الفهرس 
Acne VulgarisOnly 14 pages are availabe for public view
 |  | from | 183 |  |  |
| | | from | 183 | | |
Abstract
Acne vulgaris is a chronic inflammatory disease of the pilosebaceous follicles, characterized by comedones, papules, pustules, cysts, nodules, and often scars. Sites of predilection are the face, neck, upper trunk, upper arms and to a lesser degree the back, chest, and shoulders.
Major sequelae of acne includes; dyspigmentation (hyper-or hypopigmentation) and scarring. Scarring can occur despite appropriate or effective treatment of acne in 95% of patients.
Jacob et al. divided acne scars in July (2001), into icepick scars, rolling scars and boxcar scars. While Goodman (2003), classified the acne scars into: atrophic, hypertrophic and keloidal scars. Another similar classification was done by Kadunc and Trindale de almeida (2003) which classified acne scars into: elevated scars, dystrophic scars and depressed scars.
Our interest in treatment of acne scars is growing and many measures for treatment of acne scars became popular. For the atrophic acne scars there are; chemical peels and skin fillers, while the hypertrophic scars treatment can be carried out using intalesional injection of steroid.
Surgical measures for atrophic acne scars include; dermabrasion, punch elevation, subcision and lasers. In case of hypertrophic or keloidal acne scars, surgical measures include; lasers, cryosurgery and excision.
Microneedling therapy, also known as collagen induction therapy, is a recent addition to the treatment armamentarium for managing post-acne scars. Percutaneous collagen induction with Dermaroller 1.5 mm needles was used for treatment of atrophic acne scar in 10 patients. All patients had moderate to advance atrophic acne scar with Fitzpatrick skin type III to IV. The treatment was performed under local anesthesia with sterile aseptic technique. The number of treatment sittings was 5 sessions at monthly interval. Clinical evaluation was performed by side by side comparison of standard photographs according to Goodman and Baron (2006) global scarring grading system.. The improvement of more than 50% was observed in 70 % of cases. The improvement was more prominent in rolling and boxcar scars and was limited in icepick scars. The improvement was more in patients of Fitzpatrick skin type III and was less in patients of Fitzpatrick skin type IV. No post treatment complications were noticed. Dermaroller had been shown to be effective and safe percutaneous collagen induction for treatment of atrophic acne scar in Fitzpatrick skin type III to IV patients.
Skin biopsies were performed before treatment and eight weeks after the treatment. The histopathological measurements were carried out on hematoxylin and eosin, Masson’s trichrome stain to assess the collagen remodeling and silver stain to assess the elastin remodeling.
There is 50% increase in the epidermal thickness measured by the microscopic scale bar.
Masson’s trichrome stain for collagen revealed 53.2% mean increase in the collagen fiber content in the papillary dermis in all patients measured by Leica Q 500 IW image analyzer.
Silver stain for elastic fibers revealed 65.4% mean increase in elastic fibers in the papillary dermis measured by Leica Q 500 IW image analyzer.
In our study we observed prominent epidermal thickening, collagen remodeling and increased elastic fibers with dermaroller treatment.