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Boletin Medico Del Hospital Infantil de... 2022Acne is a chronic inflammatory disease of the pilosebaceous unit with multifactorial etiology. Abnormal proliferation of keratinocytes, altered sebum production,... (Review)
Review
Acne is a chronic inflammatory disease of the pilosebaceous unit with multifactorial etiology. Abnormal proliferation of keratinocytes, altered sebum production, inflammation of the sebaceous follicle, and colonization by Cutibacterium acnes have been traditionally implicated. However, the diet has also been highlighted in the pathogenesis because of its direct relation with some biochemical markers and the transcription of specific genes associated with sebaceous gland activity, inflammation, and bacterial proliferation, which together promote the development of the disease, affect the severity of the condition, and modify its response to treatment.
Topics: Acne Vulgaris; Diet; Humans; Inflammation; Propionibacterium acnes; Sebum
PubMed: 35468121
DOI: 10.24875/BMHIM.21000088 -
Giornale Italiano Di Dermatologia E... Dec 2020Acne fulminans (AF) is a rare and severe form of inflammatory acne presenting clinically with an abrupt outburst of painful, hemorrhagic pustules and ulceration, that... (Review)
Review
Acne fulminans (AF) is a rare and severe form of inflammatory acne presenting clinically with an abrupt outburst of painful, hemorrhagic pustules and ulceration, that may or may not be associated with systemic symptoms, such as fever, polyarthritis, and laboratory abnormalities. It typically affects male teenagers with a pre-existing acne. Although the pathogenetic mechanism has not been established yet, a role of genetic, abnormal immunologic response, drugs intake, hormonal imbalance and viral infection, as causal factors, has been identified. AF may occur as a single disease or may be associated with other disorders. Traditionally, AF has been classified, on the basis of the presence of systemic involvement, in "acne fulminans" and acne fulminans "sine fulminans," when no systemic involvement is present. Recently, four clinical variants have been proposed: acne fulminans with systemic symptoms (AF-SS), acne fulminans without systemic symptoms (AF-WOSS), isotretinoin-induced acne fulminans with systemic symptoms (IIAF-SS), isotretinoin-induced acne fulminans without systemic symptoms (IIAF-WOSS). The diagnosis of AF is usually based on clinical history and physical examination. No specific laboratory abnormalities are generally found. In selected cases, biopsy and/or radiologic imaging are helpful for a correct diagnosis. The treatment significantly differs from severe acne according to severity of clinical presentation and possible systemic involvement. Currently, systemic corticosteroids (prednisolone) and retinoids (isotretinoin) represent the first choice of treatment. Dapsone, cyclosporine A, methotrexate, azathioprine, levamisole, and biological agents such as anakinra, infliximab, adalimumab may be considered as alternative therapies in selected cases. Adjunctive topical and physical therapies may also be considered.
Topics: Acne Vulgaris; Acquired Hyperostosis Syndrome; Adolescent; Adrenal Cortex Hormones; Adult; Androgens; Anti-Inflammatory Agents; Arthralgia; Combined Modality Therapy; Debridement; Dermatologic Agents; Diagnosis, Differential; Disease Progression; Female; Humans; Immunosuppressive Agents; Inflammation; Isotretinoin; Lasers, Dye; Low-Level Light Therapy; Male; Photochemotherapy; Propionibacteriaceae; Retinoids; Symptom Assessment; Young Adult
PubMed: 33084268
DOI: 10.23736/S0392-0488.20.06711-5 -
Cutibacterium acnes (Propionibacterium acnes) and acne vulgaris: a brief look at the latest updates.Journal of the European Academy of... Jun 2018While the commensal bacterium Propionibacterium acnes (P. acnes) is involved in the maintenance of a healthy skin, it can also act as an opportunistic pathogen in acne... (Review)
Review
While the commensal bacterium Propionibacterium acnes (P. acnes) is involved in the maintenance of a healthy skin, it can also act as an opportunistic pathogen in acne vulgaris. The latest findings on P. acnes shed light on the critical role of a tight equilibrium between members of its phylotypes and within the skin microbiota in the development of this skin disease. Indeed, contrary to what was previously thought, proliferation of P. acnes is not the trigger of acne as patients with acne do not harbour more P. acnes in follicles than normal individuals. Instead, the loss of the skin microbial diversity together with the activation of the innate immunity might lead to this chronic inflammatory condition. This review provides results of the most recent biochemical and genomic investigations that led to the new taxonomic classification of P. acnes renamed Cutibacterium acnes (C. acnes), and to the better characterisation of its phylogenetic cluster groups. Moreover, the latest data on the role of C. acnes and its different phylotypes in acne are presented, providing an overview of the factors that could participate in the virulence and in the antimicrobial resistance of acne-associated strains. Overall, this emerging key information offers new perspectives in the treatment of acne, with future innovative strategies focusing on C. acnes biofilms and/or on its acne-associated phylotypes.
Topics: Acne Vulgaris; Humans; Propionibacterium acnes
PubMed: 29894579
DOI: 10.1111/jdv.15043 -
Future Microbiology Mar 2023protects skin homeostasis. The species has three subspecies, and associations between subsp. and acne, subsp. and prostate cancer, and subsp. and progressive... (Review)
Review
protects skin homeostasis. The species has three subspecies, and associations between subsp. and acne, subsp. and prostate cancer, and subsp. and progressive macular hypomelanosis have recently been suggested. Different phylotypes/clonal complexes may cause prosthetic joint and other infections, and virulence factors such as fimbriae, biofilms, multidrug-resistance plasmids, porphyrin, Christie-Atkins-Munch-Petersen factors and cytotoxicity contribute to infections. Isolates are subtyped by multiplex PCR or multi- or single-locus sequence typing; however, these methods could be better synchronized. Resistance of acneic strains to macrolides (25.0-73.0%), clindamycin (10.0-59.0%) and tetracyclines (up to 37.0%) is worrisome, but susceptibility testing is now facilitated by European Committee on Antimicrobial Susceptibility Testing disk diffusion breakpoints. New therapeutic approaches include sarecycline, antimicrobial peptides and bacteriophages.
Topics: Male; Humans; Propionibacterium acnes; Acne Vulgaris; Skin; Biofilms; Plasmids
PubMed: 37042433
DOI: 10.2217/fmb-2022-0191 -
Archives of Dermatological Research Jul 2019Acne vulgaris is a cutaneous chronic inflammatory disorder with complex pathogenesis. Four factors play vital roles in acne pathophysiology: hyperseborrhea and... (Review)
Review
Acne vulgaris is a cutaneous chronic inflammatory disorder with complex pathogenesis. Four factors play vital roles in acne pathophysiology: hyperseborrhea and dysseborrhea, altered keratinization of the pilosebaceous duct, Cutibacterium acnes (C. acnes) and inflammation. The main hormones responsible for the development of acne vulgaris include androgens, insulin and insulin-like growth factor-1. Other factors involved in this process are corticotropin-releasing hormone, α-melanocyte-stimulating hormone and substance P. Wnt/β-catenin signaling pathway, phosphoinositide 3-kinase (PI3K)/Akt pathway, mitogen-activated protein kinase pathway, adenosine 5'-monophosphate-activated protein kinase pathway and nuclear factor kappa B pathway participate in the modulation of sebocyte, keratinocyte and inflammatory cell (e.g. lymphocytes, monocytes, macrophages, neutrophils) activity. Among all the triggers and pathways mentioned above, IGF-1-induced PI3K/Akt/Forkhead box protein O1/mammalian target of rapamycin (mTOR) C1 pathway is the most important signaling responsible for acne pathogenesis. Commonly used anti-acne agents include retinoids, benzoyl peroxide, antibiotics and hormonal agents (e.g. spironolactone, combination oral contraceptive and flutamide). New approaches including peroxisome proliferator-activated receptor γ modifier, melanocortin receptor antagonists, epigallocatechin-3-gallate, metformin, olumacostat glasaretil, stearoyl-CoA desaturase inhibitor omiganan pentahydrochloride, KPT, afamelanotide, apremilast and biologics have been developed as promising treatments for acne vulgaris. Although these anti-acne agents have various pharmacological effects against the diverse pathogenesis of acne, all of them have a synergistic mode of action, the attenuation of Akt/mTORC1 signaling and enhancement of p53 signal transduction. In addition to drug therapy, diet with no hyperglycemic carbohydrates, no milk and dairy products is also beneficial for treatment of acne.
Topics: Acne Vulgaris; Anti-Bacterial Agents; Dairy Products; Dermatologic Agents; Dietary Carbohydrates; Drug Synergism; Humans; Propionibacterium acnes; Sebaceous Glands; Sebum; Signal Transduction
PubMed: 30859308
DOI: 10.1007/s00403-019-01908-x -
F1000Research 2018The skin commensal , recently renamed , along with the other major pathophysiological factors of increased seborrhea, hyperkeratinization of the pilosebaceous unit, and... (Review)
Review
The skin commensal , recently renamed , along with the other major pathophysiological factors of increased seborrhea, hyperkeratinization of the pilosebaceous unit, and inflammation, has long been implicated in the pathogenesis of acne. Recent advances have contributed to our understanding of the role of in acne. Although there are no quantitative differences in of the skin of patients with acne compared with controls, the phylogenic groups display distinct genetic and phenotypic characteristics, biofilms are more frequent in acne, and different phylotypes may induce distinct immune responses in acne. plays a further important role in the homeostasis of the skin's microbiome, interacting with other cutaneous commensal or pathogenic microorganisms such as , , and species. In the era of increasing antimicrobial resistance, the selection of acne treatment targeting and the prevention of antibiotic resistance play a key role in improving outcomes in acne patients and public health.
Topics: Acne Vulgaris; Animals; Biofilms; Drug Resistance, Microbial; Gram-Positive Bacterial Infections; Humans; Microbiota; Propionibacterium acnes; Skin
PubMed: 30613388
DOI: 10.12688/f1000research.15659.1 -
Current Problems in Dermatology 2018Acne is based on a complex, multifactorial pathophysiology beginning with a microcomedo. Comedogenesis involves follicular hyperproliferation and disturbed... (Review)
Review
Acne is based on a complex, multifactorial pathophysiology beginning with a microcomedo. Comedogenesis involves follicular hyperproliferation and disturbed keratinization, hyperseborrhea and hyperplasia of sebaceous glands as well as disturbances in skin microbiome. Acne is treated with antibiotics, retinoids, keratolytics, hormonal and anti-inflammatory agents. Efficacy and side effects of given medications are well known. The uppermost layer of the stratum corneum is acidic. The low pH provides protection by slowing down the growth of some bacteria. Increase of skin surface pH leads to impaired barrier function, disturbances in skin microbiome and inflammation. Acne-predisposed skin is in a constant state of subclinical inflammation. Subclinical inflammation may be linked to changes in skin surface pH and disturbances of the stratum corneum, allowing microorganisms to stimulate the production of pro-inflammatory cytokines. Here, based on the current literature, the possible link between the skin surface pH, epidermal barrier function and acne is reviewed.
Topics: Acne Vulgaris; Aging; Animals; Female; Humans; Hydrogen-Ion Concentration; Male; Propionibacterium acnes; Sex Characteristics; Skin; Skin Pigmentation
PubMed: 30130780
DOI: 10.1159/000489525 -
International Journal of Medical... 2021Bacteria response to their environment by producing some compounds which are used in cosmetic and pharmaceutical applications. Some probiotics can regulate immune... (Randomized Controlled Trial)
Randomized Controlled Trial
Bacteria response to their environment by producing some compounds which are used in cosmetic and pharmaceutical applications. Some probiotics can regulate immune response and modulate the symptoms of several diseases. Bacteria affect skin response to skin care products. Bacteria are thought to play an important role in acne incidence, skin moisture, and nutrient metabolism, but only a few studies have focused on the extracts of in skin care. In this study, we identified that GMNL6 enhanced collagen synthesis and the gene expression of serine palmitoyltransferase small subunit A. Meanwhile, GMNL6 reduced the melanin synthesis, the biofilm of , and the proliferation of Information from clinical observation during the ointment for external face use in people displayed that the syndromes of skin moisture, skin color, spots, wrinkles, UV spots, and porphyrins were improved. The diversification of human skin microbiomes was affected by smearing the face of volunteers with -GMNL6. Understanding the potential mechanisms of the action of -GMNL6 in dermatologic conditions promotes the development of care products.
Topics: Adult; Animals; Biofilms; Cell Line, Tumor; Collagen; Female; Fibroblasts; Humans; Lactobacillus plantarum; Male; Mice; Microbiota; Middle Aged; Ointments; Probiotics; Propionibacteriaceae; Skin; Skin Care; Staphylococcus aureus; Treatment Outcome; Young Adult
PubMed: 33526970
DOI: 10.7150/ijms.51545 -
Trends in Microbiology Apr 2023
Topics: Propionibacterium acnes; Skin
PubMed: 36328874
DOI: 10.1016/j.tim.2022.10.006 -
Journal of the European Academy of... Apr 2024Acne vulgaris is a chronic inflammatory skin disease with a complex pathogenesis. Traditionally, the primary pathophysiologic factors in acne have been thought to be:... (Review)
Review
Acne vulgaris is a chronic inflammatory skin disease with a complex pathogenesis. Traditionally, the primary pathophysiologic factors in acne have been thought to be: (1) altered sebum production, (2) inflammation, (3) excess keratinization and (4) colonization with the commensal Cutibacterium acnes. However, the role of C. acnes has been unclear, since virtually all adults have C. acnes on their skin yet not all develop acne. In recent years, understanding of the role of C. acnes has expanded. It is still acknowledged to have an important place in acne pathogenesis, but evidence suggests that an imbalance of individual C. acnes phylotypes and an alteration of the skin microbiome trigger acne. In addition, it is now believed that Staphylococcus epidermidis is also an actor in acne development. Together, C. acnes and S. epidermidis maintain and regulate homeostasis of the skin microbiota. Antibiotics, which have long been a staple of acne therapy, induce cutaneous dysbiosis. This finding, together with the long-standing public health edict to spare antibiotic use when possible, highlights the need for a change in acne management strategies. One fertile direction of study for new approaches involves dermocosmetic products that can support epidermal barrier function and have a positive effect on the skin microbiome.
Topics: Humans; Acne Vulgaris; Skin; Microbiota; Dermatitis; Dysbiosis; Anti-Bacterial Agents; Propionibacterium acnes
PubMed: 37777343
DOI: 10.1111/jdv.19540