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There was no statistically significant difference between the groups for croup severity score at the 1 and 2 hour assessments after steroid administration. However, at the 3 hour assessment the magnitude of croup was significantly lower in the placebo group than in the group treated with LY294003. However, the magnitude of croup was not related to the strength or dose of medication used in the steroid dose-ranging study [ ]. The mean weight loss in the placebo and group treated with LY294003 was 33 kg in the placebo group, 26 kg in the group treated with placebo, and 20 kg in the group treated with LY294003 + PEA [ ]. DISCUSSION Anecdotal reports suggest that acne treatment with various topical steroids may increase the frequency of severe skin eruption. However, no large randomized, controlled studies of the effect of acne treatment with different topical steroids on the occurrence of severe acne were published. Lysozyme appears to have acne-promoting activity in patients with severe acne, but a large randomized study of its efficacy in acne with and without a prior history of chronic inflammatory diseases was not conducted. Several small uncontrolled studies have also shown that topical steroids have acne-associated antiandrogenic activity. The mechanisms of this estrogen-induced increased acne-related antiangiogenesis are not yet fully understood. Our data on the effects of PEA-LY294003 on the severity of facial acne revealed improved skin function by 50% and 40%, respectively in the study participants treated with the combination and placebo. Although an initial study showed that only the placebo group showed improvement in skin function, a 3-month followup study of the study participants showed an improvement of 100% in skin function. Thus, the increased facial acne severity with PEA-LY294003 combination therapy can be attributed to a reduction in systemic acne symptoms. Previous studies have demonstrated that acne-related acne lesions were more often related to sebum secretion than those with comedones.16,17 Further, facial acne patients with severe acne, including acne with comedones, have higher sebum secretion than patients without acne.15 Therefore, the increase in comedone-related facial acne in the combination treatment with PEA-LY294003 may be explained by a reduction in sebum secretion. Although the mechanism of the increased acne severity with the combination treatment with PEA-LY294003 in study participants not treated with steroids, including those treated clinically, is unknown, another mechanism may be related to other aspects of systemic inflammation. Acne is also associated with an increased Similar articles: