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Acne Pimples – Papules and Pustules

Papulopustular Acne Introduction

Papulopustular acne is the most common form of acne. All acne begins

with a microcomedo. That lesion may progress to a closed comedo also know as a white head or an open comedo which is also know as a black head. The microcomedo, open and closed comedo all have the potential to evolve into papules and pustules. The most common presentation is to see comedones, papules and pustules in the same area. Lesions may remain localized to the face or appear on the back, chest and upper arms.

The course and extent is highly variable and unpredictable. Some patients have only a few papules that may last a few months and resolve. Others have a moderate number of papules or papules and pustules that extend to all areas of the face. At the other end of the spectrum are those who have wide spread unstable disease with many papules and pustules that last well into the twenties and thirties.

All of these lesions heal with scarring. The smallest papules and pustules leave only microscopic scars. Scars following the evolution of the larger more inflamed lesions are visible.

Rosacea and perioral dermatitis may be misdiagnosed as acne. Rosacea usually begins after age 30. Papules and pustules of uniform size are found on the forehead, cheeks and nose. There may be erythema and telangiectasias in the same location.

Perioral dermatitis occurs in women. Pinpoint papules and pustules on a red and sometimes scaling base are localized to the area around the mouth while sparring a clear zone around the vermilion order. There may be pustules adjacent to the nostrils and lateral to the eyes.