Pathophysiologie der Akne

Borelli, Claudia; Plewig, Gerd; Degitz, Klaus

doi:10.1007/s00105-005-1043-1

Cited by 5 publications

(2 citation statements)

References 32 publications

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“…Infundibular hyperkeratosis of sebaceous gland follicles with development of microcomedos is accepted as a proven early morphological and central pathogenetic event in acne vulgaris (1)(2)(3). A comparable histomorphological correlate is seen in hidradenitis suppurativa (infundibular hyperkeratosis at terminal follicles), which is a chronic-continuous or relapsing disease of the terminal follicle in flexural and anogenital regions.…”

Section: Introductionmentioning

confidence: 99%

Hidradenitis suppurativa (acne inversa): early inflammatory events at terminal follicles and at interfollicular epidermis*

Laffert

Helmbold

Wohlrab

et al. 2010

Experimental Dermatology

176

168

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Hidradenitis suppurativa (acne inversa) is a chronic suppurative and scarring inflammatory disease with predilection in the apocrine gland-bearing areas. Histological investigations in the 1990s showed keratotic occlusion of the terminal follicle structure to be the initial cause. Our investigations describe and reproduce the morphology and try to figure out very early lesions of HS. A total of 262 operative specimens from 60 patients were investigated by routine histology and 11 operative specimens by immunohistochemistry: HS is dominated by a heterogeneous histological image. 82% of the surgical specimens showed mild or pronounced follicular hyperkeratosis, whereas an isotopic hyperplasia of follicular epithelium was evident in 77%. Pronounced perifolliculitis was seen in 68% and rupture of the follicle structure in 28%. Features which had not so far been described in detail were: epidermal psoriasiform hyperplasia (43%) and subepidermal interfollicular inflammatory infiltrate (78%). In all 11 specimens, immunohistochemical investigations showed a perifollicular and subepidermal inflammation of CD-3-, CD-4-, CD-68-, CD-79- and CD-8-cells, the latter with a striking selective epitheliotropism. To conclude, we could show follicular hyperkeratosis and lymphocytic perifollicular inflammation as early patterns in pathogenesis, whereas rupture of the follicle structure takes place later. Finally, it seems that there are two hot spots of inflammatory events (perifollicular and subepidermal) composed of a comparable inflammatory cell mixture. The CD-8 cell epitheliotropism (follicular and epidermal) described here and its influence in follicular hyperkeratosis, in hyperplasia of follicular epithelium and in epidermal psoriasiform hyperplasia will be of further interest, for instance, concerning early pharmacological intervention.

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Section: Introductionmentioning

confidence: 99%

Hidradenitis suppurativa (acne inversa): early inflammatory events at terminal follicles and at interfollicular epidermis*

Laffert

Helmbold

Wohlrab

et al. 2010

Experimental Dermatology

176

168

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“…Acne vulgaris is a multifactorial disease based on an alteration in the pattern of keratinization within the pilosebaceous follicles resulting in comedo formation, an increase in sebum production which is influenced by androgens, the proliferation of Propionibacterium acnes , and the production of perifollicular inflamma‐tion [1–4]. Genetic [5], other hormonal (e. g. corticotropin‐releasing hormone CRH) [6], and psychological factors [7] may also be contributing factors.…”

Section: Introductionmentioning

confidence: 99%

Acne vulgaris – Psychosomatic aspects

Niemeier

Kupfer

Gieler

2006

J Deutsche Derma Gesell

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More than a cosmetic nuisance, acne can produce anxiety, depression, and other psychological problems that affect patients' lives in ways comparable to life-threatening or disabling diseases. Emotional problems due to the disease should be taken seriously and included in the treatment plan. A purely dermatological therapy by itself may not achieve its purpose. Even mild to moderate disease can be associated with significant depression and suicidal ideation, and psychologic change does not necessarily correlate with disease severity. Acne patients suffer particularly under social limitations and reduced quality of life. Psychological comorbidities in acne are probably greater than generally assumed. Attention should be paid to psychosomatic aspects especially if depressive-anxious disorders are suspected, particularly with evidence of suicidal tendencies, body dysmorphic disorders, or also in disrupted compliance.Therefore, patients who report particularly high emotional distress or dysmorphic tendencies due to the disease should be treated, if possible, by interdisciplinary therapy. The dermatologist should have some knowledge of the basics of psychotherapy and psychopharmacology, which sometimes must be combined with systemic and topical treatment of acne in conjunction with basic psychosomatic treatment.

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Acne vulgaris

Abeck

2011

Häufige Hautkrankheiten in Der Allgemeinmedizin

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Pathophysiologie der Akne

Abstract: Several pathogenic factors contribute to the development of acne, among them, seborrhea, follicular hyperkeratosis, propionibacteria, and inflammatory events. This article reviews current knowledge of these pathogenic factors.

Cited by 5 publications

References 32 publications

Hidradenitis suppurativa (acne inversa): early inflammatory events at terminal follicles and at interfollicular epidermis*

Hidradenitis suppurativa (acne inversa): early inflammatory events at terminal follicles and at interfollicular epidermis*

Acne vulgaris – Psychosomatic aspects

Acne vulgaris

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