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DEFINITIONAcne vulgaris:

Is a self limited disorder and chronicinflammation of the pilosebaceous

glands (hair follicles that contain largeoil-producing cells) of the face, upperarms, and upper chest.

It may appear as solid elevations ofthe skin (papules), as pus-filled blisters(pustules), ass cysts or as scars.

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EPIDEMIOLOGY

Acne is often anearly

manifestation of

puberty (about90%)

Nearly everyoneever suffer from

this disease

Nearly everyoneever suffer from

this disease

Nearly everyoneever suffer from

this disease

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ETIOPATHOGENESIS

Follicular epidermal hyperproliferation

Excess sebum production

Inflammation

The presence and activity ofPropionilbacterium acnes

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CLINICAL MANIFESTATIONS

Variety cutaneous lesion on the face,back, chest and shoulders :

- Non inflammatory lesion:

Open and closed comedos

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- Inflammatory lesion:

Papules, pustules, nodules,sometimes cysts, and scars.

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SEVERITY OF THE ACNELESION

Severit

y

Symptoms

Mild

(Grade 1)

Non inflammatory lesion only at 1 predilectionFew non-inflammatory lesions at several predilections

Few inflammatory lesion at 1 predilectionModerate

(Grade 2)

Many inflammatory lesions at 1 predilection Several inflammatory lesions at more than 1

predilections Several inflammatory lesions at more than 1 predilectionFew inflammatory lesions at more than 1 predilection

Severe

(Grade 3)

Numerous non-inflammatory lesions at more than 1predilections Numerous inflammatory lesions at 1 or more

predilections

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Mild acne Mild to

moderate

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Moderateacne

Severe

acne

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SUPPORTIVE

EXAMINATIONIn general, laboratory workup is notindicated for patients with acneunless hyperandrogenism is

suspected.Histopathology

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A. Closed comedone follicularinfundibulum is distended, filled with

keratin and sebum.B. B. Open comedone

C. Inflammatory papule infundibullar

hyperkeratosis

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DIFFRENTIAL DIAGNOSIS

Millia

Sebaceous hyperplasia

Rosacea

Trichoepitheliomas

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DIAGNOSIS

LOCATION

EFFLORESCENCE

SYMPTOMS

Millia Orbital

region

Milliary

papules,multiple

Asymptom

atic

Sebaceoushyperplasia

Nose,cheek,forehead

Papule solitaireor multiple

Asymptomatic

Rossacea Face Flushing,

inflammatorypapules,pustules, andtelangiectases

Facial

burning

Trichoepit

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MILIA SEBACEOUSHYPERPLASIA

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TRICHOEPITHELI

OMAS

ACNE ROSACEA

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TREATMENT

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PROGNOSIS

Overall the prognosis for acne isfavorable. Treatment regimens shouldbe initiated early and be sufficientlyaggressive to prevent permanentsequelae. If significant scarring doesoccur, referral for surgical correction

may be warranted