Sebum, hormones and isotretinoin in acne = Sebum, hormones and isotretinoin in acne

다국어 초록 (Multilingual Abstract)

Acne vulgaris is a common chronic disease of pilosebaceous unit in the skin. The pathophysiology of acne involves four main mechanisms of action: increased sebum production, abnormal proliferation and differentiation of keratinocytes, Propionibacterium acnes proliferation and inflammation. Sebocytes are not only target cells for androgen hormones but also important formation sites of active androgens. Androgen hormones stimulate the volume of sebaceous glands as well as the sebum secretion rate. The majority of acne patients exhibit normal levels of circulating androgens, while sebaceous glands from acne regions exhibit a stronger sensitivity to androgens than the sebaceous glands from other parts of the body. Other hormones, such as estrogen, growth hormone, insulin-like growth factors, glucocorticoids, adrenocorticotropic hormone, prolactin and melanocortins, may also be important in sebum production and the pathogenesis of acne. Treatment of acne may be complicated, often requiring systemic and topical combination therapy with long term maintenance strategy. Retinoids and antibiotics may be effective for acne lesions. Oral isotretinoin is one of the efficient therapeutic agents in acne. Isotretinoin shows several activities: decrease in sebum secretion, improvement of abnormal follicular keratinization, decrease in inflammation and inhibition of Propionibacterium acnes growth.