Acne vs rosacae

1. ACNE VS ROSACEA
Deepak b
CRRI

2. ACNE VULGARIS:
• Chronic inflammatory disease of
the pilosebaceous follicles.
• Typical lesions:Comedone,papules,
pustules, nodules and scar.
• Triggers:
• Puberty,PCOD, menses
• Oily skin, summer , cosmetics.
• PATHOGENESIS:
• Hyperkeratinization of follicle
• Bacterial proliferation , inflammation
• Excesssive sebum production

3. CLINICAL FEATURES:
• Non inflammatory lesions:
• Comedones(keratin plug of
pilosebaceous duct)
• Inflammatory lesions:
• Papules, pustules,nodules,cyst
• Propionibacterium acnes is also a
cause for acne.

4. • Hormonal acne-Commonly due to PCOD
• Due to increased level of dihydrotestosterone.
• Drug induced acne-
• Anabolic steroids (danazol,stanzolol)
• Anti convulsants.
• Acne conglobata-
• Severe inflammation , extensive inflammatory papules,tender nodules and
abscess.

6. TREATMENT:
• Primarily comedonal acne:
• Topical retinoids- reduces abnormal keratinization and unplugs the follicle.
• Mainly papular:
• Topical retinoids+Topical antibiotics (clindamycin,clarithromycin)
• Mainly pustular:
• Topical retinoids +oral antibiotics (doxycycline,Minocycline)+/- benzyl peroxide.
• Mainly nodular/nodulocystic:
• Oral isotretinoin (0.5mg/kg/day)
• Hormonal acne :
• Oral contraceptive pills(ethinyl estradiol+cyproterone acetate, ethinyl estradiol+
drospirenone.

7. ACNE ROSACEA:
• Chronic disorders of facial convexities between 30-50years of age.
• TRIGGERS:
• Sun exposure,hot liquids
• Spicy foods, alcohol , emotional disturbance
TYPES:
• Erythemato telangiectatic rosacea: Redness+telangiectasia on central cheeks.
• Papulo pustular rosacea-inflammatory papules+pustules .
• Phymatous rosacea - hypertrophic stage(phyma on skin-rhinophyma)
• Thickening of skin of nose due to sebaceous hyperplasia and fibrosis.
• Ocular rosacea- Eye involvement due to meibomian gland dysfunction
causing blepharitis, conjunctivitis and recurrent chalazion.

9. TREATMENT:
• Erythemato telangiectatic rosacea:
• Suncreen –covering both UV A AND UV B
• Papulo pustular rosacea:
• Topical metronidazole, topical azelaic acid,low
dose doxycycline
• Phymatous rosacea:
• Low dose isotretinoin therapy for 2-6months.
• Topical steroids are contraindicated.

10. ACNE VS ROSACEA:
ACNE VULGARIS
• Teenagers and young adults.
• Comedones present.
• No telangiectasia.
• Widespread.
• Not occurs near eye and nose.
• Face, shoulder,back,buttock
• Doesn’t occur episodically
ACNE ROSACEA:
• 30years and older.
• No comedones.
• Telangiectasia.
• Central face
• Occurs in eyes and nose.
• Only the face.
• Occurs episodically.