Effective medications to treat acne sometimes become unavailable in certain countries, either for economic reasons or for shortage of them in the pharmaceutical market. The purpose of this report is to review a series of drugs of topical and systemic use; some old and some new. The topical group includes agents such as sulfur, salicylic acid and the alpha-hydroxy acids, while the systemic group includes diaminodiphenylsulfone, clofazimine, ibuprofen and others. Some presumably useful physical methodologies and the recent findings in phototherapy, particularly the properties of blue light and blue-red light, are also reviewed. Finally, we report on the results obtained from the combined use of isotretinoin and methylprednisone in severe inflammatory acne, to prevent a possible triggering of the ‘pseudo’ acne fulminans.

1.
Mills OH, Kligman AM: Is sulphur helpful or harmful in acne vulgaris? Br J Dermatol 1972;86:620–627.
2.
Strauss JD, Golfdman PH, Nach S, Gans EH: A re-examination of the potential comedogenicity of sulfur. Arch Dermatol 1978;114:1340–1342.
3.
Goodman H: One Hundred Dermatologic Formulas. New York, Froben Press, 1946:29.
4.
Rees RB: Topical dermatologic medication. Cutis 1969:5:431–437.
5.
Cunliffe WJ, Gollnick HPM: Topical Therapy; in: Acne: Diagnosis and Managment. London, Martin Dunitz, 2001, pp 107–114.
6.
Davies MG, Marks R: Studies on the effect of salicylic acid on normal skin. Br J Dermatol 1976;95:187–192.
7.
Eady EA, Burke M, Pulling K: The benefit of 2% salicylic lotion in acne: A placebo-controlled study. J Dermatol Treat 1996;7:93–96.
8.
Baran R, Chivot M, Shalita AR: Acne; in Baran R, Maibach HI (eds): Cosmetic Dermatology. London, Martin Dunitz, 1994, pp 299–310.
9.
Van Scott EJ, Yu RJ: Hyperkeratinization, corneocyte cohesion and alpha hydroxy acids. J Am Acad Dematol 1984;11:867–879.
10.
Kneedler JA, Sky SS, Sexton LR: Understaning alphahydroxy acids. Dermatol Nurs 1998;10:247–54, 259–62, quiz 265–166.
11.
Pugliese PT: The skin’s antioxidant systems. Dermatol Nurs 1998;10:401–416.
12.
Mac Donald Hull SM, Cunliffe WJ: The use of corticosteroid cream for immediate reduction in the clinical signs of acne vulgaris. Acta Derm Venereol 1989;69:452–453.
13.
Cunliffe WJ, Stables G: Optimal use of isotretinoin. J Cut Med Surg 1996;1:14–25.
14.
Jansen T, Romiti R, Plewig G: Acute severe acne in a female patient (acne fulminans?). Br J Dermatol 1999;141:945–947.
15.
Perkins W, Crocket KV, Hodgkins MB, et al: The effect of treatment with 13-cis-retinoid acid on the metabolic burst of peripheral blood neutrophils from patients with acne. Br J Dermatol 1991;124:429–432.
16.
Weimar VM, Puhl SC, Smith WH, ten Broeke JE: Zinc sulfate in acne vulgaris. Arch Dermatol 1978;114:1776–1778.
17.
Wong RC, Kang S, Heezen JL, Voorhees JJ, Ellis CN: Oral ibuprofen and tetracycline for the treatment of acne vulgaris. J Am Acad Dermatol 1984;11:1076–1081.
18.
Ross CM: Treatment of acne vulgaris with dapsone. Br J Dermatol 1961;73:367.
19.
Goltz RW: Acne vulgaris and variants; in Maddin S (ed): Current Dermatologic Management. Saint Louis, Mosby, 1970, pp 35–37.
20.
Kaminsky CA, Kaminsky A, Schicci C, Velazco MV: Acne: Treatment with diaminodiphenylsulfone. Cutis 1974;13:869–871.
21.
Kenneth EG: Dapsone and sulfapyridine; in Wolwerton SE, Wilkin JK (eds): Systemic Drugs for Skin Diseases. Philadelphia, Saunders, 1991, pp 247–264.
22.
Prendiville J, Cream JJ: Clofazime esposive acne vulgaris. Br J Dermatol 1983;109:90–91.
23.
Cros D , Gamby T, Serratrice G: Acne rheumatism: Report of a case. J Rheumatol 1981;8:336–339.
24.
Helander I, Aho HJ: Solid facial edema as a complication of acne vulgaris: treatment with isotretinoin and clofazimine. Acta Derm Venereol 1987;7:535–537.
25.
Pepall LM, Cosgrove MP, Cunliffe WJ: Ablation of whiteheads by cautery under topical anaesthesia. Br J Dermatol 1991;125:256–259.
26.
Graham GF: Cryotherapy against acne vulgaris yields good to excellent results. Dermatol Prac 1972;5:13–15.
27.
Arakane K, Ryu A, Hayashi C, Masunaga T, Shinmoto K, Mashiko S, Nagano T, Hirobe M: Singlet oxigen (1 delta g) generation from coproporphyrin in Propionebacterium acnes on irradiation. Biochem Biophys Res Commun 1996;223:578–582.
28.
Young S, Bolton P, Dyson M, Harvey W, Diamantopoulos C: Macrophage responsiveness to light therapy. Lasers Surg Med 1989;9:497–505.
29.
Stillman S, Hreen S, Hart Y, Shalita AR: High-intensity narrow-band blue light is effective in the treatment of acne vulgaris: An in vitro and in vivo study. Proc 24th Ann Meet Israel Soc Dermatology, Jerusalem, 2000.
30.
Papageorgiou P, Katsambas A, Chu A: Phototherapy with blue (415 nm) and red (660) light in the treatment of acne vulgaris. Br J Dermatol 2000;142:973–978.
31.
Cunliffe WJ, Goulden V: Phototherapy and acne vulgaris. Br J Dermatol 2000;142:853–856.
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