Acne conglobata

Acne conglobata: Description, Causes and Risk Factors: ICD-10: L70.1. Acne conglobata is a severe, scarring and chronic type of acne which is composed of suppuration, cysts, sinuses, blackheads and scarring. It causes to embarrassment and stress and it is mostly occur to the male then woman at the age of 18 and 30. It is usually occurs on chest, thigh, shoulder, upper arm and face. Inflammatory nodules may grow with receding and discharge pus. Causes and Risk Factors: The exact cause of this disorder is not known. It is however believed to due to genetic susceptibility. In some individuals, it may be the first manifestation of a genetic disorder called PAPA Syndrome (Pyogenic arthritis, pyoderma gangrenosum, and severe cystic acne), in which the affected person goes on later to develop joint pain and infection, severe skin infection with acne conglobata. Such individuals have been shown to have an abnormal inheritance on their chromosome 15.
  • Primary cause of Acne conglobata is not found yet.
  • Reactivity to Propionibacterium (A genus of nonmotile, non-spore-forming, anaerobic to aerotolerant bacteria (family Propionibacteriaceae) containing Gram-positive rods that are usually pleomorphic, diphtheroid, or club shaped, with one end rounded, the other tapered or pointed. Some cells may be coccoid, elongate, bifid, or even branched. The cells usually occur singly, in pairs, in V and Y configurations, short chains, or clumps in “Chinese character” arrangement. The metabolism of these organisms is fermentative, and the products of fermentation include combinations of propionic and acetic acids. These organisms occur in dairy products, on human skin, and in the intestinal tracts of humans and other animals. They may be pathogenic. The type species is Propionibacterium freudenreichii) can change which is cause to acne conglobata.
  • Androgens and anabolic steroids also cause to this disease.
  • It may also occur after testosterone therapy stopped.
  • Thyroid medications and dioxins may trigger this disease.
Ongoing clinical research suggests that most individuals who suffer from acne conglobata inherit it from their parents, even if a person's mother and father have never shown any physical signs of the condition. Researchers believe that high levels of testosterone and androgen contribute to the condition in young men. In addition, many studies have linked anabolic steroid abuse to the development of severe acne. Regardless of the cause, the emergence patterns and physical symptoms of acne conglobata in most patients are very similar. Symptoms: acne conglobata Acne conglobata often starts as "normal acne" with comedones and pustules, and progressively degenerates into nodular cystic lesions, this is because of an overproduction of oils from the sebaceous glands. Often, cysts erupt as painful, oozing lesions on the surface of the skin that can cause disfigurement and scarring. Severe skin inflammation, swelling, pain, and sensitivity are the most common physical symptoms of the disorder. A sufferer may experience significant psychological symptoms as well, such as depression, anxiety, and self-consciousness due to prevalent, disfiguring scars. Diagnosis: Diagnosis is usually clinical with no investigations required for diagnosis. However, underlying conditions must be considered. Serum dehydroepiandrosterone sulfate (DHEAS) for adrenal tumour or congenital adrenal hyperplasia.
  • Total and free testosterone for polycystic ovarian syndrome (PCOS) or ovarian cancer. The androgen producing arrhenoblastoma is rare.
  • 17-hydroxyprogesterone for congenital adrenal hyperplasia.
  • Ratio of LH/FSH for PCOS.
  • Prolactin in case of pituitary adenoma.
  • 24-hour urinary free cortisol for Cushing's syndrome.
  • If isotretinoin is considered, baseline blood tests such as LFTs and fasting lipids are required.
Treatment: Treatment Options May Include: Antibiotics are commonly use to treat the acne conglobata because it reduces the bacteria and for antiinflammatory action.
  • Oral steroids are also useful for this disease.
  • The combined use of antibiotics and steroids give the best results.
  • Isotretinoin is used for treatment which should be used early to prevent scarring.
  • For woman hormonal therapy is the best way to treat.
  • Physical therapy is also being use to treat acne conglobata.
  • Cryotherapy is also valuable for this disease.
  • Some time surgical excision of interconnecting large nodules is beneficial.
  • Ongoing treatment sessions with light and laser therapy have proven effective in clinical trials to reduce the size of nodules and lessen the appearance of scars. Some individuals choose to undergo surgery to remove large cysts and graft healthy skin on damaged areas. With immediate treatment, many people are able to find significant relief from their symptoms and improvements in their physical appearance.
NOTE: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.

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