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Cutting-edge therapies
for skin challenges

Therapeutic focus

Innovating medical therapies for unmet needs in skin diseases is at the heart of Almirall. We continuously invest in research and development, applying medical science in the search for ground-breaking therapies.

Today, we help patients suffering with acne, actinic keratosis, dermatitis, and impetigo improve their skin.

 

Acne

Acne

Acne

Acne (acne vulgaris) is a common chronic skin condition affecting approximately 9.4% of the world’s population,1 with nearly 50 million cases in the United States alone.2 Acne is a disease of the pilosebaceous unit (PSU) and affects areas of the skin where PSUs are most dense, namely the face, torso, back, and upper arms.3

Clinical presentation varies from mild to severe and may involve both inflammatory and non-inflammatory lesions. Depending on severity, acne is characterized by open and closed comedones (blackheads and whiteheads), raised lesions (papules), inflamed pus-filled lesions (pustules), and large inflamed nodules and cysts.4

Multiple factors may cause acne or influence its severity. A family history may predispose individuals to developing acne, indicating a genetic component.6,8 Acne is also associated with age and sex, as incidence and severity are highest during puberty and the teenage years, with males often experiencing greater disease severity. Lifestyle and dietary factors may also influence acne incidence and its severity.5

Acne treatment varies and is  largely based on disease severity, Numerous prescription and over-the-counter oral medications and topical therapies are currently available.

 

Actinic keratosis

Actinic keratosis

Actinic keratosis (also known as“solar” keratosis) is a cutaneous disorder characterized by patches of rough, reddened, sun-damaged skin resulting from chronic or excessive solar radiation exposure6,7 and is one of the most common conditions seen by dermatologists.8 Actinic keratoses (AKs) are clinically described as scaly plaques or lesions of variable thickness, some of which may not be visible but are detectable by  touch.7,8 AKs are considered benign or premalignant but have the potential to become cancerous.6,8

AKs typically affect areas most exposed to the sun,  including  the face, arms, neck, and back of the hands.

Several factors increase susceptibility to developing AKs, including male sex, having fair skin, and older age.6 Worldwide prevalence prevalence ranges from 11 to 25% and varies by geographic region, with higher rates in countries close to the Equator.6,8

8The choice of therapy for AKs depends on  several factors, including lesion location and degree of progression. Lesion-directed treatments include cryosurgery and curettage, while topical agents may also be used- Field-directed therapies  treat areas with multiple AKs and typically involve topical medications, photodynamic therapy, or laser resurfacing   AKs can transform into squamous cell carcinoma.6,8 with an average  malignant transformation risk of approximately 8%, ranging from 0.025% to 16%.8,10,11 Appropriate treatment,follow-up, and  preventive strategies may reduce progression risk.8

Dermatitis

Dermatitis

Dermatitis

Dermatitis is a general term describing that describes common irritation and inflammation of the skin, typically characterized by redness, itchiness, and rash. Several types of dermatitis exist, each differing in cause and clinical  are known that vary in cause and presentation.12

Atopic dermatitis (AD), also known as atopic eczema, is a chronic, relapsing, inflammatory condition  affecting  both children and adults, with 80% to 90% of cases beginning by five years of age.​​​​​​​13,14 AD has a worldwide prevalence of 15% to 20% in children and 1% to 3%  in adults.​​​​​​​14 Clinical presentation varies with age and commonly affects the neck, eyelids, forehead, face, wrists, and the back of hands and feet.​​​​​​​14 Acute AD is characterized by dry skin and fluid-filled blisters that may ooze and crust over. Subacute AD presents with erythematous skin, dry, scaly plaqand papules, while chronic AD results in  cracked dry skin with  lichenification caused by repeated  scratching.​​​​​​​13-15 Anti-inflammatory treatments, including topical corticosteroids, combined with agents to mantain skin  hydratation, are central to AD management.

Seborrheic dermatitis (SD) is another chronic inflammatory skin disorder affecting 1% to 3% of the general population, and occurs more frequently  in males. SD may appear at any age, with many cases presenting between  two and twelve moth of age and again during adolescence or early adulthood.​​​​​​​16 SD typically affects areas with higher  sebaceous (oil-producing) gland density, such as the scalp, face, upper chest, and back.17 Presentation  varies by  age; SD in infancy is characterized by yellowish, greasy-looking scale on the scapl, commonly reffered to as “ cradle cap”.​​​​​​​18 In adolescents and adults, SD appears as chronic or relapsing patches of erythematous skin with oily, flaky scales.​​​​​​​16,18 Treatment options for SD includes anti-fungal and anti-inflammatory agents, alongside measures to support skin and scalp health.18

 

Impetigo

Impetigo

Impetigo is a common, superficial bacterial skin infection affecting more than 140 million people worldwide.19 Approximately  111 million cases occur in children, with a point prevalence of over 162 million children affected at any given time.​​​​​​​20 Impetigo disproportionately  affects  populations in developing countries and resourced-limited settings .​​​​​​​21 Risk factors include hot and humid climates low socioeconomic status, malnutrition, and poor hygiene.​​​​​​​22 The condition is highly contagious and spreads easily in schools, daycare centres, and crowded living conditions. Impetigo can affect individuals of any age but is most common  in children aged two to five years.22

There are two recognised clinical variants of impetigo:, bullous and nonbullous. Nonbullous impetigo accounts for approximately 70% of cases and is caused by Staphylococcus aureus and Streptococcus pyogenes. It Nonbullous “crusted” impetigo presents as superficial ulcerations covered by an adhering crust of dried dischargeexudate​​​​​​​23 and  commonly affectsthe face and extremities.​​​​​​​22 Bullous impetigo, caused primarily by S. aureus,​​​​​​​19 is characterized by large, flaccid, fluid-filled blisters,23 typically affects the trunk, armpits, extremities, and diaper area.​​​​​​​20 Impetigo is treated with topical, injectable, and oral medications.24 Altough complications are rare, if left untreated, impetigo can lead to deeper infections and scarring.

References
  1. Tan JKL, Bhate K. A global perspective on the epidemiology of acne. Br J Dermatol. 2015;172(Suppl 1):3-12.
  2. Oge' LK, Broussard A, Marshall MD. Acne vulgaris: diagnosis and treatment. Am Fam Physician. 2019;100(8):475-484.
  3. Raza K, Talwar V, Setia A, Katare OP. Acne: an understanding of the disease and its impact on life. Int J Drug Dev & Res. 2012;4(2):14-20.
  4. Heng, A. H. S., & Chew, F. T. Systematic review of the epidemiology of acne vulgaris. Scientific reports, 2020; 10(1):1-29.
  5. niams.nih.gov/health-topics/acne
  6. De Oliveira ECV, da Motta VRV, Pantoja PC, et al. Actinic keratosis - review for clinical practice. Int J Dermatol. 2017;177(2):350-358.
  7. Siegel JA, Korgavkar K, Weinstock MA. Current perspective on actinic keratosis: a review. Br J Dermatol. 2017;177(2):350-358.
  8. Marques E, Chen TM. Actinic keratosis. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022. http://www.ncbi.nlm.nih.gov/books/NBK557401/. Updated July 18, 2021. Accessed May 12, 2022.
  9. Eisen DB, Asgari MM, Bennett DD, et al. Guidelines of care for the management of actinic keratosis. J Am Acad Dermatol. 2021;85(4):e209-e233.
  10. Hashim PW, Chen T, Rigel D, Bhatia N, Kircik LH. Actinic keratosis: current therapies and insights into new treatments. J Drugs Dermatol. 2019;18(5):s161-166.
  11. Cramer P, Stockfleth E. Actinic keratosis: where do we stand and where is the future going to take us? Expert Opin Emerg Drugs. 2020;25(1):49-58.
  12. Dermatitis: symptoms and causes. Mayo Clinic website. https://www.mayoclinic.org/diseases-conditions/dermatitis-eczema/symptoms-causes/syc-20352380. Accessed May 12, 2022.
  13. Torres T, Ferreira EO, Gonçalo M, Mendes-Bastos P, Selores M, Filipe P. Update on atopic dermatitis. Acta Med Port. 2019;32(9):606-613.
  14. Avena-Woods C. Overview of atopic dermatitis. Am J Manag Care. 2017;23(Suppl 8):S115-S123.
  15. Berke R, Singh A, Guralnick M. Atopic dermatitis: an overview. Am Fam Physician. 2012;86(1):35-42.
  16. Clark GW, Pope SM, Jaboori KA. Diagnosis and treatment of seborrheic dermatitis. Am Fam Physician. 2015;91(3):185-190.
  17. Adalsteinsson JA, Kaushik S, Muzumdar S, Guttman-Yassky E, Ungar J. An update on the microbiology, immunology and genetics of seborrheic dermatitis. Exp Dermatol. 2020;29(5):481-489.
  18. Borda LJ, Wikramanayake TC. Seborrheic dermatitis and dandruff: a comprehensive review. J Clin Investig Dermatol. 2015;3(2):10.13188/2373-1044.1000019.
  19. Johnson MK. Impetigo. Adv Emerg Nurs J. 2020;42(4):262-269.
  20. Bowen AC, Mahé A, Hay RJ, et al. The global epidemiology of impetigo: a systematic review of the population prevalence of impetigo and pyoderma. PLoS ONE. 2015;10(8):e0136789.
  21. May PJ, Tong SYC, Steer AC, et al. Treatment, prevention and public health management of impetigo, scabies, crusted scabies and fungal skin infections in endemic populations: a systematic review. Trop Med Int Health. 2019;24(3):280-293.
  22. Hartman-Adams H, Banvard C, Juckett G. Impetigo: diagnosis and treatment. Am Fam Physician. 2014;90(4):229-235.
  23. Pereira LB. Impetigo – review. An Bras Dermatol. 2014;89(2):293-299.
  24. Abrha S, Tesfaye W, Thomas J. Intolerable burden of impetigo in endemic settings: a review of the current state of play and future directions for alternative treatments. Antibiotics (Basel). 2020;9(12):909.
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