Re: Help! I'm confused as to what to do...

Evidence for hereditary factors in Acne point to the
role of androgens and lipids
Although evidence of familial clustering exists (2) and an association
of frequency and severity of Acne in families with heavy
course in the descendants was described (3), varying distribution
and severity of Acne were shown in homozygotic twins (4), and
among heterozygotic twins acne was present in 54%sets only (5).
Interestingly, evidence of direct genetic association of acne with
androgen and lipid abnormalities has been observed: neonatal
acne was found to be associated with familial hyperandrogenism
(6), inadequate activity of steroid 21-hydroxylase, as well as
CYP21 gene mutations have been reported to be involved in the
pathogenesis of acne (7), and identical sebum excretion rates were
described in homozygotic but not in heterozygotic twins (4).
Moreover, the associations with biochemical markers involve
lipids: lower serum levels of apolipoprotein A1 (2) and lower
essential fatty acid levels in sebaceous wax esters and in epidermal
acylceramides (8) were found in twins with acne rather than in
non-acne twins.
Zouboulis et al.
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