Acne vulgaris

Published on 05/05/2015 by admin

Filed under Internal Medicine

Last modified 05/05/2015

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184 Acne vulgaris

Instruction

Look at this patient.

Salient features

History

• Steroid ingestion

• Isoniazid ingestion

• Occupational exposure to oils (oil-induced acne).

Examination

• Comedones or blackheads (Fig. 184.1), caused by plugging of hair follicles by keratin; these are hallmarks of acne.

• Generally found over the chin, face, neck, chest, upper back and upper arms (areas which have the most and the largest sebaceous glands)

• Whiteheads (i.e. distended sebaceous glands without a pore)

• Cysts (larger, deeper masses of retained sebum)

• Greasy skin

• There may be associated scarring: ice-pick scars.

image

Fig. 184.1 Acne vulgaris.

Remember: Acne vulgaris is a multifactorial disease affecting the pilosebaceous follicle and characterized by open and closed comedones, papules, pustules, nodules and scars.

Diagnosis

This patient has blackheads on the face with greasy skin (lesions), which is acne vulgaris caused by Propionibacterium acnes (aetiology); it may be cosmetically unacceptable to the patient (functional status).

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