Vestnik dermatologii i venerologiiVestnik dermatologii i venerologii0042-46092313-6294Rossijskoe Obschestvo Dermatovenerologov i Kosmetologov46910.25208/0042-4609-2019-95-1-77-81Modern pathogenetic therapy of acneSamtsovA. V.Dr. Sci. (Med.), Prof., Departmental Head, Department of Skin and Venereal Diseasesavsamtsov@mail.ruS. M. Kirov Military Medical Academy, Ministry of Defence of the Russian Federation0203201995177813005201930052019Copyright © 2019, Samtsov A.V.2019<p>The article provides an overview of literature on new data in studying acne pathophysiology. A particular attention is given to modern interpretation of the role played by inflammation in dermatosis development. The author presents an analysis of the most effective modern pathogenetically-based topical preparations, as well as an algorithm for their application.</p>subclinical inflammationinnate immunityadapaleneclindamycinсубклиническое воспалениеврожденный иммунитетадапаленклиндамицин[1. Zaenglein А., Pathy А., Schlosser В. et al. Guidelines of care for the management of acne vulgaris. J Am Acad Dermatol. DOI: 10.1016/j. jaad.2015.12.037][2. Thiboutot D., Gollnick H. New insights into the management of acne: an update from the Global Alliance to improve outcomes in acne group. J Am Acad Dermatol. 2009;60:1–50.][3. Dreno B., Gollnick H., Kang S. et al. Understanding innate immunity and inflammation in acne: implications for management. JEADV. 2015;29 (Suppl 4):3–11.][4. Gollnick H. From new findings in acne pathogenesis to new approaches in treatment. JEADV. 2015;29:1–7.][5. Jeremy A. H., Holland D. B., Roberts S. G., Thomson K. F., Cunliffe W. J. Inflammatory events are involved in acne lesion initiation. J Invest Dermatol. 2003;121:20–27.][6. Lee W., Jung H., Chi S. et al. Effect of dihydrotestosterone on the upregulation of inflammatory cytokines in cultured sebocytes. Arch Dermatol Res. 2010;302:429–433.][7. Shaheen B., Gonzales M. Acne sans P. acnes. JEADV. 2013;27:1–10.][8. Kim J., Ochoa М., Krutzik S. et al. Activation of Toll-Like Receptor 2 in Acne Triggers Inflammatory Cytokine Responses. J Immunology. 2002;169:1535–1541.][9. Vowels B., Yang S., Leyden J. Induction of proinflammatory cytokines by a soluble factor of Propionibacterium acnes — implications for chronic inflammatory acne. Infect Immun. 1995;63:3158– 3165.][10. Ichiyasu H., Suga M., Matsukawa A. et al. Functional roles of MCP-1 in Propionibacterium acnes-induced, T cellmediated pulmonary granulomatosis in rabbits. J Leukocyte Biology. 1999;65:482–491.][11. Itakura M., Tokuda A., Kimura H. et al. Blockade of Secondary Lymphoid Tissue Chemokine Exacerbates Propionibacterium acnes-Induced Acute Lung Inflammation. J Immunology. 2001;166:2071–2079.][12. Webster G. Commentary: Diet and acne. J Am Acad Dermatol. 2008;58:794–795.][13. Lodes M., Secrist H., Benson D. et al. Variable expression of immunoreactive surface proteins of Propionibacterium acnes Microbiology. 2006;152:3667–3681.][14. Zaenglein A., Thiboutot D. Expert Committee Recommendations for Acne Management. Pediatrics. 2006;118:1188–1199.][15. Самцов А. В., Аравийская Е. А. Федеральные клинические рекомендации по ведению больных акне. Под ред. А. А. Кубановой. 2018. [Samtsov A. V., Araviyskaya E. A. Federal clinical guidelines for treating patients with acne. Еd. by A. A. Kubanova. 2018 (In Russ.)]]][16. Leccia M. et al. Topical acne treatments in Europe and the issue of antimicrobal resistance. JEADV. 2015;29:1485–1492.][17. Simonart T., Dramaix M. Treatment of acne with topical antibiotics: lessons from clinical studies. Br J Dermatol. 2005;153:395–403.][18. Heba A., Alan S. Topical Clindamycin Preparations in the Treatment of Acnes Vulgaris. Exp Rev Dermatol. 2009;4(2):1–8.][19. Wolf J. E., Kaplan D., Kraus S. Efficacy and tolerability of combined topical treatment of acne vulgaris with adapalene and clindamycin: a multicenter, randomized, investigator-blinded study. Randomized controlled trial. J Am Acad Dermatol. 2003;49 (Suppl):211–217.]