Acne vulgaris Flashcards
Define acne vulgaris.
Acne vulgaris is a skin disease affecting the pilosebaceous unit.
- Comedones - small acne spots e.g. blackheads and whiteheads
- Papules
- Pustules
- Nodules
- Cysts
- Scarring, primarily on the face and trunk
What is the aetiology of acne vulgaris?
Acne is polygenic and multi-factorial:
- Sebaceous gland hyperplasia and excess sebum production caused by high androgens
- Abnormal follicular differentiation: in normal follicles, keratinocytes are shed as single cells into the lumen and then excreted. In acne, keratinocytes are retained and accumulate due to their increased cohesiveness.
- Cutibacterium (Propionibacterium) acnes - higher bacterial counts do not correlate with severity.
- Inflammation and immune response
What are risk factors for acne vulgaris?
Age 12 to 24 years
Genetic predisposition
Greasy skin/increased sebum production
Endocrine disorders
Dietary factors
Female sex/oestrogens
Obesity/insulin resistance
Hyperandrogenism
Halogenated aromatic hydrocarbons exposure
Summarise the epidemiology of acne vulgaris.
9.4% of the population
9th most prevelant disease in the world
What are the signs and symptoms of acne vulgaris?
Comedones - small acne spots e.g. blackheads and whiteheads
Papules
Pustules
Nodules
Cysts
Scarring, primarily on the face and trunk
What investigations should be performed for acne vulgaris?
CLINICAL DIAGNOSIS
(bacterial culture, hormonal evaluation)
What is the management for acne vulgaris?
Topical retinoid/salicylic acid
Consider topical antibiotic if inflammation
Corticosteroids for severe cases
What are the complications of acne vulgaris?
Scarring
Dyspigmentation
What is the prognosis of acne vulgaris?
Acne typically improves as people progress through adolescence, but it may persist into adulthood. Most people do not have long-term consequences from acne, but severe lesions may leave residual scarring in previously involved areas.
