Clinical And Sebumetric Evaluation Of Topical

Emulsions In The Treatment Of Acne Vulgaris

Journal Reading

Maria Ulfa
TITLE
Clinical and sebumetric evaluation of topical
emulsions in the treatment of acne vulgaris

TIME
Postępy Dermatologi Alergologi
4 August 2014

AUTHORS
Barkat Ali Khan, Naveed Akhtar
 •Acne vulgaris : affects adolescents and young
adults (11-30 years)

• Acne vulgaris: affecting the pilosebaceous

follicles of the dermis.

• Formation of comedones, papules, pustules,

cysts, nodules, scars, on face and neck

INTRODUCTION
1. Increased 2. Follicular
sebum hyper-
production keratinization

Phatogenic
Factors of
Acne Vulgaris 4. Inflammatory
3. Microbial mediators into the
colonization dermis

INTRODUCTION
Comedolytic (benzoyl peroxide,
azelaic acid, retinoids)
Oral/topical Plant Extracts
antibiotics(tetracycline,
erythromycin, clindamycine)

Safer and
Side Effects
Cheap

INTRODUCTION
 Plant Extracts

Rarely been
tested in targeted
patients

INTRODUCTION
 Hippophae
Cassia fistula
rhamnoides
• High levels of glycosides, • Used in modern
anthraquinones, steroids, science and technology
terpenoids phenolic for 30
compounds
• Useful in skin diseases

AIM
To investigate the effects of
formulations containing a
phenolic-rich extract of C. fistula
and H. rhamnoides in vitro and in
vivo for antiacne effects.

AIM
 Single-blind, placebo-controlled,
split-face mono-Centric study

September 2011 - December

2011

MATERIALS & METHODS

 INCLUSION EXCLUSION
• Acne secondary
• Moderate acne vulgaris • Pregnancy/intention to
become pregnant
• Lactation
• Another dermatological
disease of the face
• Oral isotretinoin (in 3
months)
• Acne treatment
• Hypersensitivity to study
formulation

MATERIALS & METHODS

 In vitro
Preparation of Antibacteril
In vitro Formulations Screening
Antibacterial
Screening
Plant Materials &
Preparation of
Plant Extracts

MATERIALS & METHODS

 Composition of
formulations (% w/w)

MATERIALS & METHODS

 25 (F1 and F3)
50
(18-30 years)
25 (F2 and F3)

500 mg Formulations  twice

Right Cheek : F3 a day (mornings and
Left Cheek : F1 and F2 evenings), 12 weeks

MATERIALS & METHODS

 Sebumetric • Sebumeter
Analysis
Clinical • Leeds grading scale (mild,
Evaluation moderate, severe)
The Percentage • %Change = [(T0–Tw)/Tw] × 100
Changes in Skin • T0 :baseline values
Sebum Content • Tw :value obtained on weekly

• Sensitivity of formulations
Patch Test
(plant extracts)

MATERIALS & METHODS

 • The Values
GraphPad Prism

Paired Sample • Variation between the active

formulations and placebo
T-Test

One-Way • Compare the results between

baseline values and the values at
ANOVA different weeks

MATERIALS & METHODS

In Vitro Anti-bacterial Activity Of Plant
Extracts
And Formulations

RESULTS
Percentage of anti-bacterial activity of
formulations

RESULTS
Score allocated by volunteers to formulations
onthe basis of itching/irritation

RESULTS
 Percentage of changes produced in skin Percentage of changes produced in skin
sebum contents after the application of F3 sebum contents after the application of
(placebo) and F1 (H. rhamnoides) F3 (placebo) and F2 (C. fistula)

RESULTS
Clinical Evaluation

RESULTS
 Sebum
Production

Micro Comedone P. acne

Proinflammatory
Triglycerides Free Fatty Acid and Chemotactic
Factors
Acne Irritant

Follicular wall &

Inflammation
Dermis

DISCUSSION
 Inhibitor : Essential Fatty Acids
5α Reductase and Phytosterols in botanical
compounds

Enlargement
Testosterone Dihidrotestosterone
Sebaceous Gland

DISCUSSION
 Formulations containing H.
rhamnoides and C. fistula
extracts can be an effective
therapy in grade I and II acne
vulgaris

CONCLUSION
CRITICAL APPRAISAL
 CRITICAL APPRAISAL
NO KRITERIA YA (+) TIDAK (-)
Judul dan Pengarang
1 Jumlah kata dalam judul <12 kata - ( 13 kata )
2 Deskripsi Judul -
3 Daftar penulis sesuai aturan jurnal -
4 Korespondensi Penulis +
5 Tempat dan waktu penelitian dalam +
judul
Abstrak
1 Abstrak 1 paragraf -
2 Mencakup IMRC +
3 Secara keseluruhan informatif +
4 Tanpa singkatan selain yang baku +
5 Kurang dari 250 kata - (259 kata)
 Pendahuluan
1 Terdiri dari 2 bagian atau 2 paragraf - (3)
2 Paragraf pertama mengemukakan alasan penelitian +
3 Paragraf kedua menyatakan hipotesis atau tujuan -
penelitian
4 Didukung oleh pustaka yang relevan +
5 Kurang dari 1 halaman +
Bahan dan Metode Penelitian
1 Jenis dan rancangan penelitian Prospektif
2 Waktu dan tempat penelitian +

3 Populasi sumber -
4 Teknik sampling -
5 Kriteria inklusi +
6 Kriteria ekslusi +
7 Perkiraan dan perhitungan besar sampel -
8 Perincian cara penelitian +
9 Blind +
10 Uji statistik +
11 Program komputer +
12 Persetujuan subjektif +
 Hasil
1 Jumlah Subjek +
2 Tabel karakteristik subjek -
3 Tabel hasil penelitian +
4 Komentar dan pendapat penulis ttg hasil +

5 Tabel analisis data dengan uji +

Pembahasan, Kesimpulan, Daftar, Pustaka
1 Pembahasan dan kesimpulan terpisah +

2 Pembahasan dan kesimpulan dipaparkan +

dengan jelas
3 Pembahasan mengacu dari penelitian -
sebelumnya
4 Pembahasan sesuai landasan teori +

5 Keterbatasan penelitian -
6 Simpulan utama +
7 Simpulan berdasarkan penelitian +
8 Saran penelitian -
9 Penulisan daftar pustaka sesuai aturan +