Cystic acne

Introduction Cystic acne forms sebaceous cysts of varying sizes, often secondary to purulent infection. After ulceration, the frozen pus is often shed with blood, and the inflammation is often not heavy, and the sinus and sputum are formed later.

Cause

There are many factors in the pathogenesis of acne, and its pathogenesis is still not very clear. Endocrine factors, the role of sebum, and microbes in hair follicles are major factors in the pathogenesis of acne.

There is a close relationship between acne and sexual endocrine. There is very little morbidity before puberty. People with loss or decline in sexual function, such as eunuchs who have been castrated by ancient courts, are not affected. People with reduced sexual function, such as testosterone, can promote the growth of beards and the occurrence of acne. When treating diseases with corticotropin or corticosteroids, it often causes acne rash, and women often have acne attacks before menstruation. Reduced symptoms of acne during pregnancy. Both men and women have androgens and estrogens. Organs that secrete sex hormones are testes and adrenal glands in men; in women, the ovaries, placenta, and adrenal glands. Androgens and estrogens have different ratios in men and women, and changes in ratios may cause acne. The development of sebaceous glands and the secretion of sebum are also associated with increased androgen levels. Among them, testosterone increases sebaceous gland activity, and progesterone and adrenal cortex are also involved in dehydroepiandrosterone (DHA), which may be involved in initial acne. makes an important impact.

Testosterone is converted into 5-alpha dihydrotestosterone with higher activity by 5- reductase in the skin, which stimulates sebaceous gland cell turnover and lipid synthesis, causing increased sebum secretion, resulting in a thicker and more sebum that cannot be completely excreted. Gradually accumulate in the hair follicle mouth, and the hair follicle catheter is also hyperkeratized by androgen action. The hair follicle wall is thick and prevents sebum excretion. The epithelial cells that fall off the hair follicle wall are mixed with thick sebum to become a cheese-like substance. The acne is formed in the mouth of the hair follicle, and the tip exposed to the outside of the hair follicle is gradually dried, and the black acne is formed by the oxidation of air, the deposition of melanin, and the pollution of dust. Corynebacterium acne, Staphylococcus aureus and Pediococcus ovale, which are present in hair follicles, in particular, Corynebacterium acne contain esterases that decompose sebum, and sebum in hair follicles is decomposed by lipase to produce more free fatty acids. Free fatty acids can cause non-specific inflammatory reactions around the hair follicles and hair follicles. When the tiny ulcers and free fatty acids on the acne wall enter the nearby dermis, the blackheads squeezing the nearby cells, so that their antibacterial power is reduced. It is susceptible to inflammation caused by bacterial infection, so the patient develops papules, pustules, hard nodules, nodules and abscesses.

In recent years, some people think that this disease is related to immunity. In the humoral immunity of patients, serum IgG levels increase, and increase with the severity of the disease. Corynebacterium acne produces antibodies in patients, and circulating antibodies reach a local pathogenesis involved in early inflammation.

About the relationship between trace elements and acne. Recently, it has been proved that the low zinc in patients with acne may affect the utilization of vitamin A, promote the keratinization of the hair follicle sebaceous glands, and the low copper will weaken the body's resistance to bacterial infection. In short, the trace elements of zinc, copper and iron in patients with hemorrhoids are low, and the increase of manganese can affect the metabolism of fat and the secretion of sex hormones in the body. In addition, the skin resistance is low, which may have a certain relationship with the incidence of hemorrhoids.

In addition, heredity is also an important factor in the development of this disease. In addition to the above factors, eating animal fats and carbohydrates, gastrointestinal disorders such as indigestion or constipation, mental stress, hot and humid climate and other factors can have adverse effects on acne patients, mineral oil contact or iodide, bromide Or oral administration of certain other drugs can also aggravate the deterioration of acne.

an examination

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Pathogens of skin and tissue parasites Skin elasticity Check skin color

Check the shape and distribution of lesions, whether there are papules, pustules, blackheads, nodules, cysts, scars, etc.

Differential diagnosis

Skin lesions mainly occur on the face, but also on the upper part of the chest and shoulders, and occasionally on other parts. The skin around the circumference is never affected. At the beginning, the patient almost had blackheads and oily sebum, and often had papules, nodules, pustules, abscesses, sinuses or scars. The magnitude of the various damages varies from one to two. The course of the disease is long and there are no symptoms. If the inflammation is obvious, it can cause pain and pain. The symptoms are light and heavy. Most patients after puberty can naturally heal or relieve symptoms. Clinically, the main manifestations of skin lesions can be divided into the following types:

1. Point acne: Blackhead acne is the main damage of acne. It is a cheese-like semi-solid embedded in the hair follicle of the hair follicle. It is black at the outer end of the hair follicle. If it is squeezed, the head is black and the body is visible. A yellow-white translucent lipid plug is discharged.

2. Papular acne: The skin lesions are mainly inflammatory small papules, and the hard small papules from millet to pea are light red to deep red. The center of the papule may have a blackhead acne or a sebaceous plug that does not become black at the top.

3. Pustular acne: mainly abscesses, pustules are the size of grain to mung bean, pustules formed at the tip of follicular pustules and papules, pus after rupture, and shallow scars.

4. Nodular acne: When the inflamed area is deep, pustular acne can develop into wall thick nodules of varying sizes, showing a reddish or purplish red color. Some are deeper and have a prominent bulge in a hemispherical or conical shape. They can be long-term or gradually absorbed, and some purulent ulcers form a significant scar.

5. Atrophic acne: Papular or pustular lesions destroy the gland, causing a pit-like atrophic scar. Broken pustules or naturally absorbed papules and pustules can cause fibrosis and atrophy.

6. Cystic acne: the formation of sebaceous cysts of varying sizes, often secondary to purulent infection, often with bloody jelly-like pus after rupture, and inflammation is often not heavy, after the formation of sinus and sputum.

7. Polymeric acne: It is the most serious type of damage. The skin lesions are polymorphous. There are many acne, papules, pustules, abscesses, cysts and sinus, scars and keloid clusters.

8. Helmintic acne: damage to the crimson or purple red papules, pustules or nodules of millet to broad bean, soft and soft, and contains pus and blood, they will not heal for a long time, and then leave a tiny scar after healing, also No pain, no infiltration. This type is more common in patients with weak bodies.

Check the shape and distribution of lesions, whether there are papules, pustules, blackheads, nodules, cysts, scars, etc.

The material in this site is intended to be of general informational use and is not intended to constitute medical advice, probable diagnosis, or recommended treatments.