By Prof. Dr. med. Gerd Plewig, Albert M. Kligman M.D., Ph. D. (auth.)
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Therefore, differences are merely quantitative, not qualitative. The adolescent population can be distributed on a continuum according to severity. Severity is the result of many intrinsic factors acting in concert. The sum of the individual strengths of these factors determines whether the individual will have acne minor or acne major. Each factor is an absolute prerequisite, lacking which the process sinks below clinical visibility. Extrinsic factors merely modify the expression of the disease.
Benda's Eisenfarbung. Rhinophym (schwache ergr6sserung). Benda's Eisenfarbung. Page 21 Above Left: Title page from Albert Neisser's Stereoscopischer medicinischer Atlas Right: Stereoscopic binocular Below: Acne vulgaris indurata. (Mitgetheilt von Dr. V. Allgeyer). From Albert Neisser (ed) Stereoscopischer medicinischer Atlas (1898) fascicle 26. Dermatologie und Syphilidologie, 11. Folge, plate 303. JA Barth, Leipzig. Black and white photographs Page 22 Ulerythema acneiforme Unna. From Malcolm Morris, Paul-Gerson Unna, Louis Adolphus Duhring, Henry-Camille Chrysostome Leloir (eds) International atlas of rare skin diseases (1889-1899), plate II.
They are reduced in granular cells and are present in only very small amounts in the stratum corneum. In contrast, neutral lipids increase. In experiments with rodents it was shown that linoleic acid, an essentially fatty acid, is of great importance for epidermal barrier function. Feeding the rodents with a linoleic acid-free diet resulted in an excessive transepidermal water loss. The mammalian sebaceous glands might be regarded as analogous to the uropygial gland. The sebaceous lipids, however, do not playa significant role in barrier function.
ACNE and ROSACEA by Prof. Dr. med. Gerd Plewig, Albert M. Kligman M.D., Ph. D. (auth.)