الفهرس 
Introduction & Aim of the workOnly 14 pages are availabe for public view
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Abstract
Acne vulgaris is a chronic inflammatory disease of the pilosebaceous follicles, characterized mainly by comedones and inflammatory lesions such as pustules, papules, nodules, cysts, and scars. Its pathogenesis includes sebaceous hypersecretion, follicular hyperkeratinization, follicular colonization by P. acnes, and immune and inflammatory responses.
Acne is a chronic inflammatory skin disease that involves the pathogenesis of four major factors, such as androgen-induced increased sebum secretion, altered keratinization, colonization of Propionibacterium acnes and inflammation (Sacchidanand et al., 2017). At the same time as sebum production is increased, there is also increased proliferation and reduced shedding of intra-follicular keratinocytes causing the pilosebaceous unit to become obstructed. As sebum and keratinocyte debris accumulate in the microcomedo, larger, clinically visible closed or open comedones develop. Colonization of the infra-infundibulum of follicles by P. acnes and the release of inflammatory mediators into the surrounding perifollicular dermis together with attraction of immunocompetent cells leads to the development of inflammatory lesions (Gollnick, 2015).
Vitamin D regulates the immune system and the proliferation and differentiation of keratinocytes and sebocytes. Moreover, it has anticomedogenic and antioxidant effect. So, a vitamin D deficiency may facilitate the pathogenesis of acne.
Vitamin D is a group of fat-soluble prohormones which were identified after the discovery of the anti-rachitic effect of cod liver oil in the early part of the 20th century. The vitamin found in cod liver oil was designated ”D” following Vitamin A, B and C, which had been discovered earlier (Zhang and Naughton, 2010).
This study was performed at Dermatology, STDs Department and Medical Biochemistry Departments Menoufia University Hospitals to study serum level of vitamin D in acne vulgaris patients on one hand, and healthy (individuals) on the other hand, also to detect relation between serum level of vitamin D and acne vulgaris severity.
This study included 45 acne vulgaris patients (15 with mild acne, 15 with moderate acne & 15 with severe acne) were recruited from Dermatology outpatient clinic, Menoufia University Hospitals & 15 age- and gender-matched healthy individuals. All subjects in this study were subjected to:
1) Informed consents were obtained from all patients and controls.
2) Full medical history taking.
3) General and dermatological clinical examination.
4) Assessment of serum 1, 25(OH)2D levels.
The results of the present study can be summerized as follow, the mean age of patients was 20.22 ± 3.21 years old. About 46.7% of cases & control group were males. About 80% of control group individuals reported adequate sun exposure compared to only 48.9% in patients.
Among acne vulgaris patients, mean duration of acne vulgaris & mean age of onset were 2.31±1.61 years & 17.91±2.0 years respectively. About 44.4% of our patients had positive family history of acne vulgaris. The serum levels of vitamin D were significantly lower in patients with acne vulgaris when compared to healthy individuals. There was negative correlation between serum levels of vitamin D & severity of acne vulgaris. Mild acne vulgaris patients had mean serum vitamin D levels 155.03±25.54 (Pg/ml) compared only to 79.44±35.48 (Pg/ml) in severe acne vulgaris patients.
Serum levels of vitamin D in patients with acne vulgaris were not associated with their age & gender & family history of acne vulgaris.
Regarding sun exposure, patients with adequate sun exposure had significant higher vitamin D serum levels (142.79±35.35) (Pg/ml) when compared to those with inadequate sun exposure (102.93±38.46) (Pg/ml).
No significant correlation was found between serum levels of vitamin D at one side & each of age of patients, age of onset of acne & duration of illness. Only in mild acne patients there was significant positive correlation between serum levels of vitamin D & duration of illness.