Acne vulgaris: pathophysiology and clinical implications in primary care – a review

Abstract

Acne is one of the commonest skin diseases in adolescents and young adults.It usually presents as rashes which could be multiple widespread mixed papules, macules and confluent pustules on indurated bases black head comedones with erythematous background. These usually appear on the cheeks, chin, forehead, pre-auricular areas, the nose and the trunk.Acne is a worldwide chronic inflammatory skin disease which affects the pilosebaceous gland. It affects about 95% of the worlds' adolescent population usually between the ages of 12-25 years though it can occur at a younger age. It affects about 9.4% of the worlds' population. Adults, neonates and infants are also affected. Some of the patients reduce extracurricular activities and are ashamed of going out with friends due to disfiguring lesions. There are several myths around the causes of acne including spiritual afflictions. Patients use several medications and seek spiritual treatment. Scar formation, a complication of acne presents in the forms of atrophic, keloidal and hypertrophic scars especially when appropriate treatment is not stated early in the course of the disease. Serial photography is used in monitoring treatment. It is in this light that the authors wish to discuss the pathophysiology of acne with a view to assist in the management and to allay the patients' fear and anxiety.

Keywords: Acne vulgaris, Propionibacterium acnes, comedones, microcomedones