TNF and acne: Further investigations uncovered foreskin keratinocyte as a common FDA-approved drug basis which might be a new introduction as the second line of acne vulgaris treatment. Keratinocytes establish the main barrier and warn the host of impending danger by secreting a variety of cytokines and chemokines including interleukin [IL]1α, IL6, tumor necrosis factor (TNF), and prostaglandins [74-78].