ACNE and ROSACEA

Twenty-five years have elapsed since the first publication of this book. The growth of basic knowledge since then has been both enormous and momentous. This has been a joyous enterprise for us. Our ability to treat acne and rosacea ef­ fectively has outpaced the vastly expanded understanding of their etiologies. Acne today is not only an eminently treatable disease; in some cases, for exam­ is actually curable. We think that no case is so severe as to pIe acne conglobata, it be beyond help with the array of diverse drugs now available. Treatment failure is really physician failure. Prevention of acne in high-risk children has also be­ come a promising possibility, now that it is possible to identify small comedones in prepuberty, as early as the age of 7 years. Topical comedolytic agents such as retinoids prescribed at the incipient stage might then prevent the evolution of the full-fledged disorder. This therapeutic maneuver could prevent the dreaded sequel of scarring. We adhere firmly to the beliefs expressed in 1975 regarding our mission. This text is dedicated to the dermatologists and other practitioners who must diagnose and treat these disfiguring, remarkably protean, common disorders.

History of Acne and Rosacea Acne.- History of Acne and Rosacea Acne.- Acne.- Etiology, Pathophysiology, and Nosology of Acne.- Prevalence.- A Precis of Pathogenesis.- Anatomy of Follicles.- Epidermal Lipids.- Sebaceous Glands.- Anatomy of Sebaceous Glands.- Physiology of Sebaceous Glands.- Micro-organisms.- Cocci.- Yeasts.- Propionibacteria.- Endocrinology of Acne.- The Evolution of the Comedo.- Dynamics of Primary Comedo Formation.- Dynamics of Secondary Comedo Formation.- Cysts.- Fistuled Polyporous Comedones.- Draining Sinuses.- Dynamics of Inflammation.- Inflammatory Lesions and Sequels.- Pustules.- Papules.- Nodules.- Draining Sinuses.- Scope of Scars.- Pitted, Crateriform, and Ice-Pick Scars.- Atrophic Scars.- Hypertrophic Scars.- Perifollicular Papular Scars.- Calcified Scars.- Keloids.- Fistulated Scars (Polyporous Comedones).- Draining Sinus.- Classification of Acne.- Models of Acne.- Acne in Animals: Canine and Feline Acne.- Animal Models.- Syrian Hamster.- Rabbit Ear.- Rhino Mouse.- Human Sebocyte Cultures.- The Acnes.- Acne in Childhood.- Acne Neonatorum.- Acne Infantum.- Acne Conglobata Infantum.- Acne Venenata Infantum.- Steroid Acne in Infants.- Hippie Acne, Lip Balm Acne, McDonald Acne, and Kelp-Acne.- Chloracne in Children.- Fetal Hydantoin Syndrome.- Androluteoma Syndrome of Pregnancy.- Acne in Puberty and Adulthood.- Acne Comedonica (Comedonal Acne).- Acne Papulopustulosa (Papulopustular Acne).- Acne Conglobata.- Acne Inversa.- Acne Fulminans.- SAPHO Syndrome.- Solid Facial Persistent Edema in Acne.- Acne Mechanica.- Back Acne.- Acne Tropicalis (Tropical Acne).- Postadolescent Acne in Women.- Premenstrual Acne.- Perimenopausal and Postmenopausal Acne.- Polycystic Ovary Syndrome and SAHA Syndrome.- Congenital Adrenal Hyperplasia.- Cushing Syndrome.- Androgen Excess.- XYY Acne Conglobata.- Body-Building Acne (Doping Acne).- Excoriations.- Acne Venenata.- Occupational Acnes.- Lip Balm Acne.- Acne Cosmetica.- Pomade Acne.- Chloracne.- Solar Comedones (Favre-Racouchot Disease).- Acne Aestivalis (Mallorca Acne).- Radiation-induced Comedones.- Genetic Syndromes Associated with Acne or Acne-like Disorders.- PAPA Syndrome.- Ectrodactyly, Soft-tissue Syndactyly, and Nodulocystic Acne.- Apert Syndrome.- Familial Dyskeratotic Comedones.- Haber Syndrome.- Acne-free Nevus and Clonal Acne.- Atrophodermia Vermiculata.- Acneiform Diseases.- Acneiform Eruptions.- Steroid Acne.- Amineptine Acne.- Ecstasy Pimples.- Rosacea.- Rosacea.- Prevalence.- Etiology and Pathogenesis.- Clinical Findings.- Histopathology.- Laboratory Findings.- Differential Diagnosis.- Treatment.- Topical.- Systemic.- Miscellaneous.- Special Treatment Cases.- Acne-like Disorders.- Perioral Dermatitis.- Demodex folliculorum.- Gram-negative Folliculitis.- Necrotizing Lymphocytic Folliculitis (Acne Necrotica).- Sebaceous Gland Hyperplasia.- Steatocystoma Multiplex.- Steatocystoma Simplex.- Eruptive Vellus Hair Cysts.- Nevus Comedonicus.- Dilated Pore.- Pilar Sheath Acanthoma.- Omphalolith: The Ugly Navel Stone.- Keratosis Pilaris.- Pseudofolliculitis Barbae.- Osteoma Cutis.- Minocycline-induced Hyperpigmentation.- Treatment of Acne.- History of Therapy: Post, Present and Future.- Strategic Approaches to the Treatment of Acne.- Diet.- Cleanliness.- Scalp Care.- External Contactants.- Emotions and Psychosomatic Factors.- How to Approach Acne.- Selection of Therapy.- Appraisal of Efficacy.- Topical Treatment.- Tretinoin (all-frans-Retinoic Acid, Vitamin A Acid).- Other Topical Retinoids.- Benzoyl Peroxide.- Topical Antibacterial Agents.- AzelaicAcid.- FusidicAcid.- Nicotinamide.- Salicylic Acid.- Systemic Treatment.- Antibiotics: Tetracyclines and Macrolides.- Isotretinoin (13-ds-Retinoic Acid).- Vitamin A (Retinol).- Sulfonamides.- Sulfones.- Estrogens and Oral Contraceptives.- Antiandrogens and Aldosterone Antagonists.- 5?-Reductase Inhibitors.- Corticosteroids.- Zinc.- Physical Therapy.- Ultraviolet Radiation.- Cryotherapy.- Abrasives.- Chemical Peels.- Lasers.- Miscellaneous.- X-Ray Therapy: A Historical Note.- Dermabrasion.- Excision.- Punch-Graft Elevation or Punch-Graft Transplant.- Dermal Filler Substances: Collagen.- Camouflage.- Psychosocial Aspects of Acne.- Spontaneous Involution of Acne.