title: Underestimated clinical features of postadolescent acne.
abstract: BACKGROUND
  Postadolescent acne is usually described as an inflammatory, mild-to-moderate dermatosis, frequently involving the lower third of the face, the jawline, and the neck. However, we have also frequently observed a clinical form predominantly characterized by retention lesions (microcomedones and macrocomedones), with few inflammatory lesions (comedonal postadolescent acne [CPAA]), which appears significantly correlated with cigarette smoking.
  
  
  OBJECTIVE
  We sought to investigate the clinical features of postadolescent acne in a group of female patients affected by acne and its relationship with cigarette smoking.
  
  
  METHODS
  A total of 226 women with acne (25-50 years) attending our department were examined by a team of 3 dermatologists, to assess the age of onset of the disease, and the number, type, and distribution of acne lesions.
  
  
  RESULTS
  In all, 192 of 226 patients (85.0%) were classified as having CPAA and 34 as having papulopustular postadolescent acne. A smoking habit was confirmed in 150 of 226 (66.3%). Remarkably, 72.9% of patients with CPAA were smokers as compared with only 29.4% of those with papulopustular postadolescent acne (P < .0001).
  
  
  CONCLUSIONS
  Possible limitations are related to geographic area or to the prevalence of darker skin types (III and IV) (data about skin types have not been collected). Other possible aggravating factors (ie, stress and diet) have not been investigated.
  
  
  CONCLUSIONS
  According to our results, CPAA appears as the most frequent clinical form of postadolescent acne and seems to be strictly correlated with cigarette smoking.
authors.affiliation: Pediatric Dermatology Department, San Gallicano Institute, Istituti Fisioterapici Ospitalieri, Rome, Italy.
authors.forename: Bruno
authors.initials: B
authors.lastname: Capitanio
authors.forename: Jo Linda
authors.initials: JL
authors.lastname: Sinagra
authors.forename: Valentina
authors.initials: V
authors.lastname: Bordignon
authors.forename: Paola
authors.initials: P
authors.lastname: Cordiali Fei
authors.forename: Mauro
authors.initials: M
authors.lastname: Picardo
authors.forename: Christos C
authors.initials: CC
authors.lastname: Zouboulis
mesh_terms: D000152:Acne Vulgaris / Q000453:epidemiology* / Q000473:pathology*; D000328:Adult; D017668:Age of Onset; D005260:Female; D006801:Humans; D008875:Middle Aged; D015995:Prevalence; D012720:Severity of Illness Index; D012880:Skin Pigmentation; D012907:Smoking / Q000453:epidemiology* / Q000473:pathology*