A 17-year-old girl with a 9-month history of papulopustular acne developed disfiguring, highly inflammatory, fluctuant nodules in both nasolabial folds within 2 months. Periodically she experienced discharge of pus and blood from these lesions. A diagnosis of disfiguring draining sinus tracts associated with acne vulgaris was made. The therapeutic regimen included intralesional corticosteroid injection, systemic corticosteroids along with a macrolide antibiotic, and systemic isotretinoin to reduce the inflammatory process. Outcome was favorable, with no recurrences during the following 10 months. Draining sinus is a malevolent lesion usually seen in severe forms of acne such as acne conglobata, acne fulminans, and acne inversa. Treatment is difficult and often unsatisfactory. In many cases, excision of the lesion is necessary to provide a permanent cure.

Acne Vulgaris↗

PubMedDate not supplied

Pathogenesis and treatment of acne in childhood.

Acne occurs more frequently in newborns and infants than one would gather from written accounts. Acne neonatorum tends to be overlooked because it is usually minor and transient. In contrast, acne infantum, which generally does not make its appearance until after 3 months of life, is more serious. Even acne conglobata may develop in infants. There are many other types of acne in childhood reflecting different pathogenetic mechanisms; included in this group are acne venenata infantum, steroid acne, hormonal disturbances, and toxic reactions.

Acne Vulgaris↗

PubMedDate not supplied

Ultrastructure of human sebaceous follicles and comedones following treatment with vitamin A acid.

Ultrastructural findings in normal human sebaceous follicles, of comedones from acne patients, and from comedones during topical treatment with vitamin A acid (VAA) are described. In normal human sebaceous follicles, the two segments of the infundibulum-the acroinfundibulum and the infrainfundibulum-show differing ultramorphological patterns of keratinization. The incomplete horny layer of the infrainfundibulum is physiological and seems to be necessary for its normal function. On the other hand, no effective barrier function is established in this region. During comedo formation, excessive keratinization takes place in the infra-infundibulum, leading to a compact and coherent horny core. VAA-treatment leads to profound alterations of keratin production, with the appearance of small, irregular, non-coherent and foamy horny cells. The comedonal wall resumes almost physiological conditions. These changes are in agreement with experimental work using VAA in vivo and in vitro and may explain the therapeutic mechanism of action of this compound in the treatment of acne.

Acne Vulgaris↗

PubMedDate not supplied

Male reproductive system in patients exposed to ionizing irradiation in the Chernobyl accident.

Twelve men with different forms and stages of chronic radiation dermatitis caused by accidental exposure to beta and gamma irradiation during and after the Chernobyl atomic power plant accident were examined. Two patients had impotentia coeundi, and the others reported various impairments of sexual function. One patient had aspermia, two patients had azoospermia, one had oligospermia, and four had normal sperm counts. In three samples abnormal forms of spermatozoa were increased. Sperm motility was decreased in 3 samples and was normal in another. Hormonal analyses demonstrated low testosterone plasma levels in two patients, an increase of follicle stimulating hormone (FSH) levels in six patients, and a decrease of luteinizing hormone (LH) in one patient. In one patient who showed an increase of plasma prolactin level, associated with low testosterone and LH, a microadenoma of the pituitary gland (prolactinoma) was detected. It would appear that there is an association between accidental exposure to ionizing radiation of varying severity and the impairment of exocrine and endocrine testicular function, sometimes resulting in long-lasting physiological and psychological problems.

Accidents↗

PubMedDate not supplied

Rosacea fulminans in a patient with Crohn's disease: a case report and review of the literature.

Rosacea fulminans is a rare disorder of unknown cause that mainly affects postadolescent women, with abrupt onset and disfiguring course if left untreated. The simultaneous occurrence of rosacea fulminans and inflammatory bowel disease is rare and has been reported predominantly in the setting of ulcerative colitis. We describe here a case of rosacea fulminans in a patient with Crohn's disease and discuss a possible association between the two conditions.

Administration, Topical↗

PubMedDate not supplied

Vitamin A acid in acneiform dermatoses.

A definition and classification of acneiform dermatoses is presented to distinguish these diseases from true acne. True acne is a follicular eruption which begins with a comedo, sometimes evolving into various inflammatory lesions. Members of true acne are acne vulgaris with its varieties, acne venenata, and comedonal acne due to physical agencies. Acneiform reactions begin with an inflammatory lesion, usually a papule or pustule. Comedones are uncommon and may follow pustules. Acneiform eruptions are almost always drug-induced, the commonest agents being corticosteroids and ACTH, iodides, bromides, anti-convulsive drugs, and INH. Topical treatment with VAA is indicated in every variety of true acne; VAA is helpful in acneiform dermatoses with secondary comedo formation, as for instance in steroid acne. Very satisfying results can be achieve with this regimen.

Acne Vulgaris↗

PubMedDate not supplied

Kinetics of epidermis and adnexa following vitamin A acid in the human.

The effects of topically applied vitamin A acid and benzoyl peroxide were investigated. Short-term (a few days) and long-term (up to 800 days) treatment was analyzed histologically and autoradiographically. Labelled and unlabelled biopsies at various time intervals were taken from face, back, and acne lesions. Kinetics were followed with 3H-TdR and 3H-histidine. All keratinizing epithelia of epidermis and adnexa are stimulated by vitamin A acid. Labelling is high (up to 20-70% L.I) and occurs within a few days. Follicles and comedones can also be stimulated, but respond less and much later than epidermis. Transit time is shortened to 3-4 days. Lose, incoherent horny cells are produced, explaining the therapeutic benefits of vitamin A acid in acne. Benzoyl peroxide is less effective in stimulating epidermopoieses in epidermis, follicles, and comedones. This autoradiographic analysis parallels therapeutic results with these two exfoliants.

Acne Vulgaris↗