The aetiopathogenesis of acne vulgaris – what's new?

Abstract

Synopsis Acne vulgaris is the most frequently diagnosed dermatosis in patients between 11 and 30. It is believed that it affects about 80% of persons in this age group or even, taking into account lesions of low intensity, 100% of young people. The aetiopathogenesis of acne is multifactorial. In all patients with acne, the following symptoms occur: excessive sebum production, excessive keratosis of excretory ducts and openings of sebaceous glands, development of bacterial flora and release of inflammatory mediators in the skin. Development of molecular biology, genetics and immunology contributed to a significant progress in studies on the pathogenesis of acne.

Skin microbiome differences relate to the grade of acne vulgaris

“…Acne is a chronic inflammatory skin disease, which affects approximately 80% of adolescents and young adults . Multiple factors, including inflammation, excess sebum, hormonal stimulation and microbial overgrowth, especially overgrowth of Cutibacterium acnes , are considered to be the main pathogenic agents of acne .…”

“…5 Multiple factors, including inflammation, excess sebum, hormonal stimulation and microbial overgrowth, especially overgrowth of Cutibacterium acnes, are considered to be the main pathogenic agents of acne. 5 Disease severity, which is dependent on the lesion type, quantity and size, is an important clinical feature for acne treatment and the evaluation of its curative effect, and the acne grading system is a standard used for the evaluation of acne severity. 6 However, very few studies have investigated the skin microbiome differences among patients with different grades of acne.…”

A Multifactorial Comparison of Ternary Combinations of Essential Oils in Topical Preparations to Current Antibiotic Prescription Therapies for the Control of Acne Vulgaris-Associated Bacteria.

“…Acne vulgaris, a chronic inflammatory disease of the pilosebaceous unit (Williams et al, ), affects approximately 80% of all 11–30 year olds (Bergler‐Czop, ). The disease manifests as seborrhoea, non‐inflammatory lesions (comedones), inflammatory lesions (papules, pustules, nodules and cysts), and scarring on the face, neck, chest and back (Williams et al, ), and is associated with substantial physical and psychological morbidity (Koo et al, ).…”

In Vitro Antimicrobial Activity of Essential Oils from Sardinian Flora against Cutibacterium (Formerly Propionibacterium) acnes and Its Enhancement by Chitosan

“…Acne vulgaris is a common skin disease that can affect people of all ages, with prevalence in up to 85% of teenagers and 11% of adults in Westernized populations [1][2][3]. It is a chronic multifactorial inflammatory disorder of the pilosebaceous follicles, typically affecting areas with the highest density of sebaceous follicles (face, upper chest and back), and is characterised by the presence of comedones, papular and pustular eruption, purulent cysts and scars [4]. Patients with acne present excessive sebum production, excessive keratosis of excretory ducts of sebaceous glands, development of bacterial flora and release of inflammatory mediators in the skin [4].…”

“…It is a chronic multifactorial inflammatory disorder of the pilosebaceous follicles, typically affecting areas with the highest density of sebaceous follicles (face, upper chest and back), and is characterised by the presence of comedones, papular and pustular eruption, purulent cysts and scars [4]. Patients with acne present excessive sebum production, excessive keratosis of excretory ducts of sebaceous glands, development of bacterial flora and release of inflammatory mediators in the skin [4]. Acne has a complex and multifactorial pathogenesis, involving different key factors: androgen-mediated stimulation of sebaceous gland activity, altered follicular keratinisation, hormonal imbalance, inflammation, immune hypersensitivity, environmental factor (season, diet) and colonisation of the bacterium Cutibacterium acnes (formerly Propionibacterium acnes) [2][3][4][5][6].…”