Continuous accumulation of sebum and deposition of keratinous material lead to development of le sions (open and closed comedones) traditionally classified as noninflammatory or, with proliferation of Propionibacte rium acnes and induction of immunomodulatory events, in flammatory lesions.
22 Moreover, unlike lesion counts, subjective global assessments consider other signs and symptoms, such as erythema and oiliness among others, in the determination of acne severity, and thus more accurately reflect the pleomorphic nature of this disease.
How ever, alternative hypotheses to explain our findings are also possible, including that dapsone may have as-yet unidentified direct effects on keratinization, corneocyte adhesion, or even sebaceous gland output that might result in comedolysis un related to anti-inflammatory mechanisms.
Abe M, Shimizu A Yokoyama Y, et al. A possible inhibitory action of diaminodiphenyl sulfone on tumour necrosis factor-alpha produc tion from activated mononuclear cells on cutaneous lupus erythe matosus.
Langner A Sheehan-Dare R, Layton A. A randomized, single-blind comparison of topical clindamycin + benzoyl peroxide (Duac) and erythromycin + zinc acetate (Zineryt) in the treatment of mild to moderate facial acne vulgaris.