***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: A double-blind study of 30 patients with mild to moderate acne vulgaris was conducted to evaluate the efficacy of a topically applied 2 % zinc sulfate solution for acne therapy . Over a 12-week period , no difference was noted between placebo- and zinc-treated participants in regard to either the number or type of acne lesions . The irritancy due to topically applied zinc was significantly greater ( p less than or equal to 0.05 ) than that due to the placebo .  Zinc serum levels were not significantly elevated between the two regimens before , during , or after treatment . This study suggests that topical zinc therapy alone is not of significant benefit in the treatment of acne vulgaris Background : Acne vulgaris is considered one of the most common disorders for which patients seek dermatologic care . In the current study , we evaluated efficacy of the 5 % nicotinamide gel versus 2 % clindamycin gel in the treatment of the mild-moderate acne vulgaris . Material s and Methods : This was a r and omized , controlled clinical trial that was performed in 2009 - 2010 . Sixty female patients with mild or moderate acne vulgaris were recurited to be treated either with 5 % nicotinamide or 2 % clindamycin gel for 8 weeks . Acne severity index ( ASI ) was used to evaluate response to treatment and SPSS software was used to analyze the data . Results : The mean of ASI at the baseline was 16.85 ± 8.5 and 18.2 ± 12.27 in nicotinamide gel and clindamycin gel , respectively ( P > 0.05 ) . The mean of ASI was significantly decreased compared with baseline ASI during the time in both groups ( P < 0.0001 ) . However , there was not a significant difference regarding reduction of ASI  between the nicotinamide and clindamycin gel ( P = 0.583 ) . Conclusion : Five percent nicotinamide gel is as effective as 2 % clindamycin gel for treatment of mild to moderate acne vulgaris . No side effect was observed during the treatment A double-blind , 12-week study was undertaken to determine the safety and efficacy of a formulation of 4 % erythromycin plus 1.2 % zinc acetate compared with its vehicle . The study was continued for 40 weeks after the 12-week double-blind phase by switching vehicle-treated patients to active treatment and continuing to give patients treated with active drug the same treatment . Seventy-three female patients started the study ; 39 completed 1 full year of study . In the first 12 weeks statistically significant differences were noted in the efficacy of the erythromycin-zinc compared with vehicle for acne severity grade s ( global assessment ) and for papule , pustule , and comedo counts . After crossover , the vehicle-treated group receiving active therapy duplicated the improvement of the group initially treated with erythromycin-zinc . No clinical problems with superinfection or secondary infection occurred during 1 year of treatment in 39 patients OBJECTIVE : The study evaluated the tolerability and efficacy of a new presented treatment for acne . The product is an OTC topical gel consisting of 2 % SA , which is also enriched in botanicals that have been shown to have anti-inflammatory properties . DESIGN : The study was design ed as a single-site , r and omized , investigator-blinded , split-face 10-day study . SETTING : Subjects enrolled with a minimum of 2 inflammatory papular acne lesions and 2 non-inflammatory open or closed comedones on both sides of the face in symmetrical locations , to the greatest degree possible . One side of each subject 's face was r and omly selected to receive the study treatment product . PARTICIPANTS : 25 subjects , 15 female and 10 males , ages 12 to 43 years , suffering from mild to moderate acne . Measurements : Study duration was 10 days , with study visits occurring at baseline ( day 0 ) , day 1 , day 2 , day 3 , day 7 , and day 10 . Subjects underwent investigator facial evaluation and lesion assessment  by dermatologist at each of the visit days . For the inflammatory lesions , the assessed parameters were erythema , elevation , in duration , and overall impression . The assessed non-inflammatory parameters were elevation and overall impression . Results : The observed difference between the treatment and the control group increased between day 1 and day 2 and reached an average of 15 % to 20 % with small varieties between the parameters and stayed similar across the remaining visits . Statistically significance ( P less than 0.005 ) was achieved for all inflammatory and non-inflammatory tested parameters . Conclusion : This study was performed to determine the safety , efficacy , and ease of use of a botanical acne treatment gel in providing a reduction in inflammatory acne lesion erythema , elevation , and in duration . Erythema and elevation were the most influential parameters in inflammatory lesion with improvement noted after 2 days of application . J Drugs Dermatol . 2017;16(6):599 - 603 In a double-blind r and omised study , 14 volunteers applied 4 % erythromycin plus 1.2 % zinc ( Zineryt lotion ) and 4 % erythromycin lotions , each on half of the forehead twice daily for 3 months . The sebum output was evaluated at 3-week intervals using the photometric and the lipid-sensitive film methods . Evaluations of casual level ( CL ) and sebum excretion rate ( SER ) were made with a Sebumeter , and total area of lipid spots ( TAS ) was measured on Sebutapes . Compared to baseline values , the formulation of the erythromycin-zinc complex induced significant reductions in SER after 6 and 9 weeks , and in CL and TAS at 3 , 6 , 9 and 12 weeks . The mean reduction in TAS was over 20 % for four successive 1-h samplings on completion of the study . Significant reductions in CL , SER and TAS were observed for the erythromycin-zinc formulation compared to the control lotion at 6 and 9 weeks , and also at 3 weeks for SER and TAS , and at 12 weeks for CL and TAS . This study indicates that sebum output is significantly reduced by the erythromycin-zinc complex . This reduction is theoretically beneficial for the acneic patient BACKGROUND Topical preparations in the form of creams or ointments are the usual treatment for acne . These agents do not seem to penetrate the skin barrier deeply enough to produce the desired effect . OBJECTIVE We conducted a r and omized , double-blinded , prospect i ve study to evaluate the effectiveness of salicylic acid  in a new delivery system , the Crown Carrier System ( CCS , Trivitaderm LLC , Asheville , NC ) for the treatment of acne . METHODS Thirty-seven patients with homogenous background s were r and omly divided into 3 groups . Group A was treated with salicylic acid in CCS , Group B was treated with CCS without salicylic acid , and Group C received salicylic acid alone . Patients were evaluated at 2 weeks and 8 weeks post-treatment . RESULTS Twenty-five patients completed the evaluation . Most patients in Group A presented with no changes in the number of acne lesions but with significant improvement of inflammatory signs . Their overall skin condition was remarkably better . CONCLUSIONS Our study is unique in that it focused on the delivery system used in the treatment of acne , rather than on the active agent . The technology of the Crown Carrier System appears to be a breakthrough that may give physicians the opportunity to administer topical treatment of skin problems in a more efficient way INTRODUCTION Chemical peeling is a well-identified therapeutic modality for acne vulgaris ( AV ) .  Jessner 's solution ( JS ) is a known peeling agent for acne since more than 100 years . Salicylic acid ( SA ) peel is a well-established peeling agent for acne . There is paucity of literature comparing the current peeling agents of choice , that is , SA with the older peeling agents , that is , JS for acne . OBJECTIVE To compare the efficacy and safety of 30 % SA vs. JS peels in treatment of mild-to-moderate facial acne in Indian patients . MATERIAL S AND METHOD A total of 40 patients with mild-to-moderate AV were enrolled for 12 weeks and were r and omly divided into two groups : group 1 , 30 % SA peels and group 2 , JS peels were performed 2 weeks apart with total of six peels in 12-week duration . Clinical improvement was assessed objective ly using Michaelsson acne scores ( MAS ) and clinical photographs . Side effects were observed at each visit . RESULTS At the end of therapy , improvement in MAS and percentage decrease in MAS were significantly higher in group 1 as compared to group 2 . Likewise , decrease in mean comedone counts in group 1 was significantly higher as compared to group 2 . However , there was no statistically significant difference in the decrease in mean papule and pustule counts between the two groups . Both the groups tolerated the peels well . CONCLUSION Thus , 30 % SA peels were more effective than JS peels in treatment of noninflammatory lesions , that is , comedones and in overall improvement of mild-to-moderate facial acne vulgaris BACKGROUND Mild-to-moderate acne vulgaris is treated with a range of mono- and combination therapies ; however , clinical evidence is still required to optimize treatment recommendations . OBJECTIVE To compare the efficacy , tolerability and safety of a combination of benzoyl peroxide 3 % and clindamycin 1 % ( BPO + CLN ) with azelaic acid 20 % ( AzA ) for the topical treatment of mild-to-moderate acne vulgaris . METHOD This was a r and omized , assessor-blinded , parallel-group , multicentre study conducted in Germany . Patients with a confirmed diagnosis of acne vulgaris , aged 12 - 45 years , were r and omized 1 : 1 to once-daily BPO + CLN gel or twice-daily AzA cream for up to 12 weeks . The primary endpoint was the percentage change in inflammatory lesions from baseline at Week 4 . Secondary endpoints included total and inflammatory lesion counts and tolerability assessment s. For selected secondary endpoints , inductive statistical analysis was performed post hoc . Patient safety was assessed by adverse event ( AE ) monitoring . RESULTS Efficacy was assessed in the modified intent-to-treat ( mITT ) population [ patients using ≥1 dose of study medication ( ITT ) , plus baseline and ≥1 post-baseline lesion count ( n = 215 ) ] . There was a statistically significant difference in the primary endpoint , with a median decrease of -52.6 % for BPO + CLN ( n = 107 ) vs.-38.8 % for AzA ( n = 108 ; P = 0.0004 ) . There was also a greater difference in secondary lesion endpoints at Week 12 , with a median decrease in inflammatory lesions of -78.8 % and -65.3 % and total lesions of -69.0 % and -53.9 % with BPO + CLN and AzA , respectively ( both P < 0.0001 ) . Tolerability was acceptable for both treatments . Overall , 55.6 % ( BPO + CLN ) and 69.7 % ( AzA ) of patients reported treatment-emergent AEs , and 15.7 % and 35.8 % of patients experienced application site reactions with BPO + CLN ( 24 events ; 17 patients ) and AzA ( 60 events ; 39 patients ) treatment , respectively ( ITT population ) . CONCLUSION BPO + CLN demonstrated greater efficacy than AzA in the treatment of mild-to-moderate acne vulgaris and has a positive tolerability and safety profile BACKGROUND No single effective topical treatment is available for treating all pathogenic factors causing acne vulgaris ( AV ) .  Salicylic acid ( SA ) , tretinoin ( all-TRA ) and clindamycin phosphate ( CDP ) are known to to be effective agents depending on their comedolytic and anti-inflammatory properties . OBJECTIVE To compare the efficacy and tolerability of SA and CDP combination ( SA+CDP ) with all-TRA and CDP ( all-TRA+CDP ) in patients with mild to moderate facial AV . METHODS Forty-six patients aged between 18 and 35 years were enrolled in a 12-week prospect i ve , single-blind , r and omized and comparative clinical study . Efficacy was assessed by lesion counts , global improvement , quality of life index and measurement of skin barrier functions . Local side effects were also evaluated . RESULTS Both combinations were effective in reducing total lesion ( TL ) , inflammatory lesion ( IL ) and non-inflammatory lesion ( NIL ) counts and showed significant global improvement as evaluated by the investigator . At the end of the study , there was no significant difference between the two groups in terms of all lesion counts . In addition , TL counts decreased faster in the all-TRA+CDP group compared with those in the SA+CDP group , with a significant difference between the two groups occurring as early as 2 weeks . Safety evaluations demonstrated that the incidence of mild to moderate side effects generally peaked at week 2 and declined gradually thereafter . Both combinations did not have an effect on stratum corneum hydration , although skin sebum values decreased with SA+CDP treatment . CONCLUSIONS Combination of SA+CDP and all-TRA+CDP was effective in decreasing lesion counts and well tolerated with minimal local cutaneous reactions in patients with mild to moderate AV BACKGROUND Acne vulgaris is a common dermatologic disease that most frequently affect 
    Output:
    
This outcome was not reported for salicylic acid versus pyruvic acid , but individual application site reactions were reported , such as scaling and redness .
Compared to benzoyl peroxide , azelaic acid probably leads to a worse treatment response , measured using PGA .
When compared to tretinoin , azelaic acid probably makes little or no difference to treatment response .