II. Epidemiology

  1. Prevalence: 75% of teenagers and young adults
  2. Acne Vulgaris may persist in some 30-40 year olds

III. Pathophysiology

  1. See Acne Vulgaris Pathophysiology
  2. See secondary acne causes below

IV. Risk Factors: Exacerbating Factors

V. Signs: Lesion Types

  1. Obstructive Acne (Papules and Pustules)
    1. Closed Comedones (White heads)
      1. Papules resulting from sebum and keratin accumulation within the Hair Follicle
    2. Open Comedones (Black heads)
      1. Closed comedones distend with trapped sebum and keratin and ultimately open
      2. Exposed lipids oxidize and Melanin is deposited
  2. Inflammatory Acne resulting from Hair Follicle rupture (in order of lesion formation)
    1. Papules
    2. Pustules
    3. Nodules
    4. Cysts
    5. Scars

VI. Signs: Distribution

  1. Face
  2. Neck
  3. Chest
  4. Upper Back

VII. Types: Severe subtypes

  1. Consider in refractory cases
  2. Referral usually indicated
  3. Conditions
    1. Gram NegativeFolliculitis
      1. Severe, inflammatory acne
      2. Onset months after starting oral antibiotics
    2. Acne Fulminans
      1. Rapidly progressive, severe inflammatory acne
      2. Associated findings
        1. Fever
        2. Arthralgia
        3. Bone diathesis
    3. Acne conglobata
      1. Severe Cystic Acne
      2. Associated with dissecting scalp Cellulitis
      3. Associated with Hydradenitis suppurativa
      4. Aggressive treatment required
    4. Pyoderma faciale
      1. Rapidly progressive facial Cystic Acne (esp cheeks)
      2. May be a variant of Acne Rosacea
      3. Affects adult women

VIII. Differential Diagnosis: Dermatologic Conditions

XI. Resources: Patient Education

  1. Information from your Family Doctor: Acne in Teens
    1. http://www.familydoctor.org/healthfacts/001/

XII. References

  1. Habif (2004) Dermatology, Mosby, p. 162-94
  2. Parker in Noble (2001) Primary Care p. 758-60
  3. Gollnick (2003) J Am Acad Dermatol 49:S1-37 [PubMed]
  4. Oge (2019) Am Fam Physician 100(8): 475-84 [PubMed]

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Related Studies

Ontology: Acne Vulgaris (C0001144)

Definition (MSH) A chronic disorder of the pilosebaceous apparatus associated with an increase in sebum secretion. It is characterized by open comedones (blackheads), closed comedones (whiteheads), and pustular nodules. The cause is unknown, but heredity and age are predisposing factors.
Concepts Disease or Syndrome (T047)
MSH D000152
ICD10 L70.0
SnomedCT 267867008, 156419001, 201214004, 88616000
English Acne Vulgaris, Acne, acne vulgaris (diagnosis), acne vulgaris, Acne Vulgaris [Disease/Finding], acne, Acne;vulgaris, Vulgaris - acne, Acne vulgaris, Common acne, Acne vulgaris (disorder), acne; vulgaris, vulgaris; acne, Acne, vulgaris
Dutch gewone acne, acne; vulgaris, vulgaris; acne, Acne, Acne vulgaris
French Acné simple, Acné vulgaire, Acné
Italian Acne vulgaris, Acne, Acne volgare
Portuguese Acne vulgar, Acne, Acne Vulgar
Spanish Acné vulgaris, acné común, acné vulgar (trastorno), acné vulgar, Acné, Acné Vulgar
Swedish Finnar
Japanese ジンジョウセイザソウ, アクネ, 尋常性ざ瘡, ざ瘡, にきび
Czech akné, acne vulgaris, Acne vulgaris, trudovina, trudovitost, akne vulgaris
Finnish Finnitauti
German Acne vulgaris, Akne vulgaris, Akne
Korean 보통 여드름
Polish Trądzik, Trądzik pospolity
Hungarian Acne vulgaris
Norwegian Acne vulgaris, Akne, Kviser