Aktuelle Vorstellungen zur Entstehung von Komedonen (Komedogenese) und Implikationen für eine Pathogenese-orientierte Aknetherapie

Zusammenfassung

Für die Entstehung von Komedonen bei der Akne werden verschiedene pathogenetische Faktoren verantwortlich gemacht. Zu den endogenen Faktoren zählen P. acnes, Interleukin-1α, androgene Effekte auf die Follikelkeratinozyten, Veränderungen des Retinol- oder Dehydroretinolgehaltes der Talgdrüse, ein relativer Linolsäuremangel im Follikel sowie komedogene Bestandteile des Talges. Exogene Faktoren wie komedogene Substanzen in Pflegemitteln und Kosmetika tragen zur Komedogenese bei. Das Zusammenspiel endogener und exogener Faktoren führt zu einer gestörten Verhornung (Proliferations-Retentions-Hyperkeratose) im Infrainfundibulum des Follikelausführungsganges. Eine Pathogenese-orientierte Aknetherapie ist auf die Normalisierung der epithelialen Verhornung mit Beseitigung der Komedonen und Verhinderung ihrer Neubildung ausgerichtet.

Abstract

A variety of pathogenetic factors may be responsible for the development of comedones in acne. Endogenic factors include P. acnes, interleukin-1α, androgenic effects on follicular keratinocytes, changes of the retinol or dehydroretinol content of the sebaceous gland, a relative linoleic acid deficiency within the follicle, and comedogenic sebum components. Exogenic factors such as comedogenic ingredients of skin care products and cosmetics contribute to comedogenesis. Endogenic and exogenic factors lead to disturbed keratinization (proliferation-retention hyperkeratosis) of the follicular infrainfundibulum. Pathogenesis-related acne therapy will normalize epithelial keratinization with clearing and prevention of comedones.

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