Degitz K, Ochsendorf F
Klinik und Poliklinik für Dermatologie und Allergologie, Ludwig-Maximilians-Universität Müchen, München, Deutschland.
Hautarzt. 2008 Jun;59(6):503-12; quiz 511. doi: 10.1007/s00105-008-1497-z.
Seborrhea, follicular hyperkeratosis, propionibacteria, and inflammatory reactions are the most important factors leading to acne. The combination of increased sebum producation and follicular hyperkeratosis facilitates an increased growth of Propionibacterium acnes. Its metabolic products lead to follicular inflammation and, in extreme cases, even to perifollicular abscesses. Sebum production is influenced by androgens, so that abnormalities in androgen levels can produce seborrhea and acne. Follicular hyperkeratosis may be triggered by a relative deficiency in linoleic acid, peroxides from sebum components, and especially by inflammatory mediators such as interleukin-1. Bacterial metabolic products such as lipases, proteases, or chemotactic factors lead to the perifollicular inflammation. This inflammation is not only a response to other pathogenetic factors, but also a cause of acne. An initial mild perifollicular inflammation can induce comedogenesis via a variety of mediators. The influence of dietary factors on the initiation and course of acne has recently received increased recognition. A connection has been postulated between acne and a high nutrients with glycemic index, as well as with milk products.
脂溢性皮炎、毛囊角化过度、丙酸杆菌及炎症反应是导致痤疮的最重要因素。皮脂分泌增加与毛囊角化过度共同作用，促使痤疮丙酸杆菌大量繁殖。其代谢产物会引发毛囊炎症，在极端情况下甚至会导致毛囊周围脓肿。皮脂分泌受雄激素影响，因此雄激素水平异常会引发脂溢性皮炎和痤疮。毛囊角化过度可能由亚油酸相对缺乏、皮脂成分中的过氧化物，尤其是白细胞介素 -1 等炎症介质引发。细菌代谢产物如脂肪酶、蛋白酶或趋化因子会导致毛囊周围炎症。这种炎症不仅是对其他致病因素的反应，也是痤疮的一个成因。最初轻微的毛囊周围炎症可通过多种介质诱导粉刺形成。饮食因素对痤疮发生及发展过程的影响近来受到越来越多的关注。痤疮与高血糖指数的营养物质以及奶制品之间被推测存在关联。
