Investigation of fungus at stratum corneum of patients with acne vulgaris

Background: The pathophysiology of acne is complex and multifactorial. In recent years, fungal infections have increased significantly.Objectives: The purpose of this study was to evaluate the role of fungi in the etiopathogenesis of acne vulgaris.Methods: This was a prospective case-control study. A total of 200 individuals (100 with acne vulgaris and 100 without acne vulgaris) were enrolled in the study. Direct microscopic investigation and culturing of the samples were done according to Clinical and Laboratory Standards Institute criteria. Descriptive analyses, independent sample t-tests, and chi-squared tests were used for statistical analysis. The subjects in the control group were paired by age and gender with the patients.Results: Direct microscopic examination revealed hyphae in the samples of all subjects with acne and in the samples of four of the healthy controls. The cultures of 18 of the patients with acne vulgaris were positive for the following: 6 with Aspergillus spp., 7 with Penicillium spp., 3 with Cladosporium spp., 1 with Candida spp., and 1 with Acremonium spp. In addition, Candida spp. was observed in the cultures of two of the healthy controls.Conclusion: We conclude that fungi may be involved in the etiopathogenesis of acne vulgaris.