Which clinical history findings are characteristic of Cutibacterium acnes infection?

Updated: Dec 03, 2019
  • Author: Sajeev Handa, MBBCh, BAO, LRCSI, LRCPI; Chief Editor: John L Brusch, MD, FACP  more...
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C acnes plays an important role in the pathogenesis of inflammatory acne–producing proinflammatory mediators, including lipases, neuraminidases, phosphatases, and proteases.

Acne usually affects the face and, to a lesser degree, the back, chest, and shoulders. On the trunk, lesions tend to be near the midline.

The 4 major pathophysiologic features of acne include the following:

  • Hyperkeratinization

  • Sebum production

  • Bacterial proliferation

  • Inflammation

Lesions can be described in 3 categories, as follows:

  • Comedonal: Comedones are either open (blackheads) or closed (whiteheads). The open comedo appears as a flat or slightly raised lesion with a central dark-colored follicular impaction of keratin and lipid. The closed comedo is a pale, slightly elevated, small papule without a visible orifice and is a potential precursor for the larger inflammatory lesions.

  • Inflammatory: Inflammatory lesions vary from small papules with an inflammatory areola to pustules (papulopustular) to large, tender, fluctuant nodules (nodular).

    Cutibacterium infection. Nodular-cystic acne. Cutibacterium infection. Nodular-cystic acne.
    Cutibacterium infection. Pustular acne. Cutibacterium infection. Pustular acne.
  • Scars: These appear as depressed or hypertrophic papules of varying sizes and shapes.

Exacerbations of acne vulgaris may follow the ingestion of numerous types of drugs, such as iodides, bromides, glucocorticoids, and lithium, as well as the application of occlusive compounds that can block follicles.

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