Acne. Andrews’ Chapter 13 Ben Adams, D.O. 1-31-06. Acne Vulgaris. Abnormal keratinization (follicular retention hyperkeratosis) Chronic inflammatory disease of the pilosebaceous follicles Comedones, papules, pustules, cysts, nodules, and often scars Face, neck, upper trunk, and upper arms.
Andrews’ Chapter 13
Ben Adams, D.O.
Post-extraction view of wisdom teeth from a 22-year-old student. Discolored roots were attributed to minocycline therapy for acne. The patient had taken tetracycline from age 15 to age 18, when he was switched to minocycline, 50 to 100 mg per day. With the exception of sporadic use (or none at all) in the summer, he had taken minocycline for 4 years.
This febrile 26-year-old white male was hospitalized prior to the availability of isotretinoin and treated with prednisone dapsone and Vleminckx's compresses.
Pomade acne in a 22-year-old Hispanic female who routinely used baby oil on her face.
Oil acne on the thigh. A 42-year-old machinist whose pants were often damp from contact with insoluble cutting oils had experienced intermittent and recurrent follicular eruptions for 8 months.
Gram-negative folliculitis of the face in a 17-year-old white male who had had acne for 2 years. The patient had been treated successfully with tetracycline and topical medications, but over the preceding 3 months he had gradually developed more pustules. Gram-negative folliculitis was suspected, and the patient was treated successfully with oral cephalexin in place of the tetracycline. (Culture yielded Escherichia coli.)
Hidradenitis suppurativa in a 62-year-old white male who had a 20-year history of abscesses and draining sinuses in his axillae, groin and intergluteal cleft. Severity and frequency of flare-ups had gradually decreased over the preceding 5 years, but serosanguineous drainage from sinuses and occasional new pustules continued to emerge.
Rosacea granuloma in a 62-year-old white male who had had a rapidly enlarging asymptomatic papule on the left side of his nose for 8 weeks. Biopsy findings were consistent with a rosacea granuloma.
Iodine-induced acne in a 17-year-old adolescent boy. The patient had been prescribed suppressive doses of Lugol's solution for hyperthyroidism and developed acne on his forehead.
Severe rhinophyma in a 65-year-old individual whose increasing lobular nasal enlargement had progressed without treatment for over 30 years.
A 40-year-old woman who had papular acneiform eruption about her mouth and chin for 8 to 10 years. It had been treated intermittently by another physician with betamethasone valerate cream. The eruption gradually improved over a 5-month period with the use of tetracycline and non-fluorinated topical steroids in gradually decreasing potency.