. The ready-reference handbook of diseases of the skin. ignate the comedo, but improperly, according to our defini-tion. It is rare that acne exists only in the papular usually it will be found that here and there the pap-ules are surmounted by a pustule, or a pustule has takenthe place of a papule. We now have A. pustulosa. Instrumous subjects the pustular element preponderates overthe papular, and the face may be greatly disfigured by thelarge number of the lesions present upon it. The pustulesare from pinhead to small pea size, and have an inflamedbase. (Fig. 5.) Together with the
. The ready-reference handbook of diseases of the skin. ignate the comedo, but improperly, according to our defini-tion. It is rare that acne exists only in the papular usually it will be found that here and there the pap-ules are surmounted by a pustule, or a pustule has takenthe place of a papule. We now have A. pustulosa. Instrumous subjects the pustular element preponderates overthe papular, and the face may be greatly disfigured by thelarge number of the lesions present upon it. The pustulesare from pinhead to small pea size, and have an inflamedbase. (Fig. 5.) Together with the acne and the comedones, we meet with ACNE. 53 milia quite commonly, and the affected parts are usuallygreasy to the feel, showing that the sebaceous glands sym-pathize in the disease. We now have a fair picture of atypical case of acne vulgaris. The face, back, neck, orchest, or all four, are dotted over in an irregular mannerwith blackish points, papules, and small pustules ; the skinof the nose and forehead looks shiny and feels greasy, and Fig. Acne vulgaris.(From Prof. George H. Foxs Service in the Vanderbilt Clinic.) perhaps there are some milia scattered about the region ofthe eyes. At times the face will look inflamed and hyper-semic, especially in young, otherwise robust, subjects. Morecommonly the complexion will have that pasty appearanceindicative of what has from old times been called thestrumous condition. If the inflammatory process has been 54 DISEASES OF THE SKIN. unusually severe, we may find a considerable amount ofscarring. Usually acne vulgaris does not leave permanentscars. The profuseness of the eruption varies greatly. Insome cases there will be but a few lesions, while in othercases they will be present in vast amount. This form ofacne generally occurs in young people. The duration of theindividual lesion is short, as it soon either dries up or dis-charges its contents. If the papules are squeezed, little plugsof sebaceous matter will be expressed.
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