Download - Acne
ACNE VULGARIS
Abdul Alraiyes
5/7/08
ACNE VULGARIS
SELF-LIMITED DISORDER OF PILOSEBACEOUS UNIT
PRIMARILY IN ADOLESCENTS
PLEOMORPHIC VARIETY OF LESIONS- COMEDONES,
PAPULES, PUSTULES, NODULES
GENETIC FACTORS PLAY A ROLE IN ACNE SEVERITY
MEDICATIONS LIKE CORTICOSTEROIDS, ISONIAZID,
PHENYTOIN, LITHIUM, PROGESTINS
CAN CAUSE ACNELIKE LESIONS
PATHOGENESIS
FOUR KEY ELEMENTS:
FOLLICULAR HYPERKERATINIZATION
SEBUM ACCUMULATION
INFLAMMATION
PRESENCE & ACTIVITY OF Propionibacterium acnes
ANDROGENS PLAY A PIVOTAL ROLE
INCREASE SEBUM PRODUCTION & ENLARGE SEBACEOUS GLANDS
CLINICAL FEATURES
OPEN & CLOSED COMEDOS, ERYTHEMATOUS
PAPULES, PUSTULES, NODULES, CYSTS &
SCARS
FACE, TRUNK & CHEST
INFLAMATORY & NON-INFLAMMATORY LESIONS
SCARRING IS A COMPLICATION OF BOTH.
CLINICAL VARIANTS OF ACNE
ACNE
CONGLOBATA: severe, scarring form of
acne where large
nodules and abscesses
become confluent to
form draining sinus
tracts
ACNE CONGLOBATA
CLINICAL VARIANTS OF ACNE
ACNE COSMETICA:persistent, low grade form
of acne result from use of
cosmetics, moisturizers,
sunscreens This type of
acne responds particularly
well to the topical
application of tretinoin.
CLINICAL VARIANTS OF ACNE
ACNE MECHANICA:results from repeated trauma
associated with sports
helmet, shoulder pads, chin
rests of violoins and violas.
CLINICAL VARIANTS OF ACNE
Acne fulminans : severe, scarring form of acne
with systemic signs and
symptoms of infection and
Leukocytosis.
CLINICAL VARIANTS OF ACNE
NEONATAL ACNE &
INFANTILE ACNE
CLINICAL VARIANTS OF ACNE
STERIODS ACNE
DIFFERENTIAL DIAGNOSIS
FOLLICULITIS :PAPULES, PUSTULES,
NO COMEDOS. USUALLY
AFFECTS TRUNK &
EXTREMITIES
DIFFERENTIAL DIAGNOSIS
PERIORAL
DERMATITIS: LONG
TERM USE OF TOPICAL
CORTICOSTEROIDS ON
FACE CAN RESULT IN
ACNEIFORM,
ERYTHEMATOUS,
INFLAMED PINK PAPULES
ON CHIN & CHEEKS.
DIFFERENTIAL DIAGNOSIS
MILIA : WHITE, PINPOINT
EPIDERMAL CYSTS AROUND
EYES
TREATMENT
TOPICAL THERAPY:
Comedonal acne: Topical retinoids –tretinoin, adaplene, tazarotene
Anti-inflammatory & reduce follicular hyperkeratinization
Inflammatory acne: Topical antibiotics with benzoylperoxide & topical retinoids
Azelaic acid : antimicrobial & comedolytic properties
Salicylic acid
TREATMENT
SYSTEMIC THERAPY
Antibiotics: A trial of 8-12 weeks is warranted to assess responsiveness.
Doxycycline, minocycline, trimethoprim-sulfamethoxazole
Isotretinoin: Cases of Refractory deep inflammmatory acne vulgaris
Hormonal therapy: OCPs , spironolactone
Intralesional glucocorticoids; deep nodular lesions
THANKS