An increased incidence of Propionibacterium acnes biofilms in acne vulgaris: a case-control study.

BACKGROUND: Acne vulgaris is a disorder of the sebaceous follicles. Propionibacterium acnes can be involved in inflammatory acne. OBJECTIVES: This case-control study aimed at investigating the occurrence and localization of P. acnes in facial biopsies in acne and to characterize the P. acnes phylotype in skin compartments. METHODS: Specific monoclonal and polyclonal antibodies were applied to skin biopsies of 38 patients with acne and matching controls to localize and characterize P. acnes and to determine expression of co-haemolysin CAMP factor, a putative virulence determinant. RESULTS: Follicular P. acnes was demonstrated in 18 (47%) samples from patients with acne and eight (21%) control samples [odds ratio (OR) 3·37, 95% confidence interval (CI) 1·23-9·23; P = 0·017]. In 14 (37%) samples from patients with acne, P. acnes was visualized in large macrocolonies/biofilms in sebaceous follicles compared with only five (13%) control samples (OR 3·85, 95% CI 1·22-12·14; P = 0·021). Macrocolonies/biofilms consisting of mixed P. acnes phylotypes expressing CAMP1 were detected in both case and control samples. Only four samples tested positive for the presence of Staphylococcus spp. and fungi were not observed. CONCLUSIONS: We have for the first time visualized different P. acnes phylotypes in macrocolonies/biofilms in sebaceous follicles of skin biopsies. Our results support the hypothesis that P. acnes can play a role in the pathogenesis of acne as acne samples showed a higher prevalence of follicular P. acnes colonization, both in terms of follicles containing P. acnes and the greater numbers of bacteria in macrocolonies/biofilms than in control samples.

Local recurrence and long-term survival in patients with gastric cancer--analysis of possible impact of clinicopathological parameters.

In a retrospective study comprising 88 patients operated upon with curative intent a number of histopathological parameters of possible prognostic value regarding local recurrence and long-time survival were analysed. Local recurrence within 5 years was found in 28 patients (32%) of which 17 (61%) were diagnosed within the first 2 years. Crude survival rates at 5 and 10 years were 25% and 15%. According to Laurén's classification the results indicated better, but not significant, 5- and 10-year survival for the diffuse type (36% vs 25%). The probability of 10-year survival suggested a better (P = 0.06) prognosis for tumours in the middle third of the stomach, and for patients operated with total gastrectomy (P = 0.025). The probability of recurrence in relation to lymph node involvement suggested a more favourable prognosis (P = 0.06) for patients without lymph node metastases, and in relation to tumour fibrosis a less favourable prognosis for pronounced fibrosis (P = 0.001).