Patogenesis del acne

Autores/as

  • Martha Helena Campo Universidad del Valle

Resumen

El acné es la enfermedad dermatológica más común. Un 80% de los adultos jóvenes, entre los 11 y 30 años de edad, se encuentran afectados. Constituye el 15% de todas las consultas médicas, y ocupa el primer puesto como causa de consulta sobre las demás enfermedades dermatológicas. Por la severidad y/o persistencia de la enfermedad, 15% a 30% de los pacientes necesitan tratamiento. El 2% a 7% tienen enfermedad severa asociada a cicatrización importante. En la mayoría de los casos hay regresión espontánea, pero un 10% persiste más de los 25 años.

Biografía del autor/a

Martha Helena Campo, Universidad del Valle

Docente Adjunto Sección de Dermatología, Universidad del Valle, Cali.

Referencias bibliográficas

1 Kraning KK, Odland GF, eds. Prevalence, morbidity and cost of Dermatological diseases. J lnvest Dermatol 1979· 73: 395-513.
https://doi.org/10.1111/1523-1747.ep12541101

2 Cunliffe WJ. Acne. London, Dunitz, 1989.

3 Strauss JS, Pochi PE: The quantitative gravimetric determination of sebum production. J lnvest Dermatol 1961; 36: 293-297.
https://doi.org/10.1038/jid.1961.48

4 Leyden JJ: New Understandings of acne pathogenesis. J Cu tan Medicine and Surgery 1996; 1: S2-2 - S2-7.
https://doi.org/10.1177/12034754960010S202

5 McGinle)'. KJ,. Webster GF, Ruggieri MR, Leyden JJ. Regional vanauons m dens1ty of cutaneous propionibacteria:

correlation of P. A enes populations with sebaceous secretion. J Clin Microbio! 1978; I 2: 672-675.

6 Doran TI, Jacobs P, Pacia E. Characterizacion of human sebaceous cells in vitro. J lnvest Dermatol 1991; 96: 341- 348.
https://doi.org/10.1111/1523-1747.ep12465246

7 Zouboulis ChC, Xia L, Detmar M, BogdanoffB, Giannakopoulos G, Goll111k H, Orfanos CE. Culture ofhuman sebocytes and markers of sebocytic differentiation in vitro. Skin Phannacol 1991; 4: 74-83.
https://doi.org/10.1159/000210927

8. Fujie T, Shikiji T, Uchida N, Urano Y, Nagae H, Arase S. Culture of cells derived from the human sebaceous gland under serum- free conditions without a biological feeder !ayer or specific matrices. Arch Dennatol Res 1996; 288: 703-708.
https://doi.org/10.1007/BF02505281

9. Akai Y, Akamatsu H, Ri S, lto A, Zouboulis ChC, Asada Y. lnfluence of free fatty acids 011 the proliferation of cultured human sebocytes in vitro. Jpn J Dermatol 1994· 104: 647-649.

10 Kligrnan AM, Wheatley V R, Milis OH Jr. Comedogenicity of human sebum. Arch Dennatol 1970; 102: 262-275.
https://doi.org/10.1001/archderm.102.3.267

11 Kellum RE. Acne Vulgaris: studies in pathogenesis: relative Irritancy of free fatty acids from C2 to C 16. Arch DermatolI 968; 97: 722-726.
https://doi.org/10.1001/archderm.97.6.722

12 Motoyoshi K. Enhanced comedo formation in rabbit ear skin by squalene and oleic acid peroxides. Br J Dermatol 1983· 109: 191-198.
https://doi.org/10.1111/j.1365-2133.1983.tb07080.x

13. Saint-Leger D, Bague A, Cohen E, Chivot M. A possible role far squalene in the pathogenesis of acne. Br J Dermatol 1986 114: 535-542.
https://doi.org/10.1111/j.1365-2133.1986.tb04060.x

14 Cunliffe WJ, Shuster S. Pathogenesis of Acne. Lancet 1969; 1 :685-687.
https://doi.org/10.1016/S0140-6736(69)92642-7

15 Ha1Tis HH, Downing DT, Stewart ME, Strauss JS. Sustainable rates of sebum secretion in acne patients and matched normal

16 control subjects_ . J Am Acad Dermatol 1983; 8: 200-203. Powel EW, Bevendge GW. Sebum excretion and sebum composition in adolescent men with and without acne vulgaris. Br J Dermatol 1970; 82: 243-249.
https://doi.org/10.1111/j.1365-2133.1970.tb12431.x

17 Strauss TS, Pochi PE, Downing DT. Acne: perspectives. J Invest Dermatol 1974; 62: 321-325.
https://doi.org/10.1111/1523-1747.ep12724280

18 Morello AM, Downing DT, Strauss JS. Octadecadienoic acids in the skin surface lipids of acne patients and normal subjects. J Invest Demiatol 1976
https://doi.org/10.1111/1523-1747.ep12482300

66: 319-323. 19 Downing DT, Stewa11 ME, Wertz PW, Strauss JS. Essential fatty acids and acne. J Am Acad Dermatol 1986· 14 : 221-225.
https://doi.org/10.1016/S0190-9622(86)70025-X

19 Downing DT, Stewa11 ME, Wertz PW, Strauss JS. Essential fatty acids and acne. J Am Acad Dermatol 1986· 14 : 221-225.
https://doi.org/10.1016/S0190-9622(86)70025-X

20 Jansen T, Plewig G, Kligman AM. Pathophysi logy of acne. Dermatologic Therapy 1998; 6: 7-17

21 Anderson KM, Liao S. Selective retention of DHT by prostatic nuclei. Nature.1968; 219: 277-279.
https://doi.org/10.1038/219277a0

22 Eicheler W, Dreher M, Hoffman R. Inmunohistochemical evidence for differential distribution of 5AR isoenzymes in human skin. Br J Dermatol 1995: 133: 371-376.
https://doi.org/10.1111/j.1365-2133.1995.tb02663.x

20 Jansen T, Plewig G, Kligman AM. Pathophysi logy of acne. Dermatologic Therapy 1998; 6: 7-17

21 Anderson KM, Liao S. Selective retention of DHT by prostatic nuclei. Nature.1968; 219: 277-279.
https://doi.org/10.1038/219277a0

22 Eicheler W, Dreher M, Hoffman R. Inmunohistochemical evidence for differential distribution of 5AR isoenzymes in human skin. Br J Dermatol 1995: 133: 371-376.
https://doi.org/10.1111/j.1365-2133.1995.tb02663.x

23 Chen W, Zouboulis ChC, Fritsch M, Kodelja V, Orfanos CE. Heterogeneity and quantitative differences oftype I 5alpha reductase expres1011 111 cultured skin epithelial cells. Dermatology 1998: 196: 51-52.
https://doi.org/10.1159/000017866

24 Lucky AW, Biro FM, 1-luster GA, et al: Acne vuloaris in premenarchal girls. Arch Dermatol 1994: I 30:°308-3 I 4.
https://doi.org/10.1001/archderm.1994.01690030040006

25 Stewa11 ME, Downing DT, Cook JS, Han en JR, Strauss JS. Sebaceous gland activity and serum dehydroepiandrosterone sulfato levels in boys and girls. Arch Dermatol I 992: 128: I 345- I 348.

26 Rosenfield RL, Deplewski D, Kentsis A, Ciletti N. Mecanisms of androgen i□duction of sebocyte differentiation. Dermatology 1998: I 96: 43-46.
https://doi.org/10.1159/000017864

27 Blauer M, Vaala ti A, Pauli S-L, Ylikomi T, Joensuu T Tuohimaa P. Location of androgen receptor in hum;n skin. lnvest Dermatol 1991: 97: 264-268.
https://doi.org/10.1111/1523-1747.ep12480373

28 Lian T, Hoyer S, Yu R, Soltani K, Lorinez AL, Hiipakka RA, L1ao S. Immunocytocl:emical localization of androgen receptors m human sk,n usmg monoclonal antibodies against the androgen receptor. J lnvest Dermatol 1993: 100: 663-
https://doi.org/10.1111/1523-1747.ep12472330

29 666. Thibou_to_t D, Harris G, fles V, Cimis G, Gilliland K, Hagari S. Ac11v1ty ofthe_ type 1 5-alfa reductase exhibits regional d1fferences III 1solated sebaceous glands and wbole skin. J lnvest Dennatol 1995: 105: 209-214.
https://doi.org/10.1111/1523-1747.ep12317162

30 Schmidt JB, Spona J, 1-luber J. Androgen receptor in hirsutism and acne. Gynecol Obstet lnvest 1986: 22:206-211.
https://doi.org/10.1159/000298915

31 Imperara- McGinley J, Gautier T, Cal LQ, Yee B, Epstein J, Poch, P. The androgen control of sebum production. Studies of subjects with dihydrotestosterone deficience and complete androgen msens111v1ty. J Clin Endocrino! Metab 1993: 76: 524-528.
https://doi.org/10.1210/jc.76.2.524

32 Thiboutot D. Hormonal action in acne: a few new clues in an unsolved mystery. Med Surg Dermatol I 994: 1: 317-319.

33 Thibouto_t D, Harris G lles V, Cimis G, Gilliland K, Hagari S. Act1v1ty ofthe_ type I 5-alpha reductase exhibits regional d1fferences 111 1solated sebaceous glands and whole skin. J lnvest Dermatol 1995: 105: 209-214.
https://doi.org/10.1111/1523-1747.ep12317162

34 Cimis G, Thiboutot D, Harris G. Localization of tha type l-5AR in isolated sebaceous glands from human scalp. J lnvest Drematol. 1994: 102: 561.

35 Akamatsu H, Zouboulis CbC, Orfanos CE. Control of human sebocyte proliferatio_n in vitro by testosterone and 5-alphad, hydrotestosterone I dependent on the localization of the ebaceous glands. J lnvest Denna10l 1992: 99: 509-511.
https://doi.org/10.1111/1523-1747.ep12616181

36 Fujie T Shikiji T, Uchida N, Uramo Y, agae H, Arase S, Culture of ce lis derived from the human sebaceous oland under serum free conditions without a biological feeder layer

37 or spec,fic matrices. Arch Dem,atol Res 1996: 28_8: 703-708. Zouboulis ChC, Xia L, Akamatsu H, Seltmann H, Fntsch M, Homemann S, Ruhl R, Chen W, Nau H, Orfanos CE. The human sebocyte culture model provides new insights into development and management of seborrhoea and acne. Dermatology l 998: 196: 21-3 l.

38 Strauss JS, Kligman AM. The effect of progesterone and progesterone-like compounds on the human sebaceous gland.

39 J lnvest Dermatol 1961: 36: 309-319. 1-lenze Ch, Hinney B, wuttke w. Lncidence of increased androgen levels III patients suffenng from acne. Dermatology 1998:196: 53-54.
https://doi.org/10.1159/000017867

40 Aizawa H, iimura M: Elevated erum insuline-like growth factor-! (IGF-1) leve! in women with posrndolecent acne. J Dermatol 1995. 22: 249-252.
https://doi.org/10.1111/j.1346-8138.1995.tb03381.x

41 Boudou P, So liman H, Chivot M. Effect of oral isotretinoin treatmenl on skin androgen receptor levels in male acneic patients. J Clin Endocrino! Metab 1995:80: 1158-1161.
https://doi.org/10.1210/jc.80.4.1158

42 Kliigman AM: An overview on acne. J lnvest Dennatol 1974: 62: 268-287
https://doi.org/10.1111/1523-1747.ep12676801

43 Knutson DD: Ultrastructural observations in acne vulgaris: The normal sebaceous follicle and acne lesions. J lnvest Dennatol 1974: 62: 288-307.
https://doi.org/10.1111/1523-1747.ep12676804

44 Strauss JS, K.Jigman AM: The pathogenic dynamics o acne vulgaris. Arch Dermatol 1960: 82: 779-790.
https://doi.org/10.1001/archderm.1960.01580050121019

45 Plewig G. Follicular keratinization. J lnvest Dermatol 1974: 62: 308-315.
https://doi.org/10.1111/1523-1747.ep12676805

46 Holmes RL, Williams M, Cunliffe WJ. Pilo-sebaceous duct ob trnction and acne. Br J dermatol 1972: 87: 327-332.
https://doi.org/10.1111/j.1365-2133.1972.tb07418.x

47 Jansen T, Plewig G, KJigman AM. Pathophysiology ofacne. Dennarologic Therapy 1998: 6: 7-17.

48 Knulson DD. Ultrastuctural observations in acne vulgaris: the normal sebaceous follicle and acne lesions. J Invest Dermatol 1974: 62: 288-307.
https://doi.org/10.1111/1523-1747.ep12676804

49 Plewig G, Fulton JE, Kligman AM. Cellular dynamics of comedo formation in acne vulgaris. Arch Dennatol Forsch 1971: 242: 12-29.
https://doi.org/10.1007/BF00595286

50 Kligman AM, Katz AG. Pathogenesis of acne vulgaris: comedogenic properties of human sebum in externa! ear canal of the rabbit. Arch Dermatol 1968: 98: 53-57.
https://doi.org/10.1001/archderm.98.1.53

51 Saint-Leger D, Bague A, Cohen E, Chivot M. A possible role for squalene in the pathogenesis of acne: in vitro study of squalene oxidation. Br J Dennatol 1986: 114: 535-542.
https://doi.org/10.1111/j.1365-2133.1986.tb04060.x

52. Motoyoshi K. Enhanced comedo fonnation in rabbit ear skin by squalene and oleic acid peroxides. Br J Dermatol 1983: 109: 191-198.
https://doi.org/10.1111/j.1365-2133.1983.tb07080.x

53 Downing DT, Stewart ME, Wenz PW, Strauss JS. Es ential fatty acids and acne. J Am Acad Dermatol 1986: 14: 221-225.
https://doi.org/10.1016/S0190-9622(86)70025-X

54 Stewart ME, We1tz PW, Grahek MO, Downing DT. Relationship between sebum secretion rates and the concentration of linoleate in sebum and epidermal lipids. Clin Res 1985: 33: 684 A.

55 Knaggs H, Holland K, Morris C, et al: Quantification of ceLlular proliferation in acne using the monoclonal antibody Ki-67. J lnvest Dermatol 1994 102: 89-92.
https://doi.org/10.1111/1523-1747.ep12371738

56 Hughes B, Morris C, Cunliffe W: Keratin expression in pilosebaceous epithelia in trunca! skin of acne patients. Br J Dermatol 1996: 134: 247-256.
https://doi.org/10.1046/j.1365-2133.1996.d01-779.x

57 Knaggs H, Hughe B, Morri C, et al: lmmunohistochemical study of desmosomes in acne vulgaris. Br J Dennatol 1994: 130: 731-737.
https://doi.org/10.1111/j.1365-2133.1994.tb03410.x

58 Guy R, Green M, Kealey T: Modeing of acne in vitro. J lnvest Dermatol. 1996: 106: 176-182.
https://doi.org/10.1111/1523-1747.ep12329907

59 lngham E, Eady A, Goodwin CE, Cove JH, Cunliffe W: Proinflammatory levels of interleukin-1 alpha- like bioactivity are present in the majority of open comedones in acne vulgaris. J lnvest Dennatol 1992: 98: 895-90.
https://doi.org/10.1111/1523-1747.ep12460324

60 Antilla HSI, Reitamo S,Saurat JH: lnterleukin immunoreactivity i ebaceou glands. Br J Dermatol 1992: 127: 585-588.
https://doi.org/10.1111/j.1365-2133.1992.tb14870.x

61 Hauser C, Saurat JH, Schmit A, Jannin F, Dayer JM: lnterleukin 1 is presenl in normal human epidermis. J lnmunol 1986: 136: 3317-3321.

62 Cork MJ, Mee JB, Duff GW: Cytokines: in Priestley GC (ed): Molecular Aspects of Dermatology. Chichester. Wiley & Sons. 1993. Pp 129-146.

63 Plewig G: Follicular keratinization. J lnvest Dermatol 1974: 62: 308-313.
https://doi.org/10.1111/1523-1747.ep12676805

64 Reenstra WR, Yaar M, Gilchrest BA: Effect of donor age 011 epidermal growth factor processing in man. Exp Cell Res 1993: 2º9: 118-122.
https://doi.org/10.1006/excr.1993.1291

65 Guy R, Kealey T: Modelling the infundibulurn in acne. Dermatology 1998: 196: 32-37.
https://doi.org/10.1159/000017862

66 Leyden JJ, McGinley KJ, Milis O, Kligman AM: Age-related changes in the resident bacteria! flora of the human face. J lnvest Dennatol 1974: 65: 379-3 1.
https://doi.org/10.1111/1523-1747.ep12607630

67 McGinley KJ, Webster GF, Leyden JJ: Regional variations of densiry of cutaneous propionibacteria: Correlation of P.acnes populations with sebaceous secretion. J Clin M icrobiol 1980: 12: 672-675.

68 Leyden JJ, McGinley KJ, Vowels B: Propionibacterium acne colonization in acne and nonacne. Dermatology 1998: 196: 55-58.
https://doi.org/10.1159/000017868

69 Stewart ME, Grahek MO, Cambier LS, Wertz PW, Downing DT: Dilutional effect of increased sebaceous gland activity on the proportion of linoleic acid in sebaceous wax esters and in epidemial acylceramides. J lnvest Dermatol 1986: 87: 733-736.
https://doi.org/10.1111/1523-1747.ep12456856

70 Leeming JP, Holland KT, Cunliffe WJ: The microbial colonizations of inflamed acne vulgaris lesions. Br J Dermatol 1988: J 18: 203-208.
https://doi.org/10.1111/j.1365-2133.1988.tb01775.x

71 Gribbon EM, Shoesmith JG, Cunliffe WJ, Holland KT: The microaerophily and photosensitivity of P.acnes. J Appl Bacteriol 1994: 77: 583-590.
https://doi.org/10.1111/j.1365-2672.1994.tb04405.x

72 1-lolland KT, Aldana O, Bojar, RA, Cunliffe WJ, Eady EA, Holland DB, lngham E, McGeown C, Till A, Walters C: Propionibacterium acnes and acne. Dermatology 1998: 196: 67-68.
https://doi.org/10.1159/000017870

73 Norris JFB, Cunliffe WJ: A histological and immunocytochemical study of early acne lesions. Br J Dennatol 1988: 118: 651-659.
https://doi.org/10.1111/j.1365-2133.1988.tb02566.x

74 Layton A, Morris C, Cunliffe WJ, lngham E: lmmunohistochemical investigations ofevolving inflammation in lesions of acne vulgaris. J lnvest Dermatol 1994: 103: 443.

75 lngham E, Eady EA, Goodwin CE, Cove JH, Cunliffe WJ: Proinflammatory leve Is of interleukin-1-al fa-like bioactivity are present in the majority of open comedones in acne vulgaris. J lnvest Dermatol 1992: 98: 895-901.
https://doi.org/10.1111/1523-1747.ep12460324

76 Kozlowska U, Blume-Peytavi U, Kodelja V, Sommer C, Goerdt S, Jablonka S, Orfanos CE: Vascular endothelial growth factor expression induced by proinflamrnatory cytokines (interleukin-1-alfa,beta) in cells of the human pilosebaceous unit. Dermatology 1998: 196: 89-92.
https://doi.org/10.1159/000017878

77 Akamarsu H, Horio T. The possible role of reactive oxygen species generated by neutrophils in mediating acne inflammation. Dermatology 1998: 196: 82-85.
https://doi.org/10.1159/000017876

78 Webster GF, Leyden JJ, ilsson UR: Complement activarion in acne vulgaris: Consumption of complement by comedone lnfect lmmun 1979: 26: 186-188.

79 Webster GF, Leyden JJ, Norman ME, Nilsson UR: Complement activation in acne vulgaris: ln vitro sn1dies with P.acnes and P.granulosum. lnfect lmmun 1978: 22: 523-529.

80 Webster GF, Leyden JJ, Tsai CC, Baehni P, McArthur WP: Polymorphonuclear leukocyte lysosomal enzyme release in response to P.acnes in vitro and its enhancement by sera from patients with inflammatory acne. J lnvest Dermatol 1980: 74: 398-401.
https://doi.org/10.1111/1523-1747.ep12544494

81 lngham E, Gowland G, Ward RM, Holland KT, Cunliffe WJ: Antibodies to P.acnes and P.acnes exocellular enzymes in the nom1al population at various ages and in patients with acne vulgaris. Br J Dermatol 1987: 116: 805-812.
https://doi.org/10.1111/j.1365-2133.1987.tb04899.x

Cómo citar

1.
Campo MH. Patogenesis del acne. rev. asoc. colomb. dermatol. cir. dematol. [Internet]. 1 de junio de 1999 [citado 28 de marzo de 2024];7(2):23-31. Disponible en: https://revista.asocolderma.org.co/index.php/asocolderma/article/view/755

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1999-06-01

Cómo citar

1.
Campo MH. Patogenesis del acne. rev. asoc. colomb. dermatol. cir. dematol. [Internet]. 1 de junio de 1999 [citado 28 de marzo de 2024];7(2):23-31. Disponible en: https://revista.asocolderma.org.co/index.php/asocolderma/article/view/755

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