1. Presented by Emily Pearl Seferovich
INCREASED PREVALENCE OF METABOLIC
SYNDROME IN PATIENTS WITH ACNE
INVERSA

2. WHAT IS ACNE INVERSA?
• Common, chronic Inflammatory skin disease
• Major Dermatological Issue in the United States
• Can be painful and leave residual scarring (physical & emotional)
• Is associated with metabolic syndrome, which may result in:
• A) Arteriosclerosis
• B) Coronary Heart Disease
• C) Myocardial Infarction
• D) Stroke

4. POST ACNE SCARRING

5. The aim of the study was to investigate the frequency of metabolic
disorder criteria in patients suffering from Acne Inversa to
determine the relationship between AI & Metabolic Sydrome
• Criteria for Metabolic Syndrome includes 3 or more of the following:
• (1) central obesity: waist circumference 102 cm (male), 88 cm (female),
• (2) hypo-HDL-cholesterolemia: plasma HDL-cholesterol ,40 mg/dl (male), ,50 mg/
dl (female),
• (3) hypertriglyceridemia: plasma triglyceride 1.695 mmol/l (150 mg/dl),
• (4) hypertension: blood pressure 130/85 mmHg or use of medication for
hypertension,
• (5) hyperglycemia: fasting plasma glucose 6.1 mmol/L (110 mg/dl) or use of
medication for hyperglycemia.

6. STUDY DESIGN
• Case Control Study
• 180 Participants total
• 100 control persons
• 80 cases of Acne Inversa
• Controls matched by age and sex with cases and had never
been diagnosed with Acne Inversa
• Participants screened for BMI, Waist Circumference, Blood
Pressure, FSTG Blood Lipids, and FSTG Blood sugar, and type/
severity of Acne Inversa

7. STUDY RESULTS
• Avg. waist circumference, plasma TG levels, fasting plasma glucose
levels, as well as the blood pressure were significantly higher in AI
patients than in control participants
• Avg. plasma HDL levels were lower in AI patients.
• Increased prevalence of the following within Case Cohort:
• Hypertriglyceridemia (odds ratio 2.24)
• Central Obesity (odds ratio 5.88)
• Hypo-HDL-cholesterolemia (odds ratio 4.56)
• Hyperglycemia (odds ratio 4.09)
• *odds ratios significantly higher in cases than in controls

8. 0
10
20
30
40
50
60
Patients without AI Patients with AI
Control
1.) Frequency of Hypo-HDL-
cholesterolemia
2.) Frequency of Central Obesity
0
10
20
30
40
50
60
Patients without AI Patients with AI
Control

9. 0
5
10
15
20
25
30
Patients without AI Patients with AI
3.) Frequency of Hypertriglyceridemia
0
5
10
15
20
25
30
Patients without AI Patients with AIControl
4.) Frequency of Hypertension
Control

10. 0
5
10
15
20
25
30
35
40
45
Patients without AI Patients with AI
5.) Frequency of Hyper-Glycaemia
0
5
10
15
20
25
30
35
40
45
Patients without AI Patients with AI
6.) Frequency of Metabolic Syndrome
Control Control

11. STUDY CONCLUSIONS
• Study findings suggest that chronic inflammation is not the major
driver of the metabolic alterations in AI patients.
• i.e. Chronic Inflammation does not cause metabolic dysfunction
• It is possible that metabolic alterations trigger AI.
• Metabolic Dys. à poor blood circulation of respective skin areas.
• Hypoxia inhibits production of IL-22, an important inducer of
antibacterial proteins in epithelial tissues
• Poor blood circulation could eventually lead to enhanced
cutaneous bacterial persistence and the outbreak of AI

13. SUMMARY OF STUDY RESULTS
• Metabolic syndrome can reduce the body’s ability to fight internal & external
infection
• Acne Inversa exemplifies this phenomenon
• Decreased production of anti-microbial proteins à infection
• Proper eating habits and weight maintenance
• Key implications for quality of life – both physical and emotional
• Skin health is important for self confidence
• How do people feel/ react when weight issues are compounded by
dermatological ones?
• How do others react to persons with skin conditions that are
perceived to represent bodily health?

14. QUESTIONS?
COMMENTS?
CONCERNS?