Acne on back lesions
Virtually universal in the middle to late teenage years, acne on back affects both males and females, although males tend to have more severe disease. Acne is seen in all races, but it is said to be milder in people of Asian descent. Acne on back in adolescents is believed to occur as a result of physiologic hormonal variations and alterations in hair follicle maturation. The clinical features of acne may be induced or exacerbated by drugs (corticosteroids, adrenocorticotropic hormone, testosterone, gonadotropins, contraceptives, trimethadione, iodides, and bromides), occupational contactants (cutting oils, chlorinated hydrocarbons, and coal tars), and occlusive conditions such as heavy clothing and tropical climates. Some families seem to be particularly affected by acne, suggesting a heritable factor..
Acne on back is divided into noninflammatory and inflammatory types, although both may coexist. The former consists of open and closed comedones. Open comedones consist of small follicular papules containing a central black keratin plug. This color is the result of oxidation of melanin pigment (not dirt). Closed comedones are follicular papules without a visible central plug. Because the keratin plug is trapped beneath the epidermal surface, these lesions are potential sources of follicular rupture and inflammation. Inflammatory acne is characterized by erythematous papules, nodules, and pustules. Severe variants (e.g. acne conglobata) result in sinus tract formation and physical scarring, in addition to the emotional scars.
MORPHOLOGY.
Comedones form as an expanding mass of lipid (sebum) and keratin within the midportion of the hair follicle. With gradual expansion, the follicle becomes dilated and the follicular epithelium and sebaceous glands atrophy. Resultant open comedones have large, patulous orifices, whereas those of closed comedones are identifiable only microscopically. Variable lymphohistiocytic infiltrates are present in and around affected follicles, and extensive acute and chronic inflammation accompanies follicular rupture. Dermal abscesses may form in association with rupture, and gradual resolution, often with scarring, ensues.
The pathogenesis of Acne
Endocrine factors have been implicated (especially androgens) because castrated persons never develop the condition. However, these do not appear to be the sole or primary cause. It has been postulated that bacterial lipases of Propionibacterium acnes break down sebaceous oils, liberating highly irritating fatty acids resulting in the earliest inflammatory phases of acne. Inhibition of lipase production is a rationale for administration of antibiotics to patients with inflammatory acne. The synthetic vitamin A derivative 13- cis-retinoic acid (isotretinoin) has brought about remarkable clinical improvement in some cases of severe acne.
Acne on back and the appearance industry
Being preoccupied with appearance, the acne on back sufferer usually have a negative self image, and may develop psychological problems.
Because the color, texture, and appearance of the skin, are important physical factors contributing to outer beauty; and when many people are more concerned with physical beauty, though inner beauty is more pleasing to the mind, real beauty would cease to matter. Needless to say that, it is not a person’s skin that makes them attractive but a combination of all the unique characteristics that they are.
The media, and television in particular, actively promote levels of attractiveness related to appearance and particular physical properties. Attractiveness has thus shaped people attitudes in favor of physical beauty in many life aspects, such as employment, social opportunities, friendship, s*xual behavior, and marriage. The media transmit messages concerning physical beauty, perfection and disfigurement, and usually offer suggestions and practical advice as to how the influence of these aspects can be reduced or altered. As they are promoting certain products, they are creating markets for advertisers at the same time. the media have propagated the idea that perfection is a normal thing in society and that those who are unattractive can easily gain this supposedly ‘normal’ appearance.
The concept of body image defined as our perception of the way that others see us, is therefore affected by any physical changes to the way that we look.
As acne develops in adolescence, a time when people are generally most sensitive about their appearance; symptoms such as depression or social anxiety reflect their real concern over body image.
The costs of treatment may also complicate the problem and can cause great distress.
The visibility of acne on back may attract attention in certain social situations, thus making the individual feel that they can’t keep their condition private or personal.The sufferer may find that some people react negatively towards them or treat them differently because of the way that they look.
Negative misconceptions about acne are still there; some people still think it is associated with a person’s inability to ‘properly take care of themselves or a lack of cleanliness and reactions to this can range from curiosity to rejection therefore, acne sufferers become socially withdrawn...to be continued.
Monday, June 16, 2008
Acne on back lesions
