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Acne

Acne. Dr. Amal Kokandi. Acne. Very common Begins usually at sebarche (preceds menarche by > year) Polymorphic, inflammatory dis. Of pilosebacious follicles in skin of face and trunk. KAU clinic-women section. Normal Pilosebaceous Unit. Pathophysiology.

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Acne

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  1. Acne Dr. Amal Kokandi

  2. Acne • Very common • Begins usually at sebarche (preceds menarche by > year) • Polymorphic, inflammatory dis. Of pilosebacious follicles in skin of face and trunk

  3. KAU clinic-women section

  4. Normal Pilosebaceous Unit

  5. Pathophysiology • Increased sebum secretion (androgens) • Abnormal keratinisation of follicular epithelium • Proliferation of Propionibacterium acnes • Inflammation

  6. Lesions • Comedones: white and black • Papules • Pustules (pimples) • Nodules • Cysts • Scars (atrophic and hypertrophic) • PIH

  7. Severity • Photographic ( Leeds) • Mild, moderate, severe • Site • Counting methods

  8. Impact • Self esteem • Depression

  9. Believes • Relation to food (chocolate, fat, dairy products, iodine) • cause • therapy • Stress • Periods

  10. Treatment • Lesion type, site and severity • Prior treatment experience and response • Acne scarring • Psychosocial disability • Social status

  11. Treatment: Topicals • Retinoids (tretinoin, isotretinoin, and adapalene) • Benzoyl peroxide • Antibiotics (erythromycin, tetracycline & clindamycin) • Azeliec acid • Others (salycilic acid….)

  12. Treatment: systemic • Systemic antibiotics (oxytetracycline, minocycline, doxycycline, erythromycin in pregnancy…..)

  13. Treatment: systemic • Hormonal therapy: oral contraceptives (↑sex hormone binding globulin→↓ free testosterone & may ↓ovarian testosterone), Cyproterone acetate+ethinylestradiol (Dianette) • Oral isoteritinoin (Roaccutane) • teratogenecity • !! Dose & duration • Side effects • monitoring

  14. Treatment (others) • Cautery for macrocomedones • Cryotherapy • Light therapy (blue or blue-red), photodynamic therapy and radiofrequency

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