dermatologic disorders
Acne Vulgaris
Symptoms and Signs of Acne Vulgaris
Skin lesions and scarring can be a source of significant emotional distress. Nodules and cysts can be painful. Lesion types frequently coexist at different stages. Comedones appear as whiteheads or blackheads. Whiteheads (closed comedones) are flesh-colored or whitish palpable lesions 1 to 3 mm in diameter; blackheads (open comedones) are similar in appearance but with a dark center. © Springer Science+Business Media © Springer Science+Business Media Pustules are elevated, usually yellow-topped lesions that contain pus. Scattered pustules appear on the face of this person with acne. Photo provided by Thomas Habif, MD. Acne most commonly manifests as comedones (whiteheads or blackheads) and also as papules (blue arrow) and pustules (black arrow). Image provided by Thomas Habif, MD. Papules and crusts are also visible. © Springer Science+Business Media Papules and comedones are present. © Springer Science+Business Media Papules and pustules are red lesions 2 to 5 mm in diameter. Papules are relatively deep. Pustules are more superficial. Nodules are larger, deeper, and more solid than papules. Such lesions resemble inflamed Cutaneous Cysts , although they lack true cystic structure. Cysts are suppurative nodules. Rarely, cysts form deep abscesses. Long-term cystic acne can cause scarring that manifests as tiny and deep pits (icepick scars), larger pits, shallow depressions, or hypertrophic scarring or Keloids . Acne conglobatais the most severe form of acne vulgaris, affecting men more than women. Patients have abscesses, draining sinuses, fistulated comedones, and keloidal and atrophic scars. The back and chest are severely involved. The arms, abdomen, buttocks, and even the scalp may be affected. Acne fulminansis acute, febrile, ulcerative acne, characterized by the sudden appearance of confluent abscesses leading to hemorrhagic necrosis. Leukocytosis and joint pain and swelling may also be present. Pyoderma faciale(also called rosacea fulminans) occurs suddenly on the midface of young women. It may be analogous to acne fulminans. The eruption consists of erythematous plaques and pustules, involving the chin, cheeks, and forehead. Papules and nodules may develop and become confluent. 