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ACNE VULGARIS

Source: www.aafp.org
Topic: Acne
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Sort Desciption: Improve Outcomes of Acne. Groups cases by primary lesions identified ... Acne NOT related to cleanliness. Frequent / harsh cleansing will worsen disease ...

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Chronic inflammation of the pilosebaceous units of adolescents and young adults ACNE VULGARIS Effects 35% 85% of US adolescents (Swinger et al 1980) 10 in 1000 cases are disfiguring 30 50 % of cases need > 8 weeks of medical treatment ACNE VULGARIS Multifactorial Etiology Genetic Follicular hyperkeratinization Inflammation Androgenic overproduction of sebum Propionibacterium Acnes (P. Acnes) Emotional stress Drugs Lithium, steroids, BCPs, ect Cosmetics Friction Diet and Hygiene DO NOT play a role Androgens sebum + inflammation Bacteria fatty acids papules & pustules Follicular hyperkeratinization keratin and lipid plug (closed whitehead/open blackhead) Action of Acne Therapies Sebum Production Comedones P. Acnes Inflammation Benzoyl Peroxide _____ Topical Antibiotics _____ Topical Retinoids _____ _____ Oral Isotretinoin Oral Tetracycline _____ AntiAndrogens _____ Basic Acne Lesions Comedone open or closed Papules with inflammation (red) without inflammation (no redness) Pustules Nodules Scars atropic hypertrophic No cysts cystic acne is a misnomer Pus filled acne lesions > 5mm in diameter 2 Special Forms Acne Conglobata Severe, cystic Coalescing nodules, cysts , abscesses Acne Fulminans Acute, severe, cystic Concomitant suppuration Fever Generalized arthritis Differential Diagnosis Steroid Acne Rosacea Perioral Dermatitis Drug eruption Gram (-) folliculitis Keratosis pilaris Verucca Vulgaris Polycystic ovary disease 11 or 12-hydroxylase block GRADING ACNE Consensus Guidelines of Global Alliance to Improve Outcomes of Acne Groups cases by primary lesions identified Uses pathophysiology to direct treatment regimens Classifying the Lesions Grade I Superficial Non-inflammatory Open and closed comedones Flesh colored papules NO inflammation NO papules/pustules NO nodules NO Scar Classifying the Lesions Grade II Superficial Inflammatory Open and closed comedones Inflammation Papules/pustules few to several No nodules ...

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