| Title | New insights to the pathogenesis of acne vulgaris: a review article | |
| Authors | Ioanna Grek, Anthony M. Kyriakopoulos and Maria Grek
Department of Aesthetics and Cosmetology, School for Professions of Health and Welfare, Technological Educational Institution of Athens, Athens, Greece |
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| Citation | Grek, I., Kyriakopoulos, A.M., Grek, M.: New insights to the pathogenesis of acne vulgaris: a review article, Epitheorese Klin. Farmakol. Farmakokinet. 20(1): 31-37 (2006) | |
| Publication Date | Accepted for publication (Final version): 15 April 2006 | |
| Full Text Language | English | |
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| Keywords | Acne vulgaris, pathogenesis, etiology, androgens, overexpression of genes, hypersensitivity response, propionibacterium acnes, neuroendocrinology of acne. | |
| Other Terms | review article | |
| Summary | Acne vulgaris is the most frequent dermatological disorder, affecting the sebaceous glands only in humans at virtually all ages but more commonly at the patients’ reproductive period. The clinical types of acne are almost unlimited having patients that suffer only with mild symptoms and others that have severe inflammatory lesions on their skin. The effect of local metabolism of androgens in the production of sebum at first and the production of acne lesions secondly is undisputable. However, latter studies using modern technology of cell biology and genetic research have indicated that the abnormal cellular behavior leading in the production of cytokines locally at acne lesions and the higher translation rates of enzymes that direct the retinoid metabolism are equally important components for the pathogenesis of acne. The subject of fresh research in the pathogenesis of acne is to understand the reason of having so much differentiation in the severity and the powerfulness of acne inflammation. The strongest supported scientific explanation is in the limits of autoimmunity, in the sense of a hypersensitivity response of the skins immune system of some patients, against a common commensal microbe called Propionibacterium acnes. P. acnes strains are known to colonize parts of the human sebaceous gland without being pathogenic. Series of studies have proven that the whole cellular wall carbohydrates off P. acnes, (especially when there has been a raise of microbial density above a critical limit) creates an environment of nutrient stress. This stressful condition raises an increasing chemical attraction of lymphocytes at the sebaceous gland. The production of cytokines from the damaged keratinocytes and a subsequent specific hypersensitivity response is in the real sense the major protagonist of the inflammation seen in acne. Modern studies are also focusing in the neurobiology of acne in patients suffering from stress. With the newest knowledge of acne pathogenesis it may be possible in the future to follow a better therapeutic approach for curing the disorder and also most importantly, to understand better other skin disorders such as psoriasis that may have many pathogenic factors in common with acne. | |
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Dermatol. 13(Suppl. 4): 31-35 (2004)
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