Acne Signs and Symptoms.

Acne presents with comedones, papules, pustules, nodules and cysts, generally on the face, neck, chest and back. Symptoms vary from whiteheads and blackheads to inflamed bumps, pimples, and painful deep lumps. Acne is usually diagnosed visually based on appearance and distribution of lesions. Differential diagnoses include keratosis pilaris, perioral dermatitis, angiofibromas, pseudofolliculitis barbae and hidradenitis suppurativa.

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Acne Signs and Symptoms.

Uploaded by

Arun Raj

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Download as PPTX, PDF, TXT or read online on Scribd

Acne – Signs And

Symptoms
CLINICAL PRESENTATION
• Acne presents as solitary or grouped comedones,
papules, pustules, nodules and cysts. Mild to severe
inflammation will accompany all with the exception of
comedones.
• Generally distributed on forehead, face, neck, chest and
back. Rarely appears on scalp. Corresponds with areas
of highest sebaceous gland density.
• Patients are usually, although not always anxious and
self-conscious about their condition, which can lend the
disease a strong emotional component.
• Many patients previously diagnosed and frustrated with
treatment.

James WD. Acne. N Engl J Med 2005;352:1463-72

Content developed by Magna Health Solutions for Abbott Healthcare Private Limited. © 2016 Abbott. All rights reserved. 16P91-049F
SYMPTOMS
Acne signs and symptoms vary depending on the
severity
• Whiteheads (closed plugged pores)

• Blackheads (open plugged pores)

• Small red, tender bumps (papules)

• Pimples (pustules), which are papules with pus at their tips

• Large, solid, painful lumps beneath the surface of the skin

(nodules)

• Painful, pus-filled lumps beneath the surface of the skin (cystic

lesions)

Mayoclinic: [Link] Accessed on Nov 30, 2015.

Content developed by Magna Health Solutions for Abbott Healthcare Private Limited. © 2016 Abbott. All rights reserved. 16P91-049F
HOW SEVERITY OF ACNE IS GRADED:
• Overall severity of acne classified as Grades 1-4, with
higher grades having a higher overall lesion count, more
inflammation, larger lesions, etc.
• Further characterized as comedonal, pustular,
papularpustular, nodular and nodulocystic.
• (Important to remember that by definition, comedonal
acne is the only subtype which is non-inflamed.)
• For Example: A mild case would be Grade I comedonal.
You see scattered open comedones on forehead and face.
• A severe case could be Grade 3 nodulocystic acne
characterized by presence of many inflamed, tender
nodules and cysts.

Leyden JJ. New understandings of the pathogenesis of acne J Am Acad Dermatol 1995;32:S15-25

Content developed by Magna Health Solutions for Abbott Healthcare Private Limited. © 2016 Abbott. All rights reserved. 16P91-049F
FACTORS WHICH TRIGGER OR
AGGRAVATE ACNE
• Hormones

• Infections

• Oil-based cosmetics

• Drugs

• Genetic factors

• Stress

Ray et al. Int J Res Pharmaceut Biosci. 20.13;3:1–16.

Content developed by Magna Health Solutions for Abbott Healthcare Private Limited. © 2016 Abbott. All rights reserved. 16P91-049F
HORMONAL ASPECT ABOUT ACNE
• Hormonal influences during puberty cause increased
sebum production/keratinization in both men and
women. Majority of these cases resolve post-puberty.
• Some research suggests that increased cortisol
production secondary to prolonged stress can lead to
androgen over- production and acne.
• Middle aged women with recurrent pre-menstrual acne
are often showing a sensitivity to the brief surge of
testosterone produced by the ovaries prior to initiation of
menses.

Leyden JJ. New understandings of the pathogenesis of acne J Am Acad Dermatol 1995;32:S15-25

Content developed by Magna Health Solutions for Abbott Healthcare Private Limited. © 2016 Abbott. All rights reserved. 16P91-049F
PATIENT EVALUATION
• Key Elements in History
• previous medications used
• current products being used for acne
• medical problems
• other medications
• use of cosmetics or hair pomades
• recreational activities and occupation
• For Female Patients
• menstrual history
• hirsutism
• use of hormonal contraceptives

James WD. Acne. N Engl J Med 2005;352:1463-72

Content developed by Magna Health Solutions for Abbott Healthcare Private Limited. © 2016 Abbott. All rights reserved. 16P91-049F
PATIENT EDUCATION
• diet
• cosmetics
• hair styles
• Hygiene
• washing of lesions
• picking lesions
• premenstrual flare
• hair care products
• improvement is not overnight
• treatment must be used regularly
• treatment is long term

James WD. Acne. N Engl J Med 2005;352:1463-72

Content developed by Magna Health Solutions for Abbott Healthcare Private Limited. © 2016 Abbott. All rights reserved. 16P91-049F
DIAGNOSIS

• Almost always a straightforward, visual

diagnosis.
• Vast majority of cases are pre-pubescent and pubescent
males and females. Significant number of cases middle-
aged women; rare in post-pubescent males.
• Few cases of acne suddenly appearing in patients with no
prior history and who don’t fit into the above categories
• Look for occupational acne: Workplace exposure to light
oils (machine oil, cosmetics) which occludes pores
leading to comedogenesis and acne.
• Only type of acne needed biopsy for diagnosis.