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Main areas affected by nodular acne are the face and back, but it can also occur on other parts of the body such as the neck, chest, upper arms, shoulders, and buttocks, ranging from just a few breakouts to more widespread blemishes.
Acne papules aren't the only red, inflamed bump you can get on the skin. Papules can be small or large. But if you have a blemish that is especially red, swollen, and painful, it may not be a papule at all. Instead, you might have an acne nodule. Nodules are similar to papules -- they both form because of a blockage of the hair follicle. But nodules happen deeper in the skin, and are more serious form of blemish than a papule. They happen when their is a deep break in the follicle wall and the infected material spills into the dermis.