Nodulocystic acne is one of the forms of acne of adolescence, manifested by the formation of deep infiltrative elements on the face and trunk or cavities filled with pus. The resolution is accompanied by a scarring process. Diagnostics includes examination by a dermatologist, skin pH-metry, dermatoscopy, bacposev with an antibioticogram. With nodulocystic acne, general and local antibiotic therapy is carried out, external agents with zinc and azelaic acid are used, mesotherapy, ozone therapy, cryotherapy, etc. are used. methods of treatment.
General information
Nodulocystic acne, like other clinical forms of acne, is an inflammatory lesion of the sebaceous glands. Most often they occur against the background of seborrheic dermatitis, in which there is an increased production of sebum. Hyperproduction by the sebaceous glands of a thick secretion leads to difficulty in its outflow through the excretory ducts of the glands. The accumulated secret is a favorable environment for the reproduction of bacteria that penetrate it from the surface of the skin. As a result of infection, an inflammatory reaction develops. The inflammatory process in captures not only the surface layer of the dermis (epidermis), but also penetrates deep into the dermis. For this reason, after the acne resolves, noticeable scars remain on the skin.
Symptoms
Along with comedones, lightning-fast and papulopustular acne, dermatology refers nodulocystic acne to juvenile forms of acne. They occur mainly in adolescents aged 15-18 years. As a rule, by the age of 20, nodulocystic acne passes, but it can persist longer.
Nodulocystic acne is characterized by the formation of numerous dense and deep infiltrates on the skin of the face, back and chest, which are also called indurative acne. At the same time, the inflammatory process is so pronounced that it goes beyond the sebaceous gland and spreads to the surrounding tissues. Indurative acne can regress, leaving behind scars and hyperpigmentation. If the process goes further, then the following form of nodulocystic acne develops — phlegmonous acne. At the same time, a cystic cavity forms in place of the inflammatory infiltrate, in which pus accumulates. Such acne begins to merge and form continuous inflammatory areas. Their resolution is accompanied by scarring and leaves behind a noticeable cosmetic defect — post-acne scars.
Diagnostics
Acne is a serious aesthetic and psychological problem for a teenager, therefore, when they appear, it is necessary to consult a dermatologist. To clarify the type of acne, a dermatoscopy may be required. Additional information about the condition of the skin is provided by the pH-metric of the skin. It is mandatory to identify the microorganisms that caused the inflammation. To do this, the separated acne is taken and its bacteriological sowing is carried out with further determination of sensitivity to antibacterial drugs.
It is necessary to differentiate nodulocystic acne from papulopustular acne, folliculitis, infiltrative-suppurative variant of ringworm, streptococcal impetigo and other forms of pyoderma.
Treatment
The high prevalence of acne with the formation of purulent cysts is an indication for systemic antibiotic therapy. The drug should be selected in accordance with the data of the antibioticogram. The same applies to antibacterial agents for external use. Ointments with azelaic acid, zinc and benzoyl peroxide are used in local treatment.
Complex therapy may include phototherapy, darsonvalization, ultrasound and microcurrent therapy, laser therapy and other physical methods of influencing the area of rashes. To increase the body’s natural defenses, ozone therapy, ultraviolet or laser blood irradiation is prescribed. Adequately carried out complex therapy can lead to the resorption of infiltrates in the indurative form of nodulocystic acne, which avoids scarring.
Treatment of scars formed after the resolution is carried out by a combination of several of the following methods: mesotherapy, laser peeling, phenolic peeling, cryotherapy and cryomassage, contouring with collagen preparations, etc. These methods are used after the inflammatory process subsides and are aimed exclusively at eliminating scarring of the skin.