Acne and rosacea

Abstract

Acne and rosacea are among the most common inflammatory skin diseases requiring consistent treatment. Current pathogenetic findings have led to new preventive and innovative therapeutic approaches. In acne vulgaris, nutritional factors have been identified as important triggers, and include extensive consumption of milk/dairy products and hyperglycemic carbohydrates, which increase the mTORC1 signaling pathway and thus sebum production. Endoplasmic reticulum stress explains the clinical trigger factors of rosacea and allows a new understanding of rosacea. Acne inversa (hidradenitis suppurativa) is not acne in the proper sense, but is an inflammation of terminal hair follicles (dissecting terminal hair folliculitis) exhibiting an increased fragility of the acroinfundibulum, in part due to reduced γ-secretase-Notch signaling, disturbed follicular stem cell homeostasis, as well as autoinflammatory processes associated with an imbalance of Th17 and regulatory T cells. Adult acne has become a worldwide concern in women, with increasing numbers of patients influenced by multiple factors. The gaining of these new insights enables use of modern and targeted therapies for these frequent, psychosocially often stressful skin diseases.