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Acne

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Acne

Acne

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  • 1. ACNE VULGARIS Abdul Alraiyes 5/7/08
  • 2. ACNE VULGARIS  SELF-LIMITED DISORDER OF PILOSEBACEOUS UNIT  PRIMARILY IN ADOLESCENTS  PLEOMORPHIC VARIETY OF LESIONS- COMEDONES, PAPULES, PUSTULES, NODULES  GENETIC FACTORS PLAY A ROLE IN ACNE SEVERITY  MEDICATIONS LIKE CORTICOSTEROIDS, ISONIAZID, PHENYTOIN, LITHIUM, PROGESTINS  CAN CAUSE ACNELIKE LESIONS
  • 3. PATHOGENESIS  FOUR KEY ELEMENTS:  FOLLICULAR HYPERKERATINIZATION  SEBUM ACCUMULATION  INFLAMMATION  PRESENCE & ACTIVITY OF Propionibacterium acnes  ANDROGENS PLAY A PIVOTAL ROLE  INCREASE SEBUM PRODUCTION & ENLARGE SEBACEOUS GLANDS
  • 4. CLINICAL FEATURES  OPEN & CLOSED COMEDOS, ERYTHEMATOUS PAPULES, PUSTULES, NODULES, CYSTS & SCARS  FACE, TRUNK & CHEST  INFLAMATORY & NON-INFLAMMATORY LESIONS  SCARRING IS A COMPLICATION OF BOTH.
  • 5. CLINICAL VARIANTS OF ACNE  ACNE CONGLOBATA: severe, scarring form of acne where large nodules and abscesses become confluent to form draining sinus tracts
  • 6. ACNE CONGLOBATA
  • 7. CLINICAL VARIANTS OF ACNE  ACNE COSMETICA: persistent, low grade form of acne result from use of cosmetics, moisturizers, sunscreens This type of acne responds particularly well to the topical application of tretinoin.
  • 8. CLINICAL VARIANTS OF ACNE  ACNE MECHANICA: results from repeated trauma associated with sports helmet, shoulder pads, chin rests of violoins and violas.
  • 9. CLINICAL VARIANTS OF ACNE  Acne fulminans : severe, scarring form of acne with systemic signs and symptoms of infection and Leukocytosis.
  • 10. CLINICAL VARIANTS OF ACNE  NEONATAL ACNE & INFANTILE ACNE
  • 11. CLINICAL VARIANTS OF ACNE  STERIODS ACNE
  • 12. DIFFERENTIAL DIAGNOSIS  FOLLICULITIS : PAPULES, PUSTULES, NO COMEDOS. USUALLY AFFECTS TRUNK & EXTREMITIES
  • 13. DIFFERENTIAL DIAGNOSIS  PERIORAL DERMATITIS: LONG TERM USE OF TOPICAL CORTICOSTEROIDS ON FACE CAN RESULT IN ACNEIFORM, ERYTHEMATOUS, INFLAMED PINK PAPULES ON CHIN & CHEEKS.
  • 14. DIFFERENTIAL DIAGNOSIS  MILIA : WHITE, PINPOINT EPIDERMAL CYSTS AROUND EYES
  • 15. TREATMENT  TOPICAL THERAPY: Comedonal acne: Topical retinoids –tretinoin, adaplene, tazarotene Anti-inflammatory & reduce follicular hyperkeratinization Inflammatory acne: Topical antibiotics with benzoyl peroxide & topical retinoids Azelaic acid : antimicrobial & comedolytic properties Salicylic acid
  • 16. TREATMENT  SYSTEMIC THERAPY Antibiotics: A trial of 8-12 weeks is warranted to assess responsiveness. Doxycycline, minocycline, trimethoprim- sulfamethoxazole Isotretinoin: Cases of Refractory deep inflammmatory acne vulgaris Hormonal therapy: OCPs , spironolactone Intralesional glucocorticoids; deep nodular lesions
  • 17. THANKS