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Acne

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Acne

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Acne

  1. 1. ACNE VULGARIS Abdul Alraiyes 5/7/08
  2. 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. 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. 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. 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. 6. ACNE CONGLOBATA
  7. 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. 8. CLINICAL VARIANTS OF ACNE  ACNE MECHANICA: results from repeated trauma associated with sports helmet, shoulder pads, chin rests of violoins and violas.
  9. 9. CLINICAL VARIANTS OF ACNE  Acne fulminans : severe, scarring form of acne with systemic signs and symptoms of infection and Leukocytosis.
  10. 10. CLINICAL VARIANTS OF ACNE  NEONATAL ACNE & INFANTILE ACNE
  11. 11. CLINICAL VARIANTS OF ACNE  STERIODS ACNE
  12. 12. DIFFERENTIAL DIAGNOSIS  FOLLICULITIS : PAPULES, PUSTULES, NO COMEDOS. USUALLY AFFECTS TRUNK & EXTREMITIES
  13. 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. 14. DIFFERENTIAL DIAGNOSIS  MILIA : WHITE, PINPOINT EPIDERMAL CYSTS AROUND EYES
  15. 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. 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. 17. THANKS

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