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Acne vulgaris is a dermatosis of unknown etiology. However, many factors are incriminated in its pathogenesis and aggravation. Androgenic stimulation at puberty is believed to increase the activity of sebaceous glands and sebum production. A change in the process of keratinization of the sebaceous follicle may produce an increased adherence of the horn cells resulting in retention hyperkeratosis.

DiagnosisThere are no diagnostic tests for acne vulgaris. Diagnosis is clinical, lesions of acne vulgaris need to be differentiated from acneiform dermatoses.

Neonatal acneIt is characterized by the formation of comedones in a newborn. The lesions are localized to the nose and adjacent areas of cheeks. It is due to stimulation of the sebaceous glands by maternal hormones. it clears spontaneously.

Drug acneProlonged application of topical steroids especially on the face, systemic cortecosteroids, adrenocorticoids, iodides, bromides and isoniazid may result in acne.

Occupational acneSeveral industrial compounds like tar derivatives, cutting oils, chlorinated hydrocarbons may cause acne. The lesions are inflammatory and present as comedones, papules, pustules, large nodules, and cysts. They tend to involve areas covered by clothing permitting intimate contact between the offending chemical and skin. face is usually spared.

Tropical acneThis develops in tropical climate and is localized to trunk and buttocks. It resembles acne conglobata and present as deep, large, inflammatory nodules.

TreatmentTopical therapy alone is indicated for mild to moderate lesions. Benzoyl peroxide is administered for comedones, while the papular and pustular lesions respond to topical antibiotics. Clindamycin and erythromycin are equally effective. They not only are bacteriostatic but also supress inflammation. They are applied twice daily and cause mild dryness and erythema.


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