الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Acne is a chronic disease of the pilosebaceous follicle under hormonal dependence involving three well-defined steps (7,8). The first step is the stimulation of sebaceous gland production, inducing hyperseborrhea that generally starts at puberty. The second step is the formation of microcomedones considered as the first elementary lesion of acne and which is due to anomalies of keratinocyte proliferation, adhesion and differentiation in the infra -infundibulum of the pilosebaceous follicle. The third step is the formation of inflammatory lesions in which Propionibacterium acnes, an anaerobic bacterium, plays an essential part. (9)
Acne is characterized by open and closed comedones (blackheads and whiteheads), which are present either alone or, more commonly, with pustules and erythematous papules (335). Lesions most commonly develop in areas with the greatest concentration of sebaceous glands, which include the face, neck, chest, upper arms, and back (334,335).
The pathogenesis of acne is currently attributed to multiple factors such as increased sebum production, alteration of the quality of sebum lipids, regulation of cutaneous steroidogenesis, androgen activity, interaction with neuropeptides (NPs), exhibition of pro- and anti-inflammatory properties, follicular hyperkeratinization and the proliferation of P. acnes within the follicle (10,11).
Propionibacterium acnes (P. acnes), a gram-positive anaerobic bacterium of the normal skin flora, plays a critical role in the development of inflammatory lesions in acne (48). It is widely accepted that inflammation may be induced by the immune response of the host to P. acnes (49).
Interleukin10 (IL-10) is one of the most important immunoregulatory cytokines with mainly anti-inflammatory and immunosuppressive effects (215). Antigen-presenting cells and lymphocytes are the primary targets of IL-10.
IL-10 is the key regulator in the cytokine network because the effects of IL-10 are believed to overcome those of IL-1alpha and to suppress the production of IL-6 and GM-CSF.
In acne patients there is a significant reduction in peripheral blood mononuclear cell secretion of anti-inflammatory IL-10.The impaired production of IL-10 by peripheral blood mononuclear cells from patients with acne was confined to CD-14+ cells that were also defective in their ablilty to phagocytose P.acne bacteria. This might suggest that a relative deficiency of IL -10 predisposes a patient to acne (314).
This study was a trial to detect the difference in serum IL-10 levels between acne patients and normal subjects and to assess the relation between the severity of acne vulgaris lesions using Investigator’s Global Assessment scale (IGA) and the serum level of IL-10 .
The study was carried out on 60 patients suffering from different grades of acne vulgaris and 30 acne free control group of matched age selected from the Dermatology outpatient clinic of Alexandria Main University Hospital. Investigator’s Global Assessment Scale (IGA) was used to evaluate the severity of acne. A blood sample was collected from each patient to measure the IL-10 level.
IL-10 level was significantly higher in the control group than in the patient group and there was no relation between the severity of acne and IL-10 level.