Acne Like Eruptions


  • It is a chronic inflammatory condition affecting the hair follicles and its oil glands(Sebaceous gland)
  • Clinical features are open comedones(black heads), closed comedones (white heads), papules and pustules in addition to cysts.
  • If associated with hirsutism and irregular period it might be a sign of Androgen overproduction like Polycystic Ovary Syndrome and other conditions.

Acne causes are:1-abnormal keratinization within the hair follicle 2- excess oil production 3-colonization of hair follicle by Propionibacterium Acne  4-Release of inflammatory mediators.

Classification and Treatment


Comedones + Inflammatory papules

Benzoyl Peroxide +-

Topical Retinoids +-

Topical antibiotic


Same + Nodules

Add oral antibiotic


Same + Cysts

Consider oral Isotretinoin



    • Chronic inflammation in the facial hair follicles and its oil glands with increased vascular reactivity ( congestion)
    • It has 4 types:
      1. Erythroteleangiectatic
      2. Papulo pustular: may mimic Acne
      3. Phymatous : severe sebaceous hyperplasia and growth (Rhynophema)
      4. Ocular:
        • It is more common in mid life in fair skin people
        • It gets worse with stress, alcohol, heat and excessive sunlight


    • Avoidance of sun, alcohol and certain foods
    • Topical: antibiotics, Permethrin, Azelaic acid, Tacrolimus
    • Oral antibiotics
    • Laser, Intense pulsed light, Electrosurgery

Hidradenitis Suppurativa

  • It is an inflammatory skin condition of the sweat glands usually in the Axilla but it can be in the groin and under breasts.
  • It causes comedones, painful nodules, abscesses and sinuses
  • Risk factors include obesity, cigarettes smoking and family history

Treatment is very difficult



Small papules or pustules

Small nodules

Antibacterial washes

Topical antibiotics

Warm compresses

Behavioral changes


Multiple abscesses or

Multiple cysts

Multiple nodules


Oral antibiotics

Wide local excision



Multiple nodules

Sinus tract

Referral to a dermatologist (TNF) and/or surgeon for wide local excision

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