Acne-Associated Syndromes: Models for Better Understanding of Acne Pathogenesis

The document reviews acne-associated syndromes and their implications for understanding acne pathogenesis. It discusses how conditions like congenital adrenal hyperplasia (CAH), seborrhoea-acne-hirsutism-androgenetic alopecia (SAHA) syndrome, polycystic ovary syndrome (PCOS), hyperandrogenism-insulin resistance-acanthosis nigricans (HAIR-AN) syndrome, synovitis-acne-pustulosis-hyperostosis-osteitis (SAPHO) syndrome, pyogenic arthritis-pyoderma gangrenosum-acne (PAPA) syndrome, and Apert syndrome contribute to the understanding of acne. These syndromes highlight the roles of androgen steroids, insulin resistance, inflammation, and fibroblast growth factor receptor 2 (FGFR2) signaling in acne development. Treatments vary from oral glucocorticoids for CAH to lifestyle modifications, oral contraceptives, and antiandrogens for SAHA and PCOS. Immunotherapeutic agents are used for SAPHO syndrome, and dapsone for PAPA syndrome due to its antineutrophilic effects. The review suggests that further studies on these syndromes could lead to a better understanding of acne pathogenesis and the development of new treatments. Additionally, a clinical review of 36 patients with frontal fibrosing alopecia (FFA) found that hydroxychloroquine significantly reduced signs and symptoms of FFA at 6 and 12 months of treatment.