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An Overview of Etiopathogenesis of Acne Vulgaris

Year 2018, Volume: 8 Issue: 1, 44 - 51, 25.01.2018

Abstract

Acne vulgaris is a chronic inflammatory disease that primarily affects the pilosebase unit. Acne vulgaris remains one of the commonest diseases to afflict humanity, with prevalence up to 90% during adolescence. Relatively little is known about its epidemiology despite the fact that acne is a universal condition in younger population. This disease is more common in developed countries than in less industrialized regions of the world. The etiopathogenesis of acne is multifactorial.  Sebum production, follicular epithelial keratinization, bacterial proliferation, and inflammation play significant role in etiopathogenesis. Recent studies shown that toll like receptors and antimicrobial peptides play a role in the pathogenesis of acne vulgaris. The relationship between diet and acne is highly controversial. Strong evidence shows that high glycemic loads diet may exacerbate acne. In addition, the factors contributing to the formation of acne also include genetic predispositions, hormonal abnormalities, psychological, environmental and iatrogenic factors. The disease is mainly observed face, chest, back and shoulders. When acne is untreated, it may cause social isolation, difficulty in finding jobs, depression and suicide attempt as a result of emotional and physical scar formation. In this article, the epidemiology and etiopathogenesis of acne are overviewed.

References

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Comedogenesis: Some new aetiological, clinical and therapeutic strategies. Br J Dermatol 2000;142:1084-91. 8- Graham GM, Farrar MD, Cruse-Sawyer JE, Holland KT, Ingham E. Proinflammatory cytokine production by human keratinocytes stimulated with Propionibacterium acnes and p.acnes GroEL. Br J Dermatol 2004;150:421-8. 9- Antilla HA, Reitamo S, Saurat JH. Interleukin 1 immunoreactivity in sebaceous glands. Br J Dermatol 1992;127:585-8. 10- Guy R, Kealey T. Modelling the infundibulum in acne. Dermatology 1998;1:32-7. 11- Ingham E, Eady EA, Goodwin CE, Cove JH, Cunliffe WJ. Proinflammatory levels of interleukin 1 alpha like bioactivity are present in the majority of open comedones in acne vulgaris. J Invest Dermatol 1992;6:895-901. 12- Forsmann T. Antibiotic resistance in acne patients under antibiotic treatment in comparison to an untreated control group with retrospective assesment of therapy. Curr Probl Dermatol 1995;22:91-7. 13- Leeming JP, Holland KT, Cunliffe WJ. The pathological and aetiological significance of microorganisms colonizing acne vulgaris comedones. J Med Microbiol 1985;20:11-6. 14- Ingham E, Walters CE, Eady EA, Cove JH, Kearney JN, Cunliffe WJ. Inflammation in acne vulgaris: Failure of skin microorganisms to modulate keratinocyte interleukin 1 alpha production in vitro.Dermatology.1998;196:86-8. 15- Jeremy AHT, Holland DB, Roberts SG, Thomson KF, Cunliffe WJ. Inflammatory events are involved in acne lesion initiation. J Invest Dermatol 2003;121:20-7. 16- Toyoda M, Morohashi M. Pathogenesis of acne. Med Electron Microsc. 2001;34:29-40. 17- Wertz PW, Miethke MC, Long SA, Strauss JS, Downing DT. The composition of the ceramides from human stratum corneum and from comedones. J Invest Dermatol. 1985;84:410-2. 18- Logan AC. Linoleic and linolenic acids and acne vulgaris. Br J Dermatol 2008;158:201-2. 19- Downing DT, Stewart ME, Wertz PW, Strauss JS. Essential fatty acids and acne. J Am Acad Dermatol 1986;14:221-5. 20- Motoyoshi K. Enhanced comedo formation in rabbit ear skin by squalen and oleic acid peroxides. Br J Dermatol 1983;109:191-8. 21- Downing DT, Stewart ME, Wertz PW, Colton SW, Abraham W, Strauss JS. Skin lipids: An update. J Invest Dermatol 1987;88:2-6. 22- Ramasastry P, Downing DT, Pochi PE, Strauss JS. Chemical composition of human skin surface lipids from birth to puberty. J Invest Dermatol. 1970;54:139-44. 23- Greene RS, Downing DT, Pochi PE, Strauss JS. Anatomical variation in the amount and composition of human skin surface lipid. J Invest Dermatol. 1970;54:240-7. 24- Zouboulis CC. Acne and sebaceous gland function. Clin Dermatol. 2004;22:360-6. 25- Stewart ME. Sebaceous gland lipids. Semin Dermatol. 1992;11:100-5. 26- Smith RN, Braue A, Varigos GA, Mann NJ. The effect of a low glycemic load diet on acne vulgaris and the fatty acid composition of skin surface triglycerides. J Dermatol Sci. 2008;50:41-52. 27- Ottaviani M, Alestas T, Flori E, Mastrofrancesco A, Zouboulis CC, Picardo M. Peroxidated squalene induces the production of inflammatory mediators in HaCaT keratinocytes: A possible role in acne vulgaris. J Invest Dermatol. 2006;126:2430-7. 28- Ferre P. The biology of peroxisome proliferator-activated receptors: Relationships with lipid metabolism and insulin sensitivity. Diabetes. 2004;53:43-50. 29- Ottaviani M, Camera E, Picardo M. Lipid mediators in acne. Mediators Inflamm. 2010; Aug 25: (cited 2010 Aug 25) 30- Weindl G, Schafer-Korting M, Schaller M, Korting HC. Peroxisome proliferator-activated receptors and their ligands: Entry into the post-glucocorticoid era of skin treatment. Drugs. 2005;65:1919-34. 31- Choudhry R, Hodgins M, Van der Kwast, Brinkmann AO, Boersma WJ. Localization of androgen receptors in human skin by immunohistochemistry: Implications for the hormonal regulation of hair growth, sebaceous glands and sweat glands. J Endocrinol. 1992;133:467-75. 32- Liang T, Hayers S, Yu R, et al. Immunocytochemical localization of androgen receptors in human skin using monoclonal antibodies against the androgen receptor. J Invest Dermatol. 1993;100:663-6. 33- Sansone G, Reisner RM. Differential rates of conversion of testosterone to dihydrotestosterone in acne and in normal human skin-a possible pathogenic factor in acne. J Invest Dermatol. 1971;56:366-72. 34- Zouboulis CC. Acne and sebaceous gland function. Clin Dermatol. 2004;22:360-6. 35- Burton JL, Libman LJ, Cunliffe WJ, Wilkinson R, Hall R, Shuster S. Sebum excretion in acromegaly. Br Med J. 1972;12:406-8. 36- Deplewski D, Rosenfield RL. Growth hormone and insulin-like growth factors have different effects on sebaceous cell growth and differentation. Endocrinology. 1999;140:4089-94. 37- Chronnell MTC, Ghali LR, Ali RS, et al. Human beta defensin -1 and -2 expression in human pilosebaceous units: Upregulation in acne vulgaris lesions. J Invest Dermatol. 2001;117:1120-5. 38- Farrar MD, Ingham E. Acne: Inflammation. Clin Dermatol. 2004;22:380-4. 39- Leeming JP, Holland KT, Cunliffe WJ. The microbial colonization of inflamed lesions. Br J Dermatol. 1988;118:203-8. 40- Philpott MP. Defensins and acne. Mol Immunol. 2003;40:457-62. 41- Dessinioti C, Katsambas AD. The role of Propionibacterium acnes in acne pathogenesis: Facts and contoversies. Clin Dermatol. 2010;28:2-7. 42- Kim J, Ochoa MT, Krutzik SR, et al. Activation of toll-like receptor 2 in acne triggers inflammatory cytonkine responses. J Immunol. 2002;169:1535-41. 43- Yüksek J. Akne vulgarisli hastalarda isotretinoin tedavisinin CD 3 (+), CD 4(+) T hücre ve ICAM-1 üzerine etkisi. Uzmanlık tezi, Ankara: Gazi Üniversitesi, 2007. 44- Zouboulis CC, Seltmann H, Neitzel H, Orfanos CE. Establishment and characterization of an immortalized human sebaceous gland cell line. J Invest Dermatol. 1999;113:1011-20. 45- Holland DB, Jeremy AHT, Roberts SG, Seukeran DC, Layton AM, Cunliffe WJ. 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Akne Vulgaris Etiyopatogenezine Genel Bakış

Year 2018, Volume: 8 Issue: 1, 44 - 51, 25.01.2018

Abstract

Akne vulgaris başlıca pilosebase üniteyi etkileyen kronik inflamatuvar bir hastalıktır. Akne vulgaris adolesanlarda %90'a varan prevalansıyla, insanlığı etkileyen en sık görülen hastalıklardan biridir. Hastalığın epidemiyolojisi ile ilgili bilinenler nispeten az olmasına karşın; akne genç popülasyonda görülen evrensel bir durumdur. Bu hastalık gelişmiş ülkelerde dünyanın daha az endüstrileşmiş bölgelerinden daha yaygındır. Aknenin etiyopatogenezi multifaktöriyeldir. Etiyopatogenezinde sebum üretimi, foliküler epitelyal keratinizasyon, bakteriyel proliferasyon ve inflamasyon önemli rol oynar. Güncel çalışmalar akne vulgaris etiyopatogenezinde toll benzeri reseptörler ve antimikrobiyal peptidlerin de rol oynadığını göstermektedir. Akne ve diyet arasındaki ilişki ise son derece tartışmalıdır. Yüksek glisemik indeksli gıdaların akne vulgarisi şiddetlendirdiğine yönelik güçlü kanıtlar mevcuttur. Ayrıca genetik yatkınlık, hormonal bozukluklar, psikolojik, çevresel ve iyatrojenik faktörler de akne gelişimine katkıda bulunur. Hastalık sıklıkla yüz, sırt, göğüs ve omuz bölgesini tutar. Tedavi edilmediği zaman emosyonel ve fiziksel bozukluklara neden olarak sosyal izolasyon, iş bulma güçlüğü, depresyon ve intihar girişimine yol açabilmektedir. Bu makalede akne vulgarisin epidemiyolojisi ve etiyopatogenezi gözden geçirilmiştir.

References

  • 1- Zaenglein AI, Graber EM, Thiboutot DM, Strauss JS. Acne vulgaris and acneiform eruptions. In: Wolff K, Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, editors. Fitzpatrick’s Dermatology in General Medicine. (7th ed). New York: McGraw Hill. 2008, pp. 690-703. 2- Cunliffe WJ, Simpson NB. Disorders of sebaceous glands. In: Champion RH, Burton JL, Burns DA, Brethnach SM (eds.). Textbook of dermatology. (6th ed) Oxford: Blackwell Science Publ; 1998, pp.1927-84. 3- Ermertcan AT. Akne ve yaşam kalitesi. Dermatose 2007;2:91-7. 4- Gollnick H. Current concepts of the pathogenesis of acne. Drugs 2003; 63: 1579-96. 5- Jappe U. Pathological mechanism of acne with special emphasis on Propionibacterium acnes and related therapy. Acta Derm Venereol. 2003; 83: 241-8. 6- Cunliffe WJ, Holland DB, Jeremy A. Comedone formation: Etiology, clinical presentation, and treatment. Clin Dermatol 2004;22:367-74. 7- Cunliffe WJ, Holland DB, Clark SM, Stables GI. Comedogenesis: Some new aetiological, clinical and therapeutic strategies. Br J Dermatol 2000;142:1084-91. 8- Graham GM, Farrar MD, Cruse-Sawyer JE, Holland KT, Ingham E. Proinflammatory cytokine production by human keratinocytes stimulated with Propionibacterium acnes and p.acnes GroEL. Br J Dermatol 2004;150:421-8. 9- Antilla HA, Reitamo S, Saurat JH. Interleukin 1 immunoreactivity in sebaceous glands. Br J Dermatol 1992;127:585-8. 10- Guy R, Kealey T. Modelling the infundibulum in acne. Dermatology 1998;1:32-7. 11- Ingham E, Eady EA, Goodwin CE, Cove JH, Cunliffe WJ. Proinflammatory levels of interleukin 1 alpha like bioactivity are present in the majority of open comedones in acne vulgaris. J Invest Dermatol 1992;6:895-901. 12- Forsmann T. Antibiotic resistance in acne patients under antibiotic treatment in comparison to an untreated control group with retrospective assesment of therapy. Curr Probl Dermatol 1995;22:91-7. 13- Leeming JP, Holland KT, Cunliffe WJ. The pathological and aetiological significance of microorganisms colonizing acne vulgaris comedones. J Med Microbiol 1985;20:11-6. 14- Ingham E, Walters CE, Eady EA, Cove JH, Kearney JN, Cunliffe WJ. Inflammation in acne vulgaris: Failure of skin microorganisms to modulate keratinocyte interleukin 1 alpha production in vitro.Dermatology.1998;196:86-8. 15- Jeremy AHT, Holland DB, Roberts SG, Thomson KF, Cunliffe WJ. Inflammatory events are involved in acne lesion initiation. J Invest Dermatol 2003;121:20-7. 16- Toyoda M, Morohashi M. Pathogenesis of acne. Med Electron Microsc. 2001;34:29-40. 17- Wertz PW, Miethke MC, Long SA, Strauss JS, Downing DT. The composition of the ceramides from human stratum corneum and from comedones. J Invest Dermatol. 1985;84:410-2. 18- Logan AC. Linoleic and linolenic acids and acne vulgaris. Br J Dermatol 2008;158:201-2. 19- Downing DT, Stewart ME, Wertz PW, Strauss JS. Essential fatty acids and acne. J Am Acad Dermatol 1986;14:221-5. 20- Motoyoshi K. Enhanced comedo formation in rabbit ear skin by squalen and oleic acid peroxides. Br J Dermatol 1983;109:191-8. 21- Downing DT, Stewart ME, Wertz PW, Colton SW, Abraham W, Strauss JS. Skin lipids: An update. J Invest Dermatol 1987;88:2-6. 22- Ramasastry P, Downing DT, Pochi PE, Strauss JS. Chemical composition of human skin surface lipids from birth to puberty. J Invest Dermatol. 1970;54:139-44. 23- Greene RS, Downing DT, Pochi PE, Strauss JS. Anatomical variation in the amount and composition of human skin surface lipid. J Invest Dermatol. 1970;54:240-7. 24- Zouboulis CC. Acne and sebaceous gland function. Clin Dermatol. 2004;22:360-6. 25- Stewart ME. Sebaceous gland lipids. Semin Dermatol. 1992;11:100-5. 26- Smith RN, Braue A, Varigos GA, Mann NJ. The effect of a low glycemic load diet on acne vulgaris and the fatty acid composition of skin surface triglycerides. J Dermatol Sci. 2008;50:41-52. 27- Ottaviani M, Alestas T, Flori E, Mastrofrancesco A, Zouboulis CC, Picardo M. Peroxidated squalene induces the production of inflammatory mediators in HaCaT keratinocytes: A possible role in acne vulgaris. J Invest Dermatol. 2006;126:2430-7. 28- Ferre P. The biology of peroxisome proliferator-activated receptors: Relationships with lipid metabolism and insulin sensitivity. Diabetes. 2004;53:43-50. 29- Ottaviani M, Camera E, Picardo M. Lipid mediators in acne. Mediators Inflamm. 2010; Aug 25: (cited 2010 Aug 25) 30- Weindl G, Schafer-Korting M, Schaller M, Korting HC. Peroxisome proliferator-activated receptors and their ligands: Entry into the post-glucocorticoid era of skin treatment. Drugs. 2005;65:1919-34. 31- Choudhry R, Hodgins M, Van der Kwast, Brinkmann AO, Boersma WJ. Localization of androgen receptors in human skin by immunohistochemistry: Implications for the hormonal regulation of hair growth, sebaceous glands and sweat glands. J Endocrinol. 1992;133:467-75. 32- Liang T, Hayers S, Yu R, et al. Immunocytochemical localization of androgen receptors in human skin using monoclonal antibodies against the androgen receptor. J Invest Dermatol. 1993;100:663-6. 33- Sansone G, Reisner RM. Differential rates of conversion of testosterone to dihydrotestosterone in acne and in normal human skin-a possible pathogenic factor in acne. J Invest Dermatol. 1971;56:366-72. 34- Zouboulis CC. Acne and sebaceous gland function. Clin Dermatol. 2004;22:360-6. 35- Burton JL, Libman LJ, Cunliffe WJ, Wilkinson R, Hall R, Shuster S. Sebum excretion in acromegaly. Br Med J. 1972;12:406-8. 36- Deplewski D, Rosenfield RL. Growth hormone and insulin-like growth factors have different effects on sebaceous cell growth and differentation. Endocrinology. 1999;140:4089-94. 37- Chronnell MTC, Ghali LR, Ali RS, et al. Human beta defensin -1 and -2 expression in human pilosebaceous units: Upregulation in acne vulgaris lesions. J Invest Dermatol. 2001;117:1120-5. 38- Farrar MD, Ingham E. Acne: Inflammation. Clin Dermatol. 2004;22:380-4. 39- Leeming JP, Holland KT, Cunliffe WJ. The microbial colonization of inflamed lesions. Br J Dermatol. 1988;118:203-8. 40- Philpott MP. Defensins and acne. Mol Immunol. 2003;40:457-62. 41- Dessinioti C, Katsambas AD. The role of Propionibacterium acnes in acne pathogenesis: Facts and contoversies. Clin Dermatol. 2010;28:2-7. 42- Kim J, Ochoa MT, Krutzik SR, et al. Activation of toll-like receptor 2 in acne triggers inflammatory cytonkine responses. J Immunol. 2002;169:1535-41. 43- Yüksek J. Akne vulgarisli hastalarda isotretinoin tedavisinin CD 3 (+), CD 4(+) T hücre ve ICAM-1 üzerine etkisi. Uzmanlık tezi, Ankara: Gazi Üniversitesi, 2007. 44- Zouboulis CC, Seltmann H, Neitzel H, Orfanos CE. Establishment and characterization of an immortalized human sebaceous gland cell line. J Invest Dermatol. 1999;113:1011-20. 45- Holland DB, Jeremy AHT, Roberts SG, Seukeran DC, Layton AM, Cunliffe WJ. 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There are 1 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Reviews
Authors

Emin Özlü

Ayşegül Baykan

Ragıp Ertaş This is me

Publication Date January 25, 2018
Submission Date July 6, 2017
Published in Issue Year 2018 Volume: 8 Issue: 1

Cite

APA Özlü, E., Baykan, A., & Ertaş, R. (2018). Akne Vulgaris Etiyopatogenezine Genel Bakış. Düzce Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi, 8(1), 44-51.
AMA Özlü E, Baykan A, Ertaş R. Akne Vulgaris Etiyopatogenezine Genel Bakış. J DU Health Sci Inst. January 2018;8(1):44-51.
Chicago Özlü, Emin, Ayşegül Baykan, and Ragıp Ertaş. “Akne Vulgaris Etiyopatogenezine Genel Bakış”. Düzce Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi 8, no. 1 (January 2018): 44-51.
EndNote Özlü E, Baykan A, Ertaş R (January 1, 2018) Akne Vulgaris Etiyopatogenezine Genel Bakış. Düzce Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi 8 1 44–51.
IEEE E. Özlü, A. Baykan, and R. Ertaş, “Akne Vulgaris Etiyopatogenezine Genel Bakış”, J DU Health Sci Inst, vol. 8, no. 1, pp. 44–51, 2018.
ISNAD Özlü, Emin et al. “Akne Vulgaris Etiyopatogenezine Genel Bakış”. Düzce Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi 8/1 (January 2018), 44-51.
JAMA Özlü E, Baykan A, Ertaş R. Akne Vulgaris Etiyopatogenezine Genel Bakış. J DU Health Sci Inst. 2018;8:44–51.
MLA Özlü, Emin et al. “Akne Vulgaris Etiyopatogenezine Genel Bakış”. Düzce Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi, vol. 8, no. 1, 2018, pp. 44-51.
Vancouver Özlü E, Baykan A, Ertaş R. Akne Vulgaris Etiyopatogenezine Genel Bakış. J DU Health Sci Inst. 2018;8(1):44-51.