Advances in the Understanding of the Pathogenesis of Inflammatory Acne

January 2016 | Volume 15 | Issue 1 | Supplement Individual Articles | 7 | Copyright © January 2016


Leon H. Kircik MD

Mount Sinai Medical Center, New York, NY
Indiana University School of Medicine, Indianapolis, IN
Physicians Skin Care, PLLC, Louisville, KY

CONCLUSION

A paradigm shift has occurred in our understanding of the pathogenesis of AV since it has moved from being viewed as primarily a hyperproliferative disorder of the sebaceous follicle to that of an inflammatory skin disorder. We also have a new perspective for the role of P. acnes in AV as well as the sequence of events in evolution of acne lesions. The fact that not every P. acnes type causes clinical acne is a revolutionary idea that shows how far we have come from the original idea of the infectious origin of the disease caused by P. acnes. Moreover, we have now accepted the presence of subclinical inflammation and therefore consider AV as a primary inflammatory process rather than a secondary inflammation to P. acnes. Additionally, inflammatory processes continue even after the resolution of papules and pustules, leading to persistent hyperpigmentary changes and finally scarring. All these changes in our understanding of acne pathogenesis may eventually lead to disappearance of nomenclature such as “non-inflammatory lesions” for comedones, and replacement of post-inflammatory hyperpigmentation with persistent inflammatory hyper-pigmentation.

DISCLOSURES

Dr. Kircik has served as an advisor, investigator, consultant, and speaker for Allergan, Bayer, Galderma, Promius Pharma, Quinnova, Stiefel/GSK, LeoPharma, Taro, Valeant, and Warner-Chilcott.

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AUTHOR CORRESPONDENCE

Leon H. Kircik MD…….................................. wedoderm@yahoo.com
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