Aspectos fisiopatológicos del acné
DOI:
https://doi.org/10.29176/2590843X.271Palabras clave:
acné vulgar, fisiopatología, ácido linoleico, receptores toll like, Propionibacterium acnesResumen
El acné es una de las enfermedades más comunes en la consulta dermatológica, es más frecuente en jóvenes y se caracteriza por la presencia de pápulas, comedones y quistes en cara, pecho y espalda. En este artículo se exponen los mecanismos conocidos de la fisiopatología con énfasis en su aspecto molecular, para un mayor entendimiento por parte del médico clínico, que permitirá un mejor abordaje terapéutico en los pacientes con esta enfermedad.
Biografía del autor/a
Arturo Argote
Médico dermatólogo; profesor, Fundación Universitaria Ciencias de la Salud, Hospital San José: jefe, Servicio de Dermatología, Clínica Reina Sofía, Bogotá, D.C., Colombia
Óscar Eduardo Mora
Médico dermatólogo; jefe, Programa de Dermatología, Fundación Universitaria de Ciencias de la Salud, Bogotá, D.C., Colombia
Laura Camila González
Médica, residente de tercer año de Dermatología, Fundación Universitaria de Ciencias de la Salud, Bogotá, D.C., Colombia
Juliana Marcela Zapata
Médica, residente de tercer año de Dermatología, Fundación Universitaria de Ciencias de la Salud, Bogotá, D.C., Colombia
Daniel Uribe
Médico, Fundación Universitaria de Ciencias de la Salud, Bogotá, D.C., Colombia
Referencias bibliográficas
1. Bhambri S, Del Rosso JQ, Bhambri A. Pathogenesis of acne vulgaris: Recent advances. J Drugs Dermatol. 2009;8:615-8.
2. Gollnick H. Current concepts of the pathogenesis of acne: Implications for drug treatment. Drugs. 2003;63:1579-96.
3. Thiboutot D, Gollnick H, Bettoli V, Dreno B, Kang S, Leyden JJ, et al. New insights into the management of acne: An update from the Global Alliance to Improve Outcomes in Acne group. J Am Acad Dermatol. 2009;60:S1-50.
4. Degitz K, Placzek M, Borelli C, Plewig G. Pathophysiology of acne. J Dtsch Dermatol Ges. 2007;5:316-23.
5. Orozco B, Campo M, Anaya L, Atuesta J, Ávila M, Balcázar L, et al. Guías colombianas para el manejo del acné: una revisión basada en la evidencia por el Grupo Colombiano de Estudio en Acné. Rev Asoc Colomb Dermatol. 2011;19:129-57.
6. Kurokawa I, Danby FW, Ju Q, Wang X, Xiang LF, Xia L, et al. New developments in our understanding of acne pathogenesis and treatment. Exp Dermatol. 2009;18;821-32.
7. Bellew S, Thiboutot D, Del Rosso JQ. Pathogenesis of acne vulgaris: What’s new, what’s interesting and what may be clinically relevant. J Drugs Dermatol. 2011;10:582-5.
8. Toyoda M, Morohashi M. Pathogenesis of acne. Med Electron Microsc. 2001;34:29-40.
9. Youn SW. The role of facial sebum secretion in acne pathogenesis: Facts and controversies. Clin Dermatol. 2010;28:8-11.
10. Makrantonaki E, Ganceviciene R, Zouboulis C. An update on the role of the sebaceous gland in the pathogenesis of acne. Dermatoendocrinol. 2011;3:41-9.
11. Ottaviani M, Camera E, Picardo M. Lipid mediators in acne. Mediators Inflamm. 2010;2010.
12. Downie MM, Guy R, Kealey T. Advances in sebaceous gland research: Potential new approaches to acne management. Int J Cosmet Sci. 2004;26:291-311.
13. Sertznig P, Seifert M, Tilgen W, Reichrath J. Peroxisome proliferator-activated receptors (PPAR) and the human skin. Am J Clin Dermatol. 2008;9:15-31.
14. Sertznig P, Reichrath J. Peroxisome proliferator-activated receptors (PPARs) in dermatology: Challenge and promise. Dermatoendocrinol. 2011;3:130-5.
15. Cunliffe WJ, Holland DB, Jeremy A. Comedone formation: Etiology, clinical presentation, and treatment. Clin Dermatol. 2004;22:367-74.
16. Wang KC, Zane LT. Recent advances in acne vulgaris research: Insights and clinical implications. Adv Dermatol. 2008;24:197-209
17. Sarici G, Cinar S, Armutcu F, Altinyazar C, Koca R, Tekin NS. Oxidative stress in acne vulgaris. J Eur Acad Dermatol Venereol. 2010;24:763-7.
18. Yosipovitch G, Tang M, Dawn AG, Chen M, Goh CL, Huak Y, et al. Study of psychological stress, sebum production and acne vulgaris in adolescents. Acta Derm Venereol. 2007;87:135-9.
19. Bruggemann H. Insights in the pathogenic potential of Propionibacterium acnes from its complete genome. Semin Cutan Med Surg. 2005;24:67-72.
20. Burkhart CN, Gottwald L. Assessment of etiologic agents in acne pathogenesis. Skinmed. 2003;2:222-8.
21. Coenye T, Honraet K, Rossel B, Nelis HJ. Biofilms in skin infections: Propionibacterium acnes and acne vulgaris. Infect Disord Drug Targets. 2008:8:156-9.
22. Farrar MD, Ingham E. Acne: Inflammation. Clin Dermatol. 2004;22:380-4.
23. Ganceviciene R, Bohm M, Fimmel S, Zouboulis CC. The role of neuropeptides in the multifactorial pathogenesis of acne vulgaris. Dermatoendocrinol. 2009;1:170-6.
24. Heymann WR. Toll-like receptors in acne vulgaris. J Am Acad Dermatol. 2006;55:691-2.
25. Taylor M, González M, Porter R. Pathways to inflammation: Acne pathophysiology. Eur J Dermatol. 2011;21:323-33.
26. Holland DB, Jeremy AH. The role of inflammation in the pathogenesis of acne and acne scarring. Semin Cutan Med Surg. 2005;24:79-83.
27. Dessinioti C, Katsambas AD. The role of Propionibacterium acnes in acne pathogenesis: Facts and controversies. Clin Dermatol. 2010;28:2-7.
28. Jappe U. Pathological mechanisms of acne with special emphasis on Propionibacterium acnes and related therapy. Acta Derm Venereol. 2003;83:241-8.
29. Blanken R, van Voorst Vader PC. Acne: Pathogenesis and therapy. Ned Tijdschr Geneeskd. 1983;127:1297-303.
30. Bojar RA, Holland KT. Acne and Propionibacterium acnes. Clin Dermatol. 2004;22:375-9.
31. Zouboulis CC. Propionibacterium acnes and sebaceous lipogenesis: A love-hate relationship? J Invest Dermatol. 2009;129:2093-6.
32. McInturff JE, Kim J. The role of toll-like receptors in the pathophysiology of acne. Semin Cutan Med Surg. 2005;24:73-8.
33. Kim J. Review of the innate immune response in acne vulgaris: Activation of Toll-like receptor 2 in acne triggers inflammatory cytokine responses. Dermatology. 2005;211;193-8.
34. Akira S, Takeda K, Kaisho T, Akira S. Toll-like receptors. Annu Rev Immunol. 2003;21:335-76.
35. Katsambas AD, Dessinioti C. Hormonal therapy for acne: Why not as first line therapy? Facts and controversies. Clin Dermatol. 2010;28;17-23.
36. Olutunmbi Y, Paley K, English JC III. Adolescent female acne: Etiology and management. J Pediatr Adolesc Gynecol. 2008;21:171-6.
37. Thiboutot D. Acne: Hormonal concepts and therapy. Clin Dermatol. 2004;22:419-28.
38. Shaw JC. Acne: Effect of hormones on pathogenesis and management. Am J Clin Dermatol. 2002;3:571-8.
39. Zouboulis CC. Acne and sebaceous gland function. Clin Dermatol. 2004;22:360-6.
40. Melnik BC. The role of transcription factor FoxO1 in the pathogenesis of acne vulgaris and the mode of isotretinoin action. G Ital Dermatol Venereol. 2010;145:559-67.
41. Davidovici BB, Wolf R. The role of diet in acne: Facts and controversies. Clin Dermatol. 2010;28:12-6.
42. Spencer EH, Ferdowsian HR, Barnard ND. Diet and acne: A review of the evidence. Int J Dermatol. 2009;48:339-47.
43. Melnik BC, Schmitz G. Role of insulin, insulin-like growth factor-1, hyperglycaemic food and milk consumption in the pathogenesis of acne vulgaris. Exp Dermatol. 2009;18:833-41.
44. Melnik B, Schmitz G. FGFR2 signaling and the pathogenesis of acne. J Dtsch Dermatol Ges. 2008;6:721-8.
45. Melnik BC, Schmitz G, Zouboulis CC. Anti-acne agents attenuate FGFR2 signal transduction in acne. J Invest Dermatol. 2009;129:1868-77.
46. Beylot C. Mechanisms and causes of acne. Rev Prat. 2002;52:828-30.
47. Pappas A, Johnsen S, Liu JC, Eisinger M. Sebum analysis of individuals with and without acne. Dermatoendocrinol. 2009;1:157-61.
48. Wang F, Kwak HS, Elbuluk N, Kaczmarek AL, Hamilton T, Voorhees JJ, et al. Retinoic acid 4-hydroxylase inducibility and clinical response to isotretinoin in patients with acne. J Am Acad Dermatol. 2009;61:252-8.
49. Lee DD, Stojadinovic O, Krzyzanowska A, Vouthounis C, Blumenberg M, Tomic-Canic M. Retinoid-responsive transcriptional changes in epidermal keratinocytes. J Cell Physiol. 2009;220:427-39.
50. Lefebvre P, Martin PJ, Flajollet S, Dedieu S, Billaut X, Lefebvre B. Transcriptional activities of retinoic acid receptors. Vitam Horm. 2005;70:199-264.
2. Gollnick H. Current concepts of the pathogenesis of acne: Implications for drug treatment. Drugs. 2003;63:1579-96.
3. Thiboutot D, Gollnick H, Bettoli V, Dreno B, Kang S, Leyden JJ, et al. New insights into the management of acne: An update from the Global Alliance to Improve Outcomes in Acne group. J Am Acad Dermatol. 2009;60:S1-50.
4. Degitz K, Placzek M, Borelli C, Plewig G. Pathophysiology of acne. J Dtsch Dermatol Ges. 2007;5:316-23.
5. Orozco B, Campo M, Anaya L, Atuesta J, Ávila M, Balcázar L, et al. Guías colombianas para el manejo del acné: una revisión basada en la evidencia por el Grupo Colombiano de Estudio en Acné. Rev Asoc Colomb Dermatol. 2011;19:129-57.
6. Kurokawa I, Danby FW, Ju Q, Wang X, Xiang LF, Xia L, et al. New developments in our understanding of acne pathogenesis and treatment. Exp Dermatol. 2009;18;821-32.
7. Bellew S, Thiboutot D, Del Rosso JQ. Pathogenesis of acne vulgaris: What’s new, what’s interesting and what may be clinically relevant. J Drugs Dermatol. 2011;10:582-5.
8. Toyoda M, Morohashi M. Pathogenesis of acne. Med Electron Microsc. 2001;34:29-40.
9. Youn SW. The role of facial sebum secretion in acne pathogenesis: Facts and controversies. Clin Dermatol. 2010;28:8-11.
10. Makrantonaki E, Ganceviciene R, Zouboulis C. An update on the role of the sebaceous gland in the pathogenesis of acne. Dermatoendocrinol. 2011;3:41-9.
11. Ottaviani M, Camera E, Picardo M. Lipid mediators in acne. Mediators Inflamm. 2010;2010.
12. Downie MM, Guy R, Kealey T. Advances in sebaceous gland research: Potential new approaches to acne management. Int J Cosmet Sci. 2004;26:291-311.
13. Sertznig P, Seifert M, Tilgen W, Reichrath J. Peroxisome proliferator-activated receptors (PPAR) and the human skin. Am J Clin Dermatol. 2008;9:15-31.
14. Sertznig P, Reichrath J. Peroxisome proliferator-activated receptors (PPARs) in dermatology: Challenge and promise. Dermatoendocrinol. 2011;3:130-5.
15. Cunliffe WJ, Holland DB, Jeremy A. Comedone formation: Etiology, clinical presentation, and treatment. Clin Dermatol. 2004;22:367-74.
16. Wang KC, Zane LT. Recent advances in acne vulgaris research: Insights and clinical implications. Adv Dermatol. 2008;24:197-209
17. Sarici G, Cinar S, Armutcu F, Altinyazar C, Koca R, Tekin NS. Oxidative stress in acne vulgaris. J Eur Acad Dermatol Venereol. 2010;24:763-7.
18. Yosipovitch G, Tang M, Dawn AG, Chen M, Goh CL, Huak Y, et al. Study of psychological stress, sebum production and acne vulgaris in adolescents. Acta Derm Venereol. 2007;87:135-9.
19. Bruggemann H. Insights in the pathogenic potential of Propionibacterium acnes from its complete genome. Semin Cutan Med Surg. 2005;24:67-72.
20. Burkhart CN, Gottwald L. Assessment of etiologic agents in acne pathogenesis. Skinmed. 2003;2:222-8.
21. Coenye T, Honraet K, Rossel B, Nelis HJ. Biofilms in skin infections: Propionibacterium acnes and acne vulgaris. Infect Disord Drug Targets. 2008:8:156-9.
22. Farrar MD, Ingham E. Acne: Inflammation. Clin Dermatol. 2004;22:380-4.
23. Ganceviciene R, Bohm M, Fimmel S, Zouboulis CC. The role of neuropeptides in the multifactorial pathogenesis of acne vulgaris. Dermatoendocrinol. 2009;1:170-6.
24. Heymann WR. Toll-like receptors in acne vulgaris. J Am Acad Dermatol. 2006;55:691-2.
25. Taylor M, González M, Porter R. Pathways to inflammation: Acne pathophysiology. Eur J Dermatol. 2011;21:323-33.
26. Holland DB, Jeremy AH. The role of inflammation in the pathogenesis of acne and acne scarring. Semin Cutan Med Surg. 2005;24:79-83.
27. Dessinioti C, Katsambas AD. The role of Propionibacterium acnes in acne pathogenesis: Facts and controversies. Clin Dermatol. 2010;28:2-7.
28. Jappe U. Pathological mechanisms of acne with special emphasis on Propionibacterium acnes and related therapy. Acta Derm Venereol. 2003;83:241-8.
29. Blanken R, van Voorst Vader PC. Acne: Pathogenesis and therapy. Ned Tijdschr Geneeskd. 1983;127:1297-303.
30. Bojar RA, Holland KT. Acne and Propionibacterium acnes. Clin Dermatol. 2004;22:375-9.
31. Zouboulis CC. Propionibacterium acnes and sebaceous lipogenesis: A love-hate relationship? J Invest Dermatol. 2009;129:2093-6.
32. McInturff JE, Kim J. The role of toll-like receptors in the pathophysiology of acne. Semin Cutan Med Surg. 2005;24:73-8.
33. Kim J. Review of the innate immune response in acne vulgaris: Activation of Toll-like receptor 2 in acne triggers inflammatory cytokine responses. Dermatology. 2005;211;193-8.
34. Akira S, Takeda K, Kaisho T, Akira S. Toll-like receptors. Annu Rev Immunol. 2003;21:335-76.
35. Katsambas AD, Dessinioti C. Hormonal therapy for acne: Why not as first line therapy? Facts and controversies. Clin Dermatol. 2010;28;17-23.
36. Olutunmbi Y, Paley K, English JC III. Adolescent female acne: Etiology and management. J Pediatr Adolesc Gynecol. 2008;21:171-6.
37. Thiboutot D. Acne: Hormonal concepts and therapy. Clin Dermatol. 2004;22:419-28.
38. Shaw JC. Acne: Effect of hormones on pathogenesis and management. Am J Clin Dermatol. 2002;3:571-8.
39. Zouboulis CC. Acne and sebaceous gland function. Clin Dermatol. 2004;22:360-6.
40. Melnik BC. The role of transcription factor FoxO1 in the pathogenesis of acne vulgaris and the mode of isotretinoin action. G Ital Dermatol Venereol. 2010;145:559-67.
41. Davidovici BB, Wolf R. The role of diet in acne: Facts and controversies. Clin Dermatol. 2010;28:12-6.
42. Spencer EH, Ferdowsian HR, Barnard ND. Diet and acne: A review of the evidence. Int J Dermatol. 2009;48:339-47.
43. Melnik BC, Schmitz G. Role of insulin, insulin-like growth factor-1, hyperglycaemic food and milk consumption in the pathogenesis of acne vulgaris. Exp Dermatol. 2009;18:833-41.
44. Melnik B, Schmitz G. FGFR2 signaling and the pathogenesis of acne. J Dtsch Dermatol Ges. 2008;6:721-8.
45. Melnik BC, Schmitz G, Zouboulis CC. Anti-acne agents attenuate FGFR2 signal transduction in acne. J Invest Dermatol. 2009;129:1868-77.
46. Beylot C. Mechanisms and causes of acne. Rev Prat. 2002;52:828-30.
47. Pappas A, Johnsen S, Liu JC, Eisinger M. Sebum analysis of individuals with and without acne. Dermatoendocrinol. 2009;1:157-61.
48. Wang F, Kwak HS, Elbuluk N, Kaczmarek AL, Hamilton T, Voorhees JJ, et al. Retinoic acid 4-hydroxylase inducibility and clinical response to isotretinoin in patients with acne. J Am Acad Dermatol. 2009;61:252-8.
49. Lee DD, Stojadinovic O, Krzyzanowska A, Vouthounis C, Blumenberg M, Tomic-Canic M. Retinoid-responsive transcriptional changes in epidermal keratinocytes. J Cell Physiol. 2009;220:427-39.
50. Lefebvre P, Martin PJ, Flajollet S, Dedieu S, Billaut X, Lefebvre B. Transcriptional activities of retinoic acid receptors. Vitam Horm. 2005;70:199-264.
Cómo citar
1.
Argote A, Mora Óscar E, González LC, Zapata JM, Uribe D. Aspectos fisiopatológicos del acné. rev. asoc. colomb. dermatol. cir. dematol. [Internet]. 1 de julio de 2014 [citado 20 de abril de 2024];22(3):200-6. Disponible en: https://revista.asocolderma.org.co/index.php/asocolderma/article/view/271
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2014-07-01
Cómo citar
1.
Argote A, Mora Óscar E, González LC, Zapata JM, Uribe D. Aspectos fisiopatológicos del acné. rev. asoc. colomb. dermatol. cir. dematol. [Internet]. 1 de julio de 2014 [citado 20 de abril de 2024];22(3):200-6. Disponible en: https://revista.asocolderma.org.co/index.php/asocolderma/article/view/271
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