A multidisciplinary approach in the management of patients with acne

Abstract

The article summarizes the data of the scientific publications about the management of patients with androgen-dependent dermatopathies, namely acne, taking into account the current view on the pathogenesis, clinical manifestations and results of the examinations of this group of women. Androgen-dependent dermatopathies are not only a medical problem but also a socio-economic one, as they lead to impaired socialization and reduced quality of life. Acne is one of the most common dermatoses. Acne is a chronic multifactorial disease of the pilosebation complex, which is clinically manifested by polymorphic rash in the form of open and closed comedones, papules, pustules, nodules. The pathogenesis of the disease is based on four main links: changes in the quantitative and qualitative composition of sebum due to hypersecretion of androgens and/or increased sensitivity of receptors to their action, impaired follicular keratinization, inflammation and changes in skin microbiome. Besides the main pathogenetic aspects, trigger factors are taken into account, such as nutrition, stress, smoking, mechanical agents. The current treatment of acne according to dermatological protocols is presented in the article, which is based on a combination of topical therapy with local retinoids and antibiotics, benzoyl peroxide, azelaic acid, in case of severe or ineffective local therapy systemic antibiotics and systemic retinoids are used. However, despite the presence of many treatment regimens for dermatosis, it is often not possible to achieve a lasting effect of treatment, and the adherence of patients to follow the doctor’s recommendations decreases. Given that the leading role in the pathogenesis of acne is due to hyperandrogenic effects on the skin, as well as the fact that the disease reduces the quality of life and self-esteem in patients, it is necessary to involve a wider range of specialists, such as dermatologists, gynecologists, endocrinologists and psychotherapists for successful treatment and prevention of persistent aesthetic skin defects.