Unanswered questions still exist regarding pathophysiology of acne vulgaris generally and particularly in this environment.
Methods: Skin surface lipid (SSL) samples were collected by the heptane sponge technique from faces of 20 Nigerians with facial acne vulgaris and 25 controls. The subjects were classified into mild and moderately severe acne groups. Total cholesterol and triglycerides were determined and expressed in percentage (%) while Undetermined Skin Surface Lipids (USSL) (free fatty acids + squalene + wax ester + diglycerides) were computed.
Results: Triglycerides and total cholesterol levels were significantly higher in subjects with acne vulgaris compared with controls (p < 0.001 and p < 0.029 respectively). There was a progressively significant increase in triglycerides from control, though mild to moderately severe acne vulgaris subjects (P < 0.01) in all cases. In contrast there was a significant progressive decrease in USSL among the three groups (P < 0.001) in all cases. No significant difference was evident for all the values on comparison of female subjects with male subjects. There were however, significant increases in triglycerides and significant decreases in USSL levels for both male and female subjects with acne vulgaris compared with their respective controls (P < 0.02, P < 0.01, P < 0.03 and P < 0.014).
Conclusion: Alterations in composition of SSL may in part be the pathophysiological basis of inflammatory acne vulgaris. Severity of the disorder appears to parallel triglyceride level but there was no association with sex. Triglycerides and total cholesterol levels are lower in SSL in this environment compared with hotter climates.