The Pillsbury acne grading scale classifies the severity of the acne from grade 1 (least severe) to grade 4 (most severe). Differential diagnosis
Many skin conditions can mimic acne vulgaris, and these are collectively known as acneiform eruptions. Such conditions include angiofibromas, epidermal cysts, flat warts, folliculitis, keratosis pilaris, milia, perioral dermatitis, and rosacea, among others. Age is one factor that may help distinguish between these disorders. Skin disorders such as perioral dermatitis and keratosis pilaris can appear similar to acne but tend to occur more frequently in childhood. Rosacea tends to occur more frequently in older adults. Facial redness triggered by heat or the consumption of alcohol or spicy food is also more suggestive of rosacea. The presence of comedones helps health professionals differentiate acne from skin disorders that are similar in appearance. Chloracne and occupational acne due to exposure to certain chemicals & industrial compounds, may look very similar to acne vulgaris. Management
Many different treatments exist for acne. These include alpha hydroxy acid, anti-androgen medications, antibiotics, antiseborrheic medications, azelaic acid, benzoyl peroxide, hormonal treatments, keratolytic soaps, nicotinamide, retinoids, and salicylic acid. Acne treatments work in at least four different ways, including the following: reducing inflammation, hormonal manipulation, killing C. acnes, and normalizing skin cell shedding and sebum production in the pore to prevent blockage. Typical treatments include topical therapies such as antibiotics, benzoyl peroxide, and retinoids, and systemic therapies, including antibiotics, hormonal agents, and oral retinoids.Recommended therapies for first-line use in acne vulgaris treatment include topical retinoids, benzoyl peroxide, and topical or oral antibiotics.
Prognosis
Without treatment, individuals with impetigo typically get better within three weeks. Complications may include cellulitis or poststreptococcal glomerulonephritis. Rheumatic fever does not appear to be related. Epidemiology
Globally, impetigo affects more than 162 million children in low- to middle-income countries. The rates are highest in countries with low available resources and is especially prevalent in the region of Oceania. The tropical climate and high population in lower socioeconomic regions contribute to these high rates. Children under the age of 4 in the United Kingdom are 2.8% more likely than average to contract impetigo; this decreases to 1.6% for children up to 15 years old. As age increases, the rate of impetigo declines, but all ages are still susceptible. History
Impetigo was originally described and differentiated by William Tilbury Fox around 1864. The word impetigo is the generic Latin word for skin eruption, and it stems from the verb impetere to attack (as in impetus). Before the discovery of antibiotics, the disease was treated with an application of the antiseptic gentian violet, which was an effective treatment. References
External links
Impetigo at Curlie
Impetigo and Ecthyma at Merck Manual of Diagnosis and Therapy Professional Edition