Serum S100A4 in patients with acne vulgaris and acne scars: Correlation with disease severity and evaluation of biomarker potential

Aim: This study aimed to investigate serum S100A4 levels in patients with acne vulgaris and acne scars, to evaluate their relationship with disease severity, and to explore the biomarker potential of S100A4 in inflammation and scarring processes. Material and Method: A total of 60 patients with acne vulgaris, 60 patients with acne scars, and 60 healthy controls were included. Disease severity in acne vulgaris patients was assessed using the Global Acne Grading System (GAGS), while scar severity was evaluated with the Scale for Acne Scar Severity (SCAR-S). Serum S100A4 levels were measured by ELISA. Demographic and clinical data were comparatively analyzed. Results: Serum S100A4 levels were significantly higher in the acne vulgaris group compared to both the healthy control and acne scar groups (p<0.05). No significant difference was observed between the control and acne scar groups (p>0.05). Serum S100A4 demonstrated a significant discriminatory capacity in distinguishing acne vulgaris patients from both controls and scar patients. A cut-off value of 700 ng/L was identified, achieving high sensitivity. Conclusion: The findings suggest that S100A4 may serve as a biological indicator of inflammatory processes in acne vulgaris but appears to have a limited role in post-acne atrophic scarring. Accordingly, serum S100A4 could be considered a complementary indicator of inflammatory burden and may provide a basis for future studies investigating the biochemical dynamics of the disease Keywords: Acne vulgaris, Acne scar, S100A4, Inflammation, Biomarker