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Skin-nontumor

Other dermatoses

Acne vulgaris

Reviewer: Mowafak Hamodat MB.CH.B, MSc., FRCPC (see Reviewers page)
Revised: 26 August 2011, last major update July 2011
Copyright: (c) 2002-2011, PathologyOutlines.com, Inc.

Definition
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● Common skin disease of seborrhea (scaly red skin), comedones (blackheads and whiteheads), papules (pinheads), pustules (pimples), nodules (large papules) and possibly scarring
● Typically affects skin with densest sebaceous follicles: face, upper chest, back; uncommon in scalp for unknown reasons

Terminology
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● Acne vulgaris is common acne, typically with comedones
● Acne rosacea is a different disorder

Etiology
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● Due to hormonal variations and alterations in hair follicle maturation
● Begins with abnormal follicular keratinization with retention of keratinous material in the follicle
● Then increased sebum production
● Then appearance of gram-positive, anaerobic, diphtheroid Propionibacterium acnes
● May become inflammatory


Stages of acne

Clinical features
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● Usually teenagers of either sex, but often more severe in males
● Worsens with drugs (steroids, testosterone, contraceptives), oils/tars, heavy clothing and tropical climates
● Non-inflammatory acne is due to open and closed comedones
● Open comedones: small follicular papules with central, black keratin plug (due to oxidation of melanin)
● Closed comedones: follicular papules with a deeper plug below the surface
● Follicles may rupture and become inflamed

Treatment
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● Antibiotics, isotretinoin, phototherapy (eMedicine, Clin Cosmet Investig Dermatol 2011;4:41)

Clinical description
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● Diverse lesions such as comedones, papules, pustules, cysts, sinuses and scars

Clinical images
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Severe lesions

Micro description
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● Three major components are comedones, inflammatory lesions and scars
● Comedones (open or closed) are cyst-like cavities filled with compact mass of keratinous material and numerous bacteria
● Closed comedo has 1-2 hairs trapped in lumen and atrophic, sebaceous acini
● Open comedo has 10–15 hairs in lumen, and sebaceous acini are atrophic or absent
● Epithelial lining of comedones is usually thin

Virtual slides
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Acne

End of Skin-nontumor > Other dermatoses > Acne vulgaris

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