Is Cutibacterium (previously Propionibacterium) acnes a potential pathogenic factor in the aetiology of the skin disease progressive macular hypomelanosis?

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Abstract

Progressive macular hypomelanosis (PMH) is a skin condition that normally causes symmetrically distributed hypopigmented macules on the front and back of the trunk, but rarely the face. To date, the pathophysiology of the condition is not well understood, but a role for the anaerobic skin bacterium Cutibacterium (previously Propionibacterium) acnes in the development of the disease has been proposed due to its sole presence within lesional, but not normal peri-lesional, skin. The success of antimicrobials in the treatment of PMH also provides circumstantial evidence that this association may be causal, although this is still to be proven. More recent culture and metagenomic typing studies indicate that strains of C. acnes subsp. elongatum (type III) may be important in the aetiology of the condition, which would help to explain why PMH does not normally affect the face since such strains are rarely present there, and why no association between this condition and acne vulgaris is found; acne appears to primarily involve type IA1 strains from C. acnes subsp. acnes (type I). In this review, we summarize current knowledge on the relationship between C. acnes and PMH, and re-examine previous challenges to the view that the bacterium plays a role in the condition against the backdrop of newly emerged data.
Original languageEnglish
Pages (from-to)338-344
Number of pages7
JournalJournal of the European Academy of Dermatology and Venereology
Volume35
Issue number2
Early online date30 Jun 2020
DOIs
Publication statusPublished - 20 Jul 2020

Bibliographical note

Funding Information:
Funding sources: J.M. is currently funded by a British Skin Foundation studentship to A.M.D (Grant Project No. 025/s/16).

Publisher Copyright:
© 2020 The Authors. Journal of the European Academy of Dermatology and Venereology published by John Wiley & Sons Ltd on behalf of European Academy of Dermatology and Venereology

Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.

Keywords

  • Cutibacterium acnes subsp. elongatum
  • progressive macular hypomelanosis
  • culture
  • metagenomics
  • typing
  • therapy

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