Acne Vulgaris

  • Acne vulgaris is a common, chronic disease of the sebaceous follicle that primarily affects the face, chest, and back
  • Most patients with acne who seek medical care are concerned with the effects on their appearance, but some patients seek care because of painful nodules or scarring
  • Morphology includes comedones, papules/pustules, and nodules
  • Diagnosis is by clinical presentation. Hormonal workup should be considered for underlying cause of hyperandrogenism in patients with atypical or refractory disease
  • Therapy should be based on the type of acne present, the distribution, and the severity; it should target multiple pathogenic factors
  • The disease usually can be managed successfully with combination therapy. First-line therapies include topical benzoyl peroxide, topical antibiotics in combination with benzoyl peroxide to avoid bacterial resistance emerging, and topical retinoids
  • A severe form of acne accompanied by a fever, arthralgias, and myalgias may indicate acne fulminans, a rare, acute inflammatory/ulcerative acne with systemic symptoms that usually requires treatment with oral corticosteroids and isotretinoin