Acneiform Lesions

Acneiform Lesions-

-Acne Vulgaris-

-results from a change in keratinization pattern in the hair follicle.  The secretion of sebum is then blocked
-lesions are complex interaction between hormones and bacteria
-When the follicle has a portal of entry at the skin a semisolid mass protrudes and this is called a blackhead
-Prefers sites of face, neck, upper arms, trunks and buttocks
-Mild acne-topical antibiotics (Clindamycin), Benzoyl Peroxide, and Topical Retinoids (Tretinoin)
-Moderate Acne-oral antibiotics (Minocycline) is added to above it treatment fails.  Females can add high does of estrogens
-Severe acne-isotretinoin inhibits sebaceous gland function and keratinization


-Rosacea-

-patients usually have a long history of reddening of the face with increases of temperature in response to heat stimuli in the mouth
-Exposure to heat may cause exacerbations
-Acne may precede the onset of rosacea

-Stage I-Persistent erythema with telangiectases
-Stage II-Persistent erythema with telangiectases, papules and tiny pustules
-Stage III-Persistent deep erythema, dense telangiectases, papules, pustules, nodules, and solid edema

-Treatment-
-Topical metronidazole gel or cream.  Sodium Sulfacetamide.  Topical erythromycin
-Systemic-Tetracycline or minocycline
-oral isotretinoin maybe helpful for refractory cases