Nor Hasyimah Binti Malek C11111885

Saidah Mafisah C11111315

Advisor :
dr. Suci Budiani

Supervisor:
DEFINITION
 A self-limited disorder of pilosebaceous unit
 Seen primarily in adolescents
 Variety of lesions:
- comedones
- papules
- pustules
- nodules
 EPIDEMIOLOGY
 Occurrence : Very common, affecting approximately
85% of young people.
 Age of Onset : Puberty; may appear first at 25 years or
older.
 Sex : More severe in males than in females.
 Race : Lower incidence in Asians and Africans.
 Genetic Aspects : There is a multifactorial genetic
background and familial predisposition. Most
individuals with cystic acne have parent(s) with a
history of severe acne. Severe acne may be associated
with XYY syndrome (rare).
ETIOLOGY & PATHOGENESIS
Multifactorial  4 basic steps:
1. follicular epidermal hyperproliferation
2. excees sebum production
3. inflammation
4. the presence & activity of Propionibacterium
acnes
 Inflammatory
Nodule
Microcomedo Comedo papule/pustule
-Rupture of
-Hyperkeratotic -Accumulation of -further expansion
follicular wall
infundibulum shed corneocytes of follicular unit
-Marked
-Cohesive & sebum -Proliferation of
perifollicular
corneocytes -Dilatation of P.acne
inflammation
-Sebum secretion follicular ostium -Perifollicular
-scarring
inflammation
HISTORY
 Since classic acne vulgaris is usually gradual in onset
 Hyperandrogenism should be considered in the
female patient whose acne is severe, sudden in its
onset, or associated with hirsutism or irregular
menstrual periods.
 A complete medication history is important, as some
medications can cause an abrupt onset of a
monomorphous acneiform eruption.
CLINICAL MANIFESTATION
 Location : The primary site of acne is the face and to a
lesser degree the back, chest, and shoulders. On the trunk,
lesions tend to be concentrated near the midline.
 Duration of Lesions : Weeks to months.
 Symptoms : Pain in lesions (especially nodulocystic
type).
 Skin Lesions : noninflammatory or inflammatory.
 The noninflammatory lesions are comedos,
which may be either closed or open and papules
 The inflammatory lesions vary from small
papules with a red border to pustules and large,
tender, fluctuant nodules.
Additional Examination
DIFFERENTIAL DIAGNOSIS
Acneiform Eruptions
 follicular eruptions
characterized by papules
and pustules resembling
acne
 induced by drugs such as
propantheline bromide,
testosterone, cyclosporine, antiepileptic medications,
lithium, and systemic corticosteroids.
Folliculitis
Rosacea
 Rosacea is characterized by
a persistent erythema of the
convex surfaces of the face,
with the cheeks and nose most
frequently affected, followed by
involvement of the brow and
chin.
 Additional features commonly
manifested include telangiectasia,
flushing, erythematous papules
and pustules
Perioral dermatitis
 This common perioral eruption consists of discrete
papules and pustules on an erythematous and at times
scaling base
 It is a distinctive dermatitis confined symmetrically
around the mouth
 There is no itching
COMPLICATION
 Transient macular erythema
 Post-inflammatory hyperpigmentation
 Permanent scarring
TREATMENT
PROGNOSIS & CLINICAL COURSE
 Favorable
 Spontaneous remission
 Prepubescent females with comedonal acne + high
DHEAS levels  predictors of severe or long-standing
nodulocystic acne
 Th/ regimens  initiated early
 Prevent permanent sequelae
THANK YOU