Ebook Roxburgh’s common skin diseases: Part 2
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Ebook Roxburgh’s common skin diseases: Part 2
Acne, rosacea and similar disordersCHAPTERĨỐAcne149Rosacea162Perioral dermatitis168Summary169The disorders described in this chapter are common, infla Ebook Roxburgh’s common skin diseases: Part 2ammatory, characterized clinically by papules and occur on the face pre-eminently. These features do not imply a common aetiopathogenesis.AcneAcne is one of the commonest skin disorders - if not the commonest. It has been estimated that 70 per cent of the population have some clinically evident acne Ebook Roxburgh’s common skin diseases: Part 2 at some stage during adolescence!DEFINITIONAcne (acne vulgaris) is a disorder in which hair follicles develop obstructing horny plugs (comedones), asEbook Roxburgh’s common skin diseases: Part 2
a result of which inflammation later develops around the obstructed follicles, causing tissue destruction and scar formation.CLINICAL FEATURESThe lesAcne, rosacea and similar disordersCHAPTERĨỐAcne149Rosacea162Perioral dermatitis168Summary169The disorders described in this chapter are common, infla Ebook Roxburgh’s common skin diseases: Part 2ually accompany the greasiness. They often occur over the sides of the nose and the forehead, but can occur anywhere (Fig. 10.1). Comedones are follicular plugs composed149Acne, rosacea and similar disordersFigure 10.1 Multiple comedones and Figure 10.2 Multiple comedones in acne, seborrhoea in acne Ebook Roxburgh’s common skin diseases: Part 2.Note the blackened tips from melanin.of follicular debris and compacted sebum. They have pigmented tips from the melanin pigment deposited by the folEbook Roxburgh’s common skin diseases: Part 2
licular epithelium at this level (Fig. 10.2). Accompanying the visible comedones are numerous invisible comedones, many of which do not have pigmentedAcne, rosacea and similar disordersCHAPTERĨỐAcne149Rosacea162Perioral dermatitis168Summary169The disorders described in this chapter are common, infla Ebook Roxburgh’s common skin diseases: Part 2Fig. 10.3). Sometimes they develop pus at their tips (pustules), but these may also arise independently. In a few patients, some of the papules become quite large and persist for long periods - they are then referred to as nodules.In severely affected patients, the nodules liquefy centrally so that Ebook Roxburgh’s common skin diseases: Part 2fluctuant cysts are formed. In reality, the lesions are pseudocysts, as they have no epithelial lining. This type of severe acne is known as cystic orEbook Roxburgh’s common skin diseases: Part 2
nodulocystic acne and can be very disabling and disfiguring.When the large nodules and cysts eventually subside, they leave in their wake firm, fibroAcne, rosacea and similar disordersCHAPTERĨỐAcne149Rosacea162Perioral dermatitis168Summary169The disorders described in this chapter are common, infla Ebook Roxburgh’s common skin diseases: Part 2(Fig. 10.4b). Even the smaller inflamed papules can cause scars and these tend to be pock-like or are triangular indentations (‘ice-pick scars’: Fig. 10.5).There is a very rare and severe type of cystic acne known as acne fulminans in which the acne lesions quite suddenly become very inflamed. At th Ebook Roxburgh’s common skin diseases: Part 2e same time the affected individual is unwell and develops fever and arthralgia. Laboratory150AcneFigure 10.3 Acne papules.Figure 10.4 (a) Nodular scaEbook Roxburgh’s common skin diseases: Part 2
rs in acne. These lesions developed following the resolution of Inflamed acne papules, (b) Hypertrophic scarring in a bridging pattern.investigation rAcne, rosacea and similar disordersCHAPTERĨỐAcne149Rosacea162Perioral dermatitis168Summary169The disorders described in this chapter are common, infla Ebook Roxburgh’s common skin diseases: Part 2 suggested that it is due to the presence of a vasculitis that is somehow precipitated as a result of the underlying acne.151Acne, rosacea and similar disordersFigure 10.5 Pock scarring of acne.SITES AFFECTEDAny hair-bearing skin can develop acne, but certain areas are much more prone than others (F Ebook Roxburgh’s common skin diseases: Part 2ig. 10.6). These acne-prone areas tend to have hair follicles with small terminal hairs and larger sebaceous glands (sebaceous follicles). The face anEbook Roxburgh’s common skin diseases: Part 2
d particularly the skin of the cheeks, lower jaw, chin, nose and forehead are usually affected. The scalp is not involved, but the back of the neck, fAcne, rosacea and similar disordersCHAPTERĨỐAcne149Rosacea162Perioral dermatitis168Summary169The disorders described in this chapter are common, infla Ebook Roxburgh’s common skin diseases: Part 2 other areas to be affected, including the outer aspects of the upper arms, the buttocks and thighs.CLINICAL COURSEAcne, rosacea and similar disordersCHAPTERĨỐAcne149Rosacea162Perioral dermatitis168Summary169The disorders described in this chapter are common, inflaGọi ngay
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