

Hirsutism is a clinical diagnosis in women, based on the Ferriman–Gallwey (FG) score. Polycystic ovary syndrome (PCOS) accounts for 75% to 80% of hirsutism, while hirsutism is idiopathic in 15% to 20% of cases, and in the remaining less than 5%, hirsutism is due to rare conditions such as congenital adrenal hyperplasia, Cushing syndrome, or drug-induced. An effective management of hirsutism should aim to correct any potential underlying hormonal disease while reducing excessive hair. In patients with PCOS, various oral contraceptive pills have shown similar efficacy in treating hirsutism. Metformin, lifestyle interventions, myo-inositol, and D-chiro-inositol have not shown efficacy for treating hirsutism. Eflornithine hydrochloride 13.9% cream is approved for the treatment of facial hirsutism in women and reduces unwanted facial hair. The use of hair removal methods, including laser or IPL hair removal, is encouraged for idiopathic hirsutism, as well as for patient-important hirsutism defined as hair growth that causes distress in the absence of an abnormal hirsutism score. In the case of a hirsute woman with an underlying endocrine disorder, in addition to hair removal offered for hirsutism, a multi-disciplinary approach is necessary with a referral to an endocrinologist and/or a gynecologist to offer treatment for the hormonal disorder.


Vitiligo

October 2023

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38 Reads

Vitiligo is an acquired form of patterned pigmentary loss. It is relatively common and affects approximately 1% of the population, as per pooled studies. It is a polygenic, multifactorial disorder in which there is patchy destruction of melanocytes by antigen-specific cytotoxic T-cells. Social stigma and impaired quality of life is commonly seen in the patients affected by vitiligo. There are many treatment options available for the disease ranging from topicals, oral medication, phototherapy and interventional therapy including procedures and surgery.



Melasma

October 2023

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67 Reads

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1 Citation

Melasma is a common, acquired pigmentation disorder of adulthood characterized by hyperpigmented tan-brown macules mainly on photo-exposed areas of the face, in a centrofacial, malar or mandibular distribution. Melasma is often recalcitrant to therapy. The principles for melasma therapy include the inhibition of the activity of melanocytes (protection from sunlight and avoidance of precipitating factors), the inhibition of the synthesis of melanin (bleaching agents), the removal of melanin (chemical peeling) and the disruption of melanin granules (lasers). Tranexamic acid is a fibrinolytic agent that causes decreased tyrosinase activity in melanocytes and has been proposed as off-label treatment for patients with moderate to severe melasma who do not respond to standard therapy. Combination treatments for melasma are further discussed. Relapse in melasma is frequent after treatment discontinuation and melasma may have a profoundly negative effect on patients’ quality of life and cause considerable psychological distress.


Botulinum Toxin in Aesthetic Medicine

October 2023

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21 Reads

During the eighteenth century, consumption of improperly preserved or stored meat and blood sausages gave rise to botulism with general muscle paralysis and many deaths in Germany. Justinus Kerner was the first to link these cases to the presence of a toxin or poison in the sausages in anaerobic conditions. He concluded that the toxin acts on the motor nerves and the autonomic nervous system and that it is strong and lethal even in small doses.


Figure 1. A patient with acne vulgaris on the face, presenting with inflammatory papules and pustules and atrophic scarring. The patient had been previously using topical antibiotics without improvement.
Figure 3. The frequency of antimicrobial resistance of C. acnes in acne patients in various countries, for A. clindamycin, B. erythromycin, C. azithromycin, D. doxycycline. (Data is derived from Tables 1 and 2. For a study period lasting more than one year, the median year value is shown. Minocycline is not shown as its use is discouraged compared to doxycycline for acne in current guidelines).
Figure 4. The frequency of antimicrobial resistance of C. acnes to any antibiotic in various countries, and the corresponding study period (data from studies included in Tables 1 and 2).
Antibiotics and Antimicrobial Resistance in Acne: Epidemiological Trends and Clinical Practice Considerations

December 2022

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617 Reads

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45 Citations

The Yale journal of biology and medicine

Antimicrobial resistance is an increasing public health problem worldwide. The interest of a focus on antimicrobial resistance in acne lies on the facts that acne vulgaris (acne) is the most common skin disease worldwide, that the bacterium Cutibacterium acnes (C. acnes, formerly Propionibacterium acnes) plays a key role in the pathogenesis of acne, while at the same time being part of the skin flora, and that antibiotics are commonly recommended for acne treatment. The overuse of topical and/or systemic antibiotics, the long treatment courses used for acne, and the availability of over-the-counter antibiotic preparations, have led to the worldwide emergence of resistant strains in acne patients. In this review, we discuss the epidemiological trends of antimicrobial resistance in acne, the need to avoid the perturbation of the skin microbiome caused by anti-acne antibiotics, and the clinical practice considerations related to the emergence of resistant strains in acne patients. In light of the increasing risk of antimicrobial resistance, raising concerns over the misuse of antibiotics, prescribing patterns can be a critical target for antibiotic stewardship efforts. Also, the selection of non-antibiotic therapies for acne, whenever possible, may offer significant advantages.


Cosmetic Dermatology

January 2022

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194 Reads

This chapter describes the basic causes of the facial aging, the most important muscles, typical manifestation of the rids, and focuses on the protection of the extratemporal facial nerve describing its anatomy and giving hints how to find them. In addition, some cosmetic procedures and their side effects have been given in this chapter.


Deoxycholic Acid (ATX-101) for Fat Reduction

November 2021

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128 Reads

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6 Citations

Journal of Drugs in Dermatology

Excess, unwanted fat in submental and other body areas has been a focus of new modalities in aesthetics. Invasive and, more recently, non-invasive modalities for removal of unwanted fat have been on an increase. ATX-101 (deoxycholic acid injection) is the only injectable drug approved in the United States and Canada for reduction of moderate or severe submental fat in adults, with ongoing trials testing its efficacy in body contouring and lipomas. It has proven efficacy in submental fat reduction with a good safety profile. This article reviews the pharmacology, mechanism of action, clinical effects and adverse effects of ATX-101. It emphasizes on careful patient selection and advises on appropriate volume administration, number of treatments, and injection technique. The literature research includes peer-reviewed articles (clinical trials or scientific reviews). Studies were identified by searching electronic databases (MEDLINE and PubMed) till December 2019 and reference lists of respective articles. Only articles published in English language were included.


Citations (64)


... By modulating sebum production, RF disrupts this cycle, potentially reducing the microbial load and inflammation. This aligns with the current understanding of acne's pathophysiology, where Cutibacterium acnes exacerbate inflammatory responses, particularly in more severe forms of the condition [17,18]. Therefore, RF's ability to target sebaceous glands not only helps reduce active lesions but also creates a less favourable environment for bacterial proliferation, which is essential for long-term acne management. ...

Reference:

Needle Radiofrequency Combined with Topical Exosome Therapy for Moderate to Severe Acne
The Microbiome and Acne: Perspectives for Treatment

Dermatology and Therapy

... Antibiotics play significant roles in ensuring the healthy growth of livestock and poultry, and antibiotics have been closely linked to the occurrence and spread of bacterial resistance 40 . The spread of antibiotic resistance complicates treatment 41 . Identifying methods to restore bacterial sensitivity to antibiotics, especially specific types of resistance, such as β-lactamase-mediated antibiotic resistance, can increase confidence in clinical treatment and alleviate the current challenges in antibiotic therapy. ...

Antibiotics and Antimicrobial Resistance in Acne: Epidemiological Trends and Clinical Practice Considerations

The Yale journal of biology and medicine

... In March 2015, the injectable deoxycholic acid formulation, ATX-101, received the FDA approval for the reduction of SMF [6]. It causes preferential fat cell membrane disruption, thus inducing lipolysis [7]. Since then, this procedure has remained the only approved injectable treatment for this indication. ...

Deoxycholic Acid (ATX-101) for Fat Reduction
  • Citing Article
  • November 2021

Journal of Drugs in Dermatology

... Hyaluronic acid, an absorbable substance that gradually degrades and is absorbed over time, lasts 3-12 months 3) . In comparison to other filler materials, it is considered safer; however, early complications (e.g., infection, allergy, tumor formation, and positional movement) have been reported within 6 weeks of the procedure 3) . ...

Complication of Soft Tissue Fillers: Prevention and Management Review
  • Citing Article
  • September 2020

Journal of Drugs in Dermatology

... Conversely, exceeding the reasonable expectations of treatments can lead to outcomes that look artificial or even cause tissue damage and complications [14,15]. Lip treatments with HA fillers are regarded as safe when performed by an experienced provider using proper techniques and the appropriate type of filler [16]. However, with the growing demand for this treatment, there has been a rise in reported cases of temporary complications in the literature [17][18][19][20]. ...

Complication of Soft Tissue Fillers: Prevention and Management Review
  • Citing Article
  • October 2020

Journal of Drugs in Dermatology

... In acne treatment, combining therapies is recommended, with physiotherapy being commonly used. Previous studies show reduced inflammatory acne lesions after laser/light treatments like IPL, PDL, and radiofrequency, without notable adverse effects [19,20]. Fractional laser therapy, traditionally for acne scars, is suggested to positively impact inflammatory lesions [21]. ...

Efficacy of 595- and 1319-nm pulsed dye laser in the treatment of acne vulgaris: a narrative review
  • Citing Article
  • June 2020

Journal of Cosmetic and Laser Therapy

... 42 It also exerts the anti-inflammatory effects towards microcomedones by blocking the lipo-oxygenase pathway and reducing neutrophil chemotaxis within the follicular units. 43 Recently, researchers have designed the fourth generation synthetic retinoid using computer-assisted molecular modeling: Seletinoid G. 45 It structurally retains discriminative affinity towards RARγ by transforming 5-hydroxy-2-(hydroxymethyl)-4Hpyran-4-one to the corresponding chloride which further reacted with potassium salt of 3,4-(methylenedioxy) cinnamic acid. 45 Seletinoid G enhances wound healing by promoting the migration of keratinocytes and improves the function of the skin barrier by correcting abnormal collagen buildup in the dermis. ...

Selective RAR agonists for acne vulgaris: A narrative review
  • Citing Article
  • May 2020

Journal of Cosmetic Dermatology

... It is unknown if this is a national trend since there are no prevalence studies reporting on the prevalence of this disorder in Colombia. 28 Contact dermatitis was the most frequent comorbidity in our study, and this association could support the hypothesis that environmental factors also play a 29 in a multicentric study, observed a greater frequency of nickel sulfate contact dermatitis (25%) in patients with FFA than in the general population (8%). That same study reported similar findings for potassium dichromate and cobalt, compounds commonly found in cosmetics and skincare products. ...

Allergic Contact Dermatitis in Patients with Frontal Fibrosing Alopecia: An International Multi-center Study

... Recently, new modalities for periocular aging have emerged, including micro-focused ultrasound (MFU) and platelet-rich plasma (PlatRP) therapies [104]. MFU enables skin tightening without damaging superficial skin by inducing small areas of thermal injury in targeted regions of the superficial dermis and subdermal connective tissue, which stimulates neocollagenesis and skin lifting [104][105][106]. MFU is indicated in patients with periocular rhytids, brow ptosis, mild to moderate skin laxity, and infraorbital hollowing [107,108]. ...

Update in minimally invasive periorbital rejuvenation with a focus on platelet‐rich plasma: A narrative review
  • Citing Article
  • March 2020

... This presents an opportunity for AI to optimize and augment these processes. 4 Artificial intelligence can analyze facial features with remarkable accuracy, identifying areas that would benefit from filler treatment and simulating potential outcomes. This technology can potentially enable dermatologists to visualize the anticipated results before the actual procedure, facilitating informed decision-making and enhancing patient communication. ...

Complications of botulinum toxin and fillers: A narrative review