Question

An 18-year-old college student comes to seek help for her acne over the face.
What is acne, what are the causes and clinical presentations of acne?

Hint:

Managing acne early can help prevent scarring. Avoid squeezing pimples, as it can exacerbate inflammation.

Answer 1

Acne is a common skin condition that is influenced by a variety of factors such as hormonal changes, genetics, and external factors like diet. Clinical presentation varies from mild non-inflammatory comedones to severe cystic lesions that may lead to scarring.
Acne is a chronic inflammatory skin condition characterized by the presence of comedones (blackheads and whiteheads), pimples, and sometimes cysts, primarily affecting areas with a high density of sebaceous glands. Causes and clinical presentations include:
1. Causes:
- Hormonal Changes: Increased androgenic hormones during puberty, menstruation, or due to conditions like polycystic ovarian syndrome (PCOS) can trigger acne.
- Increased Sebum Production: Overproduction of sebum (skin oil) by sebaceous glands.
- Follicular Hyperkeratinization: The accumulation of dead skin cells that block hair follicles.
- Bacterial Infection: The bacterium *Propionibacterium acnes* proliferates in blocked follicles.
- Genetic Factors: A family history of acne can predispose individuals to developing acne.
- Dietary Factors: High glycemic index foods, dairy products, and chocolate may contribute.
- Medications: Certain drugs like corticosteroids, lithium, and androgens can worsen acne.

2. Clinical Presentations:
- Comedones (blackheads and whiteheads): Non-inflammatory lesions resulting from the clogging of hair follicles with sebum and keratin.
- Papules: Red, inflamed bumps on the skin due to clogged pores.
- Pustules: Similar to papules, but filled with pus.
- Nodules and Cysts: Large, painful, deeper lesions that can lead to scarring.
- Inflammation: Swelling and redness around the affected area, typically on the face, chest, and back.