Acne Like Eruptions
Acne
- 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
Mild | Comedones + Inflammatory papules | Benzoyl Peroxide +- Topical Retinoids +- Topical antibiotic |
Moderate | Same + Nodules | Add oral antibiotic |
Severe | Same + Cysts | Consider oral Isotretinoin |
Rosacea
- Chronic inflammation in the facial hair follicles and its oil glands with increased vascular reactivity ( congestion)
- It has 4 types:
- Erythroteleangiectatic
- Papulo pustular: may mimic Acne
- Phymatous : severe sebaceous hyperplasia and growth (Rhynophema)
- Ocular:
- It is more common in mid life in fair skin people
- It gets worse with stress, alcohol, heat and excessive sunlight
Treatment
- 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
Mild | Comedones Small papules or pustules Small nodules | Antibacterial washes Topical antibiotics Warm compresses Behavioral changes |
Moderate | Multiple abscesses or Multiple cysts Multiple nodules Scarring | Oral antibiotics Wide local excision Women:Contraceptives,Spironolactone |
Severe | Multiple nodules Sinus tract | Referral to a dermatologist (TNF) and/or surgeon for wide local excision |
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