Pilosebaceous Follicles Research Articles

PREVALENCE AND DEGREE OF SEVERITY OF ACNE VULGARIS IN STUDENTS OF MECHANICAL ENGINEERING MAJOR IN FACULTY OF ENGINEERING DIPONEGORO UNIVERSITY

Introduction : Acne vulgaris (AV) is a chronic inflammatory disorder of pilosebaceous follicle with polymorphic dermatological manifestation such as comedones, papules, pustules, nodules, and scar. Acne vulgaris can be categorized into three degrees of severity based on lesions count: mild, moderate, and severe. There are four factors in the pathogenesis of AV: pilosebaceous follicle hyperproliferation, excessive sebum production, inflammation, and presence of Propionibacterium acnes. The degree of severity is mainly related to the number of an individual's sebaceous gland. Individuals with AV usually have large sebaceous glands that are very active, large pores, and oily skin. Objectives : To describe prevalence and severity of acne vulgaris in students of mechanical engineering major in faculty of engineering Diponegoro University batch 2018. Methods : This is an observational study with cross sectional approach in which author describes prevalence of AV and its degree of severity in students of mechanical engineering major in faculty of engineering diponegoro university batch 2018. Subjetcs were obtained from simple random sampling. There were 71 eligible subjects meeting inclusion criterias. Dermatovenereology residents performed physical examination on subjects to determine whether or not the subject had. Subjects with AV were classified into "positive" group, otherwise "negative". Subjects were obtained with simple random sampling technique. All subjects (100%) had acne vulgaris. Severity of AV varies with 38% subjects had mild AV, 59.2% had moderate AV and 2.8% had severe AV.Conclusions : All subjects (100%) had AV, mostly of moderate severity. Keywords : Acne Vulgaris; prevalence; severity

419 Demodex Mites and Rosacea: Modulation of Inflammation in Skin Resident Cells

Demodex mites are normal residents of the pilosebaceous follicles of healthy human facial skin, at low density, without inducing inflammatory response by skin resident cells (SRCs). When the Demodex population increases, such as in rosacea, an inflammatory response is initiated. The aim of this study is to evaluate how Demodex mites modulate inflammation in SRCs. Skin biopsies from rosacea patients were assessed histologically. Hair follicles were dilated or ruptured, contained mites and occasional inflammatory cells. There was mixed perifollicular inflammation and occasionally mite remnants were found within perifollicular granulomas. Live mites, isolated from human skin surface biopsies, were co-cultured with keratinocytes (HaCaT) or sebocytes (SZ95) for 24 hours at low (1 mite/cm2) and high (5 mites/cm2) densities representing normal and pathologic conditions respectively. Gene expression was analysed by RT-PCR and protein expression by flow cytometry or ELISA. A low density of mites did not induce the release of inflammatory mediators in HaCaT. However, a high density significantly increased the release of TNFα (p<0.01) IL-8 (p<0.05), and CCL2 (p<0.05) in both keratinocytes (n=8) and sebocytes (n=5). Demodex induced TLR2 gene and protein expression (p<0.01) and KLK5 release (p<0.05) only in keratinocytes whereas IL-6 was only released by sebocytes (p<0.05). Our results show that Demodex mites modulate inflammatory responses from SRCs depending on their density. Moreover, keratinocytes and sebocytes respond differently to Demodex stimulus. The contrasting effects on inflammatory responses provide evidence that they co-exist with host cells under normal skin conditions without disrupting the biobalance and have the capacity to induce inflammation when their population is markedly increased as frequently occurs in rosacea.

Human skin biology and the search for the truth

1. Human skin consists of epidermis, pilosebaceous follicles, eccrine and apocrine sweat glands, melanocytes, Langherans cells, Merkel cells, connective tissue of the dermis and hypodermis, nerves and lymphatic and blood vessels. It means that the skin is an extremely complex organ, made up of multiple cell types and structures, with remarkable morphofunctional diversity.

Cutibacterium acnes phylotypes diversity loss: a trigger for skin inflammatory process

Acne has long been understood as a multifactorial chronic inflammatory disease of the pilosebaceous follicle, where Cutibacterium acnes (subdivided into six main phylotypes) is a crucial factor. In parallel, the loss of microbial diversity among the skin commensal communities has recently been shown as often accompanied by inflammatory skin disorders. This study investigated the association of C.acnes phylotype diversity loss and the impact on Innate Immune System (IIS) activation. The IIS response of skin after incubation with phylotypes IA1, II or III individually and with the combination of IA1+II+III phylotypes, was studied in an in vitro skin explant system. The inflammatory response was monitored by immunohistochemistry and ELISA assays, targeting a selection of Innate Immune Markers (IIMs) (IL-6, IL-8, IL-10, IL-17, TGF-β). IIMs were significantly upregulated in skin when being incubated with phylotype IA1 alone compared with the combination IA1+II+III. In parallel, ELISA assays confirmed these results in supernatants for IL-17, IL-8 and IL-10. We identify the loss of C.acnes phylotype diversity as a trigger for IIS activation, leading to cutaneous inflammation. These innovative data underline the possibility to set up new approaches to treat acne. Indeed, maintaining the balance between the different phylotypes of C.acnes may be an interesting target for the development of drugs.

686 Efficacy of Silybum marianum fruit extract in inhibiting sebogenesis

Introduction: Acne is a chronic inflammatory disease of the pilosebaceous follicle. It involves several phases beginning with hyperproduction of sebum, followed by colonization by Cutibacterium acnes, comedogenesis, and subsequent inflammation. Hyperseborrhea is a critical step of acne development. Sebum is composed by the lipids synthesized by sebocytes and the cellular components of these cells released through a holocrine secretion. Objective: To evaluate the effect of the newly patented anti-acne Silybum marianum fruit extract on the production and regulation of sebum components using two ultimate in vitro models. Materials and methods: The compound was evaluated in two models (I) human sebaceous glands organ culture (HSGOC) and (ii) sebocytes derived from human induced pluripotent stem cells (ShiPS) and cultivated in a lipogenic environment. Lipids were quantified by fluorescence and other sebum components at mRNA and protein level. Results: In the model of sebaceous gland survival HSGOC, Silybum marianum fruit extract, decreased sebum content by 25%, thus the same level compared to the reference molecule isotretinoin. In the ShiPS model Silybum marianum fruit extract decreased the expression (mRNA and protein level) of proteins implicated in lipid-storage and -degradation which prevented lipid accumulation. Thus, the compound, significantly decreased lipid accumulation by 90% in this model. Conclusions: By regulating lipid metabolism, Silybum marianum fruit extract prevents lipid accumulation in two models of seborrhea. This contributes to the effects observed in patients with acne, and indicates that Silybum marianum fruit extract is a good candidate for the modulation of hyperseborrhea and associated disease.

Scalp basal cell carcinoma: A different entity?

Basal cell carcinoma is the most frequent malignant neoplasm in white-skinned individuals. It develops in different body areas, including in the scalp, which is a unique anatomical region due to the high number of pilosebaceous follicles; the scalp is protected from UV exposure, a main risk factor for basal cell carcinoma development. Moreover, scalp basal cell carcinoma has been described as more aggressive and difficult to treat than other forms of basal cell carcinoma. In this study, we reviewed the clinical and pathological characteristics, risk factors, genetics, and treatment options for scalp basal cell carcinoma to better understand this special type of cancer. Even though it is not yet clear whether scalp basal cell carcinomas represent a different entity, it seems important to give them special attention due to their potential aggressiveness, invasion capacities, tendency to relapse, and treatment difficulties.

Prevalence and Risk Factors of Acne Vulgaris in Adolescents in Belbis City, Sharkia Governorate, Egypt: A Cross-Sectional Study

Abstract Background: Acne vulgaris is the most common skin condition affecting adolescents across the globe. It is a chronic inflammatory disease of pilosebaceous follicles, characterized by the presence of comedones, papules, pustules, nodules, cysts and scars. Development of acne has been associated with many factors as genetic component, emotional stress, diet and hormonal activity such as menstrual cycles and puberty. Objectives: To estimate the prevalence of acne in adolescents at preparatory and secondary school students in Belbeis city and to identify the risk factors that may have an impact on acne. Methods: A cross sectional study was conducted on 370 adolescents aged 10-19 years in Belbeis city. A sociodemographic and risk factors questionnaires of acne was applied on students of two preparatory schools and one secondary school. Results: Among the study subjects; 21.6% reported having acne. Acne is more significant in females than males and in students in preparatory schools than students in secondary schools with p value= 0.04, 0.01 respectively. There is high significant difference between female students who have acne and female students who do not have acne regarding occurrence of menarche and increasing acne few days before menses, there is weak significant difference regarding consuming large amounts of high fat milk products in diet. The occurrence of acne is one and half time higher in students with positive history of acne in their families. Conclusion: Twenty percent of adolescence students had acne, with girls affected at higher rates than boys.

FORMULATION DEVELOPMENT AND EVALUATION OF TRANSFEROSOMAL GEL

Transfersomes are particularly optimized, ultradeformable (ultraflexible) lipid supramolecular aggregates, which are able to penetrate the mammalian skin intact. Transfersome is a type of carrier system which is capable of transdermal delivery of low as well as high molecular weight drugs. Transfersomes penetrate through the pores of stratum corneum which are smaller than its size and get into the underlying viable skin in intact form. Acne vulgaris is a disease of the pilosebaceous follicle characterized by non-inflammatory (open and closed comedones) and inflammatory lesions (papules, pustules, and nodules). In such situation transdermal drug delivery remains the most preferential mode of administration. But, stratum corneum forms the most formidable barrier for the penetration of drug through skin. To overcome the stratum corneum barrier, the use of lipid vesicles like transfersomes in delivery systems has involved increasing attention in recent years. The aim of the present study was to statistically optimize the vesicular formulations (Transfersomes) for enhanced skin delivery of a model drug Clindamycin Phosphate.&#x0D; Keywords: Transfersomes, Acne vulgaris, Clindamycin Phosphate

Native Valve Propionibacterium acnes Endocarditis From Self-injection of Vitamins

Native Valve Propionibacterium acnes Endocarditis From Self-injection of Vitamins

No Association Between Lipid Profiles and Acne Vulgaris

Background: Acne vulgaris is a chronic inflammation of pilosebaceous follicle that can spontaneously heal with clinical manifestations such as blackhead, papules, pustules, nodule, and cyst on the face, upper chest, arms, and back. Until now, the effect of lipid metabolism on sebaceous gland secretions in the pathogenesis of acne vulgaris is still under research.Materials and Methods: An analytic observational study with cross sectional design involving 30 acne vulgaris and 30 control subjects was conducted. Blood samples were taken from subjects and lipid profile levels were measured. The data were then statistically analyzed.Results: From this research, there was no significant association between lipid profiles with acne vulgaris. There was not any significant difference between the acne vulgaris and the control subjects for total cholesterol, High Density Lipoprotein (HDL), Low Density Lipoprotein (LDL) and triglyceride levels (p&gt;0.05).Conclusion: There is no significant association between lipid profiles levels and acne vulgaris.Keywords: acne vulgaris, lipid profiles, total cholesterol, HDL, LDL, triglyceride

ROLE OF JALUKAVACHARAN AND MAHAMANJISHTADI KWATH IN THE MANAGEMENT OF MUKHADUSHIKA W.S.R TO ACNE VULGARIS- A CASE STUDY

Acne vulgaris is a disease of the pilosebaceous follicle characterized by noninflammatory (open and closed comedowns) and inflammatory lesions (papules, pustules, and nodules). There are four major factors involved in the disease production viz. increased sebum production, cornification of pilosebaceous ducts, microbial involvement and inflammation. This condition is found commonly in puberty.&#x0D; In Ayurveda, it is termed as Mukhadushika In Ayurveda Mukhadushika is described under the heading of Kshudrarogas. The Shalmali thorn like eruption on the face due to vitiation of Kapha, Vata and Rakta which are found on the face of adolescent are called as Mukhadushika or YuvanPidika. Although vata, kapha and rakta are mentioned as dosha-duṣya involved in the pathogenesis of the disease, pittaja symptoms are also found in the disease like daha and paka. Patient was suffering from Acne over face (Pidika), Burning sensation over face (Daha), Itching over face (Kandu), and Discolouration of skin (Vaivarnya) since 6 months. Patient was treated with jalukavacharan and mahamanjishtadi kwath.

Acne in Lom\xe9, Togo: clinical aspects and quality of life of patients

BackgroundAcne is a chronic inflammatory condition affecting the pilosebaceous follicle that mainly affects adolescents and young adults. The aim of this study was to assess the quality of life (QOL) of patients with acne, and to determine the correlation between the QOL and the severity of acne, in Lomé (Togo).MethodFrom July 2017 to February 2018, we conducted a study in three dermatology departments of Lomé. The clinical evaluation of acne and assessment of the QOL were done using the ECLA (Echelle de Cotation des Lésions d’acné) and CADI (Cardiff Acne Disability Index) scores respectively.ResultsWe enrolled 300 patients aged 12 to 52 years; 71.3% of whom were female. The face was affected by acne in 100% of cases and papulopustular acne was the most common clinical form (66.7%). Acne was mild to moderate in 162 patients (54%) and severe in 138 (46%). Impairment was observed in all patients’ QOL (scores ranged from 1 to 14 points). There was a positive correlation between severity of acne and QOL impairment in the patients (r = 0.21; p = 0.0002). We also found a positive correlation between overall CADI score and factors F1 and F3 of the ECLA scale: the severity of facial acne (r = 0.15; p = 0.0073) and the presence of scars (r = 0.21; p = 0.0002). In contrast, the global ECLA score was significantly correlated with items 2, 3, and 5 of the CADI questionnaire: the patient’s relationship (r = 0.13; p = 0.0241), avoidance behaviors (r = 0.21; p = 0.0002) and perception of acne (r = 0.16; p = 0.0067).ConclusionAcne negatively impacts the QOL of patients. The severity of acne has an impact on the patient’s relationships, avoidance behaviors and perception of the acne.

Acne prevalence in 9 to 14-year-old old patients attending pediatric ambulatory clinics in Italy.

Acne vulgaris is a chronic inflammatory skin disease of the pilosebaceous follicles that affects patients of all ages with a younger onset being more common than in the past. To investigate on the prevalence, clinical features and treatments of acne in 9 to 14-year-old patients. A prospective observational study was conducted between April 2016 and May 2016. The study population consisted of patients attending 32 different pediatric ambulatory clinics located in Italy (North: 56.25%, Center: 18.75%, South: 25%). For each patient, a specific questionnaire was registered: i) demographic data; ii) past personal history of acne; iii) auxologic parameters. Further data were gathered for patients suffering from acne at study enrollment: i) body areas involved by the disease; ii) acne severity evaluated through a 0-5 scale (Global Evaluation Acne scale); iii) acne treatments. A total of 683 children (49.2% male; mean age 11.05 ± 1.4 years) were enrolled. Acne was present in 234/683 (34.3%) of the patients, and its prevalence increased with age being higher after 13 years of age (85/234; 36.3%) and lowest at 9 years of age (14/234; 6%). The majority of the patients suffering from acne showed a mild or almost clear disease state severity (GEA scale 1 or 2) (207/234, 88.5%), whereas severe or very severe forms (GEA scale 4 or 5) represented only 4/234, 1.7% of the cases. Acne is not a rare disease in pre-adolescent age. Adequate and prompt treatment is also needed in this class of patient to minimize disease burden and potential future disease worsening.

Trichilemmoma of the Scalp: An Unusual Presentation

Trichilemmoma is a benign tumor with origin in the ou-ter root sheath cells of the pilosebaceous follicles. The relationship between the human papilloma virus and this neoplasm remain controversial.

Characterisation of Cutibacterium acnes phylotypes in acne and invivo exploratory evaluation of Myrtacine®.

Our main objective was to compare Cutibacterium acnes (C.acnes) skin colonisation in patients with mild to moderate acne versus healthy controls and secondly, to evaluate a Myrtacine® -based cream on C.acnes total population and antibioresistant Cutibacteria in patients with acne. In 60 acne patients (Global Acne Severity Scale, GEA grades 2-3), of mean age 20 [15-30] years and in 24 age- and sex- matched healthy controls, forehead strips samplings were performed for microbiological analysis of comedones by colony forming unit (CFU) counts of global C.acnes and erythromycin (EryR) or clindamycin-resistant (ClnR) populations of Cutibacterium and determination of phylotypes by MALTI-TOF. Clinical evaluations of acne patients (GEA, lesion count, porphyrin fluorescence) were performed at baseline and after 56days of twice-daily application of a Myrtacine® -based cream. We first showed (i) high and similar levels of C.acnes colonisation in superficial pilosebaceous follicles and detection of EryR and ClnR strains in both acne and control groups; (ii) different repartition of phylotypes in acne patients versus healthy control, with a predominance of phylotype IA in acne patients and a link between phylotype IA and erythromycin resistance. Besides, after treatment with the Myrtacine® -based cream in acne patients, there was no change in C.acnes total load, but a significant decrease of EryR Cutibacteria, reduced porphyrin production by C.acnes, a decrease in acne severity (GEA), associated with reduced retentional and inflammatory lesions. Cutibacterium acnes colonisation was not significantly different in acne versus control groups. Phylotype IA was predominant in acne patient and in EryR C.acnes. A Myrtacine® -based cream significantly reduced the level of EryR Cutibacteria invivo and improved acne lesions.

Adult-onset acne: prevalence, impact, and management challenges.

Acne is a multifactorial and inflammatory disease of pilosebaceous follicles, which affects most adolescents. Recent epidemiological data revealed a difference in adults affected by this disease. Women have a high prevalence and incidence when compared with men, especially after 25 years of age. In contrast to what was initially thought, most of these patients do not present endocrinopathy capable of leading to the development of the lesions. When present, polycystic ovarian syndrome is the main cause. However, in these cases, acne is rarely the only dermatological manifestation; hirsutism and acanthosis nigricans are often present. The majority of the normoandrogenic acne patients present a history since adolescence, but in many cases the lesion distribution and intensity change with time. There is often a typical localization of the lesions in the lower third of the face and lateral region of the neck. Another interesting feature is related to the impact on quality of life (QoL), which is always intense. Often there are signs of depression, even when the lesions are mild. As most adult patients are women, in addition to the conventional options, there is also hormone treatment. Combined oral contraceptives and spironolactone are good options. Knowing more about the particularities in etiopathogenesis, impact on QoL, and specific treatment options is important to all dermatologists who face the challenge of treating acne in adults.

Confocal microscopy in adult women with acne.

Acne is an inflammatory disease of the pilosebaceous follicle, affecting 41-54% of adult women, with a particular form that involves the mandible. We characterized infundibulum morphology in two groups of adult women using reflectance confocal microscopy. First, we investigated acne visually "healthy zones" on the forehead in 15 adult women with diffuse acne and compared with acne-free controls. We then compared healthy forehead and affected mandibular zone in 15 acne patients with mandibular involvement. Exposed results had a P<0.05. Seven hundred and ninety-one follicles were observed on apparently healthy skin of 15 adult women with acne, with a larger diameter, thicker (68%), and hyper keratinized (65%) follicle border, and more keratin plugs (44%) than in controls. In the second group of 15 adult women with mandibular acne, we compared 569 follicles in the mandibular zone and 475 on forehead. In the mandibular area, follicles were significantly larger, thicker (76%), more hyper keratinized (72%), with more keratin plugs (47%) and increased inflammation (23%) compared with the forehead area. In the mandibular area, 0.2% of follicles showed isolated inflammation without hyper keratinization, and 15.3% had both thickened borders with an onion-like appearance and keratin plugs associated with inflammation. Hyper keratinization was higher in healthy skin of adult women with acne compared with controls, confirming that microcomedo is crucial in the development of acne lesions. We also demonstrate that the repartition of comedones and microcomedones is inhomogeneous with a great number in the mandibular area where acne lesions are located.

Pathogenic yeasts recovered from acne vulgaris: Molecular characterization and antifungal susceptibility pattern

Context:Acne vulgaris is a disorder showing persistent inflammation in the pilosebaceous follicles. It is one of the most prevalent dermatoses that millions of people suffer from globally.Aim:The aim of this study was to identify Candida species from patients with acne and to determine their drugs susceptibility.Subjects and Methods:A total of 70 cutaneous samples from acne vulgaris patients suspected to have Candida infections were collected. Macroscopic and microscopic morphology were recorded followed by polymerase chain reaction-sequencing of ITS regions, using universal primers. In vitro antifungal susceptibility was performed using Clinical and Laboratory Standards Institute method.Results:Overall, 11 Candida species including Candida parapsilosis 8 (72.73%), Candida krusei 1 (12.5%), Candida lusitaniae 1 (12.5%), Candida kefyr 1 (12.5%), and a Trichosporon asahi out of the collected clinical materials were isolated and identified. C. parapsilosis isolates susceptibility to diverse concentrations of the antifungal agents to isolate Cp1 study indicated that the isolated Cp8 and Cp5 with minimal inhibitory concentration (MIC) 50 = 32, 0.5, 0.25 and MIC 90 of <64, <1, <0.5 μg/ml fluconazole, itraconazole, and ketoconazole were resistant, respectively. Some of the isolates having relative strength, almost all other species of C. parapsilosis isolates were susceptible to these drugs.Conclusion:C. parapsilosis was the most prevalent Candida species in acne vulgaris samples which had higher in vitro susceptibility for antifungals.

Demodex Follicullorum Mimicking Fungal Infection: A Case Report

Demodex is an ectoparasite of pilo-sebaceous follicle and sebaceous gland, it can mimic many other inflammatory dermatoses such as folliculitis, rosacea and perioral dermatitis-like lesions. We present a case of a patient living in rural, with reddish brown scaly spots on his neck and chest resembling tinea versicolor. Laboratory examination of skin scraping and adhesive tapes revealed Demodex follicularum mites and no fungal elements. We conclude that scotch tape preparation for microscopic examination is a simple and helpful method to reveal mites presence and rule out false fungal suspicion.

Skin barrier and microbiome in acne.

Acne is an immune-mediated chronic inflammatory disease. Although several factors are involved in its pathophysiology, this process is not completely understood. Androgen hormone activity increases sebum production inside the pilosebaceous follicle, adjusting the environment for the development of Propionibacterium acnes which triggers inflammation. Knowing how others factors such as the skin barrier and microbiome are involved in acne, can help in understanding more about the disease and may help to conduct a better treatment.