Acne is a disease that can be seen in the first year of age, early childhood, prepubertal age and puberty. Neonatal acne is due mainly to considerable sebum excretion rate, and infantile acne because of high androgens of adrenal origin in girls and of adrenal and testes in boys. These pathogenic mechanisms are characteristic in these ages. Important factors like early onset of comedones and high serum levels of dehydroepiandrosterone sulfate are predictors of severe or long-standing acne in prepubertal age. Hereditary factors play an important role in acne. Neonatal, nodulocystic acne and conglobate acne has proven genetic influences. Postadolescent acne is related with a first-degree relative with the condition in 50% of the cases. Chromosomal abnormalities, HLA phenotypes, polymorphism of human cytochrome P-450 1A1 and MUC1 gene are involved in the pathogenesis of acne. Several other genes are being studied.

Jansen Th, Burgdorf W, Plewig G: Pathogenesis and treatment of acne in childhood. Pediatr Dermatol 1997;14:7–21.
Katsambas AD, Katoulis AC, Stavropoulos P: Acne neonatorum: A study of 22 cases. Int J Dermatol 1999;38:128–130.
Lucky AW: A review of infantile acne and pediatric acne. Dermatology 1998;196:95–97.
Bekaert C, Song M, Delvigne A: Acne neonatorum and familial hyperandrogenism. Dermatology 1998;196:453–454.
Agache P, Blanc D, Laurent R: Sebum levels during the first year of life. Br J Dermatol 1980;103:643–649.
Zouboulis CC, Fimmel S, Ortmann J, Turnbull J, Boschnakow A, Pochi P: Sebaceous Glands; in Hoath SB, Maibach H (eds): Neonatal Skin- Structure and Function, ed 2. New York, Marcel Dekker, in press.
Zouboulis CC, Boschnakow A: Chronological ageing and photoageing of the human sebaceous gland. Clin Exp Dermatol 2001;26:600–607.
Henderson CA, Taylor J, Cunliffe WJ: Sebum excretion rates in mothers and neonates. Br J Dermatol 2000;142:110–111.
Rosenfield RL: Hyperandrogenism in peripubertal girls. Pediatr Clin N Am 1990;37:1333–1358.
Vasiloudes PE, Morelli JG, Weston WL: Inflammatory nevus comedonicus in children. J Am Acad Dermatol 1998;38:834–836.
Janniger CK: Neonatal and infantile acne vulgaris. Cutis 1993;52:16.
De Raeva L, De Schepper J, Smitz J: Prepubertal acne: Cutaneous marker of androgen excess? J Am Acad Dermatol 1995;32:181–184.
Van Praag MCG, Van Rooij RWG, Folkers E, Spritzer R, Henke HE, Oranje AP: Diagnosis and treatment of pustular disorders in the neonate. Pediatr Dermatol 1997;14:131–134.
Rappelanoro R, Morturerx P, Couprie B, Maleville J, Taieb A: Neonatal Malassezia furfur pustulosis. Arch Dermatol 1996;132:190–193.
Niamba P, Weill FX, Sarlangue J, Labreze C, Couprie B, Taieb A: Is common neonatal cephalic pustulosis (neonatal acne) triggered by Malassezia sympodialis? Arch Dermatol 1998;134:995–998.
Lucky AW: Acne therapy and childhood. Dermatol Ther 1998;6:74–81.
Cunliffe WJ, Baron SE, Coulson IH: A clinical and therapeutic study of 29 patients with infantile acne. Br J Dermatol 2001;145:463–466.
Chew EW, Bingham A, Burrows D: Incidence of acne vulgaris in patients with infantile acne. Clin Exp Dermatol 1990;15:376–377.
Duke EMC: Infantile acne associated with transient increases in plasma concentrations of luteinizing hormone, follicle-stimulating hormone and testosterone. Akt Dermatol 1987;13:306–307.
Caputo R, Monti M, Ermacora E, Carminati G, Gelmetti C, Gianotti R, Gianni E, Puccinelli V: Cutaneous manifestations of tetrachlorodibenzo-P-dioxin in children and adolescents: Follow-up 10 years after the Seveso, Italy, accident. J Am Acad Dermatol 1988;19:812–819.
Manders S, Lucky AW: Perioral dermatitis in childhood. J Am Acad Dermatol 1992;27:688–692.
Arbegast KD, Braddock SW, Lamberty LF, Sawka AR: Treatment of infantile cystic acne with oral isotretinoin: A case report. Pediatr Dermatol 1991;8:166–168.
Horne HJ, Carmichael AJ: Juvenile nodulocystic acne responding to systemic isotretinoin. Br J Dermatol 1997;136:796–797.
Lucky AW, Biro FM, Huster GA, Morrison JA, Elder N: Acne vulgaris in early adolescent boys. Arch Dermatol 1991;127:210–216.
Lucky AW, Biro FM, Huster GA, Leach AD, Morrison JA, Ratterman J: Acne vulgaris in premenarchal girls: An early sign of puberty associated with rising levels of dehydroepiandrosterone. Arch Dermatol 1994;130:308–314.
Stewart ME, Downing DT, Cook JS, Hansen JR, Strauss JS: Sebaceous gland activity and serum dehydroepiandrosterone sulfate levels in boys and girls. Arch Dermatol 1992;128:1345–1348.
Lucky AW, Biro FM, Simbartl LA, Morrison JA, Sorg NW: Predictors of severity of acne vulgaris in young adolescent girls: Results of a five year longitudinal study. J Pediatr 1997;130:30–39.
Nengesha YM, Holcombe TC, Hansen RC: Prepubertal hidradenitis suppurativa: Two case reports and review of the literature. Pediatr Dermatol 1999;16:292–296.
Lucky AW, Henderson TA, Olson WH, Robisch DM, Lebwohl M, Swinyer LJ: Effectiveness of norgestimate and ethinyl estradiol in treating moderate acne vulgaris. J Am Acad Dermatol 1997;37:746–754.
Friedman GD: Twin studies of disease heritability based on medical records: application to acne vulgaris. Acta Genet Med Gemellol 1984;33:487–495.
Burket JM, Storrs FJ: Nodulocystic infantile acne occurring in a kindred of steatocystoma. Arch Dermatol 1987;123:432–433.
Goulden V, Clark SM, Cunliffe WJ: Post-adolescent acne: a review of clinical features. Br J Dermatol 1997;136:66–70.
Walton S, Wyatt Eh, Cunliffe WJ: Genetic control of sebum excretion and acne: A twin study. Br J Dermatol 1998;118:393–396.
Voorhees JJ, Wilkins JW; Hayes E, Harrell R: Nodulocystic acne as a phenotypic feature of the XYY genotype. Arch Dermatol 1972;105:913–919.
Marr TJ, Traisman HS: Nodulocystic acne, Chromosomal abnormality, and diabetes mellitus. Cutis 1981;27:87–88.
Funderburk SJ, Landau JW: Acne in retarded boy with autosomal chromosomal abnormality. Arch Dermatol 1976;112:859–861.
Schackert K, Scholz S, Steinbauer-Rosenthal I, Albert ED, Wank R, Plewig G: HLA antigen in acne conglobata: A negative study. Arch Dermatol 1974;110:468.
Wong SS, Pritchard MH, Holt PJA: Familial acne fulminans. Clin Exp Dermatol 1992;17:351–353.
Paraskevaidis A, Drakoulis N, Roots I, Orfanos CE, Zouboulis CC: Polymorphisms in the human cytochrome P-450 1A1 gene (CYP1A1) as a factor for developing acne. Dermatology 1998;196:171–175.
Wanner R, Zober A, Abraham K, Kleffe J, Henz BM, Wittig B: Polymorphism at codon 554 of human Ah receptor: Different allelic frequencies in Caucasians and Japanese and no correlation with severity of TCDD-induced chloracne in chemical workers. Pharmacogenetics 1999;9:777–780.
Ostlere LS, Rumsby G, Holownia P, Jacobs HS, Rustin MHA, Honour JW: Carrier status for steroid 21-hydroxylase deficiency is only one factor in the variable phenotype of acne. Clin Endocrinol 1998;48:209–215.
Sawaya ME, Shalita AR: Androgen receptor polymorphisms (CAG repeat length) in androgenetic alopecia, hirsutism, and acne. J Cutan Med Surg 1998;3:9–15.
Ando I, Kukita A, Soma G, Hino H: A large number of tandem repeats in the polymorphic epithelial mucin gene is associated with severe acne. J Dermatol 1998;25:150–152.
Hatta N, Dixon C, Ray AJ, Phillips SR, Dale M, Todd C, Meggit S, Birch-Machin MA, Rees JL: Expression, candidate gene, and population studies of the melanocortin 5 receptor. J Invest Dermatol 2001;116:564–570.
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