Acne Vulgaris

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What is Acne Vulgaris?

Acne vulgaris is a skin disease which affects the skin pore or the pilosebaceous unit. This unit consists of a hair follicle and a sebaceous or oil producing gland which are connected by a canal through which the hair shaft passes to the skin’s surface.

Acne vulgaris can affect all age groups from the newborn to the adolescent right up to the fifth decade of life.    

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What are the Different Types of Acne?

There are several different types of acne and knowing the type of acne you may be suffering from is important so that you can manage it more effectively. These include:

1. Steroid acne - This is triggered by the use of prescription steroids whether they are applied on the skin or taken intravenously or inhaled.

2. Body building acne - This is triggered by the use or rather abuse of anabolic androgenic steroids usually used for body building purposes.

3. Iatrogenic acne - This is triggered by the use of prescription medications such as phenytoin, lithium and isoniazid. It is also know as acne medicamentosa. 

4. Cosmetic acne - This is triggered by the use of oil rich skincare products that clog the skin pores. It is also known as acne cosmetica or pomade acne. 

5. Occupational acne - This is triggered by machine oils, coal tar derivatives and halogenated hydrocarbons especially by those who are exposed to them in their line of duty.

6. Acne detergens - This is triggered by excessive washing of the face as it can stimulate the sebaceous glands to produce more sebum or oil which can clog the pores. 

7. Mechanical acne - This is triggered by physical trauma and mechanical breakage of sebaceous glands by external forces such as bicycle helmets, stiff shirt collars or headbands. It is also known as acne mechanica.

8. Chloracne - This is triggered by exposure to halogenated hydrocarbons such as chlorinated dioxins and dibenzofuranes through either direct contact, inhalation or ingestion of contaminated foods.

9. Neonatal acne - This is triggered by the stimulation of the newborn baby’s sebaceous glands by the mother’s hormones. It is also known as acne neonatorum.

10. Teenage acne - This is triggered by the increase in production of androgens or male sex hormones during puberty.

11. Cyclic acne - This is triggered by the release of hormones after ovulation and it usually results in premenstrual flare-ups of acne or the development of pimples just before the monthly periods.

12. Acne conglobata - The trigger is unknown but it has been associated with chromosomal abnormalities such as the XXY karyotype. 

13. Acne fulminans - This is thought to be triggered by the bacteria Propionibacterium acnes which results in an immunological reaction.  It is also known as acne maligna or acute febrile ulcerative acne.

14. Acne keloidalis nuchae - This condition is not a “type of acne vulgaris” but it has been included in this list because its name includes the word “acne” though that is a misnomer. The specific triggers of this chronic folliculitis that develops keloid-like scars on the occipital scalp or the back of the head and neck is not known but inward growth of curved nape hairs are believed to contribute to its development.   

15. Acne rosacea - This condition is not a “type of acne vulgaris” but it has been included in this list because its name includes the word “acne”. It is triggered by the Demodex folliculorum mites, weather extremes, alcohol, hot and spicy foods.

16. Acne inversa - This condition is not a “type of acne vulgaris” but it has been included in this list because its name includes the word “acne” It is correctly known as hidradenitis suppurativa.

17. Acne aestivalis - This condition is not a “type of acne vulgaris” but it has been included in this list because its name includes the word “acne”. It is triggered by exposure to sunlight as it is a type of polymorphous light eruption. It is also known as Mallorca acne.

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To learn more about acne including

What Causes Acne Vulgaris?

What Worsens Acne Vulgaris?
What are the Symptoms of Acne Vulgaris?
What are the Signs or Physical Findings on Examination of Acne Vulgaris?
How is the Diagnosis of Acne made?
What are the Differential Diagnosis for Acne Vulgaris?
What is the Treatment for Acne Vulgaris?
How can one Prevent Acne?
Read Acne Vulgaris by Dr Miriam Kinai

Plantar Warts

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What is a Plantar Wart?

Plantar warts are viral skin infections that occur on the soles of the feet.   

What Causes Plantar Warts?

Plantar warts are caused by the Human Papilloma Virus (HPV) especially types 1, 2, 3 and 4. Warts, which can affect all age groups, are transmitted by direct as well as indirect contact. Predisposing factors for developing warts include wounds which disrupt the skin’s epithelial barrier. Hyperhidrosis or excessive sweating of the feet is associated with the development of widespread warts.   

What are the Symptoms of Plantar Warts?

Patients with plantar warts usually present with rough swellings on the soles of their feet. These swellings are usually painless but they may become painful if they are on areas that receive much pressure when walking or standing such as over the heads of the metatarsals and the heel.  

To learn more about Plantar warts including What are the signs on physical examination of plantar warts? How is the diagnosis of plantar warts made? What are the differential diagnosis for plantar warts? and What is the treatment for plantar warts?, read Plantar Warts by Dr Miriam Kinai.

Xanthelasma

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What is Xanthelasma?

Xanthelasma palpebrum is a type of xanthoma or condition in which there is a build up of fat under the skin.

What Causes Xanthelasmas?

Approximately 50% of patients who develop xanthelasma have dyslipidemias (abnormal cholesterol, very low density lipoprotein (VLDL), low density lipoprotein (LDL) and high density lipoprotein (HDL) levels). This dyslipidemia can be:

1. Primary dyslipidemia due to genetic causes such as congenital disorders of cholesterol metabolism for example familial hypercholesterolemia phenotype IIa or IIb.  

2. Secondary dyslipidemia due to sedentary lifestyles, excessive dietary saturated fats, poorly controlled diabetes, nephrotic syndrome, hypothyroidism and Cushing’s disease.

The other 50% percent of patients who develop xanthelasma have normal lipid levels.

 

What are the Symptoms of Xanthelasma?

Patients, usually women since it affects more women than men, present with yellowish swellings on the eyelid, which they report may have been progressively getting bigger. The complaints are usually due to the cosmetic appearance of the lesion as xanthelasmas are painless.  

To learn more about Xanthelasma including What are the Signs on Physical Examination of a Xanthelasma? How is the Diagnosis of Xanthelasma Made? What are the Differential Diagnosis for Xanthelasma? and What is the Treatment for Xanthelasma?, read Xanthelasma by Dr Miriam Kinai.