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The Journal of Clinical Investigation recently published the results of an important clinical study on the mechanism of action of 13-cis retinoic acid in acne therapy. Of equal importance to the study’s scientific value is the question it raises of whether clinical research into the treatment of severe acne is stagnating.
First the facts: Investigators analyzed biopsy samples of the back skin of six patients receiving 0.50 or 0.67 mg/kg/day of 13-cis retinoic acid for severe acne; skin was biopsied before treatment and 1 week after the start of therapy. A reduction in the size of the sebaceous glands was of borderline significance (P=0.16), but apoptosis increased markedly in sebaceous cells (and not in epidermal cells). Using gene arrays, w…