Document Type : Original Article

Authors

• Balakrishna P Nikam
• Mohan Kale
• Varsha Jamale
• Tunika Arora
• Asma Hussain
• Nishchhal Shrivastav

Department of Dermatology, Krishna Institute of Medical Sciences, Karad (Maharashtra), India

Abstract

Background: Self-inflicted acne excoriée is often observed in patients with compulsive skin picking, posing a challenge for diagnosis and treatment as the exact psychiatric cause remains unknown. Studies have suggested that serotonin reuptake inhibitors such as fluoxetine may help in the management of this condition. To determine the efficacy and safety profile of fluoxetine in the treatment of acne excoriée and to study the psychological profiles of patients.
Methods: Sixty patients of either sex aged ≥16 years with acne excoriée were assigned to either Group A (n=30), which received oral fluoxetine (F) (20 mg/day) and oral doxycycline (D) (100 mg/day) with topical clindamycin (1%), or Group B (n=30), which received a placebo (P), oral doxycycline (100 mg/day), and topical clindamycin (1%). Patients were evaluated for standardized rating scales and followed up every two weeks for 12 weeks.
Results: Female gender predominance was observed in both groups, with most patients exhibiting anxiety and depression. With each follow-up visit (2^nd, 3^rd, 4^th, and 5^th) in both groups (A and B), the mean AESI (91.4% vs. 26.7%), HAM-A (80% vs. 27.7%), MADRS (68.1% vs. 28.2%), YBOCS (98.27% vs. 15.63%), PGA (88.47% vs. 31.38%), and VAS (99.17% vs. 37.67%) scores decreased from baseline by the final visit, indicating improved patient conditions. Significant differences were observed between the two groups (p <0.001) in the overall response, indicating that fluoxetine was more efficacious than the control. No remarkable side effects were noted.
 
Conclusion: Fluoxetine efficiently managed acne excoriée without remarkable side effects.
Background: Self-inflicted acne excoriée is often observed in patients with compulsive skin picking, posing a challenge for diagnosis and treatment as the exact psychiatric cause remains unknown. Studies have suggested that serotonin reuptake inhibitors such as fluoxetine may help in the management of this condition. To determine the efficacy and safety profile of fluoxetine in the treatment of acne excoriée and to study the psychological profiles of patients.
Methods: Sixty patients of either sex aged ≥16 years with acne excoriée were assigned to either Group A (n=30), which received oral fluoxetine (F) (20 mg/day) and oral doxycycline (D) (100 mg/day) with topical clindamycin (1%), or Group B (n=30), which received a placebo (P), oral doxycycline (100 mg/day), and topical clindamycin (1%). Patients were evaluated for standardized rating scales and followed up every two weeks for 12 weeks.
Results: Female gender predominance was observed in both groups, with most patients exhibiting anxiety and depression. With each follow-up visit (2^nd, 3^rd, 4^th, and 5^th) in both groups (A and B), the mean AESI (91.4% vs. 26.7%), HAM-A (80% vs. 27.7%), MADRS (68.1% vs. 28.2%), YBOCS (98.27% vs. 15.63%), PGA (88.47% vs. 31.38%), and VAS (99.17% vs. 37.67%) scores decreased from baseline by the final visit, indicating improved patient conditions. Significant differences were observed between the two groups (p <0.001) in the overall response, indicating that fluoxetine was more efficacious than the control. No remarkable side effects were noted.
Conclusion: Fluoxetine efficiently managed acne excoriée without remarkable side effects.
 
Keywords: acnevulgaris,fluoxetine, doxycycline
 

Keywords

• Acne vulgaris
• Fluoxetine
• Doxycycline