Sebaceous and sweat gland disorders

Dr.Ahmed Abdul-Aziz AhmedAssistant Clinical Professor Dermatology&Venerology.F.I.B.M.S.

Acne

How a Pimple Forms(1)

A hair follicle is surrounded by sebaceous glands, which excrete sebum to the surface of the skin.

How a Pimple Forms (2)

Excess oil, unshed skin cells, and natural bacteria within the skin become sticky and create a plug around the hair follicle.

How a Pimple Forms (3)

As more sebum is produced in the plugged hair follicle, the, swelling occurs and appears on the surface of the skin. Overall, this pimple-appearing process takes 2-3 weeks.

Comedonal

Variation of Acne

Characterized by whiteheads, blackheads, papules, pustules.
Inflammatory increases and becomes more serious. It usually happens on surface but sometimes have deeper pustules.
Characterized by cysts and nodules, many are in the body, scars are easily formed.
Severe
Moderate
Light

Acne

Classifications: Comedonal (mild) acne Inflammatory (moderate) acne Nodular cystic (severe) acne
Whiteheads (comedo) vs. blackheads (comedons or open comedos)

Whitehead and blackheads

The seborrhoea, comedones and scatteredinflammatory papules of teenage acne.



CLOSED COMODOME

OPEN COMODOME

PAPULAR ACNE

PUSTULAR ACNE

Closed comedones (whiteheads)
closed comedo (a whitehead):  Accumulation of sebum converts a microcomedo into this.

Closed comedones (whiteheads)

Open comedo (blackhead)
open comedo (a blackhead): when follicular orifice is opened + distended. Melanin + packed keratinocytes + oxidized lipids  dark colour


Open comedo (blackhead)

Acne vulgaris Inflammatory papules, pustules, crusting on the forehead, cheeks, and chin.

Acne vulgaris Comedones rupturing into the dermis give rise to anintense inflammatory response with pustule and abscess formation (so-called“cystic” or nodulocystic acne).

ACNE CONGLOBATA

Prominent and inflamed cysts are the main features here.

Cysts

Acne Conglobata


Cystic acne – this is a bad prognostic sign. Most patients will have acne for decades and be left with many scars isotretinoin is the most effective drug for cystic acne

Infantile acne

Infantile acne. Pustulocystic lesions on the checks.

Infantile Acne

A group of open comedones (blackheads) following the use of a greasy cosmetic.

Steroid-induced acne in a seriously ill patient.

Warn the patient that staining may be left. This will fade overtime.

Acne scarring: worth treating a test area with a resurfacing laser

ICE PICK SCAR

THUMBPRINT SCARS

ATROPHIC SCARS

HYPERTROPHIC SCARS

KELOIDS

Rosacea

Typical rosacea with papules and pustules on abackground of erythema. Note he also has a patch of scaly seborrhoeic eczema on his brow.



Rosacea
A common eruption, more common with age There is inflammation but no obstruction of sebaceous glands Papules, pustules, diffuse erythema, and possible induration of the affected area No black heads

Inflammatory rosacea

Papules and pustules are characteristic

Rosacea

Rosacea Typical moderately severe involvement with confluent erythematous papules and pustules on the forehead, cheeks, and nose. Note the absence of comedones that are typically seen with acne vulgaris.

Inflammatory rosacea

Marked rhinophyma

RosaceaRhinophyma

Acne vs. Rosacea

acne
rosacea