Acne

Acne affects almost all teenagers, sometimes it ends with adolescence, but often plague also adults. Pathogenesis is determined by many factors – increased sebum excretion of skin sebaceous glands, sebum, disordered keratinisation of follicles and interaction of germs. Primary violation is blackhead or clogged follicle; it can be white and closed (white cap) or dark and open (black cap). Due to neutrophil migration through damaged follicular epithelium are formed papules and pustules. Inevitably form scars – perforated circular-shaped scars (“awl’s stabs”) or keloids, mainly on the chest and back.

There are many similar kinds of acne:

Acne comedonica – blackhead acne. Typically is affected the middle part of the face and the temples. This is an early stage, when blackheads are formed.

Acne papulopustulosa – acne with papules. Inflammatory acne, occurring on the face, as well as on the chest and the back.

Acne conglobata – with continuous formation of blackheads and papules come up persistent, painful nodular abscesses, scars remain large.

Acne neonatorum – newborn acne. Formation of blackheads and papules, that become pustules due to increased testosterone and androgens, which passed through the maternal placenta. Passes by itself.

Acne infantum – real newborn acne. Occurs for newborns of 3–6 months, generally for boys and does not disappear. If the parents suffered from acne, often there is a risk that later it will occur for children even in more severe form.

Acne fulminans – a severe form of acne occurring for boys, conglobata, hemorrhagic necrosis, acnes with sebum content, coalesced, sterile osteomyelitis (often clavicle), fever. Warning: acne fulminans sometimes begins systematically using high doses of retinoids.

Acne excoriée – minimally occurring acne due to intense scratching of the skin. Intense scratching of the skin is caused by psychological problems.

Acne venenata – acne comedonica caused by cosmetics, oils, pores clogging substances.

Acne mechanica – repeated traumas (footballer’s helmet, headband, backpack’s straps) affect follicles and cause acne. Blackheads in scars or secondary, resulting from abrasion, are relatively large.

Acne-like rash – monomorphic follicular papules and pustules without blackheads. A reason of their occurrence is corticosteroids, psychotropic drugs, vitamins, halogen compounds or tetracycline. Anabolic steroids can also cause or aggravate the typical acne (acne occurring from growing muscles).

Acne inversa – nodes, abscesses, purulent hidradenitis occurring in the armpits, groins and under buttocks, also known as hidradenitis suppurativa. Affections are generally not taken into consideration, they are often treated as boils, when the disease gets worse. This is very much impedes the quality of life. Subsequently occurs a risk of squamous cell carcinoma (SCC) and amyloidosis.

Gram-negative folliculitis – monomorphic follicular pustules, secondary, caused by certain gram-negative organisms, get a longer period of time using antibiotic therapy.