Presentation
Although first-line therapies exist, it is often the case that a patient will present with an underlying disorder that prohibits the use of most currently accepted treatment modalities. [ncbi.nlm.nih.gov]
Severe acne: Severe acne is constantly present and often contains cyst and pustules. [clearclinic.com]
Entire Body System
- Fatigue
Prof Hawk says he has treated thousands of people with isotretinoin and it is not renowned for causing migraines and chronic fatigue. [bbc.co.uk]
Side effects of antiadrenergic medications include breast tenderness, irregular menstruation, headaches, and fatigue. 2 End Note Alternative treatments with fewer side effects are needed for severe acne vulgaris. [pharmacytimes.com]
Side-effects for Spironolactone are rare but may include menstrual irregularities, breast tenderness, dizziness, and fatigue. Hypokalemia is extremely rare in patients who are not taking concurrent diuretics. [skintherapyletter.com]
- Fever
Its symptoms include: Fever Joint pain and inflammation, most often in the knees and hips Severe acne with bleeding ulcers, usually on the upper body Weight loss and a decrease in appetite Swelling of the spleen and liver Acne fulminans is a more severe [everydayhealth.com]
Other non-dermatological features include fever, joint pains and systemic indications of inflammation evident in a raised ESR (erythrocyte sedimentation rate). It may follow through from acne conglobata especially if treatment is unsuccessful. [healthhype.com]
[…] enclosing a mixture of keratin and sebum in varying proportions. acne ful´minans a rare form of severe cystic acne seen in teenage boys, characterized by highly inflammatory nodules and plaques that undergo suppurative degeneration leaving ulcerations, fever [medical-dictionary.thefreedictionary.com]
If systemic symptoms like fever or arthritic symptoms develop in patients with acne conglobata, the disease is termed acne fulminans. Timely treatment by a dermatologist is essential. [onhealth.com]
Acne fulminans is even more severe than acne conglobata, with systemic symptoms such as fever, joint pain, and general malaise. [emedicine.medscape.com]
Skin
- Dermatitis
The allelic size variation of the PEM gene was investigated in Japanese acne patients, atopic dermatitis patients, and healthy controls. The frequency of longer length alleles was significantly higher in severe acne patients. [ncbi.nlm.nih.gov]
Seborrhea Seborrhea is also called seborrheic dermatitis. It is responsible for the red pigmentation of the skin during acne breakouts. Seborrhea also makes the skin scaly, flaky and itchy. [progressivehealth.com]
- Erythema
Results in the two groups were comparable, although there was slightly more erythema reported in the Fitzpatrick skin types I-III subjects (0.2 versus 0.1). This could be due to the difficulty in visualizing erythema in subjects with darker skin. [ncbi.nlm.nih.gov]
More often, an irritant contact dermatitis develops, especially if used with tretinoin or when accompanied by aggressive washing methods. [39] If intensive erythema and pruritus develop, a patch test with benzoyl peroxide is indicated to rule out allergic [emedicine.medscape.com]
Adverse effects include erythema, burning, stinging, and peeling. Adapalene and tazarotene are retinoids; like tretinoin, they tend to be somewhat irritating and photosensitizing. [merckmanuals.com]
- Skin Pustule
That's acne that has more papules than pustules (more on pustules in the next slide). Papular acne is common in people with course/oily skin. Pustules (Pimples) Pustules are another kind of inflamed pimple. [onhealth.com]
Psychiatrical
- Fear
Lead study investigator and dermatologist Arielle Nagler, MD, says fears about isotretinoin side effects, as well as federal restrictions meant to prevent use of the medication during pregnancy, have also all helped contribute to prolonged antibiotic [nyulangone.org]
Control Moisturizer for Oily Skin Many people who have acne shy away from moisturizer, fearing it will aggravate their oily, acne-prone skin. [blog.mariobadescu.com]
I had always had a crippling fear of public speaking, to the point where I would often be in tears by the end of a presentation for class. But, post-Accutane, I was no longer afraid to speak in front of my peers. [refinery29.com]
I don’t use it every night, but if I have any fear there’s anything surfacing, I do. In the first month, I did get that throbbing “I’m coming!” feeling a few times, and I applied Aczone and one spot went away instantly. [scarymommy.com]
Neurologic
- Stroke
You can also add aloe gel (an antiseptic) to the cloth and gently massage around the pimple in an upwards stroking pattern, says Rena Rubin, esthetician at Haven Spa in New York City. 4. [womenshealthmag.com]
Women with a high risk or previous history of high blood pressure, stroke, heart disease, blood clots, or breast cancer should not go on hormonal medication. 7 Zap off cysts with laser therapy. [wikihow.com]
Workup
See Workup for more detail. Management Treatment of acne vulgaris should be directed toward the known pathogenic factors, including follicular hyperproliferation, excess sebum, C acnes (formerly P acnes ), and inflammation. [emedicine.medscape.com]
Microbiology
- Staphylococcus Aureus
aureus remained sensitive to tetracycline even after prolonged use of that antibiotic for acne. [46] This has significant ramifications when considering efforts to control the spread of methicillin-resistant S aureus (MRSA), because tetracycline group [emedicine.medscape.com]
Prognosis
What Is the Prognosis for Cystic Acne? With aggressive treatment, the prognosis of cystic acne is excellent. But treatment must be instituted prior to the development of significant scarring, which is irreversible and permanent. [emedicinehealth.com]
Intra-articular corticosteroid therapy, methotrexate, colchicine cystic acne Mutilating acne Dermatology A form of acne vulgaris which may affect teenagers, 2º to bacterial infection of clogged sebaceous ducts deep in the skin Management Antibiotics, isotretinoin Prognosis [medical-dictionary.thefreedictionary.com]
By age 45 years, 5% of both men and women still have acne. [22] Prognosis Acne may cause long-lasting and detrimental psychosocial and physical effects. [emedicine.medscape.com]
Etiology
Abstract The etiology of dactinomycin-associated acne has not previously been studied. An 81/2 year old girl with embryonal rhabdomyosarcoma of the left petrous bone was prepubertal at the time of presentation. [ncbi.nlm.nih.gov]
Comedone formation: etiology, clinical presentation, and treatment. Clin Dermatol. 2004 Sep-Oct. 22(5):367-74. [Medline]. Gollnick H, Cunliffe W, Berson D, Dreno B, Finlay A, Leyden JJ, et al. [emedicine.medscape.com]
Epidemiology
BACKGROUND: Little is known about the epidemiology of severe acne in the U.S. OBJECTIVES: We sought to study the U.S. prevalence, determinants and comorbidities of severe acne in adolescence. [ncbi.nlm.nih.gov]
Bhate K, Williams HC ; Epidemiology of acne vulgaris. Br J Dermatol. 2013 Mar168(3):474-85. doi: 10.1111/bjd.12149. [patient.info]
With rosacea, women ages 20 to 60 are the predominant epidemiological group. [draxe.com]
Pathophysiology
Pathophysiology The pathogenesis of acne vulgaris is multifactorial. [emedicine.medscape.com]
Prevention
If early acne develops, teaming up with the right skincare and supplements can help keep acne from becoming severe as well as prevent physical and emotional scars. Preventing severe acne can make a difference that lasts a lifetime. [orique.com]
In addition to reducing inflammatory and non-inflammatory lesions, adapalene/BPO helps prevent lesion and microcomedone formation. [ncbi.nlm.nih.gov]
So how can acne be prevented? Sometimes acne prevention isn’t possible, especially if you carry a family history or are going through hormonal changes. However, sticking to a doctor-recommended acne-cleansing regimen is a good first step. [aurorahealthcare.org]
Dermatologist-approved lesson plans, activities you can use Free to everyone, these materials teach young people about common skin conditions, which can prevent misunderstanding and bullying. [aad.org]
Medical treatment focuses on: • Healing existing spots and lessening the risk of scarring from these; Preventing future acne spots and scarring. [acneaction.ca]