Ch 36

Akne Vulgaris

Vol 1 · sayfa 592 · §6

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Fig. 36.2 Comedonal acne vulgaris. On the cheek (A) and forehead (B), there are open and closed comedones as well as postinflammatory hyperpigmen- tation (A) and inflammatory papules (B). B, Courtesy Kalman Watsky, MD.

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Fig. 36.2 Comedonal acne vulgaris. On the cheek (A) and forehead (B), there are open and closed comedones as well as postinflammatory hyperpigmen- tation (A) and inflammatory papules (B). B, Courtesy Kalman Watsky, MD.

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Fig. 36.3 Moderate acne vulgaris. Scattered papulopustules and papulo- nodules are present on the cheek. Courtesy Kalman Watsky, MD.

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Fig. 36.4 Moderate to severe acne vulgaris. Inflammatory papules and pustules as well as both open and closed comedones are evident on the cheek, forehead, and chin. Note the nodular lesion on the temple and open comedones in the concha of the ear. Scarring is present in the preauricular area.

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Fig. 36.5 Moderate to severe acne vulgaris. Multiple coalescing papules, papulopustules, and small nodules are present on the cheeks (A,B) and temple (A). Early scarring is evident laterally (A). B, Courtesy Kalman Watsky, MD.

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Fig. 36.6 Severe to very severe nodular acne. A Numerous nodules. B Acne conglobata with coalescence of purulent nodules on the forehead, with associated eyelid edema. This form is best treated with prednisone and a low dose of isotretinoin initially. B, Courtesy Julie V. Schaffer, MD.

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Fig. 36.7 Postinflammatory hyperpigmentation secondary to acne. Such pigmentary changes are common in patients with darker skin tones.

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Fig. 36.8 Scarring secondary to acne. A Pitted scars on the cheeks. B, C Mixture of atrophic and hypertrophic scars on the back. B, Courtesy Julie V. Schaffer, MD.

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Fig. 36.8 Scarring secondary to acne. A Pitted scars on the cheeks. B, C Mixture of atrophic and hypertrophic scars on the back. B, Courtesy Julie V. Schaffer, MD.

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Fig. 36.10 Acne fulminans. Eruptive, friable papulopustules with erosions, oozing, and formation of granulation tissue.

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Fig. 36.10 Acne fulminans. Eruptive, friable papulopustules with erosions, oozing, and formation of granulation tissue.

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Fig. 36.11 Solid facial edema due to acne vulgaris. There is soft tissue swelling in the central portion of the face. Courtesy Boni Elewski, MD.

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Fig. 36.12 Infantile acne. Presentations can range from numerous open comedones (A) to primarily papulopustules (B). A, Courtesy Julie V. Schaffer, MD; B, Courtesy Kalman Watsky, MD.

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Fig. 36.12 Infantile acne. Presentations can range from numerous open comedones (A) to primarily papulopustules (B). A, Courtesy Julie V. Schaffer, MD; B, Courtesy Kalman Watsky, MD.

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Fig. 36.13 Acneiform eruption secondary to high-dose dexamethasone. Abrupt eruption of monomorphous follicular papules and pustules on the chest.

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Fig. 36.14 Acneiform eruptions due to epidermal growth factor receptor inhibitors. Numerous monomorphous follicular pustules on the face of an adolescent boy treated with erlotinib.

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Fig. 36.15 Disorders in the differential diagnosis of acne vulgaris. A Pseudoacne of the transverse nasal crease in a young child. Note the milia and comedones located along this anatomical demarcation line. B Demodicosis presenting as pustules on the nose of a healthy child. An increased number of Demodex mites was observed in a scraping. C Acneiform follicular mucinosis on the cheek of a woman. D Follicular mycosis fungoides that presented as numerous lesions with a comedonal appearance on the chest, abdomen, and back. A, B, D, Courtesy Julie V. Schaffer, MD; C, Courtesy Lorenzo Cerroni, MD.

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Fig. 36.15 Disorders in the differential diagnosis of acne vulgaris. A Pseudoacne of the transverse nasal crease in a young child. Note the milia and comedones located along this anatomical demarcation line. B Demodicosis presenting as pustules on the nose of a healthy child. An increased number of Demodex mites was observed in a scraping. C Acneiform follicular mucinosis on the cheek of a woman. D Follicular mycosis fungoides that presented as numerous lesions with a comedonal appearance on the chest, abdomen, and back. A, B, D, Courtesy Julie V. Schaffer, MD; C, Courtesy Lorenzo Cerroni, MD.

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Fig. 36.15 Disorders in the differential diagnosis of acne vulgaris. A Pseudoacne of the transverse nasal crease in a young child. Note the milia and comedones located along this anatomical demarcation line. B Demodicosis presenting as pustules on the nose of a healthy child. An increased number of Demodex mites was observed in a scraping. C Acneiform follicular mucinosis on the cheek of a woman. D Follicular mycosis fungoides that presented as numerous lesions with a comedonal appearance on the chest, abdomen, and back. A, B, D, Courtesy Julie V. Schaffer, MD; C, Courtesy Lorenzo Cerroni, MD.

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Fig. 36.15 Disorders in the differential diagnosis of acne vulgaris. A Pseudoacne of the transverse nasal crease in a young child. Note the milia and comedones located along this anatomical demarcation line. B Demodicosis presenting as pustules on the nose of a healthy child. An increased number of Demodex mites was observed in a scraping. C Acneiform follicular mucinosis on the cheek of a woman. D Follicular mycosis fungoides that presented as numerous lesions with a comedonal appearance on the chest, abdomen, and back. A, B, D, Courtesy Julie V. Schaffer, MD; C, Courtesy Lorenzo Cerroni, MD.

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Fig. 36.17 Cutaneous complications of isotretinoin therapy. A Impetigo in a patient treated with isotretinoin. Multiple serous crusts are evident. B Pyogenic granuloma-like healing on the chest of an adolescent boy on his third month of isotretinoin therapy. This is more likely to occur when isotretinoin therapy is started at a full dose rather than a lower initial dose, especially in teenage boys.

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Fig. 36.17 Cutaneous complications of isotretinoin therapy. A Impetigo in a patient treated with isotretinoin. Multiple serous crusts are evident. B Pyogenic granuloma-like healing on the chest of an adolescent boy on his third month of isotretinoin therapy. This is more likely to occur when isotretinoin therapy is started at a full dose rather than a lower initial dose, especially in teenage boys.

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