Comedo and Acne Pseudocyst

  • Comedones are pseudocysts formed by occlusion of follicle by keratin and sebum.
  • The open comedo (whitehead) and closed comedo (blackhead) are small, superficial papules typical of acne vulgaris
  • Solar comedones arise in sun-damaged skin and are associated with smoking.
  • Large uninflamed pseudocysts accompany inflammatory nodules in nodulocystic acne and hidradenitis suppurativa.
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    Pseudocyst of auricle

    • Pseudocyst of auricle (external ear) follows trauma.

    Pseudocyst of auricle

    Comedones are the skin-coloured, small bumps (papules) frequently found on the forehead and chin of those with acne. A single lesion is a comedo. Open comedones are blackheads; black because of surface pigment (melanin), rather than dirt. Closed comedones are whiteheads; the follicle is completely blocked.

    Rupture of a cyst

    • Combination oily and dry mid-facial skin
    • The contents of the cyst may penetrate the capsular wall and irritate surrounding skin.
    • The area of tender, firm inflammation spreads beyond the encapsulated cyst.
    • Sterile pus may be discharged.

    Secondary infection

    • A ruptured cyst may infrequently become secondarily infected by Staphylococcus aureus, forming a furuncle (boil).

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