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American Academy of Pediatrics
Article

Acne Vulgaris in the Pediatric Patient

Rosalind Ashton and Miriam Weinstein
Pediatrics in Review November 2019, 40 (11) 577-589; DOI: https://doi.org/10.1542/pir.2018-0137
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Rosalind Ashton
*King's College London School of Medical Education, St. John's Institute of Dermatology, London, United Kingdom
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Miriam Weinstein
†The Hospital for Sick Children, Toronto, Ontario, Canada
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  1. Rosalind Ashton, MD, MSc*
  2. Miriam Weinstein, MD, FRCPC†
  1. *King's College London School of Medical Education, St. John's Institute of Dermatology, London, United Kingdom
  2. †The Hospital for Sick Children, Toronto, Ontario, Canada
  • AUTHOR DISCLOSURE

    Dr Ashton has disclosed no financial relationships relevant to this article. Dr Weinstein has disclosed funding from La Roche Posay through her hospital's charitable foundation for a program to teach patients with eczema and their families about the disease and how to manage it; is an advisory board leader/lecturer on eczema for Pfizer; is an advisory board member for Amgen and Pfizer on eczema; is an advisory board consultant for Sanofi Genzyme; is a consultant for Unilever; and is a consultant for Paladin Labs. This commentary does contain a discussion of an unapproved/investigative use of a commercial product/device.

  • Abbreviations:
    BPO:
    benzoyl peroxide
    D+A/BPO:
    doxycycline + adapalene/benzoyl peroxide
    DRESS:
    drug reaction with eosinophilia and systemic symptoms
    FDA:
    Food and Drug Administration
    IBD:
    inflammatory bowel disease
    PDL:
    pulsed dye laser
    TLR:
    Toll-like receptor
  • Practice Gap

    Acne vulgaris is a common disease seen in pediatric practices, and pediatricians should be able to develop management strategies using standard therapies, including retinoids.

    Objectives

    After completing this article, readers should be able to:

    1. Describe the pathophysiology of acne.

    2. Outline treatment options based on a patient’s clinical presentation.

    3. Discuss mechanisms of action and adverse effects of common acne medications.

    4. Explain treatment options for postacne sequelae.

    Introduction

    Acne vulgaris is a ubiquitous disease of the pilosebaceous unit, characterized by a long-term course with recurrences and relapses. It affects approximately 85% of adolescents and may persist until well into a patient’s 20s and 30s. (1)(2)(3) Psychological sequelae can be substantial and should not be underestimated. This common, very visible skin condition presents at a time when appearance is acutely important and noticeable disease marring that appearance is distressing. Embarrassment contributes to lower self-esteem and feelings of unattractiveness and worthlessness, which may be present not only during active flare-ups but also with long-lasting postinflammatory hyperpigmentation and permanent scarring. (4)

    The aim of this review is to offer up-to-date information on pathophysiology, evaluation, and management strategies for this common disease.

    The treatment of acne conglobata, acne fulminans, cloracne, drug-induced acne, hidradenitis …

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    In this issue

    Pediatrics in Review: 40 (11)
    Pediatrics in Review
    Vol. 40, Issue 11
    1 Nov 2019
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    Acne Vulgaris in the Pediatric Patient
    Rosalind Ashton, Miriam Weinstein
    Pediatrics in Review Nov 2019, 40 (11) 577-589; DOI: 10.1542/pir.2018-0137

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    Acne Vulgaris in the Pediatric Patient
    Rosalind Ashton, Miriam Weinstein
    Pediatrics in Review Nov 2019, 40 (11) 577-589; DOI: 10.1542/pir.2018-0137
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