Dermatology

1. ACNE AND ACNEIFORM
ERUPTIONS
Dr. Owen Ngalamika

2. • Acne vulgaris is one of the most common
dermatologic conditions worldwide
• The pilosebaceous unit made up of a follicle,
sebaceous gland, and a vellus hair is the target
organ affected in acne
• The face, chest, and back are areas with the
greatest concentration of pilosebaceous follicles,
corresponding to areas most commonly affected
by acne lesions

3. • The primary lesion is the microcomedo
which is a result of obstruction of the
sebaceous follicles by sebum and
abnormally differentiated and
desquamated keratinocytes that may
produce large comedones
• There can be white or black comedones
depending on whether they are exposed to
the atmosphere or not

7. Pathophysiologic factors in acne
• Blockage of the pilosebaceous duct
• Inflammation (inflammatory events may precede
the hyperkeratinization of the follicle)
• Sebaceous gland hyperplasia with excess
sebum production
• Altered follicular epithelial growth and
differentiation
• Propionebacterium acnes colonization of the
follicle

8. Acne subtypes
• Acne vulgaris (most common form)
• Neonatal acne
• Infantile acne
• Perioral dermatitis
• Acne rosacea
• Acne conglobata
• Pyoderma faciale

9. Topical therapy
• Retinoids are the single most important
topical medications used to treat acne
(e.g. adapalene, tazarotene, and tretinoin):
12 weeks may be required for maximum
benefit
• Benzoyl peroxide
• Topical antibiotics (erythromycin,
clindamycin)
• Αlpha-hydroxy acids and salicylic acid

10. Oral antibiotic therapy
• Antibiotics are indicated in patients with
inflammatory lesions (red papules,
pustules, or nodules) of moderate to
severe grade
• Tetracyclines and macrolides are most
effective
• Antibiotics should never be used as
monotherapy in acne (antibiotic
resistance)

11. Systemic retinoid therapy
• Isotretinoin is the mainstay of therapy for
severe acne
• It is indicated for patients with severe,
scarring, nodulocystic acne and those with
moderate to severe acne who have failed
an adequate trial (3 to 6 months) of
conventional therapy
• It should be used as monotherapy and can
be given for 5 to 6 months

12. Thanks