Acne vulgaris is a common disorder that affects more than 17 million individuals in the United States. Knowledge of the disease is an important part of clinical practice, particularly for the pediatric practitioner. Contrary to common belief, acne is not a disease limited to adolescents and young adults but can occur at any stage of life. This article is a case-based review of acne during childhood and adolescence. Workup is based on age and concurrent physical findings, whereas therapy depends on the type of skin lesions along with patient characteristics and preferences.
Dreno B., Poli F.Epidemiology of acne. Dermatology. 2003;206:7-10.
2.
Collier CN, Harper JC, Cantrell WC, Wang W., Foster KW, Elewski BEThe prevalence of acne in adults 20 years and older. J Am Acad Dermatol. 2008;58:56-59.
3.
Krakowski AC , Eichenfield LFPediatric acne: clinical presentations, evaluation, and management. J Drugs Dermatol. 2007;6:584-588.
4.
Essah PA, Wickham EP, III, Nunley JR, Nestler JEDermatology of androgen-related disorders. Clin Dermatol. 2006;24:289-298.
5.
Mann MW, Ellis SS, Mallory SBInfantile acne as the initial sign of an adrenocortical tumor. J Am Acad Dermatol. 2007;56(suppl):15S-18S.
6.
Yan ACCurrent concepts in acne management. Adolesc Med Clin. 2006;17:613-637.
7.
Kilkenny M., Merlin K., Plunkett A., Marks R.The prevalence of common skin conditions in Australian school students: 3. acne vulgaris. Br J Dermatol. 1998;139: 840-845.
8.
Tan JKPsychosocial impact of acne vulgaris: evaluating the evidence. Skin Therapy Lett. 2004;9:1-3,9.
9.
Baldwin HEThe interaction between acne vulgaris and the psyche. Cutis . 2002;70:133-139.
10.
Fried RG, Wechsler A.Psychological problems in the acne patient. Dermatol Ther . 2006;19:237-240.
11.
Kellett SC, Gawkrodger DJThe psychological and emotional impact of acne and the effect of treatment with isotretinoin. Br J Dermatol. 1999;140:273-282.
12.
Pearl A., Arroll B., Lello J., Birchall NMThe impact of acne: a study of adolescents' attitudes, perception and knowledge . N Z Med J. 1998;111:269-271.
13.
Smithard A., Glazebrook C., Williams HCAcne prevalence, knowledge about acne and psychological morbidity in mid-adolescence: a community-based study. Br J Dermatol. 2001 ;145:274-279.
14.
Eichenfield LF, Fried RG, Taylor SC, Paller AS, Theos A.Acne and your pediatric patient: a roundtable discussion of treatment modalities and other factors. Cutis . 2005;76(suppl 5):5-24.
15.
Layton AMOptimal management of acne to prevent scarring and psychological sequelae . Am J Clin Dermatol. 2001;2:135-141.
16.
Picardi A., Mazzotti E., Pasquini P.Prevalence and correlates of suicidal ideation among patients with skin disease . J Am Acad Dermatol. 2006;54:420-426.
17.
Gupta MA, Gupta AKDepression and suicidal ideation in dermatology patients with acne, alopecia areata, atopic dermatitis and psoriasis. Br J Dermatol. 1998; 139:846-850.
18.
Jansen T., Burgdorf WH, Plewig G.Pathogenesis and treatment of acne in childhood. Pediatr Dermatol . 1997;14:17-21.
19.
Herane MI, Ando I.Acne in infancy and acne genetics. Dermatology. 2003;206:24-28.
20.
Katsambas AD , Katoulis AC, Stavropoulos P.Acne neonatorum: a study of 22 cases. Int J Dermatol. 1999;38:128-130.
21.
Shaw JCAcne: effect of hormones on pathogenesis and management. Am J Clin Dermatol. 2002;3:571-578.
22.
Zouboulis CCAcne and sebaceous gland function. Clin Dermatol. 2004;22:360-366.
Bernier V., Weill FX, Hirigoyen V., et al. Skin colonization by Malassezia species in neonates: a prospective study and relationship with neonatal cephalic pustulosis. Arch Dermatol. 2002;138:215-218.
25.
Bergman JN, Eichenfield LFNeonatal acne and cephalic pustulosis: is malassezia the whole story? Arch Dermatol. 2002;138:255-257.
Barnes CJ, Eichenfield LF, Lee J., Cunningham BBA practical approach for the use of oral isotretinoin for infantile acne. Pediatr Dermatol. 2005;22:166-169.
29.
Cunliffe WJ , Baron SE, Coulson IHA clinical and therapeutic study of 29 patients with infantile acne. Br J Dermatol. 2001;145:463-466.
30.
Lucky AWA review of infantile and pediatric acne. Dermatology. 1998;196:95-97.
31.
Lucky AWAcne therapy in infancy and childhood. Dermatol Ther. 1998;6:74-81.
32.
Goulden V.Guidelines for the management of acne vulgaris in adolescents. Paediatr Drugs. 2003;5:301-313.
33.
Levine RM, Rasmussen JEIntralesional corticosteroids in the treatment of nodulocystic acne. Arch Dermatol. 1983;119:480-481.
Chew EW, Bingham A., Burrows D.Incidence of acne vulgaris in patients with infantile acne. Clin Exp Dermatol. 1990;15:376-377.
38.
De Raeve L. , De SJ, Smitz J.Prepubertal acne: a cutaneous marker of androgen excess?J Am Acad Dermatol. 1995;32(2, pt 1):181-184.
39.
Lucky AW, Biro FM, Huster GA, Leach AD, Morrison JA, Ratterman J.Acne vulgaris in premenarchal girls. An early sign of puberty associated with rising levels of dehydroepiandrosterone. Arch Dermatol. 1994;130: 308-314.
40.
Lucky AW, Biro FM, Huster GA, Morrison JA, Elder N.Acne vulgaris in early adolescent boys. Correlations with pubertal maturation and age. Arch Dermatol. 1991;127: 210-216.
41.
Krowchuk DPManaging adolescent acne: a guide for pediatricians . Pediatr Rev. 2005;26:250-261.
42.
Jozwiak S., Schwartz RA, Janniger CK, Michalowicz R., Chmielik J.Skin lesions in children with tuberous sclerosis complex: their prevalence, natural course, and diagnostic significance. Int J Dermatol . 1998;37:911-917.
43.
Baldwin HETricks for improving compliance with acne therapy. Dermatol Ther. 2006;19:224-236.
44.
Bojar RA, Holland KTAcne and Propionibacterium acnes. Clin Dermatol. 2004;22:375-379.
45.
Eady AE, Cove JH, Layton AMIs antibiotic resistance in cutaneous propionibacteria clinically relevant? Implications of resistance for acne patients and prescribers. Am J Clin Dermatol. 2003;4:813-831.
46.
Eady EA, Gloor M., Leyden JJPropionibacterium acnes resistance: a worldwide problem. Dermatology. 2003; 206:54-56.
47.
Leyden J., Levy S.The development of antibiotic resistance in Propionibacterium acnes. Cutis. 2001; 67(suppl 2):21-24.
48.
Leyden JJAntibiotic resistance in the topical treatment of acne vulgaris. Cutis. 2004;73(suppl 6):6-10.
49.
Swanson JKAntibiotic resistance of Propionibacterium acnes in acne vulgaris. Dermatol Nurs. 2003;15:359-362.
50.
Tanghetti E.The impact and importance of resistance. Cutis. 2007;80(suppl 1):5-9.
51.
Ross JI, Snelling AM, Carnegie E., et al. Antibioticresistant acne: lessons from Europe. Br J Dermatol. 2003; 148:467-478.
52.
Eady EA, Bojar RA, Jones CE, Cove JH, Holland KT, Cunliffe WJThe effects of acne treatment with a combination of benzoyl peroxide and erythromycin on skin carriage of erythromycin-resistant propionibacteria. Br J Dermatol. 1996;134:107-113.
53.
Eady EA, Farmery MR, Ross JI, Cove JH, Cunliffe WJEffects of benzoyl peroxide and erythromycin alone and in combination against antibiotic-sensitive and-resistant skin bacteria from acne patients. Br J Dermatol. 1994; 131:331-336.
54.
Leyden JJ, Del Rosso JQ, Webster GFClinical considerations in the treatment of acne vulgaris and other inflammatory skin disorders: focus on antibiotic resistance. Cutis. 2007;79(suppl 6):9-25.
55.
Katsambas AD , Stefanaki C., Cunliffe WJGuidelines for treating acne. Clin Dermatol. 2004;22:439-444.
56.
Gollnick H. , Cunliffe W., Berson D., et al. Management of acne: a report from a Global Alliance to improve outcomes in acne. J Am Acad Dermatol . 2003;49(suppl 1): 1S-37S.
57.
Webster GFThe pathophysiology of acne. Cutis. 2005;76(suppl 2):4-7.
58.
Bergfeld WFThe pathophysiology of acne vulgaris in children and adolescents, Part 1. Cutis. 2004;74:92-97.
59.
Harper JC, Thiboutot DMPathogenesis of acne: recent research advances. Adv Dermatol . 2003;19:1-10.
60.
Tan JK, Vasey K., Fung KYBeliefs and perceptions of patients with acne. J Am Acad Dermatol . 2001;44:439-445.
61.
Cordain L.Implications for the role of diet in acne. Semin Cutan Med Surg. 2005;24:84-91.
62.
Zaenglein AL , Thiboutot DMExpert committee recommendations for acne management. Pediatrics. 2006;118: 1188-99.
63.
Adebamowo CA , Spiegelman D., Danby FW, Frazier AL, Willett WC, Holmes MDHigh school dietary dairy intake and teenage acne. J Am Acad Dermatol. 2005;52:207-214.
64.
Smith RN, Mann NJ, Braue A., Makelainen H., Varigos GAThe effect of a high-protein, low glycemic-load diet versus a conventional, high glycemic-load diet on biochemical parameters associated with acne vulgaris: a randomized, investigator-masked, controlled trial. J Am Acad Dermatol. 2007;57:247-256.
65.
Smith RN, Mann NJ, Braue A., Makelainen H., Varigos GAA low-glycemic-load diet improves symptoms in acne vulgaris patients: a randomized controlled trial. Am J Clin Nutr. 2007;86:107-115.
66.
Strauss JS, Krowchuk DP, Leyden JJ, et al. Guidelines of care for acne vulgaris management. J Am Acad Dermatol. 2007;56:651-663.
67.
Thiboutot D.Acne: hormonal concepts and therapy. Clin Dermatol. 2004;22:419-428.
68.
Tan AW, Tan HHAcne vulgaris: a review of antibiotic therapy. Expert Opin Pharmacother. 2005;6:409-418.
69.
Sturkenboom MC, Meier CR, Jick H., Stricker BHMinocycline and lupuslike syndrome in acne patients. Arch Intern Med. 1999;159:493-497.
70.
Skidmore R. , Kovach R., Walker C., et al. Effects of sub-antimicrobial-dose doxycycline in the treatment of moderate acne. Arch Dermatol . 2003;139:459-464.
71.
Bershad SVThe modern age of acne therapy: a review of current treatment options. Mt Sinai J Med. 2001;68:279-286.
72.
Boni R., Nehrhoff B.Treatment of gram-negative folliculitis in patients with acne. Am J Clin Dermatol. 2003; 4:273-276.
73.
Deplewski D. , Rosenfield RLRole of hormones in pilosebaceous unit development . Endocr Rev. 2000; 21:363-392.
74.
Berger R., Barba A., Fleischer A., et al. A double-blinded, randomized, vehicle-controlled, multicenter, parallel-group study to assess the safety and efficacy of tretinoin gel microsphere 0.04% in the treatment of acne vulgaris in adults. Cutis. 2007;80:152-157.
75.
Marqueling AL, Zane LTDepression and suicidal behavior in acne patients treated with isotretinoin: a systematic review. Semin Cutan Med Surg. 2005;24:92-102.
76.
Layton AM, Knaggs H., Taylor J., Cunliffe WJIsotretinoin for acne vulgaris-10 years later: a safe and successful treatment . Br J Dermatol. 1993;129:292-296.
77.
White GM, Chen W., Yao J., Wolde-Tsadik G.Recurrence rates after the first course of isotretinoin. Arch Dermatol. 1998;134:376-378.
78.
Stainforth JM, Layton AM, Taylor JP, Cunliffe WJIsotretinoin for the treatment of acne vulgaris: which factors may predict the need for more than one course? Br J Dermatol. 1993;129:297-301.
79.
DiGiovanna JJIsotretinoin effects on bone. J Am Acad Dermatol. 2001;45:176S-182S.
