Acne is a common inflammatory disease that peaks in adolescence, but may affect any age group.
Lesions consist of non-inflammatory comedones (whiteheads and blackheads) and inflammatory papules, pustules, nodules, and cysts.
Systemic effects may be present with acne fulminans, a rare variant of nodulocystic acne.
Treatments include topical retinoids, keratolytics, and antibiotics; moderate to severe nodulocystic acne may require oral isotretinoin.
Acne vulgaris is a skin disease affecting the pilosebaceous unit. It is clinically characterised by comedones, papules, pustules, nodules, cysts, and/or scarring, primarily on the face and trunk. The severity of disease ranges from mild comedonal acne to severe nodulocystic acne, which can be permanently disfiguring. In addition to the physical lesions, acne can have profound psychological and social impact on patients.
History and exam
Key diagnostic factors
- presence of risk factors
- skin lesions
Other diagnostic factors
- skin tenderness
- depression, social isolation
- systemic complaints
- age 12 to 24 years
- genetic predisposition
- greasy skin/increased sebum production
- endocrine disorders
- dietary factors
- female sex/oestrogens
- obesity/insulin resistance
- halogenated aromatic hydrocarbons exposure
1st investigations to order
- clinical diagnosis
Investigations to consider
- hormonal evaluation
- bacterial culture
not hormone-related (not pregnant)
hormone-related (women, not pregnant)
- Acne keloidalis nuchae
- Acneiform eruptions
- Acne vulgaris: management
- Chinese Society of Dermatology acne guidelines 2019
AcneMore Patient leaflets
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