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Acne Vulgaris

More commonly known as acne, it is derived from the Greek work “akme” which means the highest point
Studies indicate that white patients are more likely to experience moderate to severe acne than black patients
Patients tend themselves as nervous tend to suffer more from acne

The peak of severity in females is 16-17 yrs and in males 17-19 yr

Acne clears by age of 23 – 25 in 90% of patients

Some 5% of women and 1% of men still need treatment in their thirties or even forties

Etiology
Many factors combine to cause chronic inflammation of blocked pilosebaceous follicles, pilosebacious unit is the area
relating to the hair follicle and its associated sebatious gland.

The pilosebacious unit consists of cell lined hair follicle containing rudimentary vellus hair (the fine, non pigmented hairs
that cover most of the body) and also consists of sebaceous gland. The sebaceous gland’s secretions pass up ward
through the duct that carries the hair to the surface
Pilosebaceous density is greatest on the face, upper neck and chest

For detailed information, download Powerpoint slides Acne Vulgaris PPT slides

At puberty, an abnormal cohesion takes place between the epithelial cells that cover the unit, this is called keratinization –
sebum outflow is retarded. Also androgens provoke the sebaceous glands to become multilobular which results in an
increased sebum output. Bacteria infect the part and leads to inflammation.

As sebum accumulates behind the kersoratotic plug, dilation distorts the normal follicular architecture, forming a
microcomedo (a small white head), it grows and become closed comedo known as white head

Increased and abnormal keratinization at the exit of the pilosebaceous follicle obstructs the flow of sebum, bacteria play
a pathogenic role. Propionibacterium acnes is a normal commensal, it colonizes the pilosebaceous ducts, breaks down
the triglycerides releasing free fatty acids, produces substances chemotactic for inflammatory cells and induces the
ductal epithelium to secrete pro inflammatory cytokines.

Follicular rupture, which occurs to an inflamed pilosebaceous unit, results in formation of a papule, pustule or cyst
(nodule)

Papule; an erythematous, raised lesion of less than 5 mm in size occurs in the superficial layers of the skin
Pustules; occurs when follicular rupture occurs in more superficial layers of the skin, allowing purulent material to be
visible in the center of the lesion

Nodules; if the inflammation is severe and deep in the dermis, painful cyst occur
In summary there are four main factors responsible for the pathogenesis of acne: Increased sebum production, ductal
hypercornification, bacterial proliferation and inflammation
Whitehead: A condition of the skin characterized by a small, firm, whitish, closed elevation of the skin. Also known as a
closed comedo; is a non inflammatory lesion.

Blackhead: A condition of the skin characterized by a black coloration at the skin surface. Also known as an open
comedo; is a non inflammatory lesion.

Acne pimple: A small, prominent, inflamed elevation of skin resulting from acne. May occur as a papule or pustule; is an
inflammatory lesion; may progress to a necrotic purulent nodular lesion.

For detailed information, download Powerpoint slides Acne Vulgaris PPT slides