1. Dr.Ahmed Abdul-Aziz Ahmed Assistant Clinical Professor Dermatology&Venerology. F.I.B.M.S.

2. Acne

3. How a Pimple Forms(1)
A hair follicle is surrounded by sebaceous glands, which excrete sebum to the surface of the skin.

4. How a Pimple Forms (2)
Excess oil, unshed skin cells, and natural bacteria within the skin become sticky and create a plug around the hair follicle.

5. How a Pimple Forms (3)
As more sebum is produced in the plugged hair follicle, the, swelling occurs and appears on the surface of the skin.
Overall, this pimple-appearing process takes 2-3 weeks.

6. Comedonal

9. Variation of Acne Severe Moderate Light
Characterized by whiteheads, blackheads, papules, pustules.
Inflammatory increases and becomes more serious. It usually happens on surface but sometimes have deeper pustules.
Characterized by cysts and nodules, many are in the body, scars are easily formed.
Severe
Moderate
Light

10. Acne Classifications: Comedonal (mild) acne
Inflammatory (moderate) acne
Nodular cystic (severe) acne
Acne is most common in teenagers, but it can occur at all ages. The condition usually begins at puberty and may continue for many years. Three out of four teenagers have acne to some extent, probably caused by hormonal changes that stimulate the sebaceous (oil producing) skin glands.
Other hormonal changes related to menstrual periods, pregnancy, birth control pills, or stress can also aggravate acne. Acne is caused when glands within the pores of the skin become plugged, because oil and skin cells accumulate faster than they can exit. The plug causes the hair follicle to bulge (causing whiteheads), and the top of the plug may appear dark (causing blackheads). If the plug causes the wall of the follicle to rupture, the oil, dead skin cells, and bacteria found normally on the surface of the skin can enter the skin and form small infected areas called pustules (also known as pimples or "zits"). If these infected areas are deep in the skin, they may enlarge to form firm, painful cysts.
Acne commonly appears on the face and shoulders, but may extend to the trunk, arms and legs. Acne is not caused by dirt or by masturbation or other activities, but dirt and oil on the face can aggravate the condition. Other factors that increase the chances of acne are hormonal changes, exposure to weather extremes, stress, oily skin, endocrine disorders, certain tumors, and the use of certain drugs (such as cortisone, testosterone, estrogen, and others).
Acne is not contagious. It tends to run in families. A tendency to have acne may persist through ages 30's to early 40's.
Whiteheads (comedo) vs. blackheads (comedons or open comedos)

11. Whitehead and blackheads

13. The seborrhoea, comedones and scattered inflammatory papules of teenage acne.

14. CLOSED COMODOME

15. OPEN COMODOME

16. PAPULAR ACNE

17. PUSTULAR ACNE

18. Closed comedones (whiteheads)
(a whitehead):
Accumulation of sebum
converts a
microcomedo into this.

20. Closed comedones (whiteheads)

21. Open comedo (blackhead)
(a blackhead):
when follicular orifice is opened + distended.
Melanin + packed
keratinocytes + oxidized
lipids  dark colour

22. Open comedo (blackhead)

23. Acne vulgaris Inflammatory papules, pustules, crusting on the forehead, cheeks, and chin.

24. Acne vulgaris Comedones rupturing into the dermis give rise to an
intense inflammatory response with pustule and abscess formation (so-called“cystic” or nodulocystic acne).

25. ACNE CONGLOBATA

26. Prominent and inflamed cysts are the main
features here.

27. Cysts

29. Acne Conglobata

30. Cystic acne – this is a bad prognostic sign
Cystic acne – this is a bad prognostic sign. Most patients will have acne for decades and be left with many scars
isotretinoin is the most effective drug for cystic acne

31. Infantile acne

32. Infantile acne. Pustulocystic lesions on the checks.

33. Infantile Acne

34. A group of open comedones (blackheads)
following the use of a greasy cosmetic.

35. Steroid-induced acne in a seriously ill patient.

36. Warn the patient that staining may be left. This will fade overtime.

37. Acne scarring: worth treating a test area with a
resurfacing laser

38. ICE PICK SCAR

39. THUMBPRINT SCARS

40. ATROPHIC SCARS

41. HYPERTROPHIC SCARS

42. KELOIDS

43. Rosacea

44. Typical rosacea with papules and pustules on a background of erythema
Typical rosacea with papules and pustules on a background of erythema. Note he also has a patch of scaly seborrhoeic eczema on his brow.

45. Rosacea A common eruption, more common with age
There is inflammation but no obstruction of sebaceous glands
Papules, pustules, diffuse erythema, and possible induration of the affected area
No black heads

46. Inflammatory rosacea
Papules and pustules are characteristic

47. Rosacea

49. Rosacea Typical moderately severe involvement with confluent erythematous papules and pustules on the forehead, cheeks, and nose. Note the
absence of comedones that are typically seen with acne vulgaris.

50. Inflammatory rosacea

52. Marked rhinophyma

53. Rosacea Rhinophyma

54. Acne vs. Rosacea
acne
rosacea

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