Acne

Acne is a common disease with a prevalence of more than 80-90% during puberty, and is often seen after adolescence, young adults, sometimes reaching middle age.
What is acne?
Acne is an inflammation of the sebaceous hair follicles, which is related to an increase in sebum secretion and the formation of acne. The lesions are caused by an increase in sebum secretion deposited in the hair follicles by clogging the circulation of the sebaceous glands, accompanied by inflammation, through the growth of microorganisms. Acne in sebaceous hair follicle units.

All of these images are influenced by many changes, from factors related to the internal changes of the body such as age, genetics, hormonal changes, the consequences of use of drugs, to impacts related to external factors such as: environment, climate, weather, consequences of stress, anxiety, insomnia, use of inappropriate medications - cosmetics Ly ... are factors that are associated with the development of acne, or make the condition worse

Severe forms can cause local complications (scarring) that cause loss of aesthetics, heavily affecting the emotional, social and professional life of the patient.


Acne

Very severe form can cause systemic complications such as sepsis, rheumatism.
In Vietnam, especially in the southern cities and provinces of the Mekong Delta, the use of mixing cream is very popular now, with many purposes: whitening, melasma or acne treatment.
This should not be because corticosteroid-blended creams, if applied for a long time, will have more acne, with atrophic skin atrophy.
Pathogenesis of acne
There are many factors, but there are 4 main factors:
+ Epidermal hair follicle proliferation: Epithelium of the upper hair follicle, the funnel area, begins to increase horn with increased adhesion of keratinocytes.
+ This button causes downstream keratin, sebum, bacteria to accumulate in the hair follicles, dilating the upper part of the hair follicles, forming small acne nodules.
+ Excessive production of sebum: Acne patients produce more sebum than people without acne. With the presence of a bacterium in acne, Propionibacterium acnes, causes inflammation and forms acne


+ Androgens also have an effect on sebum production, by combining and affecting the activity of sebaceous cells similar to the action on keratinocytes in hair follicles.


Acne


+ Inflammation: The small buds constantly expand due to the dense concentration of keratin, sebum, bacteria in the dermis causing inflammatory response.
+ The role of Propionibacterium acnes. P.acnes plays an active role in the inflammatory process, which is a Gram (+) bacillus, anaerobic and mild aerobic.
Factors related to acne pathogenesis

Individuals at high risk of developing acne include those who carry the XYY chromosome genotype or have endocrine disorders such as polycystic ovary syndrome, hyperrogen androgen, hyper cortisol hyperemia and early puberty. These patients often have severe acne and do not respond to standard treatments.
Types of acne
- Infant acne: Approximately 20% of healthy newborn babies occur. The lesions usually appear around 2 weeks of age and disappear completely within 3 months.


Acne

Basic lesions are small erythematous papules on the face and neck, often seen across the bridge of the nose and on the cheekbones, without the presence of acne. The disease is also known as "pustular warts of the newborn".
- Acne in young children: Appears at the age of 3-6 months and often in the presence of acne nodules. Papules, pustules, nodules may also appear on the face and scarring can occur even if the disease is mild.
- Acne common: Most cases lesions onset around puberty. Other cases can be seen from birth or child age.
- Intense androgen is observed in female patients who have severe acne, sudden onset, or in combination with hirsutism or irregular menstrual periods.
- Congenital adrenal hyperplasia, polycystic ovary syndrome and other endocrine disorders associated with an increase in androgen levels can promote acne development.


Acne


- Acne is usually characterized by papules, papules, pustules, nodules at the distribution of sebaceous glands (face, cheeks, back, chest, upper arm).
- Acne lesions are early lesions of acne, without inflammation. There are 2 types: closed nodules (whiteheads) are lesions in the hair follicles that are flat or slightly protruding, color like normal skin; and open nodules (blackheads) are slightly protruding lesions, the center of the hair follicle is black due to the tight wedge of keratin and lipids.
Scarring can be a complication of both inflammatory and non-inflammatory forms of acne. There are 4 types of scars in acne scars: funnel-shaped scars, pan-bottom scars, flat-bottom scars and hypertrophic scars.
- Keloids acne: A form of scarring of chronic folliculitis where the disease is papules and pustules on the follicle base, leading to keloid lesions.
- Cluster acne.

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