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Abstract Background: Acne is a chronic inflammatory disease of the pilosebaceous units with multifactorial pathogenesis. Adipokines such as visfatin may be involved in the pathogenesis of acne and provide a link between acne and metabolic syndrome. Objectives: To study visfatin expression in acne patient both in lesional skin and serum versus healthy controls and to study the relationship of visfatin levels with dyslipidemia/metabolic syndrome, as well as acne severity. Patients and methods: This study included 30 patients with acne vulgaris and 30 age and sex matched healthy controls. Serum and tissue visfatin were estimated by ELISA. Clinical and laboratory examinations were done to assess anthropometric data and various criteria of metabolic syndrome. Results: Tissue and serum visfatin were significantly higher in patients rather than healthy controls. However, tissue visfatin levels were significantly higher than serum ones in both patients and controls. Only serum visfatin was significantly higher in overweight rather than normal weight patients. No correlations were found between tissue and serum visfatin in both patients and controls. Both serum and tissue visfatin were not significantly different between various degrees of acne severity. Serum and tissue visfatin levels were neither correlated to any of lipid profile parameters or criteria of metabolic syndrome in acne patients. Conclusion: Visfatin is an important pro inflammatory adipokine that is actively expressed by the sebaceous glands, with significant higher expression in acne patients. Tissue rather than serum visfatin is hypothesized to play a key role in acne pathogenesis at multiple points, through its pro- inflammatory and insulin like actions |