Patient description: A 35-year-old woman presents with history of acne and mild hirsutism. The primary evaluation revealed elevated testosterone levels. She recently noticed gradual enlargement of her hands and feet and recognized that her ring is getting small for her finger. There is some irregularity in her menstrual cycle as well as some nipple discharge. She also has positive history for snoring and headache. The physical examination revealed subtle facial features of acromegaly and prognathism. Visual fields are normal by confrontation. Hirsutism, soft tissue thickening and diaphoresis of the hands and feet are noted. Laboratory evaluation in the fasting state reveals IGF-1 of 968 ng/mL and random GH of 19.7 ng/mL. MRI reveals a macroadenoma with no invasion. She is on stable doses of octreotide LAR since her diagnosis was confirmed. She is married and has 2 children. She is using IUD as her contraceptive method.

Clinical trial eligibility criteria: eligible ages (years): 18.0-60.0,  Acne Fits into one of the following diagnostic groups: 1. Healthy subject with no active skin disease or history of skin disease 2. Diagnosis of moderate-to-severe truncal acne diagnosed clinically and confirmed using the modified Leeds with no reported use of topical acne treatments within the past 2 weeks prior to enrollment in the study, and no reported use of oral acne treatments during the past 4 weeks prior to enrollment in the study 3. Diagnosis of moderate-to-severe truncal acne diagnosed clinically and confirmed using the modified Leeds who has used any topical acne treatments in the 2 weeks prior to enrolling in the study, or who has used any oral acne treatments during the 4 weeks prior to enrolling in the study 2. Age 18-60 years 3. Male or female of any race and ethnicity 4. Subject agrees to comply with study requirements  Subjects with severe medical condition(s) that in the view of the investigator prohibits participation in the study 2. Subject has Netherton's syndrome or other genodermatoses that result in a defective epidermal barrier 3. Pregnant or nursing females 4. Immunocompromised subjects (e.g., lymphoma, HIV/AIDS, Wiskott-Aldrich Syndrome), or with a history of active or malignant disease (excluding non-melanoma skin cancer) as determined by the participant's medical history. 5. Subjects with a history of psychiatric disease or history of alcohol or drug abuse that would interfere with the ability to comply with the study protocol 6. Subjects with significant concurrent medical condition(s) at screening that in the view of the investigator prohibits participation in the study (e.g., severe concurrent allergic disease, condition associated with malignancy, and condition associated with immunosuppression) 7. Active viral or fungal skin infections at the target areas 8. Are currently receiving lithium now or within the last 4 weeks. 9. Ongoing participation in an investigational drug trial 10. Use of any systemic immunosuppressive therapy less than four weeks prior to screening. 11. Subjects with diabetes 12. Injured, broken skin that, per the investigator, may lead to poor wound healing 13. Subjects with allergies to anesthetic medications