Acne Vulgaris

1. Epidemiology
   1. Prevalence: 75% of teenagers and young adults
2. Pathophysiology
   1. See Acne Vulgaris Pathophysiology
   2. Secondary causes
      1. See Hyperandrogenism
      2. Cushing's Disease
      3. Polycystic Ovary Syndrome
      4. Congenital Adrenal Hyperplasia
3. Classification of Acne Vulgaris
   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
4. 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
5. Management
   1. See Acne Vulgaris Management
6. Resources: Patient Education
   1. Information from your Family Doctor: Acne in Teens
      1. http://www.familydoctor.org/healthfacts/001/
7. 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