Abstract
Acne scars are classified into various types based on their appearances, ranging from hypertrophic to atrophic. Abnormal wound healing processes play an important role in the pathogenesis of scars; however, the exact mechanisms involved in various scar appearances have still not been elucidated. In this study, we used immunofluorescence and immunohistochemistry techniques to detect the presence of myofibroblasts, B cells, and mast cells in each type of acne scar persisting longer than 6 months. We found the highest density of myofibroblasts in hypertrophic acne scars, while in the other atrophic scars, we could not identify any myofibroblast-rich areas in our specimens. B-cell infiltration was mild and found in only 23% (4/17) of all acne scar specimens. Interestingly, mast cells were identified in all specimens, ranging from minimal to high density, and a high number of mast cells in acne scars were associated with obesity. In conclusion, myofibroblasts are abundant only in hypertrophic acne scars, and mast cells, but not B cells, might play an important role in the pathogenesis of long-standing acne scars.
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