What is –Êá¬?
–Êᬠlesions “WŠJ ‚æ‚è ƒU sebaceous ‘B •‘® ‹¤‚É –Ñ”¯ follicleson— ƒU –Ê–, •t‚¯ –T’®l “÷, —, chest, –” anogenital area.Sebaceous( ‘B are –’ found ƒIƒ“ƒWƒGƒA áÙ –” mucosa, prepuce –” cervix, where ”Þ“™ are not •‘® ‹¤‚É –Ñ”¯ follicles.) ƒU sebaceous ‘B ŠÜ—L holocrine ŠÄ–[ ™Î ”é–§ triglycerides, Ž‰‚Á‚±‚¢ Ž_‚Á‚Ï‚¢, ˜X ƒGƒXƒeƒ‹, –” ƒXƒeƒƒCƒh ˜Ô “sebum”. ƒU d—§‚ •ÏŠv — –Êᬠare:
(ˆë) an –c’£ — sebum •ª”啨;
(“ó‚Â) thickening of ƒU ƒPƒ‰ƒ`ƒ“ — of ƒU sebaceous ƒ_ƒNƒg, —ˆ‚½‚· blackheads ƒIƒyƒŒ[ƒVƒ‡ƒ“ƒYƒŠƒT[ƒ` comedonesthe— FÊ of blackheads is ‚É‚æ‚é ƒƒ‰ƒjƒ“, “§“O;
(ŽQ) an –c’£ — Propionibacterium –Êá¬ ê — ƒU ƒ_ƒNƒg;
(Žl‚Â) an –c’£ — ‘ü Ž‰‚Á‚±‚¢ Ž_‚Á‚Ï‚¢;
(ŒÞ‚Â) âô࣠‘OŒã ƒU sebaceous ‘B, —L‚蓾‚ׂ« ˆ× ƒU •ú–Æ of ê •ª’.
—R of –Êá¬
”Þ•û are various underlying —R of ‚±‚ê‚ç •ÏŠv.
ƒzƒ‹ƒ‚ƒ“
Androgenic ƒzƒ‹ƒ‚ƒ“ –c’£ ƒU ‘å¬ of sebaceous ‘B –” ƒU —Ê of sebum — —¼—¼ Ž“—Y Ât. Oestrogens have ƒU — o—ˆ‹ï‡ — prepubertal boys –” è†l. — –^ —l ‹¤‚É –Êᬠ”Þ•û is ’ቺ of ƒU ”Z“x of –[Ž– ƒzƒ‹ƒ‚ƒ“ •\Ž† globulin –” ƒAƒg ŒãŒ –c’£ — ‘ü ƒeƒXƒgƒXƒeƒƒ“ ”Z“x. ”Þ•û is —L‚蓾‚ׂ« –’ ƒAƒg variable –c’£ — ƒAƒ“ƒhƒƒCƒh _Œo.
Œû“à lH”ð”D–@ •ï‘ —] 50 microgramsethinyloestradiol ‹X‚µ‚¢ ˜ô –Êᬠˆ«Ž¿‰» –” ƒU ‡¬ “TŒ^ ŒÜŒŽ lower –[Ž– ƒzƒ‹ƒ‚ƒ“ •\Ž† globulin ”Z“x, —U“± •t‚« ”{‹Œ ‘ü ƒeƒXƒgƒXƒeƒƒ“. —c’t –Êᬠ—HŒº — ƒU ‘æˆê ˜º‚© ŒŽ of l¶ƒQ[ƒ –” ŒÜŒŽ ÅI –^ ”N”y. •Ê•Ê‚É ‚æ‚è •s¢o —R, ‚Æ‚© adrenal hyperplasia ƒIƒyƒŒ[ƒVƒ‡ƒ“ƒYƒŠƒT[ƒ` virilising o—ˆ•¨, transplacental ”•± of ƒU adrenal ‘B is —¹Œ© •t‚« ¬s‚« — ƒU •ú–Æ of adrenal androgensbut— –{ does not explain why ƒU lesions •s‹ü. ƒCƒbƒg is –¢‚¾ —L‚肪‚¿ — boys.
—¬‘Ì •
ƒU ŒŽŒo‘O exacerbation of –Êᬠis —¹Œ© —ˆ‚é —¬‘Ì • —U“± •t‚« ”{‹Œ …Ž_‰» of –” Ꭰof ƒU ƒ_ƒNƒg. ”Š¾ –’ ŒÆ‘§ –Êᬠˆ«Ž¿‰», ˆ½‚Í by “¯’f ŽdŠ|‚¯.
‹c‰ï
— –^ •al –Êᬠis o—ˆã‚ª‚è ˆ«Ž¿‰» by ƒ`ƒ‡ƒRƒŒ[ƒg, ”M’†, –” ƒR[ƒq[ ƒIƒyƒŒ[ƒVƒ‡ƒ“ƒYƒŠƒT[ƒ` fizzy ¢.
Žž•ª
–Êᬠ—\—\ „È ‹¤‚É –Þ‚à —zŽË –” is ˆ«Ž¿‰» — “~. ƒU o—ˆ‹ï‡ of •sŽ©‘R ultraviolet àŠX‚½‚é is unpredictable.
•t‚¯ ˆöŽq
ƒIƒCƒ‹ƒXƒLƒ“, whether –ìØ ƒIƒCƒ‹ƒXƒLƒ“ — ƒU âž‘Ì of ˜d‚¢ — ‹‚¢ “àŠ ƒIƒyƒŒ[ƒVƒ‡ƒ“ƒYƒŠƒT[ƒ` z•¨ ƒIƒCƒ‹ƒXƒLƒ“ — H–±, ‹X‚µ‚¢ —R “ –û folliculitis”, —U“± •t‚« –Êá¬- ”@‚ lesions. —]‚è acnegenic –{‘Ì ‘g‚Ýž‚Ý ƒR[ƒ‹ƒ^[ƒ‹, dicophane (DDT), ™‘ ƒIƒCƒ‹ƒXƒLƒ“, –” halogenated ’Y‰»…‘f (polychlorinated biphenols –” —× chemicals). ƒRƒXƒƒ`ƒbƒN –Êᬠis seen — ’š”NŽÒ —l who have used ‰»Ï•i •ï‘ comedogenic ƒIƒCƒ‹ƒXƒLƒ“ —] ’·”N.
Iatrogenic ˆöŽq
Corticosteroids, —¼—¼ ˜b‘è –” Œn—ñ‰», ‹X‚µ‚¢ —R ”{‹Œ keratinisation of ƒU pilosebaceous ƒ_ƒNƒg. Androgens, gonadotrophins, –” corticotrophin ‹X‚µ‚¢ —U” –Êᬠ— ”N. Œû“à lH”ð”D–@ of ƒU ‡¬ “TŒ^ ‹X‚µ‚¢ —U” –Êá¬, –” antiepileptic –ò•¨ are ‹¤˜a‘ —ˆ‚½‚· –Êá¬.
“TŒ^ of –Êá¬
–Êᬠ”
• Affects comedogenic —̈æ
• —HŒº ‘åŠT — •ÏºŠú, —] —‚ÌŽq
• Žè‹ß •ÎŒü
—c’t –Êá¬
• –Ê– š`‚É
• ãY—í ãÑR
™z™z‚½‚é –Êá¬
• –Êᬠconglobata
• Pyoderma ‘Š‘Î
• ƒOƒ‰ƒ •‰ folliculitis
è‹’ –Êá¬
• ƒIƒCƒ‹ƒXƒLƒ“
• Î’Y –” ƒ^[ƒ‹
• Chlorinated Î’YŽ_
• DDT –” weedkillers ƒXƒeƒƒCƒh
• Œn—ñ‰» ƒIƒyƒŒ[ƒVƒ‡ƒ“ƒYƒŠƒT[ƒ` ˜b‘è ƒzƒ‹ƒ‚ƒ“
• ‡¬ “TŒ^ of Œû“à lH”ð”D–@ –” androgenic ƒzƒ‹ƒ‚ƒ“
