Acne vulgaris is the most common skin disease of adolescence, arising when puberty-associated increased sebum production allows colonization of hair follicles by the anaerobic diphtheroid Propionibacterium acnes; the resulting local inflammatory immune response causes follicular hyperkeratinization, producing comedones (open comedones/blackheads and closed comedones/whiteheads) that can progress to inflammatory papules, pustules, and nodules. Etiology involves genetic predisposition, dietary factors, and certain medications (e.g., glucocorticoids, lithium, phenytoin), and management follows a stepwise escalation from topical agents (retinoids, benzoyl peroxide, topical antibiotics) to oral antibiotics and, for severe teratogenic-risk cases, isotretinoin.
Acne vulgaris is the most common skin disease of adolescence, arising when puberty-associated increased sebum production allows colonization of hair follicles by the anaerobic diphtheroid Propionibac…