Acne Pathophysiology
Follicular and sebaceous hypersecretion hiperkeratinizarea channel (due to increased proliferation and adhesion of corneocytes) lead to the formation of pimple that later evolves to microchist or to open comedo.
Microchistii are the starting point of the inflammatory lesions, papules, pimples, their rupture in the dermis with the formation of large retentionalemai elements, explaining comedogeneza macrochistii.Mecanismele are not fully elucidated, it appears that a major role is played by androgens, and Propionibacterium acnes with determinism in the inflammatory reaction.
Sebaceous hypersecretion is the essential condition for the formation of acne lesions. Sebaceous glands are under androgen control stimuli and is considered as the secretion of sebum is triggered and maintained by testicular origin and free testosterone and delta 4 androstendion dehidriepiandrosteronul adrenal origin.
Since testosterone dosage in patients with acne may show normal levels of serum and urine, it is considered that there is a different responsiveness to androgen (sebaceous glands) from one person to alta.Acneicii metabolize androgens into more pilots receptor-sebacate (2-up 20 times higher than healthy subjects).
In sebaceous cells enzymatic equipment is able to convert androgen precursors into active metabolites biosynthesis sebaceous lipid material: 17 beta hydroxy steroid dehydrogenase, 3 beta hydroxy steroid dehydrogenase and 5 alpha biological reductaza.efectorul endocelular developed by these enzymes is dihydrotestosterone, which is a hormonal stimulus selective secretion of sebum. The fact that acne is represented equally in both sexes that you like sebaceous secretion of adrenal androgens is under control and not under the control of testosterone.
Hiperseboreeea is valued according to the secretion sebacee.Pe forehead acne subjects this level is rising steadily and in proportion to the severity of acne.
Should not be made hormonal forms of acne only if accompanied by hirsutism or acne resistant to treatment.
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