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Papule /

Grade Comedones Nodule/cyst Total lesion

Mild <20 <15 0 <30
Moderate 20-100 15-50 <5 30-125
Severe >100 >50 >5 >125

Acne vulgaris is a chronic multifactorial inflammatory disease of the pilosebaceous unit.

1. Titus S, Hodge J. Diagnosis and Treatment of Acne. Am Fam Physician. 2012 Oct 15; 86(8):734-740
2. Lehmann HP, et al. Acne therapy: a methodology review. J Am Acad Dermatol. 2002; 47(2): 231-240
3. Gollnick H, et al. Management of acne: a report from a global alliance to improve outcomes in acne. J
Am Acad Dermatol. 2003; 49(1)
4. Menaldi SLSW, Bramono K, Indriatami W, editor. Ilmu penyakit kulit dan kelamin. Edisi 7. Jakarta:
balai penerbit FK UI; 2015.

Grading (Lehmann, et al. 2002)

Differential Diagnosis

Etiology Drugs, such as

corticosteroid, lithium,
phenytoin, isoniazid, etc.
Definition High glycemic
index food
Skin efflorescence Cosmetics, and other
occlusive agents
High androgen Genetic High humidity,
production hot weather
Whiteheads (closed comedones) are
flesh-colored or whitish palpable lesions
1 to 3 mm in diameter

papule is a circumscribed, solid cysts are closed sac-like or

elevation of skin with no visible capsule structures that may be
fluid, varying in area from a filled with semisolid material,
pinhead to 1 cm gaseous material, or liquid.

blackheads (open comedones) are Pustule is papule. that is nodules are solid, elevated areas
similar in appearance but with a filled with pus of tissue or fluid inside or under
dark center. the skin with a diameter greater
than 0.5 centimeters.

• physical scars,
• persistent hyperpigmentation,
• and psychological sequelae.

• Acne of any severity usually remits spontaneously by the early to mid 20s, but a substantial
minority of patients, usually women, may have acne into their 40s
• Noninflammatory and mild inflammatory acne usually heals without scars.
• Moderate to severe inflammatory acne heals but often leaves scarring. Scarring is not only
• Regular cleansing, min 2 times/day
• Eat food that contains high antioxidants, probiotics, and fish oil
• avoid triggers (eg, occlusive cosmetics and clothing, cleansers, lotions, high humidity, some
drugs and chemicals, possibly a high intake of milk or a high-glycemic diet).