Download Acne Vulgaris by Alan R. Shalita, James Q. Del Rosso, Guy Webster PDF

By Alan R. Shalita, James Q. Del Rosso, Guy Webster

The American pimples and Rosacea Society is devoted to advancing the technological know-how regarding zits and rosacea and to bettering verbal exchange among these attracted to those illnesses. this article isn't really intended to be a complete treatise on all facets of pimples, yet really to handle significant sights by way of stated inspiration leaders within the box within the desire that it'll bring about additional study, dialogue, and refinement of our options of either the pathogenesis and the remedy of acne.

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THE ROLE OF ANDROGENS IN COMEDOGENESIS Androgens influence various cutaneous functions, including sebaceous gland growth and differentiation, hair growth, epidermal barrier function, and wound healing. They play a central role in the stimulation of sebum production and keratinocyte proliferation (32,33). Prohormone androgens, primarily produced in the gonads and adrenal glands, are converted in the skin to the more potent testosterone and dihydrotestosterone (DHT). Type 1 5a-reductase, which is located within both the infrainfundibulum part of the duct and the sebaceous gland, catalyzes the 32 COMEDOGENESIS cutaneous conversion of testosterone to the more potent DHT (34).

THE ROLE OF INFLAMMATION IN COMEDOGENESIS Inflammation had generally been considered a secondary event in acne pathogenesis until it was demonstrated that inflammatory events in fact occur in the earliest stage of acne lesion development (17). Inflammatory markers can be detected even before hyperproliferation and abnormal differentiation of keratinocytes. The role of IL-1a in cutaneous inflammation and keratinocyte proliferation has since been closely studied. IL-1a is present in the perifollicular epidermis of uninvolved skin in acne patients before hyperproliferation or abnormal differentiation of the follicular epithelium takes place (17).

14. Blumenberg M, Komine M, Rao L, et al. Blueprint to footprint to toeprint to culprit: regulation of K6 keratin gene promoter by extracellular signals and nuclear tran scription factors. J Invest Dermatol 1998; 110:495. 15. Jiang CK, Flanagan S, Ohtsuki M, et al. Disease activated transcription factor: allergic reactions in human skin cause nuclear translocation of STAT 91 and induce synthesis of keratin 17. Mol Cell Biol 1994; 14:4759 4769. 16. Burkhart CG, Burkhart CN. Expanding the microcomedone theory and acne thera peutics: Propionibacterium acnes biofilm produces biological glue that holds corneocytes that form plug.

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