TNF and acne: In the pathogenesis of acne, an increase in sebum production that can obstruct a hair follicle containing keratin, sebum, and normal flora is known as comedones.14 The accumulation and inflammation of comedones can lead to the formation of acne papules and pustules.14C. acnes contributes to inflammatory factors of tumour necrosis factor-α (TNF-α), interleukin-6 (IL-6), IL-8, and IL-12.