{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T15:37:37Z","timestamp":1786117057791,"version":"build-2736575974"},"reference-count":29,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,2,15]],"date-time":"2026-02-15T00:00:00Z","timestamp":1771113600000},"content-version":"vor","delay-in-days":14,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Cosmetic Dermatology"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Self\u2010inflicted skin injury is a significant yet often underrecognized contributor to acne progression, particularly in postadolescent populations. It not only perpetuates lesions but also triggers inflammatory cascades, including sebaceous gland epithelialization and cystic transformation. Postadolescent acne excori\u00e9e poses unique therapeutic challenges due to the interplay of dermatological and psychological factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>\n                      To evaluate the effectiveness of a combined psychodermatological treatment\u2014CO\n                      <jats:sub>2<\/jats:sub>\n                      laser ablation and cognitive\u2013behavioral therapy (CBT)\u2014in managing chronic, treatment\u2010resistant postadolescent acne excori\u00e9e.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A case series of three patients with refractory postadolescent acne excori\u00e9e was conducted. Treatment involved CO\n                      <jats:sub>2<\/jats:sub>\n                      laser ablation to remove obstructed sebaceous glands, combined with CBT targeting maladaptive excoriation behaviors.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>All patients achieved rapid and sustained clinical improvement. The combined approach disrupted the pathomimetic cycle, eliminated visible obstructed sebaceous glands, and reduced compulsive skin manipulation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Integrating CO\n                      <jats:sub>2<\/jats:sub>\n                      laser ablation with CBT offers a dual benefit of addressing both the physical lesions and psychological drivers of acne excori\u00e9e. Multidisciplinary collaboration is essential for effective management of complex psychocutaneous disorders.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jocd.70722","type":"journal-article","created":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T06:34:47Z","timestamp":1771223687000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Integrated\n                    <scp>CO<\/scp>\n                    <sub>2<\/sub>\n                    Laser Treatment and Cognitive\u2013Behavioral Therapy for Postadolescent Acne Excori\u00e9e: Clinical Outcomes From a Case Series"],"prefix":"10.1111","volume":"25","author":[{"given":"Julian","family":"Penev","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases, Parasitology and Dermatovenerology Medical University Varna  Varna 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