Infantile Acne

Excerpt

Acne vulgaris, a common dermatologic condition, is defined by the presence of comedones. Essentially benign in nature, acne vulgaris can, however, result in permanent disfigurement and significant psychosocial sequelae. Although the condition is by far the most prevalent among the adolescent patient population, it can and does occur at any age, including infancy. The outpatient management of pediatric acne, in particular, can be challenging to even the most experienced clinicians, which stems from several issues. First, one must actively consider an extensive list of differential diagnoses. Second, establishing a diagnosis of acne vulgaris in a pediatric patient can simply represent the initial step in the ultimate diagnosis of a more serious underlying condition. Moreover, even a confirmed case of uncomplicated pediatric acne requires thoughtful management involving awareness of potential treatment side effects and effective engagement of the patient, and often the caregiver as well.

Pediatric acne subdivides into four subgroups based on the age of onset - neonatal acne, infantile acne, mid-childhood acne, and preadolescent acne. Infantile acne presents anytime between approximately 6 weeks and 12 months of age and displays a male predominance. In addition to both closed and open comedones, morphological findings often include inflamed papules, pustules, nodules, and cysts. Lesions are usually distributed to the skin of the facial region but can involve the chest and back as well. In general, most patients diagnosed with infantile acne have a moderate course at best requiring no treatment, resolving within 6 to 12 months of initial onset. However, some cases can cause scarring and be severe enough to warrant the initiation of medication. Children with infantile acne are at higher risk of developing severe acne during adolescence.