During adolescence, acne vulgaris is more common in males than in females. In adulthood, acne vulgaris is more common in women than in men.
Systemic symptoms are most often absent in acne vulgaris. In rare but severe cases, acne vulgaris could lead to acne conglobata, with highly inflammatory nodulocystic acne and interconnected abscesses. Acne fulminans is even more severe than acne conglobata, with systemic symptoms such as fever, joint pain, and general malaise.
Skin lesion cultures to rule out gram-negative folliculitis are warranted if the patient does not respond to long-term antibiotic treatment or improvement with antibiotics is not maintained.
In patients with acne vulgaris, topical antibiotics are used mainly for their role against Cutibacterium acnes (formerly Propionibacterium acnes). They may also have anti-inflammatory properties. Topical antibiotics are not comedolytic, and bacterial resistance may develop to any of these agents. Concurrent use of oral and topical antibiotics should be avoided and should not be used as monotherapy.
For more on acne vulgaris, read here.
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Cite this: William James. Fast Five Quiz: Test Yourself on Key Aspects of Summer Skin Conditions - Medscape - Jul 09, 2018.