Acne vulgaris is a common chronic skin disease involving blockage and/or inflammation of pilosebaceous units (hair follicles and their accompanying sebaceous gland). Acne can present as noninflammatory lesions, inflammatory lesions, or a mixture of both, affecting mostly the face but also the back and chest.
Acne develops from the following four factors: (1) follicular epidermal hyperproliferation with subsequent plugging of the follicle, (2) excess sebum production, (3) the presence and activity of the commensal bacteria Cutibacterium acnes (formerly Propionibacterium acnes), and (4) inflammation.
Acne Keloidalis Nuchae (AKN)
Acne keloidalis nuchae (AKN) is a condition characterized by follicular-based papules and pustules that form hypertrophic or keloidlike scars. AKN typically occurs on the occipital scalp and posterior neck and develops almost exclusively in young, African American men. The term acne keloidalis nuchae is somewhat of a misnomer because the lesions do not occur as a result of acne vulgaris, but rather a folliculitis. Moreover, histologically lesions are not keloidal, nor do the affected patients tend to develop keloidalis in other areas
Treatment of acne keloidalis nuchae (AKN) is difficult, and numerous modalities have been used with varying degrees of success .The first step in management is education, which is key to preventing disease progression. Patients need to be made aware that the condition is exacerbated by short haircuts and close shaving. In addition, tight-fitting collared shirts, athletic head gear, and self-manipulation should be avoided since they may lead to mechanical shearing of the hairs . Your doctor will give you some Treatment options .
Acne Conglobata
Acne conglobata (AC) is an uncommon and unusually severe form of acne characterized by burrowing and interconnecting abscesses and irregular scars (both keloidal and atrophic), often producing pronounced disfigurement. The comedones often occur in a group of 2 or 3, and cysts contain foul-smelling seropurulent material that returns after drainage. The nodules are usually found on the chest, the shoulders, the back, the buttocks, the upper arms, the thighs, and the face. Acne conglobata may develop as a result of a sudden deterioration of existing active papular or pustular acne, or it may occur as the recrudescence of acne that has been quiescent for many years.
Acne fulminans
Acne fulminans (AF), also known as acne maligna, was originally described as acute febrile ulcerative acne conglobata (AC). In 1958, at a meeting of the Detroit Dermatological Society, Burns and Colville presented a 16-year-old white boy with acute febrile disease and acne conglobata. Many similar cases have been reported since then. The primary features of this disease include sudden onset, severe and often ulcerating acne, fever, polyarthritis, and failure to respond to antibacterial therapy; the response to debridement in combination with steroid therapy is good. It can be the dermatologic manifestation of the synovitis-acne-pustulosis-hyperostosis-osteitis (SAPHO) syndrome. Acne fulminans is a syndrome of fulminant, necrotizing acne associated with bone lesions, constitutional symptoms, and laboratory abnormalities.
Gram-negative folliculitis
Gram-negative folliculitis first described in 1968, is an infection caused by gram-negative organisms. The infection may occur as a complication in patients with acne vulgaris and rosacea and usually develops in patients who have received systemic antibiotics for prolonged periods. Gram-negative folliculitis should be considered in patients with acne who have a flare-up of pustular or cystic lesions and in patients whose acne is resistant to treatment. Gram-negative folliculitis may also occur in the setting of hot-tub immersion and in people infected with HIV.
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