medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2023-030medsovet-7389Research ArticleЗАБОЛЕВАНИЯ КОЖИDERMAL DISEASESАкне взрослых женщин: актуальность проблемы и возможность ее решенияAdult female acne: relevance and possible solutionshttps://orcid.org/0000-0001-5723-6573ЖуковаО. В.ZhukovaO. V.

 Жукова Ольга Валентиновна, д.м.н., профессор, заведующая кафедрой дерматовенерологии и аллергологии с курсом иммунологии Медицинского института; главный врач 

117198, Россия, Москва, ул. Миклухо-Маклая, д. 6 

119071, Россия, Москва, Ленинский проспект, д. 17

Olga V. Zhukova, Dr. Sci. (Med.), Professor, Head of the Department of Dermatovenereology and Allergology with the Course of Immunology,Medicine Institute; Chief Medical Officer

6, Miklukho-Maklai St., Moscow, 117198, Russia

17, Leninskiy Ave., Moscow, 119071, Russia 

klinderma@inbox.ruhttps://orcid.org/0000-0002-0767-8821КасихинаЕ. И.KasikhinaE. I.

 Касихина Елена Игоревна, к.м.н., доцент кафедры дерматовенерологии и аллергологии с курсом иммунологии Медицинского института; врач-дерматовенеролог 

117198, Россия, Москва, ул. Миклухо-Маклая, д. 6 

119071, Россия, Москва, Ленинский проспект, д. 17

Elena I. Kasikhina, Cand. Sci. (Med.), Associate Professor, Department of Dermatovenereology and Allergology with the Course of Immunology,Medicine Institute; Dermatologist

6, Miklukho-Maklai St., Moscow, 117198, Russia

17, Leninskiy Ave., Moscow, 119071, Russia 

kasprof@bk.ruhttps://orcid.org/0000-0003-3386-1467ОстрецоваМ. Н.OstretsovaM. N.

Острецова Мария Николаевна, к.м.н., доцент кафедры дерматовенерологии и аллергологии с курсом иммунологии Медицинского института 

117198, Россия, Москва, ул. Миклухо-Маклая, д. 6 

Maria N. Ostretsova, Cand. Sci. (Med.), Associate Professor, Department of Dermatovenereology and Allergology with the Course of Immunology,Medicine Institute

6, Miklukho-Maklai St., Moscow, 117198, Russia 

ostretsova-mn@rudn.ruhttps://orcid.org/0000-0003-0968-5678ИсматуллаеваС. С.IsmatullaevaS. S.

Исматуллаева Светлана Сергеевна, ассистент кафедры дерматовенерологии, аллергологии и косметологии Медицинского института; врач-дерматовенеролог 

117198, Россия, Москва, ул. Миклухо-Маклая, д. 6 

119071, Россия, Москва, Ленинский проспект, д. 17

Svetlana S. Ismatullaeva, Assistant Professor, Department of Dermatovenereology, Allergology and Cosmetology, Medicine Institute; Dermatologist

6, Miklukho-Maklai St., Moscow, 117198, Russia

17, Leninskiy Ave, Moscow, 119071, Russia 

morgunova85ss@gmail.comРоссийский университет дружбы народов; Московский научно-практический центр дерматовенерологии и косметологииРоссияPeoples’ Friendship University of Russia; Moscow Scientific and Practical Center of Dermatovenereology and CosmetologyRussian FederationРоссийский университет дружбы народов; Московский научно-практический центр дерматовенерологии и косметологииРоссияPeoples’ Friendship University of Russia; Moscow Scientific and Practical Center of Dermatovenereology and CosmetologyRussian FederationРоссийский университет дружбы народовРоссияPeoples’ Friendship University of RussiaRussian Federation202315032023026267Copyright © Жукова О.В., Касихина Е.И., Острецова М.Н., Исматуллаева С.С., 20232023Жукова О.В., Касихина Е.И., Острецова М.Н., Исматуллаева С.С.Zhukova O.V., Kasikhina E.I., Ostretsova M.N., Ismatullaeva S.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/7389

В последние годы отмечается увеличение доли акне взрослых в структуре заболеваемости другими формами акне. Этиопатогенез заболевания сложен и до конца не ясен. Предполагается, что в данном процессе на фоне генетической предрасположенности задействованы гормональные факторы и хроническая активация врожденного иммунитета, на которые оказывают стимулирующее воздействие внешние факторы среды: ежедневный стресс, диета западного типа, употребление табака, гормональных препаратов, косметики. В статье дана современная характеристика клинического течения акне взрослых женщин. Приведены шкалы для оценки тяжести течения заболевания – GEA (Global Acne Severity Scale) и AFAST (Adult Female Acne Scoring Tool). Для акне взрослых женщин преимущественно характерна легкая или средняя степень тяжести течения. Лечение требует персонифицированного подхода с особым вниманием к индивидуальным потребностям и особенностям взрослых женщин. При подборе наружной терапии следует учитывать менее выраженную жирность кожи, медленную прогрессию заболевания с исходом в гиперпигментацию и рубцевание. Современные схемы включают назначение системных препаратов и средств наружной терапии на фоне правильно подобранного базового ухода. К наиболее эффективным средствам для наружного применения относят ретиноиды, которые способны вызывать специфический биологический ответ в результате связывания и активации рецепторов ретиноевой кислоты. Показанием для монотерапии акне взрослых женщин адапаленом служит комедональная форма акне и папуло-пустулезное акне легкой степени. Крем Адаклин (0,1%-й адапален) – высокоэффективный препарат первого выбора для патогенетической терапии акне взрослых женщин. Рациональная комбинированная и монотерапия адапаленом – залог успешной наружной терапии легких и среднетяжелых форм акне у взрослых женщин и профилактики постакне. Целью обзорной статьи было предоставить актуальную, основанную на фактических данных информацию о клинической картине, этиопатогенезе и лечении акне у взрослых женщин.

In recent years, there has been an increase in the proportion of AFA in the structure of acne incidence. The etiopathogenesis of the disease is multicomponent and has not been fully elucidated. It is assumed that hormonal factors and chronic activation of innate immunity are involved in the process against the background of genetic predisposition, which are stimulated by external environmental factors: daily stress, Western-style diet, tobacco use, hormonal drugs, cosmetics. The article presents a modern classification of the clinical course of AFA and scales for assessing the severity of the course of the disease: GEA (Global Acne Severity Scale) and AFAST (Adult Female Acne Scoring Tool). AFA is predominantly characterized by a mild or moderate course. Treatment requires a personalized approach with particular attention to the individual needs and characteristics of adult women. When choosing a topical therapy, the doctor should consider the less pronounced oiliness of the skin, the slow progression of the disease with the outcome in hyperpigmentation and scarring. Modern acne treatment regimens include systemic and topical therapy along with proper basic skin care. The most effective topical agents include retinoids, which can induce a specific biological response by binding and activating retinoic acid receptors. Comedonal and mild papulopustular acne are indications for adapalene monotherapy for acne in adult women. Adaklin (0.1% adapalene) cream is a highly effective first choice for the pathogenetic treatment of AFA. Rational mono- and combination therapy with adapalene is the key to successful external therapy of mild and moderate AFA and prevention of post-acne. The review provided up-to-date, evidence-based information on the clinical presentation, etiopathogenesis, and treatment of adult female acne (AFA).

акне взрослыхнаружные ретиноидыадапаленретиноевая кислотамонотерапияadult acnetopical retinoidsadapaleneretinoic acidmonotherapyReferencesTan J.K., Bhate K. A global perspective on the epidemiology of acne. Br J Dermatol. 2015;172(Suppl. 1):3–12. https://doi.org/10.1111/bjd.13462.Tan J.K., Bhate K. A global perspective on the epidemiology of acne. Br J Dermatol. 2015;172(Suppl. 1):3–12. https://doi.org/10.1111/bjd.13462.Burton J.L., Cunliffe W.J., Stafford I., Shuster S. The prevalence of acne vulgaris in adolescence. Br J Dermatol. 1971;85(2):119–126. https://doi.org/10.1111/j.1365-2133.1971.tb07195.x.Burton J.L., Cunliffe W.J., Stafford I., Shuster S. The prevalence of acne vulgaris in adolescence. Br J Dermatol. 1971;85(2):119–126. https://doi.org/10.1111/j.1365-2133.1971.tb07195.x.Wang Y., Xiao S., Ren J., Zhang Y. Analysis of the epidemiological burden of acne vulgaris in China based on the data of global burden of disease 2019. Front Med (Lausanne). 2022;9:939584. https://doi.org/10.3389/fmed.2022.939584.Wang Y., Xiao S., Ren J., Zhang Y. Analysis of the epidemiological burden of acne vulgaris in China based on the data of global burden of disease 2019. Front Med (Lausanne). 2022;9:939584. https://doi.org/10.3389/fmed.2022.939584.Dréno B. Treatment of adult female acne: a new challenge. J Eur Acad Dermatol Venereol. 2015;29(Suppl. 5):14–19. https://doi.org/10.1111/jdv.13188.Dréno B. Treatment of adult female acne: a new challenge. J Eur Acad Dermatol Venereol. 2015;29(Suppl. 5):14–19. https://doi.org/10.1111/jdv.13188.Rueda L.J., Porras A., Rico A. Prevalence of adult female acne in Colombia: A population-based study. Int J Womens Dermatol. 2021;7(5 Part B):727–730. https://doi.org/10.1016/j.ijwd.2021.06.003.Rueda L.J., Porras A., Rico A. Prevalence of adult female acne in Colombia: A population-based study. Int J Womens Dermatol. 2021;7(5 Part B):727–730. https://doi.org/10.1016/j.ijwd.2021.06.003.Svensson A., Ofenloch R.F., Bruze M., Naldi L., Cazzaniga S., Elsner P. et al. Prevalence of skin disease in a population-based sample of adults from five European countries. Br J Dermatol. 2018;178(5):1111–1118. https://doi.org/10.1111/bjd.16248.Svensson A., Ofenloch R.F., Bruze M., Naldi L., Cazzaniga S., Elsner P. et al. Prevalence of skin disease in a population-based sample of adults from five European countries. Br J Dermatol. 2018;178(5):1111–1118. https://doi.org/10.1111/bjd.16248.Semedo D., Ladeiro F., Ruivo M., D’Oliveira C., De Sousa F., Gayo M. et al. Adult Acne: Prevalence and Portrayal in Primary Healthcare Patients, in the Greater Porto Area, Portugal. Acta Med Port. 2016;29(9):507–513. https://doi.org/10.20344/amp.6626.Semedo D., Ladeiro F., Ruivo M., D’Oliveira C., De Sousa F., Gayo M. et al. Adult Acne: Prevalence and Portrayal in Primary Healthcare Patients, in the Greater Porto Area, Portugal. Acta Med Port. 2016;29(9):507–513. https://doi.org/10.20344/amp.6626.Perkins A.C., Maglione J., Hillebrand G.G., Miyamoto K., Kimball A.B. Acne vulgaris in women: prevalence across the life span. J Womens Health (Larchmt). 2012;21(2):223–230. https://doi.org/10.1089/jwh.2010.2722.Perkins A.C., Maglione J., Hillebrand G.G., Miyamoto K., Kimball A.B. Acne vulgaris in women: prevalence across the life span. J Womens Health (Larchmt). 2012;21(2):223–230. https://doi.org/10.1089/jwh.2010.2722.Collier C.N., Harper J.C., Cafardi J.A., Cantrell W.C., Wang W., Foster K.W., Elewski B.E. The prevalence of acne in adults 20 years and older. J Am Acad Dermatol. 2008;58(1):56–59. https://doi.org/10.1016/j.jaad.2007.06.045.Collier C.N., Harper J.C., Cafardi J.A., Cantrell W.C., Wang W., Foster K.W., Elewski B.E. The prevalence of acne in adults 20 years and older. J Am Acad Dermatol. 2008;58(1):56–59. https://doi.org/10.1016/j.jaad.2007.06.045.Poli F., Dreno B., Verschoore M. An epidemiological study of acne in female adults: results of a survey conducted in France. J Eur Acad Dermatol Venereol. 2001;15(6):541–545. https://doi.org/10.1046/j.1468-3083.2001.00357.x.Poli F., Dreno B., Verschoore M. An epidemiological study of acne in female adults: results of a survey conducted in France. J Eur Acad Dermatol Venereol. 2001;15(6):541–545. https://doi.org/10.1046/j.1468-3083.2001.00357.x.Goulden V., Clark S.M., Cunliffe W.J. Post-adolescent acne: a review of clinical features. Br J Dermatol. 1997;136(1):66–70. Available at: https://pubmed.ncbi.nlm.nih.gov/9039297/.Goulden V., Clark S.M., Cunliffe W.J. Post-adolescent acne: a review of clinical features. Br J Dermatol. 1997;136(1):66–70. Available at: https://pubmed.ncbi.nlm.nih.gov/9039297/.Kutlu Ö., Karadağ A.S., Wollina U. Adult acne versus adolescent acne: a narrative review with a focus on epidemiology to treatment. An Bras Dermatol. 2023;98(1):75–83. https://doi.org/10.1016/j.abd.2022.01.006.Kutlu Ö., Karadağ A.S., Wollina U. Adult acne versus adolescent acne: a narrative review with a focus on epidemiology to treatment. An Bras Dermatol. 2023;98(1):75–83. https://doi.org/10.1016/j.abd.2022.01.006.Bagatin E., Freitas T.H.P., Rivitti-Machado M.C., Machado M.C.R., Ribeiro B.M., Nunes S., Rocha M.A.D.D. Adult female acne: a guide to clinical practice. An Bras Dermatol. 2019;94(1):62–75. https://doi.org/10.1590/abd1806-4841.20198203.Bagatin E., Freitas T.H.P., Rivitti-Machado M.C., Machado M.C.R., Ribeiro B.M., Nunes S., Rocha M.A.D.D. Adult female acne: a guide to clinical practice. An Bras Dermatol. 2019;94(1):62–75. https://doi.org/10.1590/abd1806-4841.20198203.Khunger N., Kumar C. A clinico-epidemiological study of adult acne: is it different from adolescent acne? Indian J Dermatol Venereol Leprol. 2012;78(3):335–341. https://doi.org/10.4103/0378-6323.95450.Khunger N., Kumar C. A clinico-epidemiological study of adult acne: is it different from adolescent acne? Indian J Dermatol Venereol Leprol. 2012;78(3):335–341. https://doi.org/10.4103/0378-6323.95450.Skroza N., Tolino E., Mambrin A., Zuber S., Balduzzi V., Marchesiello A. et al. Adult Acne Versus Adolescent Acne: A Retrospective Study of 1,167 Patients. J Clin Aesthet Dermatol. 2018;11(1):21–25. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5788264/.Skroza N., Tolino E., Mambrin A., Zuber S., Balduzzi V., Marchesiello A. et al. Adult Acne Versus Adolescent Acne: A Retrospective Study of 1,167 Patients. J Clin Aesthet Dermatol. 2018;11(1):21–25. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5788264/.Rajegowda H.M., Suman B.S., Basavapura Madegowda S.K., Kalegowda D., Shettar Rajendra B.S. A clinicoepidemiological study of adult acne among females: Is it surpassing the adolescent acne? Clin Dermatol Rev. 2021;5(1):71–77. https://doi.org/10.4103/CDR.CDR_55_20.Rajegowda H.M., Suman B.S., Basavapura Madegowda S.K., Kalegowda D., Shettar Rajendra B.S. A clinicoepidemiological study of adult acne among females: Is it surpassing the adolescent acne? Clin Dermatol Rev. 2021;5(1):71–77. https://doi.org/10.4103/CDR.CDR_55_20.Zeichner J.A., Baldwin H.E., Cook-Bolden F.E., Eichenfield L.F., Fallon- Friedlander S., Rodriguez D.A. Emerging Issues in Adult Female Acne. J Clin Aesthet Dermatol. 2017;10(1):37–46. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5300732/.Zeichner J.A., Baldwin H.E., Cook-Bolden F.E., Eichenfield L.F., Fallon- Friedlander S., Rodriguez D.A. Emerging Issues in Adult Female Acne. J Clin Aesthet Dermatol. 2017;10(1):37–46. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5300732/.Williams C., Layton A.M. Persistent acne in women: implications for the patient and for therapy. Am J Clin Dermatol. 2006;7(5):281–290. https://doi.org/10.2165/00128071-200607050-00002.Williams C., Layton A.M. Persistent acne in women: implications for the patient and for therapy. Am J Clin Dermatol. 2006;7(5):281–290. https://doi.org/10.2165/00128071-200607050-00002.Dumont-Wallon G., Dréno B. Acné de la femme de plus de 25 ans: spécifique par sa clinique et les facteurs favorisants Etude rétrospective de 79 femmes. Presse Med. 2008;37(4 Pt 1):585–591. https://doi.org/10.1016/j.lpm.2007.07.014.Dumont-Wallon G., Dréno B. Acné de la femme de plus de 25 ans: spécifique par sa clinique et les facteurs favorisants Etude rétrospective de 79 femmes. Presse Med. 2008;37(4 Pt 1):585–591. https://doi.org/10.1016/j.lpm.2007.07.014.Branisteanu D.E., Toader M.P., Porumb E.A., Serban I.L., Pinzariu A.C., Branisteanu C.I. et al. Adult female acne: Clinical and therapeutic particularities (Review). Exp Ther Med. 2022;23(2):151. https://doi.org/10.3892/etm.2021.11074.Branisteanu D.E., Toader M.P., Porumb E.A., Serban I.L., Pinzariu A.C., Branisteanu C.I. et al. Adult female acne: Clinical and therapeutic particularities (Review). Exp Ther Med. 2022;23(2):151. https://doi.org/10.3892/etm.2021.11074.Rocha M.A., Bagatin E. Adult-onset acne: prevalence, impact, and management challenges. Clin Cosmet Investig Dermatol. 2018;11:59–69. https://doi.org/10.2147/CCID.S137794.Rocha M.A., Bagatin E. Adult-onset acne: prevalence, impact, and management challenges. Clin Cosmet Investig Dermatol. 2018;11:59–69. https://doi.org/10.2147/CCID.S137794.Cappel M., Mauger D., Thiboutot D. Correlation between serum levels of insulin-like growth factor 1, dehydroepiandrosterone sulfate, and dihydrotestosterone and acne lesion counts in adult women. Arch Dermatol. 2005;141(3):333–338. https://doi.org/10.1001/archderm.141.3.333.Cappel M., Mauger D., Thiboutot D. Correlation between serum levels of insulin-like growth factor 1, dehydroepiandrosterone sulfate, and dihydrotestosterone and acne lesion counts in adult women. Arch Dermatol. 2005;141(3):333–338. https://doi.org/10.1001/archderm.141.3.333.Albalat W., Darwish H., Abd-Elaal W.H., AbouHadeed M.H., Essam R. The potential role of insulin-like growth factor 1 in acne vulgaris and its correlation with the clinical response before and after treatment with metformin. J Cosmet Dermatol. 2022;21(11):6209–6214. https://doi.org/10.1111/jocd.15210.Albalat W., Darwish H., Abd-Elaal W.H., AbouHadeed M.H., Essam R. The potential role of insulin-like growth factor 1 in acne vulgaris and its correlation with the clinical response before and after treatment with metformin. J Cosmet Dermatol. 2022;21(11):6209–6214. https://doi.org/10.1111/jocd.15210.Heng A.H.S., Chew F.T. Systematic review of the epidemiology of acne vulgaris. Sci Rep. 2020;10(1):5754. https://doi.org/10.1038/s41598-020-62715-3.Heng A.H.S., Chew F.T. Systematic review of the epidemiology of acne vulgaris. Sci Rep. 2020;10(1):5754. https://doi.org/10.1038/s41598-020-62715-3.Passeron T., Zouboulis C.C., Tan J., Andersen M.L., Katta R., Lyu X. et al. Adult skin acute stress responses to short-term environmental and internal aggression from exposome factors. J Eur Acad Dermatol Venereol. 2021;35(10):1963–1975. https://doi.org/10.1111/jdv.17432.Passeron T., Zouboulis C.C., Tan J., Andersen M.L., Katta R., Lyu X. et al. Adult skin acute stress responses to short-term environmental and internal aggression from exposome factors. J Eur Acad Dermatol Venereol. 2021;35(10):1963–1975. https://doi.org/10.1111/jdv.17432.Bernard J.J., Gallo R.L., Krutmann J. Photoimmunology: how ultraviolet radiation affects the immune system. Nat Rev Immunol. 2019;19(11):688–701. https://doi.org/10.1038/s41577-019-0185-9.Bernard J.J., Gallo R.L., Krutmann J. Photoimmunology: how ultraviolet radiation affects the immune system. Nat Rev Immunol. 2019;19(11):688–701. https://doi.org/10.1038/s41577-019-0185-9.Levin J. The Relationship of Proper Skin Cleansing to Pathophysiology, Clinical Benefits, and the Concomitant Use of Prescription Topical Therapies in Patients with Acne Vulgaris. Dermatol Clin. 2016;34(2):133–145. https://doi.org/10.1016/j.det.2015.11.001.Levin J. The Relationship of Proper Skin Cleansing to Pathophysiology, Clinical Benefits, and the Concomitant Use of Prescription Topical Therapies in Patients with Acne Vulgaris. Dermatol Clin. 2016;34(2):133–145. https://doi.org/10.1016/j.det.2015.11.001.Preneau S., Dreno B. Female acne – a different subtype of teenager acne? J Eur Acad Dermatol Venereol. 2012;26(3):277–282. https://doi.org/10.1111/j.1468-3083.2011.04214.x.Preneau S., Dreno B. Female acne – a different subtype of teenager acne? J Eur Acad Dermatol Venereol. 2012;26(3):277–282. https://doi.org/10.1111/j.1468-3083.2011.04214.x.Choi C.W., Lee D.H., Kim H.S., Kim B.Y., Park K.C., Youn S.W. The clinical features of late onset acne compared with early onset acne in women. J Eur Acad Dermatol Venereol. 2011;25(4):454–461. https://doi.org/10.1111/j.1468-3083.2010.03813.x.Choi C.W., Lee D.H., Kim H.S., Kim B.Y., Park K.C., Youn S.W. The clinical features of late onset acne compared with early onset acne in women. J Eur Acad Dermatol Venereol. 2011;25(4):454–461. https://doi.org/10.1111/j.1468-3083.2010.03813.x.Silpa-Archa N., Kohli I., Chaowattanapanit S., Lim H.W., Hamzavi I. Postinflammatory hyperpigmentation: A comprehensive overview: Epidemiology, pathogenesis, clinical presentation, and noninvasive assessment technique. J Am Acad Dermatol. 2017;77(4):591–605. https://doi.org/10.1016/j.jaad.2017.01.035.Silpa-Archa N., Kohli I., Chaowattanapanit S., Lim H.W., Hamzavi I. Postinflammatory hyperpigmentation: A comprehensive overview: Epidemiology, pathogenesis, clinical presentation, and noninvasive assessment technique. J Am Acad Dermatol. 2017;77(4):591–605. https://doi.org/10.1016/j.jaad.2017.01.035.Dréno B., Thiboutot D., Layton A.M., Berson D., Perez M., Kang S. Large-scale international study enhances understanding of an emerging acne population: adult females. J Eur Acad Dermatol Venereol. 2015;29(6):1096–1106. https://doi.org/10.1111/jdv.12757.Dréno B., Thiboutot D., Layton A.M., Berson D., Perez M., Kang S. Large-scale international study enhances understanding of an emerging acne population: adult females. J Eur Acad Dermatol Venereol. 2015;29(6):1096–1106. https://doi.org/10.1111/jdv.12757.Dréno B., Poli F., Pawin H., Beylot C., Faure M., Chivot M. et al. Development and evaluation of a Global Acne Severity Scale (GEA Scale) suitable for France and Europe. J Eur Acad Dermatol Venereol. 2011;25(1):43–48. https://doi.org/10.1111/j.1468-3083.2010.03685.x.Dréno B., Poli F., Pawin H., Beylot C., Faure M., Chivot M. et al. Development and evaluation of a Global Acne Severity Scale (GEA Scale) suitable for France and Europe. J Eur Acad Dermatol Venereol. 2011;25(1):43–48. https://doi.org/10.1111/j.1468-3083.2010.03685.x.Auffret N., Claudel J.P., Leccia M.T., Poli F., Farhi D., Dréno B. AFAST – Adult Female Acne Scoring Tool: an easy-to-use tool for scoring acne in adult females. J Eur Acad Dermatol Venereol. 2016;30(5):824–828. https://doi.org/10.1111/jdv.13518.Auffret N., Claudel J.P., Leccia M.T., Poli F., Farhi D., Dréno B. AFAST – Adult Female Acne Scoring Tool: an easy-to-use tool for scoring acne in adult females. J Eur Acad Dermatol Venereol. 2016;30(5):824–828. https://doi.org/10.1111/jdv.13518.Kolli S.S., Pecone D., Pona A., Cline A., Feldman S.R. Topical Retinoids in Acne Vulgaris: A Systematic Review. Am J Clin Dermatol. 2019;20(3):345–365. https://doi.org/10.1007/s40257-019-00423-z.Kolli S.S., Pecone D., Pona A., Cline A., Feldman S.R. Topical Retinoids in Acne Vulgaris: A Systematic Review. Am J Clin Dermatol. 2019;20(3):345–365. https://doi.org/10.1007/s40257-019-00423-z.Mavranezouli I., Daly C.H., Welton N.J., Deshpande S., Berg L., Bromham N. et al. A systematic review and network meta-analysis of topical pharmacological, oral pharmacological, physical and combined treatments for acne vulgaris. Br J Dermatol. 2022;187(5):639–649. https://doi.org/10.1111/bjd.21739.Mavranezouli I., Daly C.H., Welton N.J., Deshpande S., Berg L., Bromham N. et al. A systematic review and network meta-analysis of topical pharmacological, oral pharmacological, physical and combined treatments for acne vulgaris. Br J Dermatol. 2022;187(5):639–649. https://doi.org/10.1111/bjd.21739.Stuart B., Maund E., Wilcox C., Sridharan K., Sivaramakrishnan G., Regas C. et al. Topical preparations for the treatment of mild-to-moderate acne vulgaris: systematic review and network meta-analysis. Br J Dermatol. 2021;185(3):512–525. https://doi.org/10.1111/bjd.20080.Stuart B., Maund E., Wilcox C., Sridharan K., Sivaramakrishnan G., Regas C. et al. Topical preparations for the treatment of mild-to-moderate acne vulgaris: systematic review and network meta-analysis. Br J Dermatol. 2021;185(3):512–525. https://doi.org/10.1111/bjd.20080.Eichenfield D.Z., Sprague J., Eichenfield L.F. Management of Acne Vulgaris: A Review. JAMA. 2021;326(20):2055–2067. https://doi.org/10.1001/jama.2021.17633.Eichenfield D.Z., Sprague J., Eichenfield L.F. Management of Acne Vulgaris: A Review. JAMA. 2021;326(20):2055–2067. https://doi.org/10.1001/jama.2021.17633.Thiboutot D.M., Dréno B., Abanmi A., Alexis A.F., Araviiskaia E., Barona Cabal M.I. et al. Practical management of acne for clinicians: An international consensus from the Global Alliance to Improve Outcomes in Acne. J Am Acad Dermatol. 2018;78(2 Suppl. 1):S1–S23.e1. https://doi.org/10.1016/j.jaad.2017.09.078.Thiboutot D.M., Dréno B., Abanmi A., Alexis A.F., Araviiskaia E., Barona Cabal M.I. et al. Practical management of acne for clinicians: An international consensus from the Global Alliance to Improve Outcomes in Acne. J Am Acad Dermatol. 2018;78(2 Suppl. 1):S1–S23.e1. https://doi.org/10.1016/j.jaad.2017.09.078.Катханова О.А., Катханов А.М. Опыт использования топических ретиноидов и азелаиновой кислоты в терапии акне. Клиническая дерматология и венерология. 2015;14(6):120–125. https://doi.org/10.17116/klinderma2015146120-125.Katkhanova O.A., Katkhanov A.M. The experience in the use of topical retinoids and azelaic acid in therapy of acne. Klinicheskaya Dermatologiya i Venerologiya. 2015;14(6):120–125. (In Russ.) https://doi.org/10.17116/klinderma2015146120-125.Berson D., Alexis A. Adapalene 0.3% for the treatment of acne in women. J Clin Aesthet Dermatol. 2013;6(10):32–35. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3805304/.Berson D., Alexis A. Adapalene 0.3% for the treatment of acne in women. J Clin Aesthet Dermatol. 2013;6(10):32–35. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3805304/.Hess J., Angel P., Schorpp-Kistner M. AP-1 subunits: quarrel and harmony among siblings. J Cell Sci. 2004;117(Pt 25):5965–5973. https://doi.org/10.1242/jcs.01589.Hess J., Angel P., Schorpp-Kistner M. AP-1 subunits: quarrel and harmony among siblings. J Cell Sci. 2004;117(Pt 25):5965–5973. https://doi.org/10.1242/jcs.01589.Leyden J., Stein-Gold L., Weiss J. Why Topical Retinoids Are Mainstay of Therapy for Acne. Dermatol Ther (Heidelb). 2017;7(3):293–304. https://doi.org/10.1007/s13555-017-0185-2.Leyden J., Stein-Gold L., Weiss J. Why Topical Retinoids Are Mainstay of Therapy for Acne. Dermatol Ther (Heidelb). 2017;7(3):293–304. https://doi.org/10.1007/s13555-017-0185-2.Jain S. Topical tretinoin or adapalene in acne vulgaris: an overview. J Dermatolog Treat. 2004;15(4):200–207. https://doi.org/10.1080/09546630410033006.Jain S. Topical tretinoin or adapalene in acne vulgaris: an overview. J Dermatolog Treat. 2004;15(4):200–207. https://doi.org/10.1080/09546630410033006.Crooks S.W., Stockley R.A. Leukotriene B4. Int J Biochem Cell Biol. 1998;30(2):173–178. https://doi.org/10.1016/s1357-2725(97)00123-4.Crooks S.W., Stockley R.A. Leukotriene B4. Int J Biochem Cell Biol. 1998;30(2):173–178. https://doi.org/10.1016/s1357-2725(97)00123-4.

The authors declare that there are no conflicts of interest present.