Akne Vulgaris (1)
description
Transcript of Akne Vulgaris (1)
DEFINITION
EPIDEMIOLOGYAt birth – neonatal period: mild degree of
acne( follicular stimulation by adrenal androgens)
• Puberty: often occur significant problems comedones (predominant lesion)
• Women : may persist through the 30th decade
ETIOLOGY & PATHOGENESISMultifactorial 4 basic steps:
1. follicular epidermal hyperproliferation
2. excees sebum production
3. inflammation
4. the presence & activity of Propionibacterium acnes
Microcomedo-Hyperkeratotic infundibulum-Cohesive corneocytes-Sebum secretion
Comedo-Accumulation of shed corneocytes & sebum-Dilatation of follicular ostium
Inflammatory papule/pustule-further expansion of follicular unit-Proliferation of P.acne-Perifollicular inflammation
Nodule-Rupture of follicular wall-Marked perifollicular inflammation-scarring
CLINICAL FINDING
DIFFERENTIAL DIAGNOSISClosed comedonal acne
MiliaSebaceous hyperplasia
Open comedonal acne Favre-Racouchot syndrome
Inflammatory acneRosaceaPerioral dermatitis
TREATMENTLocal Therapy cleansingTopical AgentsSystemic TherapyHormonal TherapyDietSurgeryIntralesional GlucocorticoidsPhototherapy & Lasers
ACNE VARIANTSNeonatal AcneInfantile AcneAcne ConglobataAcne Fulminans
ACNEIFORM ERUPTIONSSteroid FolliculitisDrug-Induced Acne
GlucocorticoidsPhenytoinLithiumIsoniazidHigh –dose vit.B complexHalogenated compounds
COMPLICATIONTransient macular erythemaPost-inflammatory hyperpigmentationPermanent scarring
PROGNOSIS & CLINICAL COURSEFavorableSpontaneous remissionPrepubescent females with comedonal acne
+ high DHEAS levels predictors of severe or long-standing nodulocystic acne
Th/ regimens initiated earlyPrevent permanent sequelae