Akne
Özet
Akne vulgaris, kıl folikülleri ve yağ bezlerinin tıkanmasıyla oluşan, dünya nüfusunun yaklaşık %9,4'ünü etkileyen multifaktöryel bir deri hastalığıdır. Hastalığın gelişiminde foliküler hiperkeratinizasyon, artmış sebum üretimi, Cutibacterium acnes kolonizasyonu ve enflamasyon olmak üzere dört ana patofizyolojik mekanizma rol oynar. Tanısı klinik bulgularla konulan bu durum; genetik yatkınlık, hormonal değişimler, diyet ve stres gibi çeşitli faktörlerden etkilenmekte olup tedavisi kişinin lezyon tipine ve şiddetine göre topikal veya sistemik ajanlarla bireyselleştirilerek planlanır.
Acne vulgaris is a multifactorial skin disease caused by the obstruction of pilosebaceous units, affecting approximately 9.4% of the global population. Four primary pathophysiological mechanisms drive its development: follicular hyperkeratinization, increased sebum production, Cutibacterium acnes colonization, and inflammation. Diagnosed through clinical findings, the condition is influenced by genetics, hormonal changes, diet, and stress, requiring individualized treatment plans with topical or systemic agents based on lesion type and severity.
Referanslar
Stathakis V, Kilkenny M, Marks R. Descriptiveepidemiology of acnevulgaris in the community. Australas J Dermatol. 1997;38(3):115-123. doi:10.1111/j.1440-0960.1997.tb01126.x
Collier CN, Harper JC, Cafardi JA, et al. The prevalence of acne in adults 20 years and older [publishedcorrectionappears in J AmAcadDermatol. 2008 May;58(5):874. Cafardi, Jennifer A [added]]. J AmAcadDermatol. 2008;58(1):56-59. doi:10.1016/j.jaad.2007.06.045)
Wolkenstein P, Machovcová A, Szepietowski JC, et allAcne prevalence and associations with lifestyle: a cross-sectional online survey of adolescents/youngadults in 7 Europeancountries. J EurAcadDermatolVenereol. 2018;32(2):298-306. doi:10.1111/jdv.14475
Hay RJ, Johns NE, Williams HC, et al. The global burden of skin disease in 2010: an analysis of the prevalence and impact of skin conditions. J InvestDermatol. 2014;134(6):1527-1534. doi:10.1038/jid.2013.446)
Gonçalves G, Amado JM, Matos ME et all. The prevalence of acneamong a group of Portuguesemedicalstudents. J EurAcadDermatolVenereol. 2012;26(4):514-517. doi:10.1111/j.1468-3083.2011.04080.x
O'Neill AM, Gallo RL. Host-microbiomeinteractions and recent progress into understanding the biology of acnevulgaris. Microbiome. 2018;6(1):177. Published 2018 Oct 2. doi:10.1186/s40168-018-0558-5
Kurokawa I, Danby FW, Ju Q, et al. New developments in our understanding of acnepathogenesis and treatment. ExpDermatol. 2009;18(10):821-832. doi:10.1111/j.1600-0625.2009.00890.x
Zaenglein AL, Thiboutot DM. Acnevulgaris. In: Bolognia JL, Jorizzo JL, Schaffer JV, editors. Dermatology. 3rd ed.
Gollnick H, Cunliffe W, Berson D, et al. Management of acne: a report from a Global Alliance to ImproveOutcomes in Acne. J AmAcadDermatol. 2003;49(1 Suppl):S1-S37. doi:10.1067/mjd.2003.618
Taylor M, Gonzalez M, Porter R. Pathways to inflammation: acne pathophysiology. Eur J Dermatol. 2011;21(3):323-333. doi:10.1684/ejd.2011.1357
Thiboutot D. Hormones and acne: pathophysiology, clinical evaluation, and therapies. Semin CutanMedSurg. 2001;20(3):144-153. doi:10.1053/sder.2001.28208
Imperato-McGinley J, Gautier T, Cai LQ, Yee B, Epstein J, Pochi P. The androgencontrol of sebumproduction. Studies of subjects with dihydrotestosteronedeficiency and completeandrogeninsensitivity. J ClinEndocrinolMetab. 1993;76(2):524-528. doi:10.1210/jcem.76.2.8381804)
Shaheen B, Gonzales M. A microbialaetiology of acne: what is the evidence? Br J Dermatol2011;165:474-85)
Dessinioti C, Katsambas AD. The role of propionibactreiumacnes in acnepathogenesis: facts and controversies. ClinDermatol2010;28:2-7
Norris JF, Cunliffe WJ. A histological and immunocytochemical study of early acne lesions. Br J Dermatol. 1988;118(5):651-659. doi:10.1111/j.1365-2133.1988.tb02566.x
Thiboutot D, Gollnick H, Bettoli V, et al. New insights into the management of acne: an update from the global alliance to improveoutcomes in acne group. J AmAcadDermatol2009;60:1-50
Adebamowo CA, Spiegelman D, Danby FW, Frazier AL, Willett WC, Holmes MD. High schooldietarydairyintake and teenageacne. J AmAcadDermatol. 2005;52(2):207-214. doi:10.1016/j.jaad.2004.08.007
Thiboutot D. Acne: hormonalconcepts and therapy. ClinDermatol. 2004;22(5):419-428. doi:10.1016/j.clindermatol.2004.03.010)
Cappel M, Mauger D, Thiboutot D. Correlation between serum levels of insulin-likegrowthfactor 1, dehydroepiandrosteronesulfate, and dihydrotestosterone and acnelesioncounts in adult women. ArchDermatol. 2005;141(3):333-338. doi:10.1001/archderm.141.3.333
Holmes MD, Pollak MN, Willett WC, Hankinson SE. Dietarycorrelates of plasmainsulin-likegrowthfactor I and insulin-likegrowthfactorbinding protein 3 concentrations. CancerEpidemiolBiomarkersPrev. 2002;11(9):852-861
Spencer EH, Ferdowsian HR, Barnard ND. Diet and acne: a review of the evidence. Int J Dermatol. 2009;48(4):339-347. doi:10.1111/j.1365-4632.2009.04002.x
Bowe WP, Joshi SS, Shalita AR. Diet and acne. J AmAcadDermatol. 2010;63(1):124-141. doi:10.1016/j.jaad.2009.07.043
Degitz K, Placzek M, Borelli C, Plewig G. Pathophysiology of acne. J DtschDermatolGes. 2007;5(4):316-323. doi:10.1111/j.1610-0387.2007.06274.x
Xu SX, Wang HL, Fan X, et al. The familial risk of acnevulgaris in ChineseHans - a case-control study. J EurAcadDermatolVenereol. 2007;21(5):602-605. doi:10.1111/j.1468-3083.2006.02022.
. Wolff K., Goldsmith L., Katz S., Gilchrest B., Paller AS, Leffell D. Fitzpatrick's Dermatology in General Medicine.8th Edition.New York, McGraw-Hill, 913-917
Zouboulis CC, Katsambas AD, Kligman AM. Pathogenesis and Treatment of Acne and Rosacea. Springer, 2014; 213- 221
Zeichner JA, Joshua A.Acneiform eruptions in dermatology a differential diagnosis. New York,Springer, 2014; 13-17
Bolognia J., Jorizzo J. L., & Schaffer J. V. Dermatology. Third Edition.Philadelphia,Elsevier Saunders, 548-551
Archer CB, Cohen SN, Baron SE; British Association of Dermatologists and Royal College of General Practitioners. Guidance on the diagnosis and clinical management of acne. Clin Exp Dermatol. 2012 May;37 Suppl 1:1-6. doi: 10.1111/j.1365-2230.2012.04335.x. PMID: 22486762
MoradiTuchayi S, Makrantonaki E, Ganceviciene R, Dessinioti C, Feldman SR, Zouboulis CC. Acnevulgaris. NatRevDisPrimers. 2015;1:15029. Published 2015 Sep 17. doi:10.1038/nrdp.2015.29
Cotterill JA, Cunliffe WJ. Suicide in dermatological patients. Br J Dermatol. 1997;137(2):246-250. doi:10.1046/j.1365-2133.1997.18131897.x
Dalgard F, Gieler U, Holm JØ, Bjertness E, Hauser S. Self-esteem and body satisfaction among late adolescents with acne: results from a population survey. J Am Acad Dermatol. 2008;59(5):746-751. doi:10.1016/j.jaad.2008.07.013
Greywal T, Zaenglein AL, Baldwin HE, et al. Evidence-based recommendations for the management of acne fulminans and its variants. J Am Acad Dermatol. 2017;77(1):109-117. doi:10.1016/j.jaad.2016.11.028
Dessinioti C, Katsambas A. Difficult and rare forms of acne. Clin Dermatol. 2017;35(2):138-146. doi:10.1016/j.clindermatol.2016.10.00
Goulden V. Guidelines for the management of acne vulgaris in adolescents. Paediatr Drugs. 2003;5(5):301-313. doi:10.2165/00128072-200305050-00003
Duman D. Aknede topikal tedavi. Klinik Aktüel Tıp Dermatoloji (Akne) Özel Sayısı 2007;12:28-32.)))
