A C N E PROF. SYED ATIF HASNAIN KAZMI President Pakistan Association of Dermatologists Dean Faculty of Medicine & Allied C...
Prof. Syed Ghulam Shabbir  (Late) Founder of Dermatology in Pakistan
KING EDWARD MEDICAL UNIVERSITY LAHORE
MAYO HOSPITAL LAHORE
ACNE <ul><li>Chronic inflammatory disease of the pilosebaceous follicles seen primarily in adolescents </li></ul>
BASIC LESIONS OF ACNE <ul><li>Non-inflamed lesions </li></ul><ul><li>Comedones </li></ul><ul><li>Inflamed lesions </li></u...
LESIONS <ul><li>Open comedones (black heads) </li></ul><ul><li>Closed comedones (white heads) </li></ul><ul><li>Inflammato...
Epidemiology <ul><li>80% of adolescents and young adults (11-30 years) </li></ul><ul><li>Both sexes affected, females repo...
<ul><li>Pilosebaceous Unit </li></ul><ul><li>Major Factors </li></ul><ul><li>Genetic Predisposition </li></ul><ul><li>Sebo...
Path o genesis
Path o genesis
Aggravating Factors <ul><li>Drugs: steroids etc. </li></ul><ul><li>Stress </li></ul><ul><li>Occupations: oils, chemicals <...
Clinical Features <ul><li>Sites: </li></ul><ul><ul><li>Face </li></ul></ul><ul><ul><li>Back </li></ul></ul><ul><ul><li>Ant...
M o derate Mi I d Severe GRADING
TYPES OF ACNE
ACNE VULGARIS
NODULO-CYSTIC ACNE
PUSTULAR ACNE
PYODERMA  FACIALE
ACNE CONGLOBATA
STEROID ACNE
NEONATAL ACNE
ACNE  EXCORIEE
ACNE AGMINATA
POMADE ACNE
Management <ul><li>Severity of acne </li></ul><ul><li>Presence or likelihood of scarring </li></ul><ul><li>Psychological i...
<ul><li>Patient education </li></ul><ul><li>Removal of aggravating factors </li></ul><ul><li>Pharmaceutical treatment </li...
Patient Education <ul><li>Acne is </li></ul><ul><li>Not infectious/contagious </li></ul><ul><li>Not caused by poor hygiene...
<ul><li>Encouragement to continue the therapy </li></ul><ul><li>Whole face needs to be treated and not the visible spots o...
Topical Therapies <ul><li>Retinoids ( Isotrex ) </li></ul><ul><li>Benzoyl peroxide ( Brevoxyl ) </li></ul><ul><li>Antibiot...
Systemic Therapies <ul><li>Antibiotics ( Minoderm ) </li></ul><ul><li>Retinoids </li></ul><ul><li>Dapsone </li></ul><ul><l...
 
 
 
Why to use Isotretinoin? <ul><li>Nodulocystic, disfiguring, resistant acne </li></ul><ul><li>Presence or likelihood of sca...
Nodulocystic Acne
Nodulocystic Acne
Acne Conglobata Severe Form of Nodulocystic Acne
Severe Form of Nodulocystic Acne Acne Conglobata
Nodulocystic Acne
Isotretinoin Therapy Before After
Isotretinoin Side Effects <ul><li>Many  General side effects  have been reported such as; dryness of the skin and mucous m...
DRY EYE
CHEILITIS
Mucocutaneous side effects are inevitable but easily tolerated. The lips and nose are always affected by drying
 
Sunburn after Isotretinoin Therapy
Acute paronychia after Isotretinoin therapy
MOOD CHANGE - DEPRESSION
Adjunct therapies <ul><li>Skin care </li></ul><ul><ul><li>Normal washing, twice daily </li></ul></ul><ul><ul><li>Avoid phy...
Course and Prognosis <ul><li>Mostly clear by early twenties </li></ul><ul><li>Some may continue in third/fourth decade </l...
Myths <ul><li>Acne only appears during teenage </li></ul><ul><li>Marriage will improve acne </li></ul><ul><li>Acne should ...
<ul><li>THANK YOU </li></ul>
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Prof .Atif Kazmi

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  • dr atif hello its me munazza men ne ap k bare men parha hai mere baal bht gir rhe hen skin khali ho rhe hai naey baal nae arhe plz muje btaen men kia krun me 21 years old and unmarried
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  • Mucocutaneous side effects are inevitable but easily tolerated. The lips and nose are always affected by drying and sometimes the eyes.
  • An issue has arisen regarding mood swing with Ro-accutane, particularly depression
  • Prof .Atif Kazmi

    1. 2. A C N E PROF. SYED ATIF HASNAIN KAZMI President Pakistan Association of Dermatologists Dean Faculty of Medicine & Allied Chairman & Head Department of Dermatology KEMU/ Mayo Hospital, Lahore
    2. 3. Prof. Syed Ghulam Shabbir (Late) Founder of Dermatology in Pakistan
    3. 4. KING EDWARD MEDICAL UNIVERSITY LAHORE
    4. 5. MAYO HOSPITAL LAHORE
    5. 6. ACNE <ul><li>Chronic inflammatory disease of the pilosebaceous follicles seen primarily in adolescents </li></ul>
    6. 7. BASIC LESIONS OF ACNE <ul><li>Non-inflamed lesions </li></ul><ul><li>Comedones </li></ul><ul><li>Inflamed lesions </li></ul><ul><li>Papules </li></ul><ul><li>Pustules </li></ul><ul><li>Nodules </li></ul>
    7. 8. LESIONS <ul><li>Open comedones (black heads) </li></ul><ul><li>Closed comedones (white heads) </li></ul><ul><li>Inflammatory papules </li></ul><ul><li>Pustules </li></ul><ul><li>Nodules </li></ul><ul><li>Cysts </li></ul><ul><li>Scar </li></ul>
    8. 9. Epidemiology <ul><li>80% of adolescents and young adults (11-30 years) </li></ul><ul><li>Both sexes affected, females report earlier </li></ul><ul><li>8-10 years </li></ul>
    9. 10. <ul><li>Pilosebaceous Unit </li></ul><ul><li>Major Factors </li></ul><ul><li>Genetic Predisposition </li></ul><ul><li>Seborrhoea </li></ul><ul><li>Comedogenesis </li></ul><ul><li>Bacterial colonization </li></ul><ul><li>Inflammation </li></ul>
    10. 11. Path o genesis
    11. 12. Path o genesis
    12. 13. Aggravating Factors <ul><li>Drugs: steroids etc. </li></ul><ul><li>Stress </li></ul><ul><li>Occupations: oils, chemicals </li></ul><ul><li>Cosmetics </li></ul><ul><li>Foods ? </li></ul><ul><li>Premenstrual flare </li></ul>
    13. 14. Clinical Features <ul><li>Sites: </li></ul><ul><ul><li>Face </li></ul></ul><ul><ul><li>Back </li></ul></ul><ul><ul><li>Anterior trunk </li></ul></ul><ul><ul><li>Upper arms </li></ul></ul><ul><li>Pleomorphic lesions </li></ul>
    14. 15. M o derate Mi I d Severe GRADING
    15. 16. TYPES OF ACNE
    16. 17. ACNE VULGARIS
    17. 18. NODULO-CYSTIC ACNE
    18. 19. PUSTULAR ACNE
    19. 20. PYODERMA FACIALE
    20. 21. ACNE CONGLOBATA
    21. 22. STEROID ACNE
    22. 23. NEONATAL ACNE
    23. 24. ACNE EXCORIEE
    24. 25. ACNE AGMINATA
    25. 26. POMADE ACNE
    26. 27. Management <ul><li>Severity of acne </li></ul><ul><li>Presence or likelihood of scarring </li></ul><ul><li>Psychological impact of the disease </li></ul><ul><li>Experience with anti-acne therapy </li></ul><ul><li>Pregnancy </li></ul>
    27. 28. <ul><li>Patient education </li></ul><ul><li>Removal of aggravating factors </li></ul><ul><li>Pharmaceutical treatment </li></ul><ul><li>Adjunct therapies </li></ul><ul><li>Maintenance therapy </li></ul>Management ( contd)
    28. 29. Patient Education <ul><li>Acne is </li></ul><ul><li>Not infectious/contagious </li></ul><ul><li>Not caused by poor hygiene </li></ul><ul><li>Not to pick/scratch lesions </li></ul><ul><li>Acne may worsen premenstrually </li></ul><ul><li>Improvement may take 4-6 weeks </li></ul><ul><li>Worsening may occur during early weeks </li></ul>
    29. 30. <ul><li>Encouragement to continue the therapy </li></ul><ul><li>Whole face needs to be treated and not the visible spots only </li></ul>Patient Education ( contd )
    30. 31. Topical Therapies <ul><li>Retinoids ( Isotrex ) </li></ul><ul><li>Benzoyl peroxide ( Brevoxyl ) </li></ul><ul><li>Antibiotics ( Clinagel ) </li></ul><ul><li>Azelaic acid </li></ul><ul><li>Combination Drugs e.g. Isotrexin ---Isotretinoin & Erythromycin and Duac ---Clindamycin & Benzoyl Peroxide </li></ul>
    31. 32. Systemic Therapies <ul><li>Antibiotics ( Minoderm ) </li></ul><ul><li>Retinoids </li></ul><ul><li>Dapsone </li></ul><ul><li>Steroids </li></ul>
    32. 36. Why to use Isotretinoin? <ul><li>Nodulocystic, disfiguring, resistant acne </li></ul><ul><li>Presence or likelihood of scarring </li></ul><ul><li>Psychological distress </li></ul><ul><li>Prevention of suicidal tendency </li></ul>
    33. 37. Nodulocystic Acne
    34. 38. Nodulocystic Acne
    35. 39. Acne Conglobata Severe Form of Nodulocystic Acne
    36. 40. Severe Form of Nodulocystic Acne Acne Conglobata
    37. 41. Nodulocystic Acne
    38. 42. Isotretinoin Therapy Before After
    39. 43. Isotretinoin Side Effects <ul><li>Many General side effects have been reported such as; dryness of the skin and mucous membranes, photophobia, muscle and joint pain, insomnia, lethargy </li></ul><ul><li>Central Nervous System side effects include pseudotumor cerebri, visual disturbances, hearing deficiencies, headache, nausea, malaise and drowsiness, Amnesia, hallucinations </li></ul><ul><li>Psychiatric disorders include behavioural disorders, seizures, psychosis, schizophrenia, depression, suicide ideation, suicide attempt and suicide </li></ul><ul><li>Isotretinoin is also a teratogen </li></ul>
    40. 44. DRY EYE
    41. 45. CHEILITIS
    42. 46. Mucocutaneous side effects are inevitable but easily tolerated. The lips and nose are always affected by drying
    43. 48. Sunburn after Isotretinoin Therapy
    44. 49. Acute paronychia after Isotretinoin therapy
    45. 50. MOOD CHANGE - DEPRESSION
    46. 51. Adjunct therapies <ul><li>Skin care </li></ul><ul><ul><li>Normal washing, twice daily </li></ul></ul><ul><ul><li>Avoid physical scrubs </li></ul></ul><ul><ul><li>Soaps containing chlorhexidine not beneficial </li></ul></ul><ul><li>Comedo extractor/electrocautery </li></ul><ul><li>Chemical peeling </li></ul><ul><li>Microderm abrasion/Laser Resurfacing </li></ul><ul><li>Fillers </li></ul>
    47. 52. Course and Prognosis <ul><li>Mostly clear by early twenties </li></ul><ul><li>Some may continue in third/fourth decade </li></ul><ul><li>Residual scarring </li></ul>
    48. 53. Myths <ul><li>Acne only appears during teenage </li></ul><ul><li>Marriage will improve acne </li></ul><ul><li>Acne should not be treated </li></ul><ul><li>Spicy foods, eggs, mangoes cause acne </li></ul><ul><li>Betnovate/Archi/Stillmans improve acne </li></ul>
    49. 54. <ul><li>THANK YOU </li></ul>

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