الفهرس 
Acne VulgarisOnly 14 pages are availabe for public view
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Abstract
Acne, the most common skin disease, is a chronic inflammatory disease of the
pilosebaceous unit, characterized by seborrhea, formation of comedones, erythematous
papules and pustules, less frequently by nodules, deep pustules, or pseudocysts and, in
some cases, is accompanied by scarring.
The pathogenesis of acne lesions is multifactorial. Four major mechanisms have
been implicated in the pathogenesis of acne lesions: Increased and altered sebum
production under the control of androgens, altered keratinization, leading to comedone
formation, Colonization of the follicle with P. acnes and release of inflammatory
mediators into the skin.
The metabolic syndrome, which comprises the presence of three, or more, of
five risk factors, such as obesity, increased cholesterol and triglycerides, hypertension,
and glucose intolerance, have recaptured the attention in acne vulgaris research. The
diseases with the strongest association are psoriasis, hidradenitis suppurativa, acne
vulgaris and acanthosis nigricans. In the same line, all types of acne have an
inflammatory and chronic nature, even subclinical forms, thus it is possible that acne
predisposes an augmented risk of metabolic alterations on a long-term basis.
The fatty acid-binding proteins (FABPs) belong to a family of low-molecularweight intracellular lipid-binding proteins involved in the regulation of lipid metabolism
and inflammation. Among those, epidermal-type fatty acid binding protein (E-FABP or
FABP5) that was first identified in epidermis, and its cutaneous expression also includes
sebaceous glands and hair follicles.
The aim of this work is to uncover the role of E-FABP in acne vulgaris
development and its relation to metabolic syndrome through its immunohistochemical
expression.
The study was a hospital-based case–control study involving a series of 30 cases
of acne vulgaris and 30 healthy controls. Each case was submitted to thorough history
taking, complete general and dermatological examinations with assessment of the
disease severity. Skin biopsies were taken from the patients after taking written consents for immunohistochemical expression of E-FABP and venous samples were taken and examined for serum lipid profile and random blood sugar, also waist circumference and
blood pressure were measured at the enrolment visit.
Results of the present study revealed that cholesterol level and LDL-c were
significantly higher in cases than controls, also immunohistochemical expression of
epidermal fatty acid binding protein (E-FABP) in the epidermis and dermal components
has higher intensity and H score in cases than controls.
In the current work, the median H score values of E-FABP in epidermis and
dermis was significantly higher in inflammatory acne cases than noninflammatory ones,
also it showed significant elevation with increasing the clinical severity of AV cases.
Also in the present study, acne vulgaris cases with severe dermal inflammation
exhibited significantly higher median H score value of E-FABP expression in
epidermis, dermal endothelial cells, inflammatory cells together with fibroblasts in
comparison to cases with mild or moderate dermal inflammation. In the same line, it
was significantly higher in acne cases featuring follicular rupture and dermal fibrosis.
Significant positive correlations were found between H score value of E-FABP
expression in epidermis and its H scores of expressions in dermal structures (adnexa,
endothelial cells, fibroblast and inflammatory cells) among the studied cases.
Results of the present study revealed also no significant correlation between H score value of E-FABP expression in the epidermis and dermis with laboratory
investigations of the studied cases.