Summary
Definition
History and exam
Key diagnostic factors
- skin lesions
Other diagnostic factors
- skin tenderness
- systemic complaints
Risk factors
- age 12 to 24 years
- genetic predisposition
- oily skin/increased sebum production
- medications
- masculinizing hormone therapy
- endocrine disorders
- dietary factors
- male sex (acne during adolescence)
- female sex (acne during adulthood)
- obesity/insulin resistance
- halogenated aromatic hydrocarbons exposure
Diagnostic tests
1st tests to order
- clinical diagnosis
Tests to avoid
- microbiologic testing
Tests to consider
- hormonal evaluation
Treatment algorithm
not hormone-related (not pregnant)
hormone-related (women, not pregnant)
pregnant
Contributors
Authors
Robert P. Dellavalle, MD, PhD, MSPH
Professor of Dermatology and Public Health
University of Colorado School of Medicine
Colorado School of Public Health
National Dermatology Program Director
US Department of Veterans Affairs
Eastern Colorado Health Care System
Aurora
CO
Disclosures
RPD has received editorial stipends (Journal of Medical Internet Research Dermatology (JMIR Dermatology)), royalties (UpToDate), and expenses reimbursement (Cochrane). RPD is an editor-in-chief of JMIR Dermatology, a joint coordinating editor for Cochrane Skin, a dermatology section editor for UpToDate, a social media editor for JAAD, and a coordinating editor representative on the Cochrane Council. He is a Cochrane Council Co-Chair.
Torunn E. Sivesind, MD
Dermatology Research Instructor and Fellow
University of Colorado Anschutz School of Medicine
Aurora
CO
Disclosures
TES has received fees for serving as a medical advisor to Antedotum Inc. and receives fellowship funding from Pfizer. TES serves as an editorial board member-at-large for the Journal of Medical Internet Research Dermatology.
Madeline Adelman, MD
Dermatology Research Fellow
University of Colorado Anschutz School of Medicine
Aurora
CO
Disclosures
MA receives fellowship funding from the Pfizer Global Medical Grant.
Ramiro Rodriguez, MD
Dermatology Fellow
University of Colorado Anschutz Medical Campus
Aurora
CO
Disclosures
Acknowledgements
Professor Dellavalle, Dr Sivesind, Dr Adelman, and Dr Rodriguez would like to gratefully acknowledge Dr Sarah Shangraw, Dr Mark Naftanel, Dr Yolanda Rosi Helfrich, and Dr Amanda Howland, previous contributors to this topic. The authors would like to thank Dr John Barbieri for his review of the topic. JB has received consulting fees from Dexcel Pharma.
Disclosures
SS, MN, YRH, and AH declare that they have no competing interests.
Peer reviewers
Gina Taylor, MD
Resident
Department of Dermatology
SUNY Downstate Medical Center
New York
NY
Disclosures
GT declares that she has no competing interests.
Gillian Murphy, MD, FRCPI, FRCP, Edin
Consultant Dermatologist
Dermatology
Beaumont Hospital
Dublin
Ireland
Disclosures
Not disclosed.
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