DEFINITION

EPIDEMIOLOGY
At 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 &
PATHOGENESIS
Multifactorial 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

Nodule
-Rupture of
follicular wall
-Marked
perifollicular
inflammation
-scarring

CLINICAL FINDING

DIFFERENTIAL DIAGNOSIS
Closed comedonal acne
Milia
Sebaceous hyperplasia

Open comedonal acne

Favre-Racouchot syndrome
Inflammatory acne
Rosacea
Perioral dermatitis

TREATMENT
Local Therapy cleansing
Topical Agents
Systemic Therapy
Hormonal Therapy
Diet
Surgery
Intralesional Glucocorticoids
Phototherapy & Lasers

ACNE VARIANTS
Neonatal Acne
Infantile Acne
Acne Conglobata
Acne Fulminans

ACNEIFORM ERUPTIONS
Steroid Folliculitis
Drug-Induced Acne
Glucocorticoids
Phenytoin
Lithium
Isoniazid
High dose vit.B complex
Halogenated compounds

COMPLICATION
Transient macular erythema
Post-inflammatory hyperpigmentation
Permanent scarring

PROGNOSIS & CLINICAL

COURSE

Favorable
Spontaneous remission
Prepubescent females with comedonal acne +
high DHEAS levels predictors of severe or
long-standing nodulocystic acne
Th/ regimens initiated early
Prevent permanent sequelae