punctiform acne

Introduction

Introduction 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 yellow. A white translucent lipid plug is discharged. 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.

Cause

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.

1, hemorrhoids and sexual endocrine have a close relationship, rarely before puberty, people with loss or decline in sexual function, such as the ancient court castrated eunuch not onset, people with reduced sexual function, such as the application of testosterone can promote the growth of beard and hemorrhoids The occurrence of acne-prone rash is often caused by corticotropin or corticosteroids. Women often have acne attacks before menstruation. Reduced symptoms of acne during pregnancy. Both men and women have androgens and estrogens. The organ that secretes sex hormones is the testis and adrenal glands in men, and the ovaries, placenta, and adrenal glands in women. Androgens and estrogens have different ratios in men and women, and changes in ratios may cause acne.

2. The development of sebaceous glands and the secretion of sebum are also related to the increase of androgen. Among them, testosterone increases the activity of sebaceous glands, and progesterone and dehydroepiandrosterone (DHA) in the adrenal cortex also participate in the action. May play an important role. 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.

3. 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.

4. 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.

5. In addition, heredity is also an important factor in the occurrence 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.

Examine

an examination

Related inspection

Skin smear microscopy serum interleukin-6 demodex

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

Diagnosis

Differential diagnosis

According to the majority of patients, young people, such as the face and upper chest and back, blackheads can be diagnosed, but should be identified with the following diseases:

1. Acne-like drug eruption caused by bromine and iodine: There is a history of taking medicine, there is no typical blackhead acne, the rash is systemic, and the incidence is not limited by age.

2. Occupational acne: Workers who come into contact with pyrolysis oil, machine oil, petroleum, paraffin, chloronaphthalene and other compounds can cause acne-like rash, usually related to occupations. At the same time, the workers who work at the same time often suffer the same damage. Very dense, often occurs in contact areas, such as the back of the hand, forearms, elbows, etc.

3. Rosacea: more common in middle-aged people, the rash only occurs in the face, more common in the central part, often accompanied by hair cell vasodilation.

4. Facial disseminated miliary lupus: most of the damage is dark red or brownish yellow papules and small nodules. In the lower edge of the eyelid, the skin lesions were arranged in a dike shape, and the color of the apple sauce was changed by the slide examination, and the damage was inconsistent with the hair follicle.

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