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Acne vulgaris


Acne is a chronic inflammatory disease of the pilosebaceous units ( Fig. 42.14 ) Fig. 42.14 An haematoxylin and eosin stain of a longitudinal frozen section of a clinically normal pilosebaceous follicle from the back of an acne patient. A mild perifollicular infiltrate is present. (Courtesy of Dr A. Jeremy, Skin Research Centre, Institute of Molecular and Cellular Biology, Faculty of Biological Sciences, University of Leeds, UK.) It is characterized by seborrhoea, the formation of open and closed comedones, erythematous papules and pustules ( Fig. 42.15 ) and in more severe cases nodules, deep pustules and pseudocysts ( Fig. 42.16 ). In many cases a degree of scarring will ensue. Fig. 42.15 Mixed non-inflammatory and inflammatory acne lesions. Fig. 42.16 Deep-seated inflammation resulting in an acne cyst. (Courtesy of Dr A. Yung, Auckland, New Zealand.) Four major factors are involved in the pathogenesis: (i) increased sebum production, (ii) hypercornification of the pilosebaceous duct, (iii) abnormality of the microbial flora especially colonization of the duct with P. acnes , and (iv) inflammation. The condition usually starts in adolescence and frequently resolves by the mid-twenties [1] . Prevalence data is variable depending on the time of the study and population assessed. In one community based study, acne was noted in 56% of boys and 45% of girls aged between 14 ... log in or subscribe to read full text

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