Comedogenesis: some new aetiological, clinical and therapeutic strategies.

摘要: Hypercornification is an early feature of acne and precedes inflammation. It associated with ductal hyperproliferation there are many controlling factors such as androgens, retinoids cytokines. Cycling normal follicles comedones may explain the natural resolution and, in longer term, disease itself. There a need to tailor treatment according comedonal type. Suboptimal therapy can often result from inappropriate assessments comedones, especially microcomedones, missed sandpaper submarine macrocomedones. Macrocomedones produce devastating flares, particularly if patients inappropriately prescribed oral isotretinoin. Gentle cautery under topical local anaesthesia useful lesions. The newer new formulations all-trans-retinoic acid show better benefit/risk ratio. Evidence-based studies required allow adequate comparisons.