Acne vulgaris, commonly known as acne or pimples, is a
common skin disorder that plagues about 85% to 100% of people at some time
during their lives. It affects people of every age, gender and race, although
it is more evident in teenagers. Acne vulgaris is actually characterized by
non-inflammatory follicular papules or comedones as well as by inflammatory
papules, pustules, and nodules in its more acute forms.
Acne vulgaris occurs as it affects the areas of the skin
with the densest population of sebaceous follicles. The common areas affected
are the face, neck, upper part of the chest, and the back, although it may also
appear on different parts of the body like the head and the genital area.
Numerous studies have noted that there are generally four major factors that
are responsible for the development of an acne lesion.
The pathogenesis of acne vulgaris is deemed multifactorial
due to this finding. These four factors that trigger the development of acne
vulgaris include the follicular epidermal hyperproliferation and
hyperkeratinization, excess sebum, propionibacterium acnes, and inflammation.
The follicular epidermal hyperproliferation and hyperkeratinization actually
appears to be one of the main events in the formation and development of acne
vulgaris.
The findings have noted that the increasing levels of the adrenally
derived androgen dehydropiandrosterone sulfate (DHEAS) are correlated with the
emergence of the microcomedo, which is actually the primary acne vulgaris
lesion. This development may then aggravate the follicular epidermal
hyperproliferation, which may also be stimulated by an alteration in sebum and
lipid levels in the acne vulgaris lesions. Excess sebum is the second factor in
the formation of acne vulgaris. It plays its role as the hormonal changes
greatly trigger the formation of acne vulgaris.
Then, there is the P. acnes,
which is a microaerophilic organism found in many acne vulgaris lesions. It
basically stimulates inflammation by emitting proinflammatory mediators that
disperse through the follicle wall. Some findings also note that
hypersensitivity to P. acnes can explain why many of the people develop
inflammatory acne vulgaris.
Finally, recent studies have shown that inflammation may be
a primary or secondary phenomenon in the development of acne vulgaris. Its
secondary inflammatory response has been shown on its association to P. acnes.
However, the proinflammatory cytokines IL-1a expression has been recognized in
the microcomedone, which may play a large role in the formation of acne
vulgaris.
Acne vulgaris, through recent findings, has been found out to cause
physical pain and psychological suffering. It can even lead to scarring which
may last for a lifetime, and certain illness like fever and arthritis may
result from it.
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