In acne vulgaris (synonyms: Acne; Acne vulgaris; Contact acne; Cosmetic acne; Majorca acne; ICD-10 L70.0: Acne vulgaris) is a skin disease that usually occurs during puberty. Increased numbers of comedones (blackheads) form, from which papules, pustules and nodules then develop. The facial and upper trunk areas are particularly affected. Acne is the most common dermatological disease. In acne, various efflorescences (skin manifestations) occur. These include:
- Primary, non-inflammatory efflorescences such as comedones.
- Secondary, inflammatory efflorescences such as papules (nodular thickening of the skin), pustules (pustules), abscesses (encapsulated accumulations of pus).
- Tertiary efflorescences that are no longer inflammatory, such as scars or cysts (lumps filled with fluid in body tissues).
Three forms of acne are distinguished, depending on the severity of the disease:
- Acne comedonica – there are more closed and open comedones on the face, especially in the nasal region.
- Acne papulopustulosa – there are increased papules and pustules on the face, and less frequently on the neck, back or arms
- Acne conglobata – most severe form of acne; there are all efflorescences, in part also fistula comedones, especially on the back and neck area
In addition, there are several other special forms of acne:
- Acne fulminans – in the presence of acne conglobata may develop a febrile infection, which manifests itself with polyarthralgias (joint pain) and necrosis (dead areas) of the skin areas altered by acne
- Acne inversa (acne tetrade) – mild acne conglobata, perifolliculitis (inflammation of several hair follicles) especially in the armpits and groin and a pilonidal sinus (coccyx fistula) lead overall to pronounced scarring
- Acne excoriée des jeunes filles – mild acne due to constant manipulation of the efflorescences, occurring mainly in girls and young women
- Acne medikamentosa – acne triggered mainly by glucocorticoids (drugs against inflammation and allergic reactions).
- Acne neonatorum – mild acne with papules and pustules, which recedes within a few months.
- Acne venenata (contact acne) – acne occurring due to contact with various substances such as oil, pitch or dioxin; especially in people who have a predisposition to acne vulgaris.
- Acne mechanica – occurrence of acne vulgaris due to inflammation at pressure points.
- Cosmetic acne – can occur with improper skin care.
- Acne aestivalis (Mallorca acne) – formation of papules on light-exposed (exposed to sunlight) areas of the body; sunscreens are probably involved in the formation
Sex ratio: boys are affected slightly more often than girls. The age of first manifestation is around the age of 10. Frequency peak: The maximum incidence of acne is between the ages of 15 and 18. However, 10-20% of adults may also be affected. The prevalence (disease incidence) is 60-80% (during puberty). The prevalence in men is about 30 % and in women about 24 %. Course and prognosis: In 70 % of those affected, acne progresses very mildly; in 30 %, drug therapy is administered. The disease shows courses from more than three months up to 10-30 years. In the majority of cases, there is spontaneous regression after puberty. In about 2-7 %, significant scars remain. In about 10% of cases, the disease persists beyond the age of 25 (predominantly in women). Comorbidities (concomitant diseases): Acne is increasingly associated with psychosomatic diseases such as depression, social anxiety, body dysmorphic disorders (“fear of ugliness”) and obsessive-compulsive disorders.
