A medical illustrative diagram titled 'PATHOGENESIS OF ACNE' depicting the longitudinal progression of acne vulgaris within a pilosebaceous unit. The diagram is divided into five sequential stages: 1) Early comedo: Shows hyperkeratosis and androgen-stimulated sebum production. 2) Later comedo (Closed): Illustrates a 'whitehead' with a keratin and sebum plug beneath the epidermis. 3) Later comedo (Open): Depicts a 'blackhead' with a dilated follicular opening and darkened keratin plug. 4) Inflammatory papule/pustule: Shows Propionibacterium acnes proliferation, neutrophil infiltration, and rupture of the comedo wall leading to sebaceous lobule regression. 5) Nodule/cyst: Demonstrates marked T-cell inflammation and deep tissue involvement with potential for scarring. Key anatomical labels include the epidermis, follicular epithelium, and sebaceous lobule. A legend identifies visual representations of corneocytes, sebum, and P. acnes. This diagram serves as a primary educational resource for understanding the transition from non-inflammatory microcomedones to severe inflammatory acne lesions.

This clinical photograph shows the face of a patient in a perioperative setting, demonstrating advanced rhinophyma, the end-stage clinical manifestation of acne rosacea. The nose is severely enlarged with a bulbous, irregular, and lobulated morphology that has obliterated the normal anatomical subunits. The nasal skin exhibits intense erythema, prominent pitting, and sebaceous gland hyperplasia. Diffuse facial erythema is also visible across the forehead and cheeks, consistent with underlying rosacea. Surgical markings are present on the central forehead. The image illustrates the classic visual features used to diagnose rhinophyma clinically and serves as a teaching tool for identifying dermal fibrosis and telangiectasias in dermatological and plastic surgery contexts. The primary educational focus is on the progressive tissue hypertrophy and skin surface irregularities associated with chronic inflammatory skin conditions of the face.

This clinical photograph represents a before-and-after comparison of a patient undergoing dermatological treatment for sebaceous hyperplasia. Panel A shows the lateral view of the nose with numerous small, skin-colored to slightly yellowish, umbilicated papules characteristic of hypertrophic sebaceous glands. The lesions are clustered on the nasal dorsum and tip, creating a cobblestone texture. Panel B demonstrates the same anatomical region following treatment with an Erbium laser. There is a significant clinical improvement, with nearly complete resolution of the papules and restoration of a smooth, uniform skin surface. The after-image shows minimal evidence of scarring or post-inflammatory hyperpigmentation, illustrating the efficacy of laser ablation for benign adnexal tumors. This comparison is useful for teaching medical students and dermatology residents about the clinical presentation of sebaceous hyperplasia and the outcomes of ablative laser therapy in aesthetic medicine.