A microbial aetiology of acne has been suggested since the beginning of the last century. There is considerable evidence, circumstantial at best, which suggests that micro-organisms, particularly Propionibacterium acnes, are important in the pathogenesis of acne vulgaris. However, it is still unclear whether Propionibacterium acnes is actually a causal agent in the development of non-inflamed or inflamed acne lesions. Based on a review of the microbiological data on normal and acne affected skin, we propose that Propionibacterium acnes neither initiates comedogenesis nor does it have a role in the initiation ...
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