Acne Vulgaris (acne of adolescence) is one of the most common disorders of the skin and affects nearly 85% of the population between 12 and 25. There are other varieties of acne, but are much less common and will not be developed in this content.
Acne has a significant hereditary component. Its peak incidence is at 14 years for females and 16 males, who are more frequent and severe.
Its clinical presentation does not provide diagnostic difficulties or the doctor or patient. Contributes significantly to the scope psychosocial problems such as depression, anxiety and isolation. Successful management of acne is, therefore, of vital importance to the practice of family doctor.
Acne lesions develop from a structure called the pilosebaceous unit. It is formed by the association of sebaceous glands in the hair follicle. Acne vulgaris is a chronic disorder of the pilosebaceous unit that occurs mainly on the face, back and chest. These are areas of highest density of pilosebaceous units.
The pathogenesis is: androgens stimulate sebum production, which in turn determines a germ that grow anaerobic part of the normal flora:
Propionibacterium acnes. This splits the fat into glycerol and fatty acids, which would be responsible for the hyperkeratinization (overgrowth of the epidermis) and the impairment of the desquamation of follicular epithelium. This process leads to plug formation and inflammation, represented clinically by erythematous papules and comedones.
Fr acnes can cause an inflammatory response that leads to the formation of pustules and, if there is an exaggerated response of cysts and nodules.
Some authors believe that acne is not a disease but a normal developmental process with functions related to a subconscious olfactory communication system of the human species. It is unknown why improvement in almost all patients in their 20s and disappears before age 25, taking into account that sebum production remains the same and P. acnes does not disappear from the surface of the skin (only 1% of men and 5% of women have acne at 40 years).
Evaluation of adolescent patients with acne.
The interview of the patient with acne should be framed on the principles developed in the class of adolescents. The family doctor can occupy an important place in the management of these patients since it knows the family and patient. While acne is a benign entity, can be devastating from the standpoint of psychosocial.
Therefore, the most interesting aspect of the assessment of acne is to determine how the disease is concerned about the patient. To assess how concerned the acne (and, consequently, how aggressive the treatment) is necessary to use indirect questions like: Who is more worried about acne, you or your parents?, Have you ever not because you went somewhere acne was wrong?, etc. Many times the doctor has a misleading impression of the concern that each patient with acne.
For example, a 14 year old boy with severe acne can be annoying and a little girl of 16 years with few comedones may be very concerned and willing to do everything possible to control them.
The examination of patients with acne is very important. You must ask yourself at great length about the treatments to fight acne previously used and the circumstances that aggravate acne (menstruation, certain foods, etc.)..
It is also important to know whether the patient is receiving medication that may exacerbate or cause acne (corticosteroids, lithium, iodine, phenytoin, anabolic steroids and high doses of vitamin B2, B6 and B12). Oral contraceptives may improve acne, but those are high in progesterone can exacerbate it.
Important
There is evidence that the severity of acne is a risk factor for suicide in adolescents and that individuals with acne have higher rates of unemployment.
Since acne is a benign self-limiting disease many physicians do not nest within their clinical practice. However, if not treated properly and can leave emotional scars on the skin that can last a lifetime.
One should not underestimate the psychological impact of acne in patients. As a general rule, the physician should think that this organization cares more teenagers than they recognize in the office.
Saturday, May 15, 2010
Introduction to Acne
There is no doubt that during adolescence, the excessive aesthetics of the acne becomes a critic of the self-esteem. Many teens, though the "big" do not understand, they are emotionally paralyzed by this problem and are difficult to interact with their peers.
Acne is the most common dermatosis, affecting 80% of the world population at some point in their lives. It is inconceivable that many people, including doctors, do not give this disease the attention it deserves, appealing generally to household treatments, often with negative results and to catastrophic.
Understanding the Acne
Acne is a skin disease of the hair follicle, from self-limited multifactorial etiology that primarily affects the skin areas with the highest density of sebaceous glands, from which we can include face, chest and upper back.
Causes a set of elementary lesions including comedones, papules, pustules, nodules and scars, whose presence will depend on the shape and intensity of clinical manifestation.
Although it is difficult to estimate prevalence, we could say that in Spain, between 2.5 and 3.5 million have some degree of acne, which makes it one of the most common skin diseases. Have a higher prevalence at puberty and adolescence, although it is not uncommon in children and adults. It occurs most often in Caucasians than in black or Oriental.
In adolescence appears to be more male, however in later ages, the ratio is reversed and the lesions may persist for more years or so later manifest itself many years, some doctors have considered the acne as "things age ", or banal and physiological process that requires no treatment.
This view has now changed, as the acne scars of a wrongly diagnosed and treated can become really important and limitations from the point of view of quality of life of the subject.
So we are now more aware of the need for an accurate diagnosis of each type of acne seeking proper treatment and individualized for each patient.
In Synthesis
Acne occurs when skin pores become blocked because the fat and skin cells accumulate faster than it can go. The blockage causes a follicle bulge (causing whiteheads) and the top of the obstruction may darken (causing blackheads). If the obstruction causes a break in the wall of the follicle, dead skin cells, fat and bacteria, normally found on the surface of the skin, can penetrate and form small infected areas called pustules. If these infected areas are deep in the skin may increase in size until it forms firm, painful cysts.
Acne is not caused by dirt, masturbation or other activities, but the dirt and grease on the face can aggravate the condition. Other factors that increase the chances of acne are hormonal changes, exposure to extreme weather conditions, stress, oily skin, endocrine disorders, certain tumors and the use of certain medications (such as cortisone, testosterone, estrogen and others).
Acne is the most common dermatosis, affecting 80% of the world population at some point in their lives. It is inconceivable that many people, including doctors, do not give this disease the attention it deserves, appealing generally to household treatments, often with negative results and to catastrophic.
Understanding the Acne
Acne is a skin disease of the hair follicle, from self-limited multifactorial etiology that primarily affects the skin areas with the highest density of sebaceous glands, from which we can include face, chest and upper back.
Causes a set of elementary lesions including comedones, papules, pustules, nodules and scars, whose presence will depend on the shape and intensity of clinical manifestation.
Although it is difficult to estimate prevalence, we could say that in Spain, between 2.5 and 3.5 million have some degree of acne, which makes it one of the most common skin diseases. Have a higher prevalence at puberty and adolescence, although it is not uncommon in children and adults. It occurs most often in Caucasians than in black or Oriental.
In adolescence appears to be more male, however in later ages, the ratio is reversed and the lesions may persist for more years or so later manifest itself many years, some doctors have considered the acne as "things age ", or banal and physiological process that requires no treatment.
This view has now changed, as the acne scars of a wrongly diagnosed and treated can become really important and limitations from the point of view of quality of life of the subject.
So we are now more aware of the need for an accurate diagnosis of each type of acne seeking proper treatment and individualized for each patient.
In Synthesis
Acne occurs when skin pores become blocked because the fat and skin cells accumulate faster than it can go. The blockage causes a follicle bulge (causing whiteheads) and the top of the obstruction may darken (causing blackheads). If the obstruction causes a break in the wall of the follicle, dead skin cells, fat and bacteria, normally found on the surface of the skin, can penetrate and form small infected areas called pustules. If these infected areas are deep in the skin may increase in size until it forms firm, painful cysts.
Acne is not caused by dirt, masturbation or other activities, but the dirt and grease on the face can aggravate the condition. Other factors that increase the chances of acne are hormonal changes, exposure to extreme weather conditions, stress, oily skin, endocrine disorders, certain tumors and the use of certain medications (such as cortisone, testosterone, estrogen and others).
Psoriasis and Pregnancy
Many psoriasis patients are afraid to pass the disease to their children. Since psoriasis is not contagious, there is no risk that it would be sent, or stroking the baby to breastfeed. However, there is a genetic predisposition to psoriasis. According to studies, the risk of transmission when the parent gets from 8 to 15% and if both parents are affected is 50 to 60%.
Childhood Psoriasis
to appear in childhood psoriasis in 15% of cases, and before 20 years in one of every three cases. It is a non-contagious chronic skin disease that develops from a specific genetic predisposition. The environmental factors that cause may be external (such as seasonal changes or clothing in contact with the skin) or internal (such as infectious diseases, emotional stress and some drugs).
The clinical symptoms of psoriasis in children usually resemble the adult. However, the condition tends to take in children atypical shapes that can make diagnosis difficult. Some children dermatosis affecting the buttocks, eyelids and scalp closely resemble psoriasis.
The clinical symptoms of psoriasis in children usually resemble the adult. However, the condition tends to take in children atypical shapes that can make diagnosis difficult. Some children dermatosis affecting the buttocks, eyelids and scalp closely resemble psoriasis.
Psoriasis Treatments
Psoriasis treatment focuses on symptom control and prevention of secondary infections of the skin. There is no treatment to cure psoriasis, but nevertheless we will use a therapeutic measure or another depending on the extent and severity of the disorder.
Psoriasis that covers all or most of the body is an emergency that requires hospitalization. The body loses large amounts of fluid and is susceptible to severe secondary infections that may become systemic, involve internal organs and even progress to septic shock and death.
Psoriasis that covers all or most of the body is an emergency that requires hospitalization. The body loses large amounts of fluid and is susceptible to severe secondary infections that may become systemic, involve internal organs and even progress to septic shock and death.
Root causes of Psoriasis
Although the specific origin is unknown psoriasis, it is known that is a genetic disease. In fact, it has located the gene whose alteration affects the appearance of psoriasis. We also know that is an inherited disease. If one of the two parents is psoriatic, one in eight children may suffer. If both parents are affected, the probability is one in every four.
However, not being a psoriatic, children will be. It can also happen to be inherited genetic alteration, but not develop the disease because it involves both exogenous (external) in its appearance.
However, not being a psoriatic, children will be. It can also happen to be inherited genetic alteration, but not develop the disease because it involves both exogenous (external) in its appearance.
Diagnosis of Psoriasis
The diagnosis of the condition is usually not difficult because the plates are recognizable by a visual inspection, which does not mean that in some cases more complex and has to resort to biopsy. Still, it is important that the diagnosis of psoriasis is performed by a doctor or dermatologist.
Once the correct diagnosis can prescribe it only considers the most appropriate treatment according to the characteristics of psoriasis and the patient.
Once the correct diagnosis can prescribe it only considers the most appropriate treatment according to the characteristics of psoriasis and the patient.
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