Thank you! Rob streeper. I have review all these papers. I think it is not enough to explain the question: Why androgen level in serum of acne patient is so higher than these who have no acne? Is it because the secretion of androgen can not be regulated endocrine system? What is the regulator of secretion of androgen? How to regulate the secretion of androgen in our body?

The secretory function of hypothalamic-pituitary-gonad axis and hypothalamic-pituitary-adrenal axis is controlled and modulated directly or indirectly by nervous system (text book). The nervous system is affected by internal and external environment changes and send signal to endocrine system. A time of increased stress may also promote other hormone secretion… but …(I thinking)

Why increased stresses promote hypothalamic-pituitary-gonad axis and hypothalamic-pituitary-adrenal axis upregulate androgen secretion? What is the function of androgen besides its sexual stimulation.

Dear All,

I cannot agree with the comment "androgen level in serum of acne patient is higher than in these who have no acne", since this does not represent the scientific evidence. Moreover, just because androgen levels in serum of patients with acne are not higher than in non-acne individuals, efforts have been undertaken to measure androgen metabolites in urine without discriminating success either. Therefore, the valid dermatoendocrinology concept is that the difference is neither at the levels of circulating androgens nor at that of their urine metabolites but at the intracellular levels of active androgens in target organs and their binding capacity to the amdrogen receptors.

Dietary habits and food has always been a controversy.

http://www.ncbi.nlm.nih.gov › ... › Dermatoendocrinol › v.4(1); Jan 1, 2012

I'm sure this discussion will open mew horizons in the management of acne

Dear Prof. Dr. Christos Zouboulis:

I still have some question about the pathogenesis of acne.

Why is there such a difference at the intracellular levels of active androgens in target organs and their binding capacity to the androgen receptors? There are many androgen target organ, why androgen can cause acne inflammation of the follicle duct on face? A variety of inflammatory factors and mediators increased in the blood, but it did not cause inflammatory reaction, why inflammation occurs in hair follicle duck on facial skin? The acne inflammation develops quickly. No bacteria in very early acne lesion.

Thank you!

Jiang Hao

Rob Streeper, The acne inflammation develops quickly and strongly damage nomal tissues. No bacteria in early inflammatory acne lesion. Bacteria infected acne lesion after nomal tissues damaged

Among Acne lesions are normal skin. P.acne can present on normal skin surface does not cause allergic reactions. mechanical trauma is not acne

Thank you Rob Streeper ! Some athletes take drugs and hormone

Will this study done in 1980 open new frontiers of understanding acne

http://www.ncbi.nlm.nih.gov/pubmed/6448587

I have an article abstract but not the full text and would love to get it. In my clinic i practice the low dose isotretinoin and am getting good results.

http://www.ncbi.nlm.nih.gov/pubmed/7714084

Thank you satyaprasad Venkata:

I don’t think Anti-estrogens or estrogens are possible therapy aimed at acne pathogeny treatment. There are excessive numbers of epithelial cells apoptosis and desquamated from the follicle walls in acne lesion. why?

External use isotretinoin can cause desquamation, peeling, dry, itching, rhagadia on skin and mucous membrane. Isotretinoin is a byproduct of vitamin A; It induces apoptosis (cell death) in various cells in the body such as epithelial cells. Clinically, we found that most severe acne lesions can self healing within two month without any treatment of young people. I mean therapeutic effect of isotretinoinin treament of acne is not enough.

.

Dr Hao, the article about isotretinoin and transcription factor has a role of in the management of acne and it is not totally inactive against acne

http://www.ncbi.nlm.nih.gov/pubmed/20930691

Dear Dr. Jiang,

the pilosebaceous unit in facial skin as well as at the middle breast, back and shoulders is a sebaceous follicle, i.e. large sebaceous gland and relatively smaller hair apparatus. This fact as well as the publication of Rinn JL et al. 128:776, 2008 on the patchwork of the skin indicates different genetic susceptability of the skin organelles in different areas of the body.

Dear Prof. Christos Zouboulis

Thank you!

is this article?

http://med.stanford.edu/labs/vanderijn-west/documents/chang_2008.pdf

I will carefully review it

There are excessive numbers of epithelial cells apoptosis and desquamated from the follicle walls and around acne lesion. Why are these cells apoptosis and desquamated? Is the increased activity of the androgen receptor a special abnormal signal sent by these being apoptosis cells? Is the difference at the intracellular levels of active androgens in target organs and their binding capacity to the androgen receptors related to epithelial cells apoptosis and desquamated from the follicle walls and around acne lesion?

Dear Rob Streeper：

There are so many articles about pathogenesis of acne vulgaris have been published in journal with high authority and high impact factor. But these articles are not perfect and not deeply enough to explain pathogenesis of acne. Because the authors have neglected important pathological changes in acne lesions, which may directly manifest the pathophysiological characteristics of acne. Thank you for your very good questions.

Jiang Hao

Hi Rob,

There are so many question about acne which can not be easily answered. We need further more study and think. Thank you for Max Planck's words.

Happy New Year!

Hao

Hello Jiang happy new year.androgens and acne, epithelial cells apoptosis, androgen receptor, pilosebaseos unit.keratin plugsP acnes. if all of these are taken into consideration then acne is understood to be a multifactorial disorder.Why acne starts at teenage, why acne is more in PCOS,why ance has 4 stages, why some acnes result in scars, why salicilic acid peel is beneficial in acne, anti androgen and isotretinoin or vitmin A derivatives usefull in acne.many more questions need answers.

Thank you, Satyaprasad Venkata.

There are too many questions about acne. It seems that medical doctors not deeply understand pathogenesis of acne and therapeutics of acne is palliative. Many common people do not think acne is a kind of disease and not care about it.