Management of Acne (Part-1)

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Management of Acne 1 where do we stand ?
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Introduction

• Common disease of pilosebaceous unit in
  adolescent(Physiologic).
• Its cause is multi factorial has pleomorphic
  clinical presentation.
• Different modality of treatment are available,
  but selection of appropriate method is Vital.

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Natural history

• Starts at adolescent-resolve by mid-twenties
• 83-95 suffers - at about 14-19years of age
• 8 late onset acne - 0ver 25years age

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Intro Factorsduction

• Genetics
• Environmental
• Sebum- 1.Triglycride is hydrolysed by P.acnes to
  free fatty acid,
• 2. increased squalene, 3.decreased
  Linoleic acid
• P.acnes- lipase, phosphatase hyaluronate lyase
• Ductal keratinocyte- IL-1?,IL-1ß, TNF

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Major pathological events in acne
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Special features of pilosebaceous unit

• Propionibacterium acnes -unique composition of
  sebum
• Release of IL-1?,IL-1ß, TNF from ductal
  keratinocytes
• Androgen receptors Keratinocytes of hair
  follicle Basal cells of sebaceous unit
• Follicular keratinocytes has increased
• 17ß-hydroxysteroid dehydrogenase
  5?-reductase
• activity (Type-I isoenzyme)pivotal in
  development of
• sebaceous gland and acne

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Factors responsible for Keratinocyte
hyperproliferation

• Androgenic hormone Dihydrotestosterone (DHT)
• Decrease Linoleic acid
• Increased Interleukin (IL)-1 ?

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Management of Acne Part 2 (Coming Soon)
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