Reduce Sebum Production Naturally

Oily Skin Solution

If you know what the annoyances of oily skin are, you will want this book; no question about it. If you struggle with skin that just always feels a little bit greasy no matter what and is constantly fighting acne, you will want this guide. This ebook gives you the ingredients to start making your skin feel a little more like every else's, and gets rid of the unsightly blemishes as a result of acne or other oily side-effects. Patricia Evens shows you that tradition, commercial moisturizers really won't do anything for you You will not be able to fight skin grease with those. Learn what you Really need to do to start repairing your skin and getting better-feeling skin. You don't need to spend a lot of money to help you All it takes is the information in this book! Don't suffer from oily skin Start improving now! Read more here...

Oily Skin Solution Overview

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Extraepithelial Glands Holocrine Sebaceous Glands

Histology Nervous Tissue

Sebaceous glands consist of bulbous multilayered epithelium cones, termed sebaceous bulbs or sacs, which lack a luminal space (cf. Figs. 612, 613). The neck of the main bulb opens to the hair shaft. The cells inside the bulb grow larger, produce sebum and consequently, change into sebum cells 2. Their nuclei then die (apoptosis). In the usual preparations used for teaching purposes, the fat droplets are removed. This leads to more and more vacuoles in the cells at the center. While producing the secretory product, the cells die and are extruded together with the secretory material (sebum) holocrine extrusion, holocytosis, (cell lysis). New cells arrive from a supply line, which start at the peripheral cell layer (substitute cells, basal cells) 0. 1 Sebum in the neck of the gland

Holocrine Sebaceous Glands

This parallel section of several alveoli of sebaceous glands shows peripheral basal or germinal cells . The cells are basophilic and appear homogeneous, although small granules are sporadically found. While accumulating secretory product, the cell size and number of fat droplets increase. This explains the vacuoles in routine preparations. The nuclei become pyknotic and disintegrate. The nuclei in this image are already very deformed. Finally, the cells burst open and become part of the sebum (cf. Figs. 134, 612).

Eyelid Lesions and Tissues of Origin

Lymphatic Endothelial Cells Dermis

Large sebaceous glands empty into the hair follicle. Proliferations of the secretory epithelium produce solid dermal tumors called sebaceous adenomas (Fig. 4). Occasionally the excretory duct becomes blocked with accumulation of sebum, producing a sebaceous cyst (steatocystoma). More commonly, however, the block is higher up in the follicle and although the cyst is still contains some sebum the epithelial lining adds keratin and leads to the diagnosis of trichilemmal ( tricholemmal) or pilar cyst. Apocrine sweat glands of Moll normally produce a somewhat viscous secretion that empties into the hair follicle (Fig. 5). Solid tumors arising from the secretory epithelium give rise to apocrine adenomas. If the duct becomes obstructed, a cyst results that can have a layered precipitate of cellular debris. These are apocrine hidrocystomas. In addition to cutaneous layers and their included adnexal appendages eyelid lesions can arise from other eyelid structures. Most important in this group...

Follicular Diseases Causing Scarring Alopecia

Follicular destruction results in scarring alopecia that can be classified as primary or secondary. In primary scarring alopecias, the follicle is the target of inflammation. In secondary scarring alopecias, the follicle is an innocent bystander that, nevertheless, is destroyed. Examples of secondary scarring alopecias include morphea and tumors (alopecia neoplastica). In this chapter, we will consider only the primary scarring alopecias. In this group of diseases, the inflammation can be primarily lymphocytic or neutrophilic. Although all parts of the follicle can be involved, the disease is felt to destroy the bulge area of the follicle, where the arrector pili muscles insert. This area contains the follicular stem cells necessary for regeneration of the lower follicle during normal follicular cycling. When this part of the follicle is destroyed, the follicle is doomed. The sebaceous glands are also destroyed in primary scarring alopecias. The destruction of these structures and the...

Components of the Integument

Composed of two layers of connective tissue containing blood vessels, nerves, sensory receptors, and sweat and sebaceous glands. Beneath the dermis is a layer of loose connective and adipose tissues that forms the superficial fascia of gross anatomy termed the hypodermis. This layer is considered along with the skin, though technically it is not part of the integument.

Histological Features

There is a diffuse or nodular dense infiltrate in the dermis and or in the subcutis that surrounds and invades pilosebaceous units. The latter are irregularly enlarged and show deformation of the follicular walls. Destruction of the hair follicles and sebaceous glands can occur. The infiltrate is composed of either atypical lymphocytes with cerebriform nuclei showing high mitotic activity or monocytoid centrocyte-like B-cells intermingled with a few plasma cells. A typical finding is the presence of small clusters of histiocytes in the perifollicular areas. Granulomas with foreign body reactions are seen rarely (2).

Transappendageal Transport

Preferential staining of hair follicles following topical application of iron, bismuth, sulfonamides, and dyes in a number of different vehicles Changes in pharmacological response to epinephrine and histamine applied in propylene glycol observed with changes in follicular density Follicular deposition of vitamin A observed by quantitative fluorescent microscopy following application in various solvents 14C-Labeled pesticide absorption and urinary excretion increased over follicle-rich areas such as the scalp and forehead, follicular route possibly contributing Trichlorocarbanalide compound deposition in follicles and sebaceous glands seen to vary with vehicle 3H hydrocortisone from hydroalcoholic penetration, optimum 5 im Greater concentrations of hydrocortisone and testosterone observed in epidermis and dermis of normal skin, particularly at the depth of sebaceous glands, compared with follicle-free skin. In vivo effect less pronounced than in vitro Flux and absorption of caffeine,...

Morphologic and Physiologic Skin Differences in Dark Skin

Dark skin demonstrates significantly greater intrinsic photoprotection because of the increased content of epidermal melanin. Clinical photodamage, actinic keratoses, rhytides, and skin malignancies are less common problems in deeply pigmented skin. However, darker skin types are frequently plagued with dyschromias because of the labile responses of cutaneous melanocytes 7 . In a survey of 2000 black patients seeking dermatologic care in a private practice in Washington, DC, the third most commonly cited skin disorders following acne and eczema was pigmentary problems other than vitiligo 8 . Of these patients, the majority had a diagnosis of post-inflammatory hyper-pigmentation, followed in frequency by melas-ma. In a survey of 100 women of color assessing issues of cosmetic concerns for darker skin types, the most commonly cited problems were dark spots or blotchy skin, texturally rough skin, and increased sensitivity to topical products 9 . Patients surveyed also complained of oily...

Heterotopic Ectodermal and Mesodermal Structures Figs 4347

Heterotopic Sebaceous Glands

Formation of sebaceous glands beneath ectocervical epithelium. H& E Fig. 46. Formation of sebaceous glands beneath ectocervical epithelium. H& E Fig. 47. Formation of sebaceous glands beneath ectocervical epithelium. H& E, higher magnification Fig. 47. Formation of sebaceous glands beneath ectocervical epithelium. H& E, higher magnification

Transfer across biological membranes

The skin is impermeable to most chemicals. For a drug to be absorbed it must pass first through the epidermal layers or specialized tissue such as hair follicles or sweat and sebaceous glands. Absorption through the outer layer of skin, the stratum corneum, is the rate limiting step in the dermal absorption of drugs. This outer layer consists of densely packed keratinized cells and is commonly referred to as the dead layer of skin because the cells comprising this layer are without nuclei. Drug substances may be absorbed by simple diffusion through this layer. The lower layers of the epidermis, and the dermis, consist of porous nonselective cells which pose little barrier to absorption by passive diffusion. Once a chemical reaches this level, it is then rapidly absorbed into the systemic circulation because of the extensive network of venous and lymphatic capillaries located in the dermis. Drug absorption through the skin depends on the characteristics of the drug and on the condition...

Microanatomical And Embryological Considerations

Although we often think of hair follicles, sebaceous glands, and apocrine glands as distinct elements, all three components actually stem from the same structure, which has been termed the folliculosebaceous-apocrine unit. For practical purposes, the terms follicle, hair follicle, folliculosebaceous unit, and folliculosebaceous-apocrine unit are used interchangeably. The folliculosebaceous-apocrine unit is a structure that provides insulatory, cosmetic, and pheromonic functions to the mammalian organism. The eccrine unit is a completely independent structure that serves as a thermoregulatory device via secretion of sweat. Sebaceous and apocrine glands emanate from the primary follicle and reside within the adjacent dermis. Virtually, all follicles sport sebaceous glands, whereas apocrine glands usually involute at most body sites, remaining detectable in genital and axillary sites, in periorbital and periauri-cular skin, and sometimes in skin of the scalp. The sebaceous duct,...

Clinical manifestation

Background of facial flushing erythema and telangiectasia over the cheeks and forehead inflammatory papules and pustules, predominantly over the nose, forehead, and cheeks extra-facial involvement over the neck and upper chest prominent sebaceous glands with development of thickened and disfigured nose (rhinophyma) Ocular variant conjunctival injection, chalazion, and episcleritis Granulomatous variant (lupus miliaris dis-seminata faciei) inflammatory, erythema-tous or flesh-colored papules distributed symmetrically across the upper face, particularly around the eyes and nose

Labia Minora Labia Minora Pudendi

The labia minor are skin folds, which are homologous to the penis. They are covered by a multilayered squamous epithelium U. The labia majora pudendi cover the labia minor partially or completely. The surface shows keratiniza-tion of the multilayered squamous epithelium. The subepithelial basal cell layer is frequently heavily pigmented. The loose connective tissue 2 of the labia contains collagen fibers as well as elastic fibers. It forms high papilla. There are hardly any adipocytes. Due to abundant blood vessels, the tissue appears red. Hair is not present. However, there are many sebaceous glands 3. This micrograph shows the vestibular face of the labium minus pudendi from an adult woman. 3 Sebaceous glands

Sebaceous Cell Carcinoma

Cutaneous Horn Formation

INTRODUCTION Sebaceous cell carcinoma is a highly malignant neoplasm that arises from sebaceous glands, and the vast majority of these occur around the eyelids. It can derive from the meibomian glands, glands of Zeis, and from sebaceous glands associated with the pilosebaceous unit. Sebaceous cell carcinoma is an aggressive tumor with a high recurrence rate, a significant metastatic potential, and a notable mortality rate. Although relatively rare, sebaceous gland carcinoma represents the third most common eyelid malignancy, accounting for 1.0 to 5.5 of all eyelid cancers. It affects all races and occurs more commonly in women than in men. It usually presents in the sixth to seventh decades, but cases in younger patients, even children, have been reported. There is a clear link between sebaceous gland carcinoma and prior radiation therapy. It may invade locally into the globe, the orbit, the sinuses, or the brain. Metastases spread via local lymphatics to preauricular and...

Species Variation in Skin Structure

Most species in which skin permeability has been investigated are mammals, and their skin is macroscopically separated into three layers, the stratum corneum, the viable epidermis, and the dermis. The most important considerations in terms of barrier function are differences in the sebum, SC, and follicles. Small laboratory animals, such as rats, mice, and rabbits, lack sweat glands, but have more hair follicles than human skin. For example, guinea pig skin contains about 4,000-5,000 follicles cm2, rat skin about 8,000 follicles cm2, and rabbit skin more than 10,000 follicles cm2, whereas human skin contains about 6 follicles cm2 (225,226). The SC thickness in most animal species is between 15 and 30 m but, in general, this tends to increase with animal size. Thus, the thickness of the SC of rats is about 20 m, whereas that of pig and human are about 30 m. Although the morphological structure of the SC shows reasonable consistency among species, there are some infrequent deviations....

Hair Follicles and Sweat Ducts

Hair Ostium

Possible routes of penetration through hair follicles could involve the hair fiber itself, through the outer root sheath of the hair into the viable cells of the follicle, or through the air-filled canal and into the sebaceous gland. In addition, the release of sebum by the sebaceous glands may provide a lipoidal pathway that may influence absorption by this route (228). The route for the sweat duct may involve diffusion through either the lumen or walls to below the epidermis and through the thin ring of kera- There are estimated to be close to 500-1000 pilosebaceous units square centimeter of skin on areas such as the face and scalp, each with an orifice with a diameter of 50-100 m and 4 X 10 5 cm2 surface area. These orifices represent 0.1 of the surface area of the skin in low-density areas and up to 10 in high-density areas, such as those on the face and scalp. The openings lead down to an epithelial surface which does not have a protective SC, and exists only from the ostia of...

Acne A Introduction

Acne vulgaris commonly affects the face, chest, and upper back, and usually presents during puberty. The clinical features include an increased rate of sebum secretion, comedones, papules, and pustules (Fig. 3). Severe acne may be complicated by atrophic or nodular keloid-type scars or by the formation of chronic nodules and cysts (Fig. 4). Patients with acne tend to have a higher sebum excretion rate than others, and there is a degree of correlation between the sebum secretion rate and the severity of the acne (11,12). Circulating androgens stimulate the sebaceous glands with resulting hypertrophy and increased sebum secretion. Furthermore, there is abnormal keratin- ization of the epithelium lining the hair follicle, which may lead to obstruction of the follicle with resulting comedone (blackhead) formation. Propionibacterium acnes, a gram-positive commensal bacterium, proliferates within the obstructed hair follicle, and may break down the lipid esters of sebum to liberate...

Seborrheic Dermatitis Dandruff

Dandruff and seborrheic dermatitis are often mentioned together. Dandruff is the mildest manifestation of seborrheic dermatitis and it cannot be separated from seborrheic dermatitis. Therefore, what is mentioned in the literature for seborrheic dermatitis is also true for dandruff and vice versa. Seborrheic dermatitis is characterized by inflammation and desquamation in areas with a rich supply of sebaceous glands, namely, the scalp, face, and upper trunk (1). It is a common disease and the prevalence ranges from 2 to 5 in different studies. It is more common in males than in females. The disease usually starts during puberty and is more common around 40 years of age. Seborrheic dermatitis is characterized by red scaly lesions predominantly located on the scalp, face, and upper trunk. The skin lesions are distributed on the scalp, eyebrows, nasolabial folds, cheeks, ears, pre-sternal and interscapular regions, axillae, and groin. Around 90 to 95 of all patients have scalp lesions and...

Peeling Technique

2 Before applying glycolic acid the skin is cleaned with alcohol to reduce the acid neutralized by oily skin. Glycolic acid is applied in any cosmetic unit order, rapidly covering the entire face within about 20 s with a large cotton applicator. A starting application time for weekly or monthly applications with 50 or 70 unbuffered glycolic acid is generally in the range of 3 min, and the time is increased with subsequent peels. Neutralizers with sodium bicarbonate marketed to the physician have no advantage over water rinsing as long as all acid is removed thoroughly from all rhytidis and cosmetic units.

Treatment of Acne

The aims of treatment are to reduce the bacterial population of the hair follicles to encourage the shedding of comedones to reduce the rate of sebum production and to reduce the degree of inflammation. Topical therapy is appropriate for mild-to-moderate acne, but more severe forms of acne, in which there is a risk of scarring, will require systemic therapy. Skin cleansers such as Phisomed or Hibiscrub are of some value. Benzoyl peroxide reduces comedone formation, as well as reducing the population of P. acnes, and may also have an anti-inflammatory effect. Benzoyl peroxide cream may be applied twice daily at an initial concentration of 2.5 and increased to 5 or 10 as tolerated. Benzoyl peroxide can have an irritant effect and may also bleach both hair and clothing.

Distichiasis

Distichiasis

Distichiasis is a congenital or acquired condition in which there is an accessory row of eyelash cilia behind the normal row. The disorder may be familial with an autosomal dominant pattern of inheritance, but may also follow severe inflammatory or traumatic injury. It is believed that these abnormal lashes develop as a result of metadifferentiation of primary epithelial germ cells originally intent upon meibomian gland development. The meibomian glands are modified sebaceous glands that are not associated with the eyelashes or other hairs. In the skin sebaceous glands are usually associated with a hair follicle and an apocrine sweat gland to form a pilosebaceous unit. Under some circumstances it is believed that the meibomian gland can undergo differentiation into a primitive pilosebaceous unit producing an abnormal distichitic eyelash.

Erythromycin base

Special Concerns Use of other drugs for acne may result in a cumulative irritant effect. Additional Side Effects When used topically Erythema, desquamation, burning sensation, eye irritation, tenderness, dryness, pruritus, oily skin, generalized urticaria. Drug Interactions Antagonism has been observed when topical eryth-romycin is used with clindamycin. How Supplied Enteric coated capsule 250 mg Enteric coated tablet 250 mg, 333 mg, 500 mg Gel Jelly 2 Ointment 2 Ophthalmic ointment 5 mg g Pad 2 Solution 1.5 , 2 Swab 2 Tablet 250 mg, 500 mg Tablet, Coated particles 333 mg, 500 mg

Pathophysiology

The pilosebaceous follicles are the target sites for acne. The pathophysiology of acne centers on interplay of follicular hyperkeratinization, increased sebum production, action of Propionibacterium acnes (P. acnes) within the follicle, and production of inflammation (Table 11.1). Sebum has a central role in the pathogenesis of acne it provides a medium for the proliferation of P. acnes. Patients with acne also have seborrhea, a correlation existing between the amount of sebum produced and the severity of acne. In both sexes there is a gradual increase in sebum excretion from puberty, reaching a pick at about the age of 16-20 years. Sebaceous gland activity is under endocrine control and the main stimulus to the sebaceous glands is represented by androgens of both gonadal and adrenal origin. Testosterone and dihydrotestos-terone are the two most potent androgens in stimulating sebum production. The leakage into the dermis of pro-inflammatory cytokines such as IL-1 and TNF-pro-duced by...

Clinical Patterns

Total disintegration of a comedo with far-reaching consequences. The dissolution of the adjacent pilosebaceous units propagate the inflammatory reaction and the abscess can reach the subcutaneous tissue (Fig. 11.5) sinus formation between nodules may also occur, with devastating cosmetic effects. The cysts are large, skin-colored, rubbery nodules, 5-20 mm in diameter, occurring mainly on the back and less frequently on the cheeks, especially in the case of acne conglobata (Figs. 11.6,11.7 and 11.8). Histo-logically they are not true cysts as they are not lined by an epithelium. In fact, the cysts in acne are a result of repeated ruptures and re-encapsulations, and may be best defined as secondary comedones. Pressure releases a cheesy, crumbly material (corneocytes, hairs, bacteria and sebum).

Epidermoid Cyst

Pilar Epidermoid Cyst

INTRODUCTION The epidermoid cyst is also referred to as infundibular cyst, epidermal inclusion cyst, keratinous cyst, or frequently and erroneously sebaceous cyst. The sebaceous cyst is similar clinically but arises from obstruction in the hair follicle and is referred to as a pilar or trichilemmal cyst. The epidermoid cyst is a very common skin lesion that arises from traumatic entrapment of surface epithelium or from aberrant healing of the infundibular epithelium of the hair follicle following episodes of follicular inflammation. They can also be seen following any injury to the skin, including surgery. When congenital, they likely arise from sequestration of epidermal rests along embryonic fusion planes. Epidermoid cysts are not of sebaceous origin, but rather produce normal keratin rather than sebum. These cysts may present anytime from adolescence through adulthood, but commonly in the third and fourth decades.

Telogen Effluvium

Loose Anagen

Figure 12 Marginal hair loss with preservation of the marginal fringe in an African-American woman (A) and Latina woman (B) with permanent traction alopecia. (C) Scalp biopsy from the patient in (B) demonstrates preservation of sebaceous glands. However, several follicular units contain no follicles (thin arrows) or one to two follicles, often vellus follicles (thick arrow). Figure 12 Marginal hair loss with preservation of the marginal fringe in an African-American woman (A) and Latina woman (B) with permanent traction alopecia. (C) Scalp biopsy from the patient in (B) demonstrates preservation of sebaceous glands. However, several follicular units contain no follicles (thin arrows) or one to two follicles, often vellus follicles (thick arrow). Figure 18 (A) Low power view of a scalp biopsy from a patient with follicular degeneration syndrome (FDS). Almost all follicles have been replaced by fibrosis. Two remaining follicles demonstrate absence of inner root sheaths in their inferior...

Laser Resurfacing

When evaluating a patient who is considering laser skin resurfacing, several factors need to be evaluated regardless of the type of laser being used. The patient's skin type, skin thickness, degree of oil content, and the area to be resurfaced are among the most important variables to be considered. Thinner, drier skin in the lower eyelid region of an elderly patient will generally require fewer passes as compared with the thicker, oily skin in the forehead region of a younger patient. Laser treatment should therefore be individualized and the pulse energy selected appropriately. A higher pulse energy will produce more complete ablation and vaporization of the tissue, whereas a lower pulse energy will result in less tissue vaporization. However, lower energies also elicit increased dermal damage secondary to increased conductive thermal injury. For this reason, higher pulse energies are preferred, as greater precision is obtained with fewer passes. Although some physicians prefer to...

Blepharitis

Seborrheic Blepharitis Pictures

INTRODUCTION Blepharitis is a general term referring to eyelid margin inflammation. The two most prevalent factors appear to be a dysfunction of the sebaceous glands (meibomian glands), and colonization by pathogenic staphylococci. Additional common features include a diminished or abnormal tear production, chronic conjunctivitis, and structural changes in the lid margin due to chronic inflammation. Several organisms have at times been implicated in the etiology of blepharitis, including Moraxalla, Demodex folliculorum, and Malassezia furfur (Pityrosporum ovale), however, it now appears the most likely organism is Staphylococcus. Once the bacteria colonize the lid margin and meibomian glands they are virtually impossible to eradicate. Through their production of aggravating exotoxins and enzymes that convert lipids to fee fatty acids, they are responsible for many of the ongoing tissue changes and chronic inflammation seen in blepharitis. They remain sequestered deep in the meibomian...

Jessners Solution

Salicylic acid has been formulated in a hydro-ethanolic vehicle at concentrations of 20 and 30 for use as a superficial peeling agent 18 . It is a lipophilic agent that produces desquamation of the upper lipophilic layers of the stratum corneum. Grimes 19 treated 25 patients with skin types V and VI with salicylic acid peels. Conditions treated included acne vulgar-is, post-inflammatory hyperpigmentation, oily skin, with textural changes, and melasma. Patients were pretreated for 2 weeks with hydro-quinone 4 , followed by a series of two 20 and three 30 salicylic acid peels. Peels were performed biweekly. Moderate to significant improvement was observed in 88 of the patients treated. Minimal to mild side effects occurred in 16 . Three patients experienced hy-perpigmentation that resolved in 7-14 days. Thirty-five Korean patients with facial acne were treated biweekly for 12 weeks with 30 salicylic acid peels 20 . Both inflammatory and non-inflammatory lesions were significantly...

Mode of Action

The mode of action of the retinoids has not been completely elucidated, but they have profound effects on differentiation, cell growth, and immune response. Retinoids are capable of regulating epithelial differentiation in the skin, mucous membranes, and mesenchymal tissues. They promote cell proliferation in normal epidermis but inhibit epidermal keratinocytes in psoriatic lesions. Sebaceous glands are significantly reduced in size (up to 90 ), and sebum excretion is reduced by isotretinoin. In general, retinoids are reported to stimulate humeral and cellular immunity, although immune-inhibitory effects have also been described. They can boost antibody production, increasing T-helper cells but not natural killer cells. Anti-inflammatory effects include inhibition of motility of neutrophils and eosinophils and their migration into the dermis. Isotretinoin seems to inhibit nitric oxide and tumor necrosis factor a production by keratinocytes and to reduce inducible nitric oxide synthase...

Bioavailability

This apparent greater efficacy of pour-on formulations against external parasites is presumably the result of deposition of the active compound on, and in, the skin. The high lipophilicity of the macrocy-clic lactones is likely to result in the formation of depots of active ingredient in skin lipids and oil and fat secretions. This characteristic has been exploited in topical formulations of ivermectin that provide long-term residual control of blowfly and lice on sheep (Eagleson et al., 1993a, 1993b Thompson et al., 1994), and selamectin which controls fleas on dogs and cats for at least 1 month (Benchaoui et al., 2000). Even greatly exaggerated oral or injectable doses of macrocyclic lactones are considered unlikely to provide residual control of fleas (Zakson-Aiken et al., 2001). In sheep, topically applied ivermectin is thought to bind to skin lipids and secretions and may be passively distributed around the sheep's body in this medium following application to a discrete site...

Skin and Hair

The dermis is made up of connective tissue and contains structures such as hair follicles, sweat glands, sebaceous glands (which produce an oily substance called sebum), blood vessels, lymph vessels (which carry lymph into and out of the lymph glands), and nerves. Your skin also has some other important roles, including sensation such as touch, temperature, and pain and regulation of body temperature through perspiration and dilation (widening) and constriction (narrowing) of blood vessels.

Eyelids Palpebrae

Eyelids are skin folds, which can be actively moved. They consist of a tough connective tissue skeleton H (tarsus superior and tarsus inferior). Toward the outside, it is covered by the musculus orbicularis oculi (pars palpebralis) 2. The surface covering of the eyelid is a multilayered keratinizing squamous epithelium with only a few velum hairs. The outer lid is about 2 mm wide and consists of a dull anterior 4 and a sharp-edged posterior palpebral limb O. This tissue continues in the multilayered nonkeratinizing squamous epithelium of the palpebral part of the conjunctiva (conjunctiva tarsi) 0 .A multi-layered columnar epithelium with goblet cells is only found beyond the level of the fornix of the conjunctiva. Long cilia (eyelashes) C3 protrude from the anterior rim of the lid. They are rooted in the lid plate (see Fig. 626). The sebaceous glands (Zeis glands), apocrine scent glands and the sweat glands of the cilia (Mollglands) end in the hair follicle of the eyelashes. The right...

Sebaceous Adenoma

Sebaceous Adenoma

INTRODUCTION Cutaneous adnexal neoplasms showing sebaceous differentiation are difficult to classify. Because of the intimate relationship of sebaceous glands with other adnexal structures associated with the pilosebaceous unit these lesions often display complex histologic features combining sebaceous, hair follicle, and sweat gland tissues. Sebaceous neoplasms run the gamut from benign to malignant lesions. These include sebaceous gland proliferation (sebaceous hyperplasia), congenital sebaceous hamartomas (nevus sebaceum), sebaceous adenoma, and sebaceous carcinoma. Sebaceous adenoma is an uncommon, often solitary lesion usually seen in patients over 40 years of age, with a predilection for the eyelid and brow, occurring in elderly patients.

Rosacea

Papulopustular Rosacea

INTRODUCTION Rosacea is a common chronic condition of unknown etiology characterized by facial flushing, inflammatory papules and pustules, erythema, and telangiectasia. The onset is usually between ages 25 to 50 years, but has been reported in all age groups including children as young as two years. There is a 2 1 predilection for males. The clinical findings result from inflammation of the skin, capillary proliferation, and collagen deposition. Recent studies have shown an increase in the presence of a prostaglandin-like substance and an increase in free fatty acids in the sebaceous glands. Symptoms tend to be worsened by heat, hot or spicy foods, and alcohol. Symptoms may be caused by or worsened by potent topical steroids. CLINICAL PRESENTATION Skin lesions consisting of variable combinations of patchy erythema, telangiectasia, small papules, pustules, and hypertrophic sebaceous glands occur on the brow, eyelids, and midface. Heat, sunlight and possibly gastrointestinal stimuli...

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