BMJ Best Practice Podcast Acne vulgaris
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Feb 12, 2024 Professor John Barbieri, Assistant Professor of Dermatology, discusses the causes and symptoms of acne, the importance of accurate diagnosis and treatment, the benefits and precautions of using isotretinoin, dispigmentation as a side effect, and the role of diet in acne.
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Fundamental Cause Of Acne
- Acne is a disorder of the pilosebaceous unit driven by androgens and pore obstruction.
- C. acnes and inflammation convert comedones into papules, nodules, and cysts.
Confirm Acne Before Treating
- Confirm the diagnosis and rule out mimickers like pityrosporum folliculitis, perioral dermatitis, and rosacea.
- Assess lesion types, severity, and patient treatment goals for shared decision-making.
Hormonal Basis And When To Investigate
- All acne is hormonally driven by androgens, though some patients have pronounced hyperandrogenemia.
- Look for signs like hirsutism or acanthosis nigricans that suggest further endocrine workup.