Acne Diagnosis

The diagnosis of acne is based on the history and physical examination. Lesions most commonly develop in areas with the greatest concentration of sebaceous glands, which include the face, neck, chest, upper arms, and back.

Acne vulgaris may be defined as any disorder of the skin whose initial pathology is the microscopic microcomedo. The microcomedo may evolve into visible open comedones ("blackheads") or closed comedones ("whiteheads"). Subsequently, inflammatory papules, pustules, and nodules may develop. Nodulocystic acne consists of pustular lesions larger than 0.5 cm. The presence of excoriations, postinflammatory hyperpigmentation, and scars should be noted.

Acne may be triggered or worsened by external factors such as mechanical obstruction (i.e., helmets, shirt collars), occupational exposures, or medications.. Cosmetics and emollients may occlude follicles and cause an acneiform eruption. Topical corticosteroids may produce perioral dermatitis, a localized erythematous papular or pustular eruption.

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