February 22, 2017

ACNE and ROSACEA by Prof. Dr. med. Gerd Plewig, Albert M. Kligman M.D., Ph. D.

By Prof. Dr. med. Gerd Plewig, Albert M. Kligman M.D., Ph. D. (auth.)

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The epidermis of hairless mice synthesizes fatty acids with adjustment to barrier requirements, indicating that the epidermis is capable of de novo synthesis of these substances. After restoration of normal barrier function, epidermal fatty acid synthesis returns to normal. , modified desmosomes in the stratum corneum, are most important for corneocyte adhesion. These cells possess oligosaccharide side-chains which are capable of protecting desmosomes and corneosomes against proteolysis. The concept of the brick and mortar model.

D lot. " 11 flU. ,. t 811'\11.... . hl.. (0.. ) 101. "tnri. nla. tDr. ) I~. 0. IiGrpt1"(~. ', HJ. u. p 1M. \fl. a1lt. tDr. ) :n o. 01 .... 1. (D•• IIEYEIL) S II . s. " I. ro. I•• r 110... 1111. u fol\a\l ..... anall... IProt. to. 'M. poet . \ rackl. U.. I. plll.... t ... ) "I. (~J'~~~;,-) LElP'tIG, 1898. VERLAG YO. JOHANN AMBROSIUS BARTH. ' ............... RUokolcb\ au' 41. ,.... _ I ..... 1<: ! ~ Y T! ((':. ; ((I'( ) Jt\ u; I":\~" \ 24 ~~~@~@@WL7 [f@~~@[;Q)~WS)~@~@@WL7 @[ljJ(Q] ~@S)@~@@W @~ L%~[ljJ~ 25 26 Prevalence Acne is a typical pleomorphic disease.

The larger irregular depressions are small scars. The skin is obviously oily Below: Cheek of a young woman without acne. One can barely make out the pores. The skin is nonoily 32 The Pilosebaceous Unit: The Stage Setting These sketches illustrate the architecture and size differences of the three types of facial follicles. Left: Vellus follicle. These are very numerous. Their sebaceous lipids contribute to the surface lipids but are mere bystanders in acne Middle: Sebaceous follicle. This is the theater where the drama of acne is performed.

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