A disease of pilosebaceous units, especially infundibula, that may manifest itself as noninflammatory lesions, i.e., comedones and intact cysts, or as inflammatory lesions, i.e., papules, nodules, and pustules. The process may resolve without residua, or alternatively, with scars of different types, e.g., keloidal or atrophic, boxcar, pitted, or in rarely encountered acne necrotica, cribriform. The condition usually affects adolescents on the face (99% of cases), back (60% of cases), and chest (15% of cases). At times, the condition may be seen much earlier in neonates, infants, mid-childhood (1-7 years old), and pre-adolescents (7-12 years old). Signs of androgen excess in pediatric patients age 12 or younger should prompt a systemic workup for endocrine dysfunction.
Nast A, Dréno B, Bettoli V, et al. European evidence-based (S3) guidelines for the treatment of acne. J Eur Acad Dermatol Venereol 2012 Feb;26 Suppl 1:1-29.
Eichenfield LF, Krakowski AC, Piggott C, et al. American Acne and Rosacea Society. Evidence-based recommendations for the diagnosis and treatment of pediatric acne. Pediatrics 2013 May;131 Suppl 3:S163-86.