Acne Vulgaris

Chronic skin disease involving blockage or inflammation of the hair follicle and sebaceous glands ( pilosebaceous units ) Androgen dependent disorder of pilosebaceous follicles or pilosebaceous unit Four primary pathogenic factors which interact to produce lesions Increased sebum production by the sebaceous glands Alteration in follicular keratinization process Propionibacteriumacnes (Gr +ve anaerobic rod) follicular hypercolonization Release of inflammatory mediators

mild-Typically limited to face with non inflammatory closed and open comedones with few inflammatory lesions moderate-Increased number of inflammatory papules and pustules on face and often mild truncal disease severe-Nodules and cysts are present and often widespread truncal disease Face neck and chest have greatest density of pilosebeceous units

Nodulocystic-Comedones , inflammatory lesions and large nodules greater than 5 mm in diametre acne conglobata-Severe acne inflammatory lesions predominate and run together , may exudate or bleed- high risk sacrring Acne fulminans-Sudden severe inflammatory reaction that precipitates deep ulcerations and erosions -sometimes with systemic effects others-Acne excorciee Acne mechanica Acne cosmetica Chloracne

Assessment-Assessment of morphology and severity is an important first step Lesion morphology will dictate optimal treatment approach Ascertain severity- Mild , moderate or severe ( look for scarring , pigmentation ) Consider any aggravating factors ( eg medications ) Address...