Different cutaneous innate immunity profiles in acne patients with and without atrophic scars

BACKGROUND: Acne is a chronic inflammatory disease associated with scar development in many patients. OBJECTIVES: To check whether early inflammatory events in the epidermis via keratinocytes influence the development of scars in acne patients. METHODS: We investigated several immunological markers involved in epidermal innate immunity in both clinically normal skin and inflammatory early papules in acne patients prone to scars or not. RESULTS: In normal skin of acne patients prone to scars vs not prone to scars, TLR-4, IL-2, IL-10, TIMP-2 and JUN were significantly overexpressed and the MMP-9 protein level was decreased. Similar results were obtained in early inflammatory papules (no more than three days), except for TLR-4. CONCLUSION: These results suggest for the first time a link between the early events of inflammation with levels of activation of innate immunity in normal epidermis of acne patients and the development of scars. These markers could be a target for drugs in the field of scar prevention.