Posted on March 25, 2008 in Latest News
The skin structure consists of hair follicles and the sebaceous glands associated with it. Together, these are known as the pilosebaceous units. Acne is caused due the changes in these units. Acne vulgaris is the most common form of acne. These acne lesions include blackheads, whiteheads, papules, pustules, nodules and cysts.
Severe acne may significantly limit one’s social life and even interfere with opportunities for employment. This can affect one’s self confidence in oneself. Therefore, it is important to see a specialist in such cases.
Dermatologists have the most experience treating the different types of severe acne.
Four types of severe acne, described in detail below, are:
Acne conglobata
Acne conglobata is a severe form of cystic acne characterized by deep, inflammatory nodules that track under the skin to other nodules. Acne conglobata can cause deep scarring and is difficult to treat. Many people with acne conglobata also have hidradenitis suppurativa.
Acne conglobata may be preceded by acne cysts, papules or pustules that do not heal, but instead rapidly deteriorate. Occasionally, acne conglobata flares up in acne that had been dormant for many years.
Several courses of treatment may be necessary over a period of years. Even after effective treatment, the patient should have regular checkups by a dermatologist for any signs of recurrence.
Acne fulminans
Acne fulminans (AF), also known as acne maligna, was originally described as acute febrile ulcerative acne conglobata (AC). Symptoms of severe and often ulcerating acne include fever and inflammation and aching of joints, especially hips and knees. Corticosteroids or non-steroidal anti-inflammatory medications may be given to reduce inflammation.
Nodulocystic Acne
Nodulocystic acne is a severe type of acne characterized by cysts that may measure several centimeters in diameter. These cysts may occur singly or be widespread; they occur over the face, neck, scalp, back, chest, and shoulders. They are often painful.
Nodulocystic acne usually requires an aggressive treatment regimen that may include isotretinoin and antibiotics, or intralesional corticosteroids that “melt” the cyst over a period of 3 to 5 days.
Gram-negative folliculitis
Gram-negative folliculitis, first described by Fulton et al in 1968, is an infection caused by gram-negative organisms. The infection may occur as a complication in patients with acne vulgaris and rosacea and usually develops in patients who have received systemic antibiotics for prolonged periods. The word “Gram” refers to a blue stain used in laboratories to detect microscopic organisms. Certain bacteria do not stain blue and are called “Gram negative.”
It is important for patients and their families to know that severe, disfiguring forms of acne may require years of treatment and patients can experience one or more treatment failures.
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