ACNE VULGARIS

Patogenesis:

Etiology of acne vulgaris is multifactorial. The disease usually starts at the puberty when
under the infuence of androgens starts the function of sabecous glands.

Factors : retentional folicular hyperkeratosis, hyperfunction of sabaceous glands,

propionibacterium and androgens

Clinical picture :

AV is usually seen in puberty and it is more common in males than in females. It is localized
on the skin of centrofacial region, presternaly and inttrascapulay. Primay change is
microcomendon which is not visible but without it there wouldn't be acne. The
microcomendons become ''closed commedones'' semi-circular up to 2mm with small central
depreson trough which you can squeeze out the filamentous contens. ''Open comendon''are
centers with black dot , the black color comes from melanin. If there is more comedons the
disease is called acne comendonica. Inflammatory lesions are possible only from closed
comedones. Those are papules and pustules acne pustulosa. If there are also cystic nodules
without inflammation than is acne nodulo-cystica. Acne can last for several years and than
they retrive.

Differential diagnosis : -

Acne medicamentosa changes that are caused by glucocoriticosterods, isoniaside.

Acne olesa are on tighs, legs and arms. They are caused by contact wit oil.

Treatment
Mild acne

Topical antibiotcs (clindamycin,erytromycin) and benzoyl peroxide

Topical retinoids (retinoic acid, adapalene, tazarotene )

Moderate acne

Oral antibiotics (doxycycline, minocycline ) + regimen above.

Severe acne : topical treatment and systemic treatment with isotretnion for cystic acne.
ROSECA
Is inflammatory dermatosis localized on face.

Clinical picture : roseeca is usually seen in middle age persons, but can be seen in any age. It
is more common in woman than man .

Changes are localized on the face (chin,nose,forhead) but it can be spread to cheeks, sides on
the neck, v-area of neck,auriculim. Early lesion is erythema which later becomes persiatant
difuse passive erythema. On erythema there are telangiaectasis (permanenet vasodilatation).

Differential diagnosis: seborrohoic and steroid dermatitis, sarcoidosis

Treatment : topical metronidasole

Topical antibiotics (erythromicin )

Sytemic

Minocyline, doxycline