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Prof .Atif Kazmi
Prof .Atif Kazmi
Prof .Atif Kazmi
Prof .Atif Kazmi
Prof .Atif Kazmi
Prof .Atif Kazmi
Prof .Atif Kazmi
Prof .Atif Kazmi
Prof .Atif Kazmi
Prof .Atif Kazmi
Prof .Atif Kazmi
Prof .Atif Kazmi
Prof .Atif Kazmi
Prof .Atif Kazmi
Prof .Atif Kazmi
Prof .Atif Kazmi
Prof .Atif Kazmi
Prof .Atif Kazmi
Prof .Atif Kazmi
Prof .Atif Kazmi
Prof .Atif Kazmi
Prof .Atif Kazmi
Prof .Atif Kazmi
Prof .Atif Kazmi
Prof .Atif Kazmi
Prof .Atif Kazmi
Prof .Atif Kazmi
Prof .Atif Kazmi
Prof .Atif Kazmi
Prof .Atif Kazmi
Prof .Atif Kazmi
Prof .Atif Kazmi
Prof .Atif Kazmi
Prof .Atif Kazmi
Prof .Atif Kazmi
Prof .Atif Kazmi
Prof .Atif Kazmi
Prof .Atif Kazmi
Prof .Atif Kazmi
Prof .Atif Kazmi
Prof .Atif Kazmi
Prof .Atif Kazmi
Prof .Atif Kazmi
Prof .Atif Kazmi
Prof .Atif Kazmi
Prof .Atif Kazmi
Prof .Atif Kazmi
Prof .Atif Kazmi
Prof .Atif Kazmi
Prof .Atif Kazmi
Prof .Atif Kazmi
Prof .Atif Kazmi
Prof .Atif Kazmi
Prof .Atif Kazmi
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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
  • Transcript

    • 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
    • 3. Prof. Syed Ghulam Shabbir (Late) Founder of Dermatology in Pakistan
    • 4. KING EDWARD MEDICAL UNIVERSITY LAHORE
    • 5. MAYO HOSPITAL LAHORE
    • 6. ACNE <ul><li>Chronic inflammatory disease of the pilosebaceous follicles seen primarily in adolescents </li></ul>
    • 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>
    • 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>
    • 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>
    • 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>
    • 11. Path o genesis
    • 12. Path o genesis
    • 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>
    • 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>
    • 15. M o derate Mi I d Severe GRADING
    • 16. TYPES OF ACNE
    • 17. ACNE VULGARIS
    • 18. NODULO-CYSTIC ACNE
    • 19. PUSTULAR ACNE
    • 20. PYODERMA FACIALE
    • 21. ACNE CONGLOBATA
    • 22. STEROID ACNE
    • 23. NEONATAL ACNE
    • 24. ACNE EXCORIEE
    • 25. ACNE AGMINATA
    • 26. POMADE ACNE
    • 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>
    • 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)
    • 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>
    • 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 )
    • 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 &amp; Erythromycin and Duac ---Clindamycin &amp; Benzoyl Peroxide </li></ul>
    • 32. Systemic Therapies <ul><li>Antibiotics ( Minoderm ) </li></ul><ul><li>Retinoids </li></ul><ul><li>Dapsone </li></ul><ul><li>Steroids </li></ul>
    • 33. &nbsp;
    • 34. &nbsp;
    • 35. &nbsp;
    • 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>
    • 37. Nodulocystic Acne
    • 38. Nodulocystic Acne
    • 39. Acne Conglobata Severe Form of Nodulocystic Acne
    • 40. Severe Form of Nodulocystic Acne Acne Conglobata
    • 41. Nodulocystic Acne
    • 42. Isotretinoin Therapy Before After
    • 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>
    • 44. DRY EYE
    • 45. CHEILITIS
    • 46. Mucocutaneous side effects are inevitable but easily tolerated. The lips and nose are always affected by drying
    • 47. &nbsp;
    • 48. Sunburn after Isotretinoin Therapy
    • 49. Acute paronychia after Isotretinoin therapy
    • 50. MOOD CHANGE - DEPRESSION
    • 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>
    • 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>
    • 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>
    • 54. <ul><li>THANK YOU </li></ul>

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