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 benzoyl
peroxide & 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, trimethoprimsulfamethoxazole
Isotretinoin: Cases of Refractory deep
inflammmatory acne vulgaris
Hormonal therapy: OCPs , spironolactone
Intralesional glucocorticoids; deep nodular lesions

THANKS