Plewig G
Klinik und Poliklinik für Dermatologie und Allergologie, Ludwig-Maximilians-Universität München, Frauenlobstr. 9-11, 80337 München.
Hautarzt. 2010 Feb;61(2):99-100, 102-4, 106. doi: 10.1007/s00105-009-1829-7.
For the initiation of acne multiple factors are required from endogenous to exogenous sources. The morphogenesis of acne is well studied, and the principle steps are discussed in the paper. Acne is a disease of humans, developing in sebaceous follicles. The first step is a proliferation-retention hyperkeratosis in the infundibulum, thus forming a follicular filament, from which a microcomedo arises. Finally open and closed comedones appear. This sequence is not strictly followed, but quite typical. Androgen stimulation activates sebaceous lipogenesis. At this point propionibacteria colonize the follicle and comedones. At earlier or later stages of the comedo development inflammatory phenomena appear, ranging from subtle to severe. Depending on the amount of inflammation, scars may develop. There is an undisputable genetic component for the initiation of acne, as twin studies have shown. The or these genetic factors have not been determined yet. The inflammatory cascade is up-regulated by immunological factors. Exogenous factors, underestimated in the past, seem to play an important role as well, as epidemiological studies and recent publications from different investigators have shown. Nutrition, particularly hyperglycemic food and milk products, are directly involved in the pathogenesis of acne.
痤疮的发病需要多种内源性和外源性因素。痤疮的形态发生已得到充分研究，本文将讨论其主要步骤。痤疮是一种发生于人类皮脂腺毛囊的疾病。第一步是漏斗部出现增殖性潴留性角化过度，从而形成毛囊细丝，进而产生微粉刺。最终出现开放性和闭合性粉刺。这个顺序并非严格遵循，但相当典型。雄激素刺激会激活皮脂腺脂质生成。此时，丙酸杆菌在毛囊和粉刺中定植。在粉刺发展的早期或晚期，会出现从轻微到严重程度不等的炎症现象。根据炎症程度，可能会形成疤痕。正如双胞胎研究所示，痤疮的发病存在无可争议的遗传因素。然而，这些遗传因素尚未确定。免疫因素会上调炎症级联反应。过去被低估的外源性因素似乎也起着重要作用，正如流行病学研究和不同研究者最近的出版物所表明的那样。营养，尤其是高糖食物和奶制品，直接参与痤疮的发病机制。
