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What is acne?

Do you suffer from acne or from pyoderma faciale?

With acne, there are comedones. Not so with PF.

Acne pimples can pop up all over the place. With PF, pimples are limited to the face. They don't even go near eyes, mouth, ears, hairline, neck, or under the chin. Yes, we all wish they would be confined to the bum.

The following is from Fitzpatrick’s Color Atlas and Synopsis of Clinical Dermatology 2013:

Acne Vulgaris (Common Acne)

An inflammation of pilosebaceous units

Appears in certain body areas (face, trunk, rarely buttocks).

Manifests as comedones, papulopustules, nodules, and cysts.

Results in pitted, depressed, or hypertrophic scars.

Very common, affecting approximately 85% of young people. Age of Onset: Puberty: may appear first at 25 years or older. More severe in males than in females. Lower incidence in Asians and Africans.

There is a multifactorial genetic background and familial predisposition. Most individuals with cystic acne have parent(s) with a history of severe acne.

Comedones are keratin plugs that form within follicular ostia, frequently associated with surrounding erythema and pustule formation. Comedones associated with small ostia are referred to as closed comedones or "white heads"; those associated with large ostia are referred to as open comedones or "black heads".

Follicular plugging (comedone) prevents drainage of sebum; adrogens (quantitatively and qualitatively normal in serum) stimulate sebaceous glands to produce more sebum. Bacterial (p. acnes) lipase converts lipids to fatty acids and produce proinflammatory mediators (IL-I, TNF-ɑ) that lead to an inflammatory response. Distended follicle walls break, sebum, lipids, fatty acids, keratin, bacteria enter the dermis, provoking an inflammatory and foreign-body response. Intense inflammation leads to scars.

Comedones are required for diagnosis of any type of acne. Comedones are not a feature of acne-like conditions, and the following conditions: Face S. aureus folliculitis, pseudofolliculitis barbae, rosacea, perioral dermatitis.

Often clears spontaneously by the early twenties but can persist to the fourth decade or older. Flares occur in the winter and with the onset of menses.

Acneiform Eruptions in Dermatology - A Differential Diagnosis. Joshua A. Zeichner, M.D. (Editor). Springer, New York, 2014:

Acne vulgaris is a polymorphic inflammatory skin disease, clinically characterized by mixture of comedones, superficial and deep inflamed papules, pustules, and nodules.

It is a chronic inflammation of the pilosebaceous unit.


This is the acne link to the

American Academy of Dermatology





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