{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T14:59:59Z","timestamp":1767193199623,"version":"3.48.0"},"reference-count":19,"publisher":"BMJ","issue":"8","license":[{"start":{"date-parts":[[2025,8,19]],"date-time":"2025-08-19T00:00:00Z","timestamp":1755561600000},"content-version":"unspecified","delay-in-days":18,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"UK Dermatology Clinical Trials Network"},{"name":"British Society for Paediatric and Adolescent Dermatology"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,7,29]]},"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Spironolactone is a useful and effective acne treatment option for adult female patients. We aim to establish whether spironolactone could be a safe treatment for the management of acne in the female adolescent population as well. The objective of this scoping review is to provide an evidence map of the safety profile of spironolactone in the paediatric population aged 0\u201317 across all clinical indications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>This scoping review will be conducted according to the Joanna Briggs Institute scoping review protocol. Relevant publications will be searched on the MEDLINE, Embase and Web of Science databases from inception until July 2025. The authors of included studies will be contacted using contact details provided in the manuscript to check for any further published or unpublished data on the review question. An initial search will be conducted using keywords to identify relevant articles. After identifying the research strategy, articles will be extracted into a reference management tool, and a two-part study selection process will be systematically applied by two reviewers. The first part consists of screening titles and abstracts to define the eligibility of each article. In the second part, the full texts will be screened and only relevant articles will be kept. All articles related to the safety of spironolactone in children and adolescents across all clinical indications will be included. Data will be extracted using a scoping review management software such as Covidence, collated and charted to summarise all the relevant methods, outcomes and key findings in the articles.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>This scoping review will provide an extensive overview of the available safety evidence for the use of spironolactone in children and teenagers. Since the scoping review methodology consists of reviewing and collecting data from publicly available materials, this study does not require ethics approval. The results will be disseminated in a peer-reviewed publication.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-106758","type":"journal-article","created":{"date-parts":[[2025,8,19]],"date-time":"2025-08-19T15:15:53Z","timestamp":1755616553000},"page":"e106758","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Creating an evidence map of the safety profile of spironolactone across all clinical indications to establish whether it may be a safe treatment in female adolescent acne: a protocol for a scoping review"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-3404-8289","authenticated-orcid":false,"given":"Fiona C","family":"Sexton","sequence":"first","affiliation":[{"name":"Department of Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Myranda","family":"Attard","sequence":"additional","affiliation":[{"name":"Department of Dermatology, HCS Belfast Health and Social Care Trust, Belfast, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa","family":"O\u2019Higgins","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zahra","family":"Moledina","sequence":"additional","affiliation":[{"name":"Department of Dermatology, King\u2019s College Hospital NHS Foundation Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julia","family":"Fordham","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Torbay and South Devon NHS Foundation Trust, Torquay, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Grishma","family":"Ramesh","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Nottingham University Hospitals NHS Trust, Nottingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Law","sequence":"additional","affiliation":[{"name":"Department of Paediatric Endocrinology, Nottingham University Hospitals NHS Trust, Nottingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susannah","family":"George","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Brighton and Sussex University Hospitals NHS Trust, Worthing, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Esther","family":"Burden-Teh","sequence":"additional","affiliation":[{"name":"Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,8,19]]},"reference":[{"key":"2025123106472385000_15.8.e106758.1","doi-asserted-by":"crossref","DOI":"10.2196\/29282","article-title":"Global Burden of Skin Disease Representation in the Literature: Bibliometric Analysis","volume":"4","author":"Pulsipher","year":"2021","journal-title":"JMIR Dermatol"},{"key":"2025123106472385000_15.8.e106758.2","unstructured":"British Journal of Dermatology . Over half of people who have ever had acne feel it has affected their self-confidence, 2018. Available: https:\/\/www.skinhealthinfo.org.uk\/over-half-of-people-who-have-ever-had-acne-feel-it-has-affected-their-self-confidence\/ [Accessed 28 May 2018]."},{"key":"2025123106472385000_15.8.e106758.3","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.c5812","article-title":"Association of suicide attempts with acne and treatment with isotretinoin: retrospective Swedish cohort study","volume":"341","author":"Sundstr\u00f6m","year":"2010","journal-title":"BMJ"},{"key":"2025123106472385000_15.8.e106758.4","unstructured":"British Journal of Dermatology . Diagnosis of acne on the rise in the UK and globally since 1990, 2024. Available: https:\/\/www.bad.org.uk\/diagnosis-of-acne-on-the-rise-in-the-uk-and-globally-since-1990\/ [Accessed 28 May 2025]."},{"key":"2025123106472385000_15.8.e106758.5","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1016\/j.ijwd.2016.11.002","article-title":"The age-old problem of acne","volume":"3","author":"Mahmood","year":"2017","journal-title":"Int J Womens Dermatol"},{"key":"2025123106472385000_15.8.e106758.6","unstructured":"NICE . National Institute for Health and Care Excellence; Acne vulgaris: management, 2021. Available: https:\/\/www.nice.org.uk\/guidance\/ng198 [Accessed 28 May 2025]."},{"key":"2025123106472385000_15.8.e106758.7","unstructured":"Dermatology Times Staff . Parents worries about severe acne\u2019s impact on teens. Dermatology Times; 2021. Available: https:\/\/www.dermatologytimes.com\/view\/parents-worries-about-severe-acne-s-impact-on-teens [Accessed 28 May 2025]."},{"key":"2025123106472385000_15.8.e106758.8","first-page":"669","article-title":"Potential harms of long-term acne treatment with oral antibiotics","volume":"66","author":"Dao","year":"2020","journal-title":"Can Fam Physician Med Fam Can"},{"key":"2025123106472385000_15.8.e106758.9","doi-asserted-by":"publisher","DOI":"10.1177\/2042098614554919"},{"key":"2025123106472385000_15.8.e106758.10","doi-asserted-by":"crossref","DOI":"10.1111\/dth.13669","article-title":"Knowledge levels and concerns about oral isotretinoin treatment in the parents of adolescent acne patients","volume":"33","author":"Kara Polat","year":"2020","journal-title":"Dermatol Ther"},{"key":"2025123106472385000_15.8.e106758.11","doi-asserted-by":"publisher","DOI":"10.1111\/j.1523-1747.2004.t01-2-.x"},{"key":"2025123106472385000_15.8.e106758.12","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.1984.tb04045.x"},{"key":"2025123106472385000_15.8.e106758.13","doi-asserted-by":"crossref","unstructured":"Santer M , Lawrence M , Renz S , et al . Effectiveness of spironolactone for women with acne vulgaris (SAFA) in England and Wales: pragmatic, multicentre, phase 3, double blind, randomised controlled trial. BMJ 2023;e074349. doi:10.1136\/bmj-2022-074349","DOI":"10.1136\/bmj-2022-074349"},{"key":"2025123106472385000_15.8.e106758.14","doi-asserted-by":"crossref","first-page":"777","DOI":"10.1210\/jcem-41-4-777","article-title":"Effect of Spironolactone on Sex Hormones in Man","volume":"41","author":"Stripp","year":"1975","journal-title":"The Journal of Clinical Endocrinology & Metabolism"},{"key":"2025123106472385000_15.8.e106758.15","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1210\/jcem-45-2-255","article-title":"Gynecomastia and Semen Abnormalities Induced by Spironolactone in Normal Men","volume":"45","author":"Caminos-torres","year":"1977","journal-title":"The Journal of Clinical Endocrinology & Metabolism"},{"key":"2025123106472385000_15.8.e106758.16","doi-asserted-by":"publisher","DOI":"10.1345\/aph.1E618"},{"key":"2025123106472385000_15.8.e106758.17","doi-asserted-by":"crossref","first-page":"2077","DOI":"10.1007\/s00431-022-04768-2","article-title":"Diuretics in pediatrics","volume":"182","author":"Lava","year":"2023","journal-title":"Eur J Pediatr"},{"key":"2025123106472385000_15.8.e106758.18","unstructured":"Qaialdo . European Medicines Agency; INN-spironolactone, 2023. Available: https:\/\/www.ema.europa.eu\/en\/documents\/product-information\/qaialdo-epar-product-information_en.pdf [Accessed 7 Sep 2025]."},{"key":"2025123106472385000_15.8.e106758.19","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.f2634","article-title":"Acne vulgaris","volume":"346","author":"Dawson","year":"2013","journal-title":"BMJ"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2025-106758","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T14:49:26Z","timestamp":1767192566000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2025-106758"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8]]},"references-count":19,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2025,8,19]]},"published-print":{"date-parts":[[2025,8]]}},"alternative-id":["10.1136\/bmjopen-2025-106758"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2025-106758","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"type":"print","value":"2044-6055"},{"type":"electronic","value":"2044-6055"}],"subject":[],"published":{"date-parts":[[2025,8]]}}}