| Abstract | Akne je kronična upalna dermatoza koja se najčešće javlja u adolescentnoj dobi. Čimbenici koji su uključeni u etiopatogenezu ove bolesti su pojačano stvaranje loja, poremećaj keratinizacije folikula, folikularna reaktivnost, hormoni, mikroorganizmi, upala i prehrana. Predilekcijska mjesta su seborejička područja. Tri su osnovna klinička oblika bolesti: acne comedonica, acne papulopustulosa i acne conglobata. Bolest se najčešće povlači u ranoj odrasloj dobi, ali može trajati i do srednje životne dobi.
Glavni cilj liječenja akne jest ublažiti simptome bolesti te spriječiti nastanak ožiljaka i pojavu recidiva bolesti. U liječenju blažih oblika akne primjenjuje se lokalna terapija, dok je u težim oblicima bolesti uz lokalnu potrebno uvesti i sustavnu terapiju.
Iako su dijeteski čimbenici odavno smatrani nevažnim, suvremeni stav jest da prehrana ima bitnu ulogu u pojavnosti akne i stupnju kliničke manifestacije. Iznosi se hipoteza o inzulinskoj rezistenciji koja je uključena u etiologiju akne.
Emocionalni stres može dovesti do egzacerbacije akne (anksioznost, frustriranost, stres). S druge strane se kod pacijenata kao posljedica akni mogu razviti psihički problemi koji su posebno važni u adolescentnoj dobi jer se te godine smatraju kritičnima za razvoj identiteta (nisko samopouzdanje, bijes, smanjena socijalna inetrakcija).
Uzrok akne, naročito kod adolescentica, često su povišene razine muških spolnih hormona. Kao posljedica se javlja masna koža, akne, pojačana dlakavost, te pojačano opadanje kose do ćelavost.
U porastu je mišljenje da pozitivna obiteljska anamneza pridonosi prevalenciji koju povezujemo s polimorfizmom u promotroskoj regiji TNF gena, pri čemu je TNF glavni faktor upale. |
| Abstract (english) | Acne is a chronic inflammatory dermatosis which most commonly affects adolescents and young adults. The etiopathogenesis factors of acne are excess sebum production, follicular kyoerkeratinization, follicular reactivity, hormones, microorganisms, inflammation and diet. Predilection sites are the areas of skin with a dense population of sebaceous follicles. There are three main clinical forms of the disease: acne comedonica, acne papulopustulosa and acne conglobata. The disease frequently withdraws in young adulthood. However, it may affect people in middle adulthood as well. The main aim of the treatment is to reduce the symptomes, prevent scarring and relapse. Mild cases are treated locally/topically, whereas severe cases require systemic treatment. Although dietary factors have long been considered irrelevant, the contemporary view is that diet plays a significant role in the incidence of acne and the level od their clinical manifestation. We are presented with the hypothesis of insulin resistance in acne etiology. Emotional stress can exasperate acne (anxiety, frustration, stress). On the other hand, acne can lead to psychological distress in patients, which is of particular importance in adolescence as this age is considered critical in the development of identity (low self-esteem, anger management issues, inhibited social interaction). Acne can be aggravated or initiated by increased androgen levels, particularly in female adolescents. The condition is usually presented as oily skin, acne, increased body/facial hair, excessive hair loss and baldness. It is increasingly considered that positive family anamnesis contributes to the prevalence which is associated with polymorphism in the promotor region of the THF gene, where THF gene is the main driver of the inflammation. |
