ACNE VULGARIS: A REVIEW ON PATHOPHYSIOLOGY AND TREATMENT
Abstract
ABSTRACT
Acne vulgaris is a disease associated with sebaceous follicle. It starts appearing after the onset of puberty and can extend up to 40-50 years of age. As
far as the pathogenesis of acne is concerned, it is not fully understood up till now. Treatment of acne is very frustrating and involves an understanding
of etiopathological factors. This review focuses on various factors accountable, pathogenesis, and therapy of acne.
Keywords: Acne, Skin diseases, Acne therapy, Propionibacterium acnes, Acne vulgaris.
Downloads
References
REFERENCES
Kaur D, Prasad SB. Anti acne activity of acetone extract of Plumbago
indica root. Asian J Pharm Clin Res 2016;9(2):285-7.
Gupta MA, Gupta AK. Depression and suicidal ideation in dermatology
patients with acne, alopecia areata, atopic dermatitis and psoriasis. Br J
Dermatol 1998;139(5):846-50.
Cunliffe WJ. Natural history of acne. In: Cunliffe WJ, editor. Acne.
London: Martin Dunitz; 1989. p. 2-10.
Gollnick HP, Zouboulis CC, Akamatsu H, Kurokawa I, Schulte A.
Pathogenesis and pathogenesis related treatment of acne. J Dermatol
;18(9):489-99.
Harris HH, Downing DT, Stewart ME, Strauss JS. Sustainable rates of
sebum secretion in acne patients and matched normal control subjects.
J Am Acad Dermatol 1983;8(2):200-3.
Blauer M, Vaalasti A, Pauli SL, Ylikomi T, Joensuu T, Tuohimaa P.
Location of androgen receptor in human skin. J Invest Dermatol
;97(2):264-8.
Choudhry R, Hodgins MB, Van der Kwast TH, 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
;133(3):467-75.
Thigpen AE, Silver RI, Guileyardo JM, Casey ML, McConnell JD,
Russell DW. Tissue distribution and ontogeny of steroid 5a-reductase
isozyme expression. J Clin Invest 1993;92(2):903-10.
Luu-The V, Sugimoto Y, Puy L, Labrie Y, Lopez-Solache I, Singh M,
et al. Characterization, expression, and immunohistochemical
localization of 5-a-reductase in human skin. J Invest Dermatol
;102(2):221-6.
Thiboutot D, Harris G, Iles V, Cimis G, Gilliland K, Hagari S.
Activity of the type I 5 a-reductase exhibits regional differences
in isolated sebaceous glands and whole skin. J Invest Dermatol
;105(2):209-14.
Chen W, Zouboulis CC, Orfanos CE. The 5 areductase system and its
inhibitors: Recent development and its perspective in treating androgendependent
skin disorders. Dermatology 1996;193(3):177-84.
Zouboulis CC, Seltmann H, Hiroi N, Chen W, Young M, Oeff M,
et al. Corticotropin-releasing hormone: An autocrine hormone that
promotes lipogenesis in human sebocytes. Proc Natl Acad Sci U S A
;99(10):7148-53.
Orth DN, Kovacs WJ. The adrenal cortex. In: Wilson JD, Foster DW,
Kronenberg HM, Larsen PR, editors. Williams Textbook of
Endocrinology. Philadelphia, PA: WB. Saunders; 1998. p. 517-664.
Zouboulis CC, Xia L, Akamatsu H, Seltmann H, Fritsch M,
Hornemann S, et al. The human sebocyte culture model provides new
insights into development and management of seborrhoea and acne.
Dermatology 1998;196(1):21-31.
Leyden J, Bergfeld W, Drake L, Dunlap F, Goldman MP, Gottlieb AB,
et al. A systemic type I 5 alpha-reductase inhibitor is ineffective in the
treatment of acne vulgaris. J Am Acad Dermatol 2004;50(3):443-7.
Placzek M, Arnold B, Schmidt H, Gaube S, Keller E, Plewig G, et al.
Elevated 17-hydroxyprogesterone serum values in male patients with
acne. J Am Acad Dermatol 2005;53(6):955-8.
Zouboulis CC, Böhm M. Neuroendocrine regulation of sebocytes - A
pathogenetic link between stress and acne. Exp Dermatol
;13 Suppl 4:31-5.
Weeks JG, McCarty L, Black T, Fulton JE Jr. The inability of a
bacterial lipase inhibitor to control acne vulgaris. J Invest Dermatol
;69(2):236-43.
Downing DT, Stewart ME, Wertz PW, Strauss JS. Essential fatty acids
and acne. J Am Acad Dermatol 1986;14:221-5.
Zouboulis C. Update on sebaceous gland physiology: Induction of
inflammation and its clinical implications. JEADV 2001;15 Suppl 2:102.
Guy R, Kealey T. Modelling the infundibulum in acne. Dermatology
;196(1):32-7.
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
;98(6):895-901.
Eller MS, Yaar M, Ostrom K, Harkness DD, Gilchrest BA. A role for
interleukin-1 in epidermal differentiation: Regulation by expression of
functional versus decoy receptors. J Cell Sci 1995;108:2741-6.
Akamatsu H, Horio T. The possible role of reactive oxygen species
generated by neutrophils in mediating acne inflammation. Dermatology
;196(1):82-5.
Marples RR, McGinley KJ. Corynebacterium acnes and other anaerobic
diphtheroids from human skin. J Med Microbiol 1974;7(3):349-57.
Holland KT. Microbiology of acne. In: Cunliffe WJ, editor. Acne.
London: Martin Dunitz; 1989. p. 178-210.
Leyden JJ, McGinley KJ, Mills OH, Kligman AM. Age-related changes
in the resident bacterial flora of the human face. J Invest Dermatol
;65(4):379-81.
McGinley KJ, Webster GF, Ruggieri MR, Leyden JJ. Regional
variations in density of cutaneous propionibacteria: Correlation of
Propionibacterium acnes populations with sebaceous secretion. J Clin
Microbiol 1980;12(5):672-5.
Eady EA, Ingham E. Propionibacterium acnes – Friend or foe. Rev Med
Microbiol 1994;5(3):163-73.
Webster GF, Leyden JJ, Musson RA, Douglas SD. Susceptibility
of Propionibacterium acnes to killing and degradation by human
neutrophils and monocytes in vitro. Infect Immun 1985;49(1):116-21.
Kirschbaum JO, Kligman AM. The pathogenic role of Corynebacterium
acnes in acne vulgaris. Arch Dermatol 1963;88:832-3.
Eady EA, Cove JH, Holland KT, Cunliffe WJ. Erythromycin resistant
propionibacteria in antibiotic treated acne patients: Association with
therapeutic failure. Br J Dermatol 1989;121(1):51-7.
Holland KT, Holland DB, Cunliffe WJ, Cutcliffe AG. Detection of
Propionibacterium acnes polypeptides which have stimulated an
immune response in acne patients but not in normal individuals. Exp
Dermatol 1993;2(1):12-6.
Layton AM, Morris C, Cunliffe WJ, Ingham E. Immunohistochemical
investigation of evolving inflammation in lesions of acne vulgaris. Exp
Dermatol 1998;7(4):191-7.
Herane MI, Ando I. Acne in infancy and acne genetics. Dermatology
;206(1):24-8.
Jeremy AH, Holland DB, Roberts SG, Thomson KF, Cunliffe WJ.
Inflammatory events are involved in acne lesion initiation. J Invest
Dermatol 2003;121(1):20-7.
Zouboulis CC, Nestoris S, Adler YD, Orth M, Orfanos CE, Picardo M,
et al. A new concept for acne therapy: A pilot study with zileuton, an
oral 5-lipoxygenase inhibitor. Arch Dermatol 2003;139(5):668-70.
Krowchuk DP, Stancin T, Keskinen R, Walker R, Bass J, Anglin TM.
The psychosocial effects of acne on adolescents. Pediatr Dermatol
;8(4):332-8.
Degitz K, Placzek M, Arnold B, Plewig G. Endokrinologische Aspekte
bei Akne. In: Plewig G, Degitz K, editors. (Hrsg): Fortschritte Der
Praktischen Dermatologie Und Venerologie. Vol. 17. Berlin: Springer;
p. 172-9.
Cunliffe WJ. Acne and unemployment. Br J Dermatol 1986;115(3):386.
Simpson NB. Social and economic aspects of acne and the cost-
effectiveness of isotretinoin. J Dermatol Treat 1993;4 Suppl 2:S6-9.
Burke BM, Cunliffe WJ. The assessment of acne vulgaris--the Leeds
technique. Br J Dermatol 1984;111(1):83-92.
Harkaway KS, McGinley KJ, Foglia AN, Lee WL, Fried F, Shalita AR,
et al. Antibiotic resistance patterns in coagulase-negative staphylococci
after treatment with topical erythromycin, benzoyl peroxide, and
combination therapy. Br J Dermatol 1992;126(6):586-90.
Cunliffe WJ, Holland KT. Clinical and laboratory studies on treatment
with 20% azelaic acid cream for acne. Acta Derm Venereol Suppl
(Stockh) 1989;143:31-4.
Lipson AH, Collins F, Webster WS. Multiple congenital defects
associated with maternal use of topical tretinoin. Lancet
;341(8856):1352-3.
Jick SS, Terris BZ, Jick H. First trimester topical tretinoin and congenital
disorders. Lancet 1993;341(8854):1181-2.
Eady EA, Cove JH, Joanes DN, Cunliffe WJ. Topical antibiotics for
Asian J Pharm Clin Res, Vol 9, Issue 4, 2016, 54-59
Prasad
the treatment of acne vulgaris: A critical evaluation of the literature
on their clinical benefit and comparative efficacy. J Dermatol Treat
;1:215-26.
Eady EA, Jones CE, Tipper JL, Cove JH, Cunliffe WJ, Layton AM.
Antibiotic resistant propionibacteria in acne: Need for policies to
modify antibiotic usage. BMJ 1993;306(6877):555-6.
Darley CR, Moore JW, Besser GM, Munro DD, Edwards CRW,
Rees LH, et al. Androgen status in women with late onset or persistent
acne vulgaris. Clin Exp Dermatol 1984;9:28-35.
Greenwood R, Brummitt L, Burke B, Cunliffe WJ. Acne: Double
blind clinical and laboratory trial of tetracycline, oestrogencyproterone
acetate,
and
combined treatment.
Br
Med J (Clin Res Ed)
;291(6504):1231-5.
Hammerstein J, Meckies J, Leo-Rossberg I, Moltz L, Zielske F. Use
of cyproterone acetate (CPA) in the treatment of acne, hirsutism, and
virilism. J Steroid Biochem 1975;6(6):827-36.
Bottomley WW, Yip J, Knaggs H, Cunliffe WJ. Treatment of closed
comedones--comparisons of fulguration with topical tretinoin and
electrocautery with fulguration. Dermatology 1993;186(4):253-7.
Vahlquist A, Rollman O, Holland DB, Cunliffe WJ. Isotretinoin
treatment of severe acne affects the endogenous concentration of
vitamin A in sebaceous glands. J Invest Dermatol 1990;94(4):496-8.
Rademaker M, Wallace M, Cunliffe W, Simpson NB. Isotretinoin
treatment alters steroid metabolism in women with acne. Br J Dermatol
;124(4):361-4.
Perkins W, Crocket KV, Hodgins MB, Mackie RM, Lackie JM. The
effect of treatment with 13-cis-retinoic acid on the metabolic burst of
peripheral blood neutrophils from patients with acne. Br J Dermatol
;124(5):429-32.
Layton AM, Cunliffe WJ. Guidelines for optimal use of isotretinoin in
acne. J Am Acad Dermatol 1992;27:S2-7.
Layton AM, Knaggs H, Taylor J, Cunliffe WJ. Isotretinoin for acne
vulgaris--10 years later: A safe and successful treatment. Br J Dermatol
;129(3):292-6.
Cunliffe WJ, Gray JA, Macdonald-Hull S, Hughes BR, Calvert RT,
Burnside CJ, et al. Cost effectiveness of isotretinoin. J Dermatol Treat
;1:285-8.
Walker BR, MacKie RM. Serum lipid elevation during isotretinoin
therapy for acne in the west of Scotland. Br J Dernsatol
;122(4):531-7.
Published
How to Cite
Issue
Section
The publication is licensed under CC By and is open access. Copyright is with author and allowed to retain publishing rights without restrictions.