Atrophic scar formation in patients with acne involves long-acting immune responses with plasma cells and alteration of sebaceous glands

Carlavan, Isabelle; Bertino, Béatrice; Rivier, Michel; Martel, Philippe; Bourdès, Valérie; Déret, Sophie; Reiniche, Pascale; Ménigot, Corinne; Khammari, Amir; Dréno, Brigitte; Fogel, Paul; Voegel, Johannes J.

doi:10.1111/bjd.16680

Cited by 40 publications

(52 citation statements)

References 26 publications

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“…A comparison of immune responses in biopsies from subjects prone versus subjects not prone to acne scarring identified a large nonspecific immune response with few memory T cells in those not prone to scarring, which subsided upon resolution. In contrast, a predominantly specific immune response with a high proportion of memory T cells was identified in acne lesions of subjects prone to scars; this response was initially small and ineffective but increased and resulted in resolved lesions . A nodule inflammatory infiltrate was shown to consist primarily of lymphocytes and giant cells .…”

Section: Discussionmentioning

confidence: 88%

“…In contrast, a predominantly specific immune response with a high proportion of memory T cells was identified in acne lesions of subjects prone to scars; this response was initially small and ineffective but increased and resulted in resolved lesions. 18 A nodule inflammatory infiltrate was shown to consist primarily of lymphocytes and giant cells. 12 However, the exact inflammatory infiltrate and associated cytokines are still poorly described.…”

Section: Baseline Nodulementioning

confidence: 99%

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Evolution and duration of nodules in severe nodular acne on the back: results from a four‐week non‐interventional, prospective study

Khammari¹,

Blanchet‐Réthoré

Bourdès

et al. 2019

Acad Dermatol Venereol

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Background Severe nodular acne is characterized by inflammatory nodules and scarring. Their natural evolution and duration are insufficiently investigated. Aim To investigate the evolution and duration of untreated acne nodules. Methodology Four‐week, single‐centre, non‐interventional, prospective study in subjects with severe nodular acne on the back. Nodule evolution and duration was assessed using standardized photographs taken twice weekly. Results Data from 23 subjects were evaluable. Mean age was 25.1 ± 4.9 years, 87% were males, and mean acne duration was 9.7 ± 6.7 years. At baseline, the overall total nodule count was 132 (mean number: 5.7 ± 3.0 nodules/subject). Among others, the following two main pathways were observed: nodules evolving directly into atrophic scars (31.8%) and nodules evolving towards papules into atrophic scars (37.9%). After 4 weeks, 77.3% of baseline nodules had evolved into atrophic scars. After baseline visit, a total of 247 new nodules (3.1 ± 2.2 nodules/week/subject) with a mean duration of 4.9 ± 2.6 days were observed. The mean duration of new nodules was significantly longer in subjects (n = 16) with ≥6 new nodules compared to subjects (n = 7) with <6 new nodules (5.2 ± 1.4 vs. 3.6 ± 0.8 days; P = 0.008)). There was no correlation between the number of new nodules and acne duration or with the number of baseline nodules. Conclusion This study documents the natural nodule evolution and duration over 4 weeks and showed in 23 patients the scarring potential of untreated severe nodular acne of the back.

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Section: Discussionmentioning

confidence: 88%

Section: Baseline Nodulementioning

confidence: 99%

Evolution and duration of nodules in severe nodular acne on the back: results from a four‐week non‐interventional, prospective study

Khammari¹,

Blanchet‐Réthoré

Bourdès

et al. 2019

Acad Dermatol Venereol

Self Cite

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“…This issue of the BJD contains a thorough examination of the immunological processes behind atrophic scar formation in patients with acne . Acne is a very common skin condition that affects a large population of patients.…”

mentioning

confidence: 99%

“…Although a previous study in the literature had examined the inflammatory response of patients with scar‐prone acne, Carlavan et al . have compared these lesions over a 3‐week period in order to offer more comprehensive evidence …”

mentioning

confidence: 99%

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The utility of understanding atrophic acne scar formation for prevention and treatment

Wang

Saedi

2018

Br J Dermatol

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Laser Treatment of Traumatic Scars and Contractures: 2020 International Consensus Recommendations

Seago

Shumaker

Spring³

et al. 2019

Lasers Surg Med

109

112

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Background and Objectives: There is currently intense multidisciplinary interest and a maturing body of literature regarding laser treatments for traumatic scars, but international treatment guidelines and reimbursement schemes have not yet caught up with current knowledge and practice in many centers. The authors intend to highlight the tremendous potential of laser techniques, offer recommendations for safe and efficacious treatment, and promote wider patient access guided by future highquality research.

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Atrophic scar formation in patients with acne involves long-acting immune responses with plasma cells and alteration of sebaceous glands

Abstract: Long-lived acne papules are characterized by a B-cell infiltrate. A relationship exists between the duration and severity of inflammation and the alteration of sebaceous gland structures, leading to atrophic scar formation in acne.

Cited by 40 publications

References 26 publications

Evolution and duration of nodules in severe nodular acne on the back: results from a four‐week non‐interventional, prospective study

Evolution and duration of nodules in severe nodular acne on the back: results from a four‐week non‐interventional, prospective study

The utility of understanding atrophic acne scar formation for prevention and treatment

Laser Treatment of Traumatic Scars and Contractures: 2020 International Consensus Recommendations

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