Serum Hepcidin and C Reactive Proteins as Predictive Markers for Post Acne Scarring

Abstract

Abstract Background Acne vulgaris is a common inflammatory skin condition affecting a large section of population. Hepcidin, a small peptide produced by the liver, is a recently discovered key regulator of iron homeostasis that was classified as a typeII acute phase protein. The synthesis of hepcidin is greatly stimulated by inflammation or by iron overload. C‑reactive protein (CRP) is one of the best indicators of systemic inflammation, considering that its serum levels show no circadian change across the 24 hrs. IL‑1, IL‑6 and TNF‑α that are found in the acne lesions are also major inducers of CRP production by the liver. Thus, CRP levels could be elevated in acne if the amount of local inflammation is high enough. Aim of the Work To measure serum Hepcidin and C reactive proteins in acne vulgaris patients & assess their ability as predictive serum markers for postacne scarring. Patients and Methods This Observational Cross sectional study, was carried out on 60 moderate, severe & very severe acne patients aged from 16 to 40 years old (with and without postacne scarring), recruited from the outpatient clinics of Dermatology, Venereology & Andrology departments of Ain-Shams University and MUST university Hospitals, from February 2019 toFebruary 2020. Results Levels of serum hepcidin protein of studied acne pateints were higher than normal range, while CRP serum levels were almost within normal range. Besides, Pateints with post acne scars had significantly lower serum hepcidin levels and higher CRP levels than pateints without. Furthermore, there was highly significant negative correlation between Hepcidin protein serum levels and duration and grade of acne, as well as post acne scarring grade. However, there was highly significant positive correlation between CRP serum levels and duration and grade of acne, as well as post acne scarring grade. Conclusion Serum hepcidin and CRP levels may provide an objective tool to predict the clinical outcome of acne vulgaris lesions and might help in determining the susceptible patients for scarring thus, configuring the therapeutic plan to start an aggressive treatment in patients prone to scar formation regardless of the clinical severity of acne vulgaris itself.