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Chapter 2. Acne Vulgaris

Distribution

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Fig. 2-1

The face is the favored site.


Individual Lesions

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Fig. 2-2

Comedones may be “open” (black) and “closed” (white).


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Fig. 2-3

Comedones, “open” and “closed,” the latter being synonymous with milia.


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Fig. 2-4

“Open” comedones are present mostly, but milia are, too.


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Fig. 2-5

A cluster of comedones situated on an uncommon site.


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Fig. 2-6

Comedones, inflamed papules, and tiny atrophic scars.


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Fig. 2-7

Comedones, inflamed papules, and tiny pitted scars.


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Fig. 2-8

Comedones, patulous infundibula, and small atrophic scars.


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Fig. 2-9

Comedones, patulous infundibula, and tiny atrophic scars.


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Fig. 2-10

Inflamed papules and nodules, as well as scars. The nodules represent the effects of rupture of infundibular cysts.


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Fig. 2-11 A

The upper part of the chest is a common site, as is the upper part of the back.


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Fig. 2-11 B

The upper part of the chest is a common site, as is the upper part of the back.


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Fig. 2-12 A

Comedones, patulous infundibula, inflamed papules, pustules, hemorrhagic crusts, and scars; (b) closeup view of (a).


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Fig. 2-12 B

Comedones, patulous infundibula, inflamed papules, pustules, hemorrhagic crusts, and scars; (b) closeup view of (a).


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Fig. 2-13

Comedones, patulous ostia of infundibula, inflamed papules, inflamed nodules (ruptured infundibular cysts), and scars.


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Fig. 2-14

Inflamed papules, some of them excoriated (“acneexcoriée des jeunes filles” because it occurs mostlyin young girls).


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Fig. 2-15

Comedones, inflamed papules (some of them excoriated), and scars.


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Fig. 2-16

Comedones, inflamed papules, and a few pustules.


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Fig. 2-17

Inflamed papules and papulopustules.


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Fig. 2-18

Patulous ostia of infundibula, inflamed papules, pustules, and scars.


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Fig. 2-19

Inflamed papules and nodules, as well as papulopustules, patulous ostia, and scars.


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Fig. 2-20

Patulous ostia of infundibula, inflamed papules, pustules, and scars.


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Fig. 2-21

Inflamed papules and papulopustules, and residual hyperpigmented atrophic scars.


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Fig. 2-22

Inflamed papules, papulopustules, pustules, and crusts.


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Fig. 2-23

Inflamed papules, papulopustules, and pustules.


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Fig. 2-24

Inflamed papules, inflamed nodules, and papulopustules.


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Fig. 2-25

Inflamed papules, pustules, and crusts.


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Fig. 2-26

Inflamed papules, papulopustules, erosions, and hemorrhagic crusts. The erosions are secondary to excoriation.


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Fig. 2-27

Excoriated papules.


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Fig. 2-28

Inflamed papules and plaques, erosions, hemorrhagic crusts, and scars.


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Fig. 2-29

Inflamed plaque, erosions, hemorrhagic crusts, and pustules.


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Fig. 2-30

Inflamed papules and plaques, hemorrhagic crusts, and scars.


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Fig. 2-31 A

Inflamed papules, erosions, large vegetative hemorrhagic crusts, and scars.


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Fig. 2-31 B

Inflamed papules, erosions, large vegetative hemorrhagic crusts, and scars.


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Fig. 2-32

Papules, nodules, scars, and crusts.


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Fig. 2-33

Pitted scars.


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Fig. 2-34

Atrophic scars.


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Fig. 2-35

Atrophic and hypertrophic scars.


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Fig. 2-36

Many small keloids.


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Fig. 2-37

Large keloids on the chest, and inflamed papules and scars on the face.


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Fig. 2-38

Keloids.


Neonatal Acne

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Fig. 2-39

Papulopustules and pustules.


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Fig. 2-40

Inflamed papules (some of them purpuric) and papulopustules.


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Fig. 2-41

Inflamed papules and milia.


Acne Keloidalis

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Fig. 2-42

Infundibulocentric pustules and keloidal papules.


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Fig. 2-43

Comedones, infundibular cysts, pustules, and keloids.


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Fig. 2-44

Keloids with tufted hairs.


Hidradenitis Suppurativa

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Fig. 2-45

Patulous ostia of infundibula, pus at ostia of sinus tracts, noninflamed and inflamed nodules, an ulcer, and linear scars.


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Fig. 2-46

Markedly patulous ostia of infundibula, some representing the opening of sinuses, papules, nodules, and scars.


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Fig. 2-47

Patulous ostia of sinuses, some having discharged pus, nodules, and hypertrophic scars.


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Fig. 2-48

Scars at sites of sinuses.


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Fig. 2-49

Patulous ostia of sinuses and depressed hyperpigmented scars.


Steroid Acne

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Fig. 2-50

Monomorphous infundibular papules.


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Fig. 2-51

Monomorphous infundibular papules in a patient in intensive care.


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Fig. 2-52 A

Monomorphous infundibular papules and papulopustules.


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Fig. 2-52 B

Monomorphous infundibular papules and papulopustules.


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Fig. 2-52 C

Widespread discrete papules and papulopustules are all infundibulocentric.


Favre-Racouchot

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Fig. 2-53

Cluster of comedones and infundibular cysts on sun-damaged skin.


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Fig. 2-54 A

Numerous comedones and infundibular cysts of different sizes in clusters on skin injured badly by sunlight.


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Fig. 2-54 B

Numerous comedones and infundibular cysts of different sizes in clusters on skin injured badly by sunlight.


New! Additional Images

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Fig. 2-55

Acne vulgaris: Papules, papulopustules, pustules, nodules, and atrophic scars, as well as patulous ostia of infundibula that previously housed a comedo.


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Fig. 2-56

Acne: Comedones, papules, papulopustules, pustules, and hypopigmented atrophic scars.


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Fig. 2-57

Acne: Comedones, papules, and atrophic scars.


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Fig. 2-58

Acne keloidalis. Papules, some scaly, others crusted of acne keloidalis.


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Fig. 2-59

Acne conglobata. Comedones, papules, papulopustules, and honey-colored and hemorrhagic crusts, some of which have peculiar geometric outlines by virtue of lesions having become confluent, of acne conglobata.


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Fig. 2-60

Acne. Comedones, papules, papulopustules, and pustules.


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Fig. 2-61

Acne. Numerous milia, i.e., tiny infundibular cysts.


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Fig. 2-62

Acne. Tiny atrophic scars.


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Fig. 2-63

Acne keloidalis.Comedones, milia, keloids, and atrophic scars of acne keloidalis.


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Fig. 2-64

Steroid acne. Papules, situated mostly in the center of the face, are a result of topical application for months of high-potency corticosteroids, of steroid acne.


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Fig. 2-65

Steroid acne. Papules and papulopustules, each situated at the ostium of an infundibulum, a result of systemic administration of corticosteroid (steroid acne).


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Fig. 2-66

A plum-colored nodule, the result of rupture of an infundibular cyst, situated above a linear scar within which are dilated ostia of infundibula, each of which represents an opening of a pilonidal sinus.


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Fig. 2-67 A

Acne vulgaris. Papules, papulopustules, and hemorrhagic crusts.


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Fig. 2-67 B

Acne vulgaris. Papules, papulopustules, and hemorrhagic crusts.


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Fig. 2-68

Favre-Racouchot syndrome. Comedones and milia (small infundibular cysts) of Favre-Racouchot syndrome consequent to injury of skin by rays of the sun received for many decades. There also are seborrheic keratoses.


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Fig. 2-69

Neonatal acne. Milia, i.e., tiny infundibular cysts, range from pinpoint to papular and cover most of the face of a neonate (neonatal acne).