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Acne vulgaris

Rolle der Hormone

Acne vulgaris

The role of hormones

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Zusammenfassung

Peripher wirkende Androgene kontrollieren die zelluläre Funktion durch die Bindung an die Androgenrezeptoren. Follikuläre Keratinozyten und Talgdrüsenzellen sind Zielzellen für Androgene, die – direkt oder indirekt – eine Keratinozytenproliferation und eine Vergrößerung der Talgdrüsen sowie eine erhöhte Sebumexkretionsrate bewirken. Der Beginn der Akne fällt häufig mit der Adrenarche, und zwar mit dem Beginn der Synthesesteigerung des Vorstoffes von Testosteron Dehydroepiandrosteronsulfat durch die Nebennierenrinde, zusammen. Die meisten Aknepatienten weisen keine erhöhten Androgenblutspiegel auf. Stattdessen zeigen Talgdrüsenzellen aus Akneregionen eine höhere Ansprechbarkeit auf Androgene als Talgdrüsenzellen aus anderen Körperarealen. Hormonwirksame Lipide, Hormone in der Nahrung und Neuropeptide können auch eine Rolle bei der Entstehung von Akneeffloreszenzen spielen. Das Ziel der antiandrogenen Therapie der Haut ist die Talgdrüse, und ihre primäre Wirkung ist sebostatisch.

Abstract

Peripherally active androgens control cellular functions by binding to androgen receptors. Follicular keratinocytes and sebocytes are target cells for androgens, which, directly or indirectly, stimulate keratinocyte proliferation and the volume of sebaceous glands as well as the sebum secretion rate. Acne often begins with the adrenarche, namely with the up- regulation of adrenal synthesis of dehydroepiandrosterone sulfate, a hormone that is upstream to testosterone. The majority of acne patients exhibit normal levels of circulating androgens, while sebaceous glands from acne regions exhibit a stronger sensitivity to androgens than the sebaceous glands from other parts of the body. Hormone-like active lipids, hormones in diet and neuropeptides may also play a role in the development of acne lesions. The target of antiandrogen treatment of the skin is mainly the sebaceous gland and the primary effect is sebostasis.

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  1. Klinik für Dermatologie, Venerologie und Allergologie/Immunologisches Zentrum, Städtisches Klinikum Dessau, Auenweg 38, 06847, Dessau-Roßlau, Deutschland

    C.C. Zouboulis

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Zouboulis, C. Acne vulgaris. Hautarzt 61, 107–114 (2010). https://doi.org/10.1007/s00105-009-1830-1

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