الفهرس 
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Abstract
Acne vulgaris is considered one of the most common dermatological disorders. Acne is the skin condition most commonly encountered by physicians. There are four major factors implicated in the etiology of acne: increased sebum production, follicular hyperkeratinization, increased Propionibacterium acnes within the follicle and inflammation. The primary lesion of acne is the comedones(open and closed) other lesions present include papules, pustules, nodules and cysts. Psychological impact of acne cannot be ignored. Treating early inflammation in acne lesions may be the best approach to prevent acne scarring.
Acne is a multifactorial disease in which clinical expression depend on the interaction of several factors.Psycological, hormonal and neuorogenic factors can influence the course of acne.Dietary factors have long been implicated in the pathogenesis of acne that increased consumption of dietary fat or carbohydrate intake in diet can also alter sebum composition. The relationship between blood lipids such as cholesterol, triglycerides, plasma lipoprotein, apolipoprotein and acne is not widely reported.
Our study is designed to be a prospective case control study. It will be carried on eighty [80] adult females during their childbearing period. Patients will be classified into three groups according to the clinical severity which is mild, moderate and severe using Global Acne Grading System.
These patients were subjected to various routine investigations along with lipid profile and serum testosterone, estrogen and progesterone levels during luteal phase (19 th to 21 st day). Their results were compared with a group of 20 age-matched healthy controls.
The mean age of patients was 19.01±3.32 years while the mean age of controls was 20.35±4.04 years. There is no statistically significant difference between cases and controls.
Plasma cholesterol and low density lipoprotein (LDL) levels were significantly increased in the patients when compared to controls, these difference are highly significant statistically.
In our study, we found patients had decreased high density lipoprotein (HDL) and ApoA1 lipoprotein levels when compared to controls. The both decrease of HDL and ApoA1 lipoprotein levels were highly significant statistically.
Serum triglycerides levels had no statistically significant difference between patients and controls.
There was a high statistically significant difference between different grades of acne as regard serum level of cholesterol that the cholesterol level increases with the severity of acne. Serum low density lipoprotein cholesterol had statistically significant difference between different grades of acne that the low density lipoprotein (LDL) level also increases with the severity of the acne.
Age, Serum high density lipoprotein (HDL) and ApoA1 lipoprotein levels had statistically significant difference between different grades of acne that the age, high density lipoprotein (HDL) and ApoA1 lipoprotein levels decrease with the severity of the acne.
Serum triglycerides levels had no statistically significant difference between different grades of acne.
Sreum testosterone levels in acne vulgaris patients were increased when compared to controls .The increase was statistically highly significant. Serum estrogen levels in acne patients were decreased when compared to controls. This decrease in estrogen levels in patients of acne was statistically highly significant. Serum progesterone levels in patients of acne vulgaris were increased when compared to controls. This increase in progesterone levels in patients of acne was statistically highly significant.
In our study we found estrogen had statistically significant difference between different grades of acne. That the level of estrogen decreases with the severity of acne.
Serum testosterone and progesterone levels had no statistically significant difference between different grades of acne.
There was a positive correlation between estrogen and triglycerides, and a high positive correlation with high density lipoprotein cholesterol and ApoA1 lipoprotein while there is a negative correlation between estrogen and cholesterol and low density lipoprotein cholesterol.
Testosterone had a positive correlation with cholesterol, low density lipoprotein (LDL). There was a negative correlation between testosterone and triglycerides, high density lipoprotein (HDL) and ApoA1 lipoprotein. There was a positive correlation between progesterone and cholesterol, triglycerides and high density lipoprotein (HDL) while there was a negative correlation between progesterone and low density lipoprotein (LDL) and ApoA1 lipoprotein.