Acne is a disease of the pilosebaceous unit caused by multiple factors including abnormal keratinization, increased sebum production, proliferation of P. acnes bacteria, and hormones. The primary lesions are closed and open comedones, papules, pustules, nodules, cysts, and scars. Treatment focuses on correcting keratinization, modulating the immune response, reducing sebum production, and decreasing androgenic effects to inhibit P. acnes growth. Topical therapies include retinoids, benzoyl peroxide, and azelaic acid, while systemic options include isotretinoin, hormonal contraceptives, and spironolactone.

2. ACNE
Breif Review

3. Acne Vulgaris - Treatment Based
on Pathogenesis
• A disease of the pilosebaceous unit of the skin
• start appearing in adolecence
• Pathogenesis is multifactorial
• It causes social, and psychological quality of life
impairment

4. Pathogenesis of Acne
• Abnormal follicular keratinization
• More sebum production
• Proliferation of Propionobacterium acnes
• Hormonal factors
• Host immune response

5. Primary Lesions of Acne
• Closed comedones
• Open comedones
• Red papules
• Pustules
• Nodules or some times Cysts
• Scars

6. Primary Lesions of Acne
• Closed comedo
• Open comedo
• Red papule
• Pustule
• Nodule or Cyst
• Scar

7. • Acne in 4th and 5th
Grade Girls is
Correlated with
increased DHEAS
during adrenarche

8. The Comedo
keratinaceous debris, that blocks the orifice of pilocebaceous
unit

9. Acne Therapies Principles
• Correct altered follicular keratinization
• Modulate host immune response
• Reduce sebum production
• Decrease androgenic effects
• Inhibit the growth of P. acnes

10. Acne Treatments
• For comedonal lesions - topical retinoids
– Tretinoin (Retin-A)
– Adapalene (Differin)
– Tazarotene (Tazorac)
• Add benzoyl peroxide 2.5% to 5% if few
papules are present too. (Bleaches clothes)
• Or add azelaic acid

11. Systemic therapies for acne
– Isotretinoin (Accutane™, Sotret etc.)
– DHEAS, free testosterone, 17 OH-P
– Ortho Tri-cyclen, Yasmin, Allese
– Spironolactone