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Treatment should be sought immediately in order to avoid hospitalization. If not treated, hospitalization for an extended period of time (usually two weeks) is likely. During hospitalization, the patient is tested for signs of system degradation, especially of the skeletal structure and the digestive tract. By this time open sores will develop on the upper torso. Some will be the size of dimes, others will be large enough to stick a couple fingers into. They will crust up, causing cohesion to any fabric the sores touch, which is extremely painful to remove. It is recommended to sleep on one's sides until the cystic condition subsides, in order to avoid any uncomfortable situations. Debridement and steroid therapy is preferred over antibiotics. Recurrent AF is extremely rare. Bone lesions typically resolve with treatment, but residual radiographic changes, such as sclerosis and hyperostosis, may remain. Scarring and fibrosis may result from this acute inflammatory process.
The disease activates at the height of puberty, usually at around 13 years of age. Acne fulminans predominantly affects young males aged 13 to 22 years with a history of acne.
Acne fulminans (also known as "acute febrile ulcerative acne") is a severe form of the skin disease, acne, which can occur after unsuccessful treatment for another form of acne, acne conglobata. The condition is thought to be an immunologically induced disease in which elevated level of testosterone causes a rise in sebum and population of "Propionibacterium acnes" bacteria. The increase in the amount of "P acnes" or related antigens may trigger the immunologic reaction in some individuals and lead to an occurrence of acne fulminans. In addition to testosterone, isotretinoin may also precipitate acne fulminans, possibly related to highly increased levels of "P acnes antigens" in the patient's immune system. Acne fulminans is a rare disease. Over the past several years, fewer cases of this disease have occurred, possibly because of earlier and better treatment of acne. Approximately 100 patients with acne fulminans have been described.
Several triggering factors should be taken into consideration:
- Obesity is an exacerbating rather than a triggering factor, through mechanical irritation, occlusion, and maceration.
- Tight clothing, and clothing made of heavy, non-breathable materials.
- Deodorants, depilation products, shaving of the affected area – their association with hidradenitis suppurativa is still an ongoing debate amongst researchers.
- Drugs, in particular oral contraceptives (i.e., oral hormonal birth control; "the pill") and lithium.
- Hot and especially humid climates (dry/arid climates often cause remission).
In stage III disease, fistulae left undiscovered, undiagnosed, or untreated, can lead to the development of squamous cell carcinoma, a rare cancer, in the anus or other affected areas. Other stage III chronic sequelae may also include anemia, multilocalized infections, amyloidosis, and arthropathy. Stage III complications have been known to lead to sepsis, but clinical data is still uncertain.
Fiddler’s neck does not usually form unless the musician is practicing or playing for more than a few hours each day, and only seems to develop after a few years of serious playing. Thus, when not infected or otherwise problematic, fiddler’s neck may be known as a benign practice mark and may be worn proudly as an indication of long hours of practice. Blum & Ritter (1990) found that 62% of 523 professional violinists and violists in West Germany experienced fiddler’s neck, with the percentage among violists being higher (67%) than among violinists (59%). Viola players are believed to be more predisposed to developing fiddler’s neck than violinists because the viola is larger and heavier, but this has not been empirically confirmed.
The development of fiddler’s neck does not depend on preexisting skin problems, and Blum & Ritter find that only 23% of men and 14% of women in their study reported cutaneous disorders in other parts of the face (mainly acne and eczema) that were independent of playing the violin or viola. Fiddler’s neck may exacerbate existing acne, but acne may also be limited solely to the lesion and not appear elsewhere. Nonetheless, musicians with underlying dermatologic diseases like acne and eczema are more endangered by fiddler’s neck than others. Males may develop folliculitis or boils due to involvement of beard hair.
Although the exact cause of feline acne is unknown, some causes include:
- Hyperactive sebaceous glands
- Poor hygiene
- Stress
- Developing secondary to fungal, viral, and bacterial infections
- Reaction to medication
- Drinking from plastic containers to which the cat is allergic
- Demodicosis or mange, causing itchiness and hair loss
- Suppressed immune system
- Hair follicles that don't function properly
- Rubbing the chin (to display affection or mark territory) on non-sanitized household items
- Hormonal imbalance
- Contracting the infection from other cats in the same household
Risk factors for the development of acne, other than genetics, have not been conclusively identified. Possible secondary contributors include hormones, infections, diet and stress. Studies investigating the impact of smoking on the incidence and severity of acne have been inconclusive. Sunlight and cleanliness are not associated with acne.
The proximal causes of fiddler’s neck are friction and pressure, but both repetitive shearing stress and occlusion with consequent trapping of sweat give rise to progressive damage. This damage along with poor hygiene predisposes the area to local infection, and such infection can progress to scarring and other long-term effects. Hot weather is reported to exacerbate fiddler’s neck, as are tiredness, playing emotional music, and playing in smaller groups where individual stress is higher. Type I hypersensitivity reactions may also be involved, particularly to rosewood and ebony in the chinrest and tailpiece, as well as to varnish of the instrument body when chinrests are not used and to rosin deposits on the instrument and on chin cloths. Nickel or other metal allergies are common causes if the chin rest has a metal clip that comes into constant contact with the skin. Rosin exposure in particular may lead to abietic acid dermatitis.
Oil production in the sebaceous glands increases during puberty, causing comedones and acne to be common in adolescents. Acne is also found premenstrually and in women with polycystic ovarian syndrome. Smoking may worsen acne.
Oxidation rather than poor hygiene or dirt causes blackheads to be black. Washing or scrubbing the skin too much could make it worse, by irritating the skin. Touching and picking at comedones might cause irritation and spread infection. It is not clear what effect shaving has on the development of comedones or acne.
Some, but not all, skin products might increase comedones by blocking pores, and greasy hair products (like pomades) can worsen acne. Skin products that claim to not clog pores may be labeled noncomedogenic or non-acnegenic. Make-up and skin products that are oil-free and water-based may be less likely to cause acne. It is not known whether dietary factors or sun exposure make comedones better, worse or have no effect.
A hair that does not emerge normally can also block the pore and cause a bulge or lead to infection (causing inflammation and pus).
Genes may play a role in the chances of developing acne. Comedones may be more common in some ethnic groups. People of recent African descent may experience more inflammation in comedones, more comedonal acne, and earlier onset of inflammation.
There are various causes of madarosis.
- Ophthalmological conditions: blepharitis is an infection of the eyelid. Anterior blepharitis is either "staphylococcal blepharitis,"or "seborrhoeic blepharitis" and posterior blepharitis is due to the meibomian gland.
- Dermatologic conditions: there are multiple types of dermatological conditions that can result in madarosis. These include Atopic dermatitis, Seborrhoeic dermatitis atopic dermatitis, and Psoriasis on the eyelids can result in madarosis. Others include: frontal fibrosing alopecia, ulerythema ophryogenes, acne rosacea, telogen effluvium, follicular mucinosis, and cutaneous sarcoidosis.
- Nutritional defects: Severe malnutrition can cause chronic hair loss. Hypoproteinemia causes hair loss by early onset of telogen. Zinc deficiencies like acrodermatitis enteropathica, can lead to the loss of eyebrow/eyelash hair. Other deficiencies like biotin and iron make it possible for loss of hair as well.
- Infections: There are many bodily infections that can cause the loss of eyelashes/eyebrows. The most common infection may be leprosy, such as lepromatous leprosy. Syphilis or other viral infections like herpes or HIV can cause the loss of eye hair as well. Fungal infections, like paracoccidioidomycosis, trichophyton, or microsporum, are also possible infection causes.
- Trauma: Most trauma injuries cause madarosis from the psychological standpoint, known as trichotillomania
- Drugs/Medications: Crack cocaine or chemotherapy drugs. Other drugs include:propranolol, valproic acid, barbiturates, MMR vaccine, botulinum toxin, epinephrine, antithyroid drugs, anticoagulants, and lipid-lowering drugs
- Genetics
- Autoimmune disorders: alopecia areata, discoid lupus erythematosus, chronic cutaneous lupus erythmatosus, Graham-Little syndrome, and Parry Romberg syndrome
- Other diseases: hypothyroidism, hyperthyroidism, hypoparathyroidism, hypopituitarism, and amyloidosis
There only prevention method is determining the underlying condition before treatment options are too late.
The predisposition to acne for specific individuals is likely explained by a genetic component, a theory which is supported by studies examining the rates of acne among twins and first-degree relatives. Severe acne may be associated with XYY syndrome. Acne susceptibility is likely due to the influence of multiple genes, as the disease does not follow a classic (Mendelian) inheritance pattern. Multiple gene candidates have been proposed including certain variations in tumor necrosis factor-alpha (TNF-alpha), IL-1 alpha, and CYP1A1 genes, among others. Increased risk is associated with the 308 G/A single nucleotide polymorphism variation in the gene for TNF.
Genetic, environmental, hormonal, and immune-system factors have been shown to be involved in the manifestation of seborrhoeic dermatitis.
Seborrhoeic dermatitis may be aggravated by illness, psychological stress, fatigue, sleep deprivation, change of season and reduced general health.
In children, excessive vitamin A intake can cause seborrhoeic dermatitis. Lack of biotin, pyridoxine (vitamin B), or riboflavin (vitamin B) may be a cause in babies.
Those with immunodeficiency (especially infection with HIV) and with neurological disorders such as Parkinson's disease (for which the condition is an autonomic sign) and stroke are particularly prone to it.
Acne conglobata is a highly inflammatory disease presenting with comedones, nodules, abscesses, and draining sinus tracts.
This condition generally begins between the ages of 18 and 30. It usually persists for a very long time, and often until the patient is around 40 years old. Although it often occurs where there is already an active acne problem, it can also happen to people whose acne has subsided. Although the cause of this type of acne is unknown, it is associated with testosterone and thus appears mainly in men. It can be caused by anabolic steroid abuse and sometimes appears in men after stopping testosterone therapy. It can also happen to someone who has a tumor that is releasing large amounts of androgens, or to people in remission from diseases, such as leukemia. In certain persons, the condition may be triggered by exposure to aromatic hydrocarbons or ingestion of halogens.
Women, especially those who are menopausal, are more likely than men to develop rosacea.
Seborrhea affects 1 to 5% of the general population. It is slightly more common in men, but affected women tend to have more severe symptoms. The condition usually recurs throughout a person's lifetime. Seborrhea can occur in any age group but usually starts at puberty and peaks in incidence at around 40 years of age. It can reportedly affect as many as 31% of older people. Severity is worse in dry climates.
In 2007, Richard Gallo and colleagues noticed that patients with rosacea had high levels of the antimicrobial peptide cathelicidin and elevated levels of stratum corneum tryptic enzymes (SCTEs). Antibiotics have been used in the past to treat rosacea, but they may only work because they inhibit some SCTEs.
Feline acne is a problem seen in cats primarily involving the formation of blackheads accompanied by inflammation on the cat's chin and surrounding areas that can cause lesions, alopecia, and crusty sores. In many cases symptoms are mild and the disease does not require treatment. Mild cases will look like the cat has dirt on its chin, but the dirt will not brush off. More severe cases, however, may respond slowly to treatment and seriously detract from the health and appearance of the cat. Feline acne can affect cats of any age, sex or breed, although Persian cats are also likely to develop acne on the face and in the skin folds. This problem can happen once, be reoccurring, or even persistent throughout the cat's life.
Sebaceous glands are skin glands that produce oil and are mostly found in the skin of the chin, at the base of the tail, and in the eyelids, lips, prepuce, and scrotum. They are connected to hair follicles. In acne, the follicles become clogged with black sebaceous material, forming comedones (also known as blackheads). Comedones can become irritated, swollen, infected, and ultimately pustules. These may elicit itching and discomfort due to swelling and bacterial growth inside infected glands. Cats may continue to scratch and reopen wounds, allowing bacterial infections to grow worse. Bacterial folliculitis occurs when follicules become infected with "Staphylococcus aureus", and commonly associated with moderate-to-severe feline acne. Secondary fungal infections (species "malassezia") may also occur.
Other conditions that can cause similar-appearing conditions include skin mites, ringworm, yeast infection, or autoimmune diseases such as eosinophilic granuloma complex ("rodent ulcers"). These can be ruled out by a simple biopsy of affected cells.
Feline acne is one of the top five most common skin conditions that veterinarians treat.
Atrophia Maculosa Varioliformis Cutis (AMVC) is a condition involving spontaneous scarring, specifically depressed scars on the face occurring over a period of months to years. It appears to only affect children and young adults, is considered to be quite rare, normally occurs on the cheeks, temple area and forehead, and is not well understood nor presently treatable. Case reports indicate the scars deepen over time but remain relatively superficial, and with the frequency of new scar appearance diminishing over time.
AMVC is quite difficult to diagnose, for reasons including the depressed box and ice pick scars being very similar to that caused by Acne vulgaris. A confident diagnosis can be made if such scars recently appeared without present acne and without a history of acne. Otherwise the correct diagnosis is usually not made, and even doing so provides little benefit as there is no treatment. It has been suggested in case reports that the condition, although rare, is likely underreported.
Acne conglobata presents with blackheads appearing around the face, neck, chest, upper arms and buttocks in groups of two or three. Pimples form around the blackheads; they are large and engorged with fluid and may be sensitive to touch. They remain for a while and continue to grow and fill with pus until they eventually rupture. After the lesion has drained, it fills up again. After they rupture, several nodules can fuse together to form larger shapes. The lesions remain for a long time. They form a scab in the center but they continue to spread outwards. When the lesions do eventually heal, they leave scars that can be the usual type of acne scar (atrophic) or a raised bump like those normally left behind by a burn or a cut (keloidal).
The Mayo Clinic suggests the following: antibiotics (generally the lowest side effect profile compared to other treatments); corticosteroids (e.g., prednisone); but corticosteroids have many side effects, including "moon face" for the duration of the medication's trial usage, as well as unwanted hair growth for females and/or osteoporosis with long-term use. Tumor necrosis factor (TNF)-alpha inhibitors like infliximab (Remicade) and adalimumab (Humira) have shown promise for some, but they should probably be considered a third-line treatment, as treatment is associated with increased risk of infection, heart failure and certain cancers. Surgery is also available for those overwhelmed by the condition, but it will not cure the condition, just relieve the skin-related issues for a while. The disease is pernicious and is almost always guaranteed to return, if not in the same spot where the surgery was performed.
Some products for adult acne may help relieve some symptoms for hidradenitis sufferers, although there is no guarantee it will work in all or even most individuals. Birth control Medication may relieve some symptoms for women; there is a hormonal treatment for men as well but that has not proven to be safe or effective as of yet.
Alternative treatments include alpha hydroxy acids (naturally available in small amounts in citrus fruits), Azelaic acid, and zinc. It is not thought that they are as effective as standard medical treatment but they tend to have less side effects. Some suggest tea tree oil and a specific strain of brewer's yeast, called CBS 5926. However, the former can cause contact dermatitis for some as well as breast development in teenage boys and should not be used if one suffers from rosacea as well due to it making the symptoms of that strand of acne worse; the latter (CBS 5962) can cause migraines and intestinal issues for some. None of these have been formally tested by the FDA so beware the risk you take when you forgo traditional Western medicine for herbal supplements.
There are two major types of classifications of madarosis.The first is labeled as "non-scarring." Non-scarring the hair has the ability to regrowth after treatment of the primary disorder. Scarring madarosis is when the hair loss is permanent and can only regrow after cosmetic treatments.
Hidradenitis suppurativa is a chronic inflammatory skin condition, considered a member of the acne family of disorders. It is sometimes called acne inversa. The first signs of HS are small bumps on the skin that resemble pimples, cysts, boils, or folliculitis. As the disease progresses and abscesses reoccur, they become larger and more painful; eventually tunnels of scar tissue connect the lesions. These lesions may open up if they become too enlarged and drain bloodstained pus. One risk factor is age; HS usually first appears during the 20s and early 30s. The condition is much more common in women than in men but is usually more serious and debilitating in men. Other associated conditions include obesity, diabetes, metabolic syndrome, arthritis, acne, and other inflammatory disorders. Early diagnosis of this disease is very important to decrease the number of flares, pain, and discomfort.
Comedones are associated with the pilosebaceous unit, which includes a hair follicle and sebaceous gland. These units are mostly on the face, neck, upper chest, shoulders and back. Excess keratin combined with sebum can plug the opening of the follicle. This small plug is called a microcomedo. Androgens increase sebum (oil) production. If sebum continues to build up behind the plug, it can enlarge and form a visible comedo.
A comedo may be open to the air ("blackhead") or closed by skin ("whitehead"). Being open to the air causes oxidization, which turns it black. "Propionibacterium acnes" is the suspected infectious agent in acne. It can proliferate in sebum and cause inflamed pustules (pimples) characteristic of acne. Nodules are inflamed, painful deep bumps under the skin.
Comedones that are 1 mm or larger are called macrocomedones. They are closed comedones and are more frequent on the face than neck.
Solar comedones (sometimes called senile comedones) are related to many years of exposure to the sun, usually on the cheeks, not to acne-related pathophysiology.
Pimple-popping, or Zit-popping, is the act of bursting or popping pimples with one's finger. Pimple-popping can lead to the introduction of bacteria into the pimple, infection, the creation of more pimples, and permanent scarring. Thus, popping is usually deprecated by dermatologists and estheticians and it is recommended to let the pimples run through their life span.
Excoriated acne (also known as Picker's acne or Acne excoriée des jeunes filles) is a mild acne accompanied by extensive excoriations.