In the complex etiology of acne vulgaris, many innate or "constitutional" factors have been implicated. For example, Witten and Sulzberger1 in a current formulation, list the causes of acne under the three main headings of hormones, pilosebaceous response, and susceptibility to infection. Each heading subsumes a variety of anatomical and physiological mechanisms which may underlie the occasional progression of acne from the virtually universal comedo of the late teens to a disfiguring disease. These mechanisms are for the most part inherent, genetically determined characteristics of the individual. While some authors2,3 have studied heredity in acne directly, reporting a strong influence, others4,5 stress the genetic basis for the wide individual variation in response to stimuli which can evoke acne, whether endogenous (hormonal) or exogenous (allergy, diet, drugs, fatigue, occupational exposure).
In seeking clues to the etiology and therapy of acne, therefore, correlations have properly been
DAMON A. Constitutional Factors in Acne VulgarisPrevalence in White Soldiers and Lack of Association with Ancestry, Complexion, Body Hair, Blood Group, Handedness, Plasma Pepsinogen, and Physique. AMA Arch Derm. 1957;76(2):172–178. doi:10.1001/archderm.1957.01550200016003
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