Acne Vulgaris

1. See Also
   1. Acne Vulgaris Pathophysiology
   2. Medication Causes of Acne Vulgaris
   3. Acne Vulgaris Management
   4. Adjunctive Acne Vulgaris Management
   5. Moderate Acne Vulgaris Management
   6. Severe Acne Vulgaris Management (includes Cystic Acne)
   7. Acne Rosacea
2. Epidemiology
   1. Prevalence: 75% of teenagers and young adults
3. Pathophysiology
   1. See Acne Vulgaris Pathophysiology
   2. Secondary acne causes
      1. See Medication Causes of Acne Vulgaris
      2. See Hyperandrogenism
      3. Cushing's Disease
      4. Polycystic Ovary Syndrome
      5. Congenital Adrenal Hyperplasia
4. Signs: Lesion Types
   1. Obstructive Acne
      1. Open Comedones (Black heads)
      2. Closed Comedones (White heads)
   2. Inflammatory Acne (in order of lesion formation)
      1. Papules
      2. Pustules
      3. Nodules
      4. Cysts
      5. Scars
5. Signs: Distribution
   1. Face
   2. Neck
   3. Chest
   4. Back
6. 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
7. Differential Diagnosis
   1. See Medication Causes of Acne Vulgaris
   2. See secondary acne causes above
   3. Acne Rosacea
   4. Hidradenitis Suppurativa
   5. Miliaria
   6. Perioral Dermatitis
   7. Pseudofolliculitis Barbae
   8. Seborrheic Dermatitis
   9. Superficial Folliculitis
8. Management
   1. See Acne Vulgaris Management
   2. Adjunctive Acne Vulgaris Management
   3. Moderate Acne Vulgaris Management
   4. Severe Acne Vulgaris Management (includes Cystic Acne)
9. Resources: Patient Education
   1. Information from your Family Doctor: Acne in Teens
      1. http://www.familydoctor.org/healthfacts/001/
10. 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]