• Title/Summary/Keyword: folliculitis

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Hair transplantation in patients with hair loss or scar deformity in the side hairline after midface-lifting surgery

  • Kim, Yang Seok;Na, Young Cheon;Park, Jae Hyun
    • Archives of Plastic Surgery
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    • v.46 no.2
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    • pp.147-151
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    • 2019
  • Background Successful aesthetic plastic surgery is devoid of both unsightly scarring and postoperative disfigurement. Patients undergoing midface-lifting surgery are very often disconcerted by an altered side hairline, including sideburns, despite considerable amelioration of facial wrinkles. This study was conducted to identify an effective means of approaching an altered hairline and the unavoidable scarring arising from midface-lifting surgery. Methods A total of 37 patients who underwent corrective surgery with hair transplantation for hair loss or scar deformity arising from midface-lifting surgery from June 2014 to June 2017, and were observed for more than 6 months thereafter, were enrolled in the study. Prior to corrective surgery, the patients were administered a multiple-choice survey regarding their dissatisfaction arising from midface-lifting surgery. Among the 37 patients, 24, 12, and one underwent donor harvesting by the strip method, non-shaven follicular unit extraction, and partial shaving follicular unit extraction, respectively. Additionally, 33 of the 37 patients underwent hair transplantation in the frontotemporal recess area along with hairline correction surgery. The average number of transplanted grafts was 1,025. Results Surgery resulted in a natural and satisfactory appearance in all patients. The average patient and physician subjective satisfaction scores were 4.6 and 4.8, respectively. No adverse events such as folliculitis occurred. Conclusions Side-hairline correction surgery by hair transplantation can be considered an effective method of realigning an altered hairline accompanied by scars following midface-lifting surgery.

Identifying the Patterns of Adverse Drug Responses of Cetuximab

  • Park, Ji Hyun
    • Korean Journal of Clinical Pharmacy
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    • v.32 no.3
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    • pp.226-237
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    • 2022
  • Background: Monoclonal antibodies for the treatment of patients with different types of cancer, such as cetuximab, have been widely used for the past 10 years in oncology. Although drug information package insert contains some representative adverse events which were observed in the clinical trials for drug approval, the overall adverse event patterns on the real-world cetuximab use were less investigated. Also, there have been no published papers that deal with the full spectrums of adverse drug events of cetuximab using national-wide drug safety surveillance systems. Methods: In this study, we detected new adverse event signals of cetuximab in the Korea Adverse Event Reporting System (KAERS) by utilizing proportional reporting ratios, reporting odds ratios, and information components indices. Results: The KAERS database included 869,819 spontaneous adverse event reports, among which 2,116 reports contained cetuximab. We compared the labels of cetuximab among the United States, European Union, Australia, Japan, and Korea to compare the current labeling information and newly detected signals of our study. Some of the signals including hyperkeratosis, tenesmus, folliculitis, esophagitis, neuralgia, disseminated intravascular coagulopathy, and skin/throat tightness were not labeled in the five countries. Conclusion: We identified new signals that were not known at the time of market approval.

Pathological observations of guinea pigs experimentally infected with Trichophyton verrucosum var album (Trichophyton verrucosum var album 의 실험적(實驗的) 감염(感染) 기니픽에 대한 병리학적(病理學的) 관찰(觀察))

  • Won, Joung-han;Cho, Sung-hwan
    • Korean Journal of Veterinary Research
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    • v.33 no.2
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    • pp.309-320
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    • 1993
  • Guinea pigs were cutaneously inoculated with Trichophyton verrucosum var album, that is a common causative fungus of dermatophytosis in cattle. The developmental process of lesions, clinical and histopathological changes and reisolations of the fungi were studied to evaluate the pathogenicity of Trichophyton verrucosum var album in guinea pigs. Results obtained through the experiments were summarized as follows : 1. The incidence of infection of the clipping group was 13(86%) of 15 animals, and that of the plucking group was 14(93%) of 15 animals. In both of the clipping and plucking groups, visible cutaneoas lesions were developed between 4 and 7 days post inoculation(p.i.). The spreading and the climax stages persisted for 4 to 11 and 6 to 12 days, respectively. 2. In macroscopic observations, formation of various degree of erythemas and scales over the inoculated skin sites were observed in the spreading stage. In the climax stage, exudative changes and dark red crusts were formed as typical circular lesions. In the healing stage, the lesions revealed shedding of crust, alopecia and hair regrowth. 3. In histopathological observations, infiltration of inflammatory cells, hyperplasia, microabscesses and keratinous-hyaloid materials of epidermis were observed in the spreading stage. Hyphal invasion was primarily observed at the level of epidermis and pilosebaceous ducts. In the climax stage, the infected epidermis was thick with severe hyperplasia, hyperkeratosis and acanthosis. The microabscesses with fungal hyphae, folliculitis and hyperplasia of external root sheath were observed in the dermis. The fungal hyphae were observed only in the tissues of hair follicles, that were internal root sheath, cuticle, the keratinized portions of cortex and medulla 4. In reisolation of the inoculated fungus, all trials for ten animals showed positive cultures until 25 days p.i.. Afterward, the reisolation rates were gradually decreased, showing all negative after 40 days p.i..

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Split-thickness Skin Graft on the Face from the Medial Arm Skin (상완내측 피부를 이용한 안면부의 부분층 식피술)

  • Moon, Seong Won;Noh, Bok Kyun;Kim, Eui Sik;Hwang, Jae Ha;Lee, Sam Yong
    • Archives of Plastic Surgery
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    • v.34 no.1
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    • pp.70-76
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    • 2007
  • Purpose: Full-thickness skin grafts are usually used in facial reconstruction, but on occasion, split-thickness skin graft is also used from the scalp due to the limitation of donor site. However, there were complications, such as alopecia, folliculitis and blood loss. In addition, it can not be used in patients with baldness. Under the circumstances, we used medial arm skin as split-thickness skin graft donor site in lieu of scalp. We investigated the efficacy of the medial arm skin as a donor site of facial skin graft in comparison with scalp. Methods: From 2000 to 2005, the split-thicknesss skin grafts were performed using the medial arm skin in 10 patients and the scalp in 10 patients. We inspected the skin color match, texture match by the visual analogue scale. Scar contracture was estimated by the Visitrak $grade^{(R)}$(Smith & Nephew). The statistical analysis was performed by SPSS 12.0. Results: There was a more satisfaction in color match, texture, and scar contracture in medial arm skin than in scalp. Conclusion: According to these results, medial arm skin may be used efficiently as an alternative donor site of scalp in the facial reconstruction.

A Literature Study of Dermatosurgical Diseases in the ImJeungJiNamUiAn (臨證指南醫案에 나타난 피부외과 질환에 대한 문헌고찰)

  • Cho, Jae-Hun;Chae, Byung-Yoon;Kim, Yoon-Bum
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.15 no.2
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    • pp.271-288
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    • 2002
  • Authors investigated the pathogenesis and treatment of dennatosurgical diseases in the ImJeungJiNamUiAn(臨證指南醫案). 1. The symptoms and diseases of dermatosurgery were as follows; 1) BanSaJinRa(반사진라) : eczema, atopic dermatitis, seborrheic dermatitis, psoriasis, lichen planus, pityriasis rosea, hives, dermographism, angioedema, cholinergic urticaria, urticaria pigmentosa, acne, milium, syringoma, keratosis pilaris, discoid lupus erythematosus, hypersensitivity vasculitis, drug eruption, polymorphic light eruption, rheumatic fever, juvenile rheumatoid arthritis(Still's disease), acute febrile neutrophilic dermatosis(Sweet's syndrome), Paget's disease, folliculitis, viral exanthems, molluscum contagiosum, tinea, tinea versicolor, lymphoma, lymphadenitis, lymphangitis, granuloma annulare, cherry angioma 2) ChangYang(瘡瘍) : acute stage eczema, seborrheic dermatitis, stasis ulcer, intertrigo, xerosis, psoriasis, lichen planus, ichthyosis, pityriasis rosea, rosacea, acne, keratosis pilaris, dyshidrosis, dermatitis herpetiformis, herpes gestationis, bullae in diabetics, pemphigus, lupus erythematosus, fixed drug eruption, erythema multiforme, toxic epidermal necrolysis, toxic shock syndrome, staphylococcal scaled skin syndrome, scarlet fever, folliculitis, impetigo, pyoderma gangrenosum, tinea, candidiasis, scabies, herpes simplex, herpes zoster, chicken pox, Kawasaki syndrome, lipoma, goiter, thyroid nodule, thyroiditis, hyperthyroidism, thyroid cancer, benign breast disorder, breast carcinoma, hepatic abscess, appendicitis, hemorrhoid 3) Yeok(疫) : scarlet fever, chicken pox, measles, rubella, exanthem subitum, erythema infectiosum, Epstein-Barr virus infection, cytomegalovirus infection, hand-foot-mouth disease, Kawasaki disease 4) Han(汗) : hyperhidrosis 2. The pathogenesis and treatment of dermatosurgery were as follows; 1) When the pathogenesis of BalSa(발사), BalJin(發疹), BalLa(발라) and HangJong(項腫) are wind-warm(風溫), exogenous cold with endogenous heat(外寒內熱), wind-damp(風濕), the treatment of evaporation(解表) with Menthae Herba(薄荷), Arctii Fructus(牛蒡子), Forsythiae Fructus(連翹) Mori Cortex(桑白皮), Fritillariae Cirrhosae Bulbus(貝母), Armeniaoae Amarum Semen(杏仁), Ephedrae Herba(麻黃), Cinnamomi Ramulus(桂枝), Curcumae Longae Rhizoma(薑黃), etc can be applied. 2) When the pathogenesis of BuYang(부양), ChangI(瘡痍) and ChangJilGaeSeon(瘡疾疥癬) are wind-heat(風熱), blood fever with wind transformation(血熱風動), wind-damp(風濕), the treatment of wind-dispelling(疏風) with Arctii Fructus(牛蒡子), Schizonepetae Herba(荊芥), Ledebouriellae Radix(防風), Dictamni Radicis Cortex(白鮮皮), Bombyx Batrytioatus(白??), etc can be applied. 3) When the pathogenesis of SaHuHaeSu(사후해수), SaJin(사진), BalJin(發疹), EunJin(은진) and BuYang(부양) are wind-heat(風熱), exogenous cold with endogenous heat(外寒內熱), exogenous warm pathogen with endogenous damp-heat(溫邪外感 濕熱內蘊), warm pathogen's penetration(溫邪內陷), insidious heat's penetration of pericardium(伏熱入包絡), the treatment of Ki-cooling(淸氣) with TongSeongHwan(通聖丸), Praeparatum(豆?), Phyllostachys Folium(竹葉), Mori Cortex(桑白皮), Tetrapanacis Medulla(通草), etc can be applied. 4) When the pathogenesis of JeokBan(적반), BalLa(발라), GuChang(久瘡), GyeolHaek(結核), DamHaek(痰核), Yeong(?), YuJu(流注), Breast Diseases(乳房疾患) and DoHan(盜汗) are stagnancy's injury of Ki and blood(鬱傷氣血), gallbladder fire with stomach damp(膽火胃濕), deficiency of Yin in stomach with Kwolum's check (胃陰虛 厥陰乘), heat's penetration of blood collaterals with disharmony of liver and stomach(熱入血絡 肝胃不和), insidious pathogen in Kwolum(邪伏厥陰), the treatment of mediation(和解) with Prunellae Spica(夏枯草), Chrysanthemi Flos(菊花), Mori Folium (桑葉), Bupleuri Radix(柴胡), Coptidis Rhizoma(黃連), Scutellariae Radix(黃芩), Gardeniae Fructus(梔子), Cyperi Rhizoma(香附子), Toosendan Fructus(川?子), Curcumae Radix(鬱金), Moutan Cortex(牧丹皮), Paeoniae Radix Rubra(赤芍藥), Unoariae Ramulus Et Uncus(釣鉤藤), Cinnamorni Ramulus(桂枝), Paeoniae Radix Alba(白芍藥), Polygoni Multiflori Radix (何首烏), Cannabis Fructus (胡麻子), Ostreae Concha(牡蠣), Zizyphi Spinosae Semen(酸棗仁), Pinelliae Rhizoma(半夏), Poria(백복령). etc can be applied. 5) When the pathogenesis of BanJin(반진), BalLa(발라), ChangI(瘡痍), NamgChang(膿瘡). ChangJilGaeSeon(瘡疾疥癬), ChangYang(瘡瘍), SeoYang(署瘍), NongYang(膿瘍) and GweYang(潰瘍) are wind-damp(風濕), summer heat-damp(暑濕), damp-warm(濕溫), downward flow of damp-heat(濕熱下垂), damp-heat with phlegm transformation(濕熱化痰), gallbladder fire with stomach damp(膽火胃濕), overdose of cold herbs(寒凉之樂 過服), the treatment of damp-resolving(化濕) with Pinelliae Rhizoma(半夏), armeniacae Amarum Semen(杏仁), Arecae Pericarpium(大腹皮), Poria(백복령), Coicis Semen(薏苡仁), Talcum(滑石), Glauberitum(寒水石), Dioscoreae Tokoro Rhizoma(??), Alismatis Rhizoma(澤瀉), Phellodendri Cortex(黃柏), Phaseoli Radiati Semen(?豆皮), Bombycis Excrementum(?沙), Bombyx Batryticatus(白??), Stephaniae Tetrandrae Radix(防己), etc can be applied. 6) When the pathogenesis of ChangPo(瘡泡), hepatic abscess(肝癰) and appendicitis(腸癰) are food poisoning(食物中毒), Ki obstruction & blood stasis in the interior(기비혈어재과), damp-heat stagnation with six Bu organs suspension(濕熱結聚 六腑不通), the treatment of purgation(通下) with DaeHwangMokDanPiTang(大黃牧丹皮湯), Manitis Squama(穿山甲), Curcumae Radix(鬱金), Curcumae Longae Rhizoma(薑黃), Tetrapanacis Medulla(通草), etc can be applied. 7) When the pathogenesis of JeokBan(적반), BanJin(반진), EunJin(은진). BuYang(부양), ChangI(瘡痍), ChangPo(瘡泡), GuChang(久瘡), NongYang(膿瘍), GweYang(潰瘍), Jeong(정), Jeol(癤), YeokRyeo(疫?) and YeokRyeolpDan(疫?入?) are wind-heat stagnation(風熱久未解), blood fever in Yangmyong(陽明血熱), blood fever with transformation(血熱風動), heat's penetration of blood collaterals(熱入血絡). fever in blood(血分有熱), insidious heat in triple energizer(三焦伏熱), pathogen's penetration of pericardium(心包受邪), deficiency of Yong(營虛), epidemic pathogen(感受穢濁), the treatment of Yong & blood-cooling(淸營凉血) with SeoGakJiHwangTang(犀角地黃湯), Scrophulariae Radix(玄參), Salviae Miltiorrhizae Radix(丹參), Angelicae Gigantis Radix(當歸), Polygoni Multiflori Radix(何首烏), Cannabis Fructus(胡麻子), Biotae Semen(柏子仁), Liriopis Tuber(麥門冬), Phaseoli Semen(赤豆皮), Forsythiae Fructus(連翹), SaJin(사진), YangDok(瘍毒) and YeokRyeoIpDan(역려입단) are insidious heat's penetration of pericardium(伏熱入包絡), damp-warm's penetration of blood collaterals(濕溫入血絡), epidemic pathogen's penetration of pericardium(심포감수역려), the treatment of resuscitation(開竅) with JiBoDan(至寶丹), UHwangHwan(牛黃丸), Forsythiae Fructus(連翹), Curcumae Radix(鬱金), Tetrapanacis Medulla(通草), Acori Graminei Rhizoma(石菖蒲), etc can be applied. 9) When the pathogenesis of SaHuSinTong(사후신통), SaHuYeolBuJi(사후열부지), ChangI(瘡痍), YangSon(瘍損) and DoHan(盜汗) are deficiency of Yin in Yangmyong stomach(陽明胃陰虛), deficiency of Yin(陰虛), the treatment of Yin-replenishing(滋陰) with MaekMunDongTang(麥門冬湯), GyeongOkGo(瓊玉膏), Schizandrae Fructus(五味子), Adenophorae Radix(沙參), Lycii Radicis Cortex (地骨皮), Polygonati Odorati Rhizoma(玉竹), Dindrobii Herba(石斛), Paeoniae Radix Alba(白芍藥), Ligustri Lucidi Fructus (女貞子), etc can be applied. 10) When the pathogenesis of RuYang(漏瘍) is endogenous wind in Yang collaterals(陽絡內風), the treatment of endogenous wind-calming(息風) with Mume Fructus(烏梅), Paeoniae Radix Alba (白芍藥), etc be applied. 11) When the pathogenesis of GuChang(久瘡), GweYang(潰瘍), RuYang(漏瘍), ChiChang(痔瘡), JaHan(自汗) and OSimHan(五心汗) are consumption of stomach(胃損), consumption of Ki & blood(氣血耗盡), overexertion of heart vitality(勞傷心神), deficiency of Yong(營虛), deficiency of Wi(衛虛), deficiency of Yang(陽虛), the treatment of Yang-restoring & exhaustion-arresting(回陽固脫) with RijungTang(理中湯), jinMuTang(眞武湯), SaengMaekSaGunjaTang(生脈四君子湯), Astragali Radix (황기), Ledebouriellae Radix(防風), Cinnamomi Ramulus(桂枝), Angelicae Gigantis Radix(當歸), Ostreae Concha(牡蠣), Zanthoxyli Fructus(川椒), Cuscutae Semen(兎絲子), etc can be applied.

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Development of Smart Packaging for Cream Type Cosmetic (크림 제형 화장품용 스마트 패키징 기술 개발)

  • Jeon, Sooyeon;Moon, Byounggeoun;Oh, Jaeyoung;Kang, Hosang;Jang, Geun;Lee, Kisung
    • KOREAN JOURNAL OF PACKAGING SCIENCE & TECHNOLOGY
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    • v.25 no.3
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    • pp.79-87
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    • 2019
  • The degree of cosmetic's oxidation depends on the storage conditions and external conditions when using the product. The microbial contamination and oxygen exposure often results in the quality deterioration of cosmetics. In addition, the problem is that consumers often use cream-type cosmetics, which have short expiration period (6-12 months), even after the product is expired. When using the deteriorated cosmetics, it can be fatal to consumers' safety including some symptoms such as folliculitis, rashes, edema, and dermatitis. Therefore, it is necessary to develop sealed smart packaging for cosmetics to prevent the deterioration of cosmetics and improve consumer safety. In this study, we have developed smart packaging design for cosmetics that can measure the surrounding environment and expiration date for the cosmetics in the real time. In addition, the smart packaging includes sensor, which are linked to the mobile application. Users can find out the measurement results through the application. Also, the packaging design and functions were set up based on the survey results by the user and feasible model can be produced based on user choice. The measurement in the three environment has been done after manufactured the sensor, PCB, and mobile application. As a result, it works normally within a certain range under all three environmental conditions. It is believed that the information on expiration dates and storage environment can be efficiently delivered to the consumers through developed cosmetics smart packaging and applications. The development of UI/UX design for consumer is further studied. The UX/UI design of the application plays an essential role in achieving this goal through the commercialization the cosmetic products in the wide range.

Analysis of Characteristics of Dermatology Outpatients in Korean Medicine Ophthalmology, Otolaryngology & Dermatology at Dunsan Korean Medicine Hospital - From March, 2016 to February, 2019 - (둔산한방병원 한방안이비인후피부과 내원 피부질환 환자 특성 분석 - 2016년 3월부터 2019년 2월까지 -)

  • Kim, Su-Yeong;Jung, Hyun-A
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.33 no.4
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    • pp.16-31
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    • 2020
  • Objectives : This study is designed to analyze outpatients who received medical treatment for skin diseases in ophthalmology & otolaryngology & dermatology clinic of Korean Medical Hospital from March 1st, 2016 to February 28th, 2019. To discover the tendencies of dermatology outpatients and provide the base data for future researches in dermatology patients' characteristics, korean medical treatments on dermatology field, more statistical analysis and establishment of korean medical health care policy. Methods : We classified dermatology outpatients who received treatments in ophthalmology & otolaryngology & dermatology clinic of Korean Medical Hospital from March 1st, 2016 to February 28th, 2019 according to gender, year, age, seasonal, main diagnosis, visit days. The statistical analysis was performed using IBM SPSS 23.0 Results : The results of the analysis on 651 dermatology patients treated in ophthalmology & otolaryngology & dermatology clinic of Dunsan Korean Medical Hospital for the past 3 years are as follows. 1. The number of outpatients who visited ophthalmology & otolaryngology & dermatology clinic of Dunsan Korean Medical Hospital for skin diseases were 651; 286 male(43.9%) and 365 female(56.1%). The number of female patients were approximately 1.27 times higher. 2. The average age of the dermatology outpatients were 37.6. The most frequent visitors turned out to be 20s, and the number of 20s, 30s patients were 267, consisting 41.0% of the whole patients. 3. By examining the change on yearly basis, we noticed that the number of outpatients treated with skin diseases steadily increased with the years. 1) In the analysis of the number of patients classified by gender and year, the number of male and female patients both increased with the years. 2) In the analysis of the number of patients classified by age and year, there were statistically significant difference between two groups. 3) In the analysis of the number of patients classified by season and year, there were statistically significant difference between two groups. 4) In the analysis of the number of patients classified by main diagnosis and year, there were statistically significant difference between two groups. 4. In the analysis of the number of outpatients by seasonal basis, the number of the outpatients visited in summer was the largest by 185(28.4%), followed by winter 181(27.8%), spring 148(22.7%), and the autumn 137(21.0%). 1) In the analysis of the number of patients classified by age and season, there were no statistically significant difference. 2) In the analysis of the number of patients classified by age and season, there were no statistically significant difference. 5. By classifying the outpatients according to main diagnosis, it turned out that there were 40 diagnosis, with eczema the largest followed by urticaria, allergic contact dermatitis, seborrheic dermatitis, and folliculitis. 6. The average number of visit days of dermatology outpatients were 10.24 days, and the number declined steadily with the years. 1) In the analysis of the number of patients classified by gender and visit days, there were no statistically significant difference. 2) In the analysis of the number of patients classified by age and visit days, the visit days of 70s were the shortest and the patients below 20s were longer than the other age groups. Conclusions : By analyzing the outpatients who received medical treatment for skin diseases in ophthalmology & otolaryngology & dermatology clinic of Korean Medical Hospital from March 1st, 2016 to February 28th, 2019 according to gender, year, age, seasonal, main diagnosis, visit days, We drew various meaningful results. The outpatients with skin diseases increased steadily by the years, and patients visited in winter especially shown the outstanding increase. And though the number of female patients were larger than male, the increase was bigger in male patients. We hope that this results would provide useful resources for future researches in dermatology patients'characteristics, korean medical treatment and establishment of korean medical health care policy.

Efficacy and Safety of Topical Application of Epidermal Growth Factor (EGF) for Korean Acne Patient (한국인 여드름 환자에서 표피성장인자가 함유된 외용제의 피부 적용에 대한 유효성 및 안전성 평가)

  • Suh, Joon Hyuk;Hyun, Moo Yeol;Jang, Seong Eum;Choi, Sun Young;Kim, Myeung Nam;Kim, Beom Joon
    • Journal of the Society of Cosmetic Scientists of Korea
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    • v.42 no.2
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    • pp.111-118
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    • 2016
  • Acne vulgaris is a chronic inflammatory condition characterized by comedo, papule, cyst, nodule and postinflammatory hyperpigmentation. Meanwhile, it is also induced by adverse event of drugs. Among them, acneiform folliculitis is a side effect of epidermal growth factor receptor (EGFR) inhibitor, which is an anticancer agent, and its incidence may occur in upward of 75 ~ 100% of cases. The main method of acne vulgaris treatment is oral antibiotics, retinoids, topical medication and so on. However, it is limitation that teratogenicity caused by retinoids and antibiotic resistance increased by using antibiotics. In this study, we aimed to evaluate the clinical efficacy and safety of topical recombinant human (rh) EGF in treating facial acne vulgaris. Twenty three Koreans (age: 10 ~ 29 years) with mild to moderate acne vulgar participated in the study and applied topical rhEGF cream (trouble control EGF) with 3 products (trouble control clarifying cleansing foam, trouble control all-clear filling toner, redroll calming moisture) on their face twice daily for four weeks. Several assessment methods were applied: Acne lesion counts score by investigator's global assessment, efficacy and satisfaction score by subjects. Skin sebum output level, hydration level and redness level were also measured at each visit. At the final visit, skin sebum level, transepidermal water loss, skin redness statistically decreased and acne lesions (comedone, papule) were statistically reduced. No severe side effects were observed during the study. In conclusion, topical rhEGF seems to be an effective and safe adjuvant treatment option for mild acne vulgaris.