Disorders of the Sebaceous Glands

We examined the prevalence of depression (measured by the Carroll Rating Scale for Depression, CRSD), wishes to be dead and acute suicidal ideation among 480 patients with dermatological disorders that may be cosmetically disfiguring, i.e. non-cystic facial acne (n = 72; 5.6% suicidal ideation), alopecia areata (n = 45; 0% suicidal ideation), atopic dermatitis (n = 146; 2.1% suicidal ideation) and psoriasis (79 outpatients, 2.5% suicidal ideation and 138 inpatients, 7.2% suicidal ideation). Analysis of variance revealed that the severely affected psoriasis inpatients (mean +/- SD total body surface area affected: 52 +/- 23.4%) had the highest (P 10). The 5.6-7.2% prevalence of active suicidal ideation among the psoriasis and acne patients was higher than the 2.4-3.3% prevalence reported among general medical patients. Our findings highlight the importance of recognizing psychiatric comorbidity, especially depression, among dermatology patients and indicate that in some instances even clinically mild to moderate disease such as non-cystic facial acne can be associated with significant depression and suicidal ideation.

Propionibacterium acnes is a major inhabitant of adult human skin, where it resides within sebaceous follicles, usually as a harmless commensal although it has been implicated in acne vulgaris formation. The entire genome sequence of this Gram-positive bacterium encodes 2333 putative genes and revealed numerous gene products involved in degrading host molecules, including sialidases, neuraminidases, endoglycoceramidases, lipases, and pore-forming factors. Surface-associated and other immunogenic factors have been identified, which might be involved in triggering acne inflammation and other P. acnes-associated diseases.