TNF and acne: Microbial dysbiosis, particularly involving C. acnes and Staphylococcus epidermidis, contributes to acne by influencing innate immunity pathways such as PPAR and IFN signaling and TNF, IL, TLR, and MMP activation, leading to immune dysregulation, epithelial dysfunction, and overgrowth of pathogenic microbes [70,73].