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$Unique_ID{BRK03417}
$Pretitle{}
$Title{Acne}
$Subject{Acne Acne Vulgaris Cystic Acne Acne Conglobata Acne Fulminans
Excoriated Acne of Young Women Acne Excorie Des Jeunes Filles Chloracne
Atypical Acneiform Eruptions Acne Rosacea}
$Volume{}
$Log{}
Copyright (C) 1990 National Organization for Rare Disorders, Inc.
818:
Acne
** IMPORTANT **
It is possible that the main title of the article (Acne) is not the name
you expected. Please check the SYNONYM listing to find the alternate names
and disorder subdivisions covered by this article.
Synonyms
Acne Vulgaris
Cystic Acne
Information on the following disorders can be found in the Related
Disorders section of this report:
Acne Conglobata
Acne Fulminans
Excoriated Acne of Young Women (Acne Excorie Des Jeunes Filles)
Chloracne
Atypical Acneiform Eruptions
Acne Rosacea
General Discussion
** REMINDER **
The information contained in the Rare Disease Database is provided for
educational purposes only. It should not be used for diagnostic or treatment
purposes. If you wish to obtain more information about this disorder, please
contact your personal physician and/or the agencies listed in the "Resources"
section of this report.
Acne is a common skin disorder. Acne Vulgaris, the most common form of
acne, affects many adolescents during puberty. The skin eruptions primarily
appear on the face, upper back and/or chest due to overactive oil-secreting
(sebaceous) glands. Hormone changes during puberty activate the oil-
secreting glands.
Symptoms
Characteristics of acne include blackheads and/or whiteheads (comedones).
Sometimes more severe skin lesions appear such as papules, pustules and cysts
which develop on the face, and sometimes on the neck, shoulders, upper back
and/or chest.
Whiteheads (comedones) are plugs of oil (sebum) and dead skin cells
caused by clogged skin pores that block oil (sebum) and prevent it from
flowing freely to the surface of the skin. Blackheads (open comedones) occur
when the plug reaches the surface of the skin where it turns black when
exposed to air. Whiteheads (closed comedones) begin under the surface of the
skin and either turn into blackheads or lead to inflammation. Inflammation
causes small elevated growths (papules), some containing dead skin cells and
inflammatory fluid (pustules). Cystic Acne is a severe form of acne in which
small fluid-filled cysts develop in the skin.
Causes
The exact cause of acne is unknown. A contributing factor to acne in
adolescents is overactive oil-secreting sebaceous glands which are related to
changes in activity of hormones. Other possible factors may be heredity,
emotional stress, oil-based moisturizers and cosmetics. Most doctors now
believe that acne is not related to personal hygiene or diet, although some
still recommend staying away from peanut butter, fried foods, chocolate, and
other foods that are greasy or have a high sugar content even though there is
no evidence that diet is related to acne.
Affected Population
Acne is extremely common, affecting many adolescents during puberty. Four
out of five teenagers develop acne at some point. Most cases of acne last
only a few years. Some cases last for just a few weeks or months, others can
last for many years.
Related Disorders
The following disorders are subtypes of acne:
Acne Conglobata may occur alone, or may be part of a symptom complex in
conjunction with Hidradenitis Suppurativa and connective tissue inflammation
(cellulitis) of the scalp. Skin lesions from Acne Conglobata usually occur
on the neck and upper back or chest, but may spread to the upper arms, lower
back, buttocks, and thighs. The typical acne skin eruptions are present, but
symptoms are chronic with abscesses and circumscribed tissue masses
(nodules). Cysts also develop. The cysts contain foul-smelling fluid, and
severe scarring often occurs. Although this form of acne resists treatment
with ordinary antibiotics, symptoms may be controlled by the use of the drug
Accutane (isotretinoin) in some cases.
Acne Fulminans is a rarer form of acne which occurs most often in
adolescent males. Mild Acne Vulgaris initially develops but it is
unexpectedly followed by markedly inflamed and painful lesions on the upper
back and/or chest and occasionally the face. Lesions may bleed and/or crust,
and may be accompanied by fever and other systemic abnormalities. Treatment
with isotretinoin, with or without corticosteroid drugs and antibiotics, can
be effective in most cases.
Excoriated Acne of Young Women (Acne Excorie Des Jeunes Filles) is a type
of acne caused by inflicted rubbing or scratching of skin eruptions resulting
in increased scarring. Although it is often found among young women, it can
be found in any age group and both sexes.
Chloracne may develop among workers exposed to chlorinated hydrocarbons.
Treatment of the skin lesions should be accompanied by removal of the
irritating substance from the environment.
Atypical Acneiform Eruptions are seen in any age group and are not always
limited to oil-secreting (sebaceous) glands. These eruptions may appear as a
result of corticosteroid, androgen, or progesterone drug therapy.
Occupational problems such as skin contact with machine oils, especially
insoluble cutting oils, may also cause this type of acne. Eating iodine or
bromine salts, and drugs such as diphenylhydantoin (phenytoin) and lithium,
can induce this skin condition.
Acne Rosacea is limited to the nose, cheeks and forehead, typically
beginning during adulthood. The facial skin, especially the nose, becomes
oily, reddened and bumpy. Small red blood vessels are visible. In extreme
cases, the nose may appear very red and bulbous. (For more information on
this disorder, choose "acne rosacea" as your search term in the Rare Disease
Database).
Therapies: Standard
Treatment of acne includes gently washing affected areas two to three times a
day with medicated soap, shampooing as necessary, and if necessary treatment
with benzoyl peroxide products which can be purchased in any pharmacy without
prescriptions. It is important to keep affected areas free from oil. Water-
based rather than oil-based moisturizers and cosmetics are recommended.
For more serious cases of acne, physicians or dermatologists can help.
Tretinoin (which contains vitamin A acid), or antibiotics such as
clindamycin, erythromycin, minocycline, or tetracycline are often prescribed.
In severe cases that are resistant to antibiotics, Accutane (isotretinoin)
may be prescribed. However, this drug can cause severe birth defects if
taken by a pregnant woman, so women of child-bearing age should use
contraceptives while taking Accutane.
If scarring from acne occurs, dermabrasion (professional skin planing)
may be of cosmetic benefit to the patient once the acne has subsided.
Therapies: Investigational
Research on skin disorders is moving forward at a rapid pace. A better
understanding of the skin and its components is necessary for development of
new treatments for acne. For information about skin research, contact the
National Institute of Arthritis, Musculoskeletal and Skin Disorders
Clearinghouse listed in the Resources section of this report.
This disease entry is based upon medical information available through
November 1990. Since NORD's resources are limited, it is not possible to
keep every entry in the Rare Disease Database completely current and
accurate. Please check with the agencies listed in the Resources section for
the most current information about this disorder.
Resources
For more information on acne, please contact:
National Organization for Rare Disorders
P.O. Box 8923
New Fairfield, CT 06812-1783
(203) 746-6518
Acne Research Institute
1236 Somerset Lane
Newport Beach, CA 92260
(914) 722-1805
The National Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Information Clearinghouse
Box AMS
Bethesda, MD 20892
(301) 495-4484
References
CECIL TEXTBOOK OF MEDICINE, 18th Ed.: James B. Wyngaarden, and Lloyd H.
Smith, Jr., Editors; W.B. Saunders Co., 1988. Pp. 2332-2333.
THE COLUMBIA UNIVERSITY COLLEGE OF PHYSICIANS AND SURGEONS COMPLETE HOME
MEDICAL GUIDE: Donald F. Tapley, M.D., et al., eds; Crown Publishers, Inc.,
1985. Pp. 246, 626-628.
INTERNAL MEDICINE, 2nd Ed.: Jay H. Stein, ed.-in-chief; Little, Brown
and Co., 1987. Pp. 1379-1380.
WORLD BOOK MEDICAL ENCYCLOPEDIA: Erich E. Brueschke, M.D., et al., eds;
World Book, Inc., 1988. Pp. 12-13.