Moteb Alotaibi, Ishag Adam
Acne vulgaris affects an estimated 9.4% of the world's population and is the eighth most prevalent disease globally. Helicobacter pylori has been implicated in several inflammatory dermatoses, but the evidence linking it to acne rests on a small number of clinic-based studies, and no data have been reported from Africa. We examined this association in a school-based case-control study of adolescents aged 10-19 years attending public schools in Almatamah Locality, northern Sudan, between October and November 2022. Acne was diagnosed and graded by trained physicians using the Global Acne Grading System, and H. pylori IgG/IgM antibodies were detected by a rapid immunochromatographic assay. Groups were compared using the χ2, Mann-Whitney, and Fisher-Freeman-Halton exact tests, and associations were estimated by univariate and multivariable logistic regression. Of 313 adolescents enrolled, 130 had acne (99 [76.2%] mild, 28 [21.5%] moderate, and 3 [2.3%] severe) and 183 did not. Seroprevalence was higher among adolescents with acne (19/130, 14.6%; 95% CI, 9.6-21.7) than among those without (5/183, 2.7%; 95% CI, 1.2-6.2), a difference of 11.9 percentage points (95% CI, 5.7-19.1; P < 0.001). Female sex (adjusted odds ratio [AOR] 2.80; 95% CI, 1.72-4.56) and H. pylori seropositivity (AOR 5.28; 95% CI, 1.86-14.94) were independently associated with acne, whereas body mass index was not. Among adolescents with acne, seropositivity was not associated with severity (P = 0.850). H. pylori seropositivity was associated with acne vulgaris in this population, but the absence of a severity gradient and the small number of exposed participants warrant cautious interpretation.