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ACNE

Acne is a self-limited disorder primarily of teenagers and young adults, although perhaps 10 to 20% of adults may continue to experience some form of the disorder. The responsible cause
for the development of the disease in adolescence is the increase in sebum production by sebaceous glands after puberty. Small cysts, called comedones, form in hair follicles due to blockage of the follicular
openings by retention of sebum and keratinous material.
The activity of bacteria within the comedones releases free fatty acids from sebum, causes inflammation within the cyst, and leads to rupture of the cyst wall. An inflammatory foreign-body reaction develops as a result of extrusion of oily and keratinous debris
from the cyst.
The clinical hallmark of acne is the comedone, which maybe closed (whitehead) or open (blackhead). Closed comedones appear 1- to 2-mm pebbly white papules, which are accentuated when the skin is stretched. They are the precursors of inflammatory lesions of acne. The contents of closed comedones are not easily come out. Open comedones, which rarely result in inflammatory acne lesions, have a large dilated follicular opening and are filled with easily expressible debris. Comedones are usually accompanied by inflammatory lesions: papules, pustules, or nodules.
The earliest lesions seen in early adolescence are generally mildly inflamed or noninflammatory comedones on the forehead. Subsequently, more typical inflammatory lesions develop on the cheeks, nose, and chin. The most common location for acne is the face, but involvement of the chest and back is not uncommon. Most disease remains mild and does not lead to scarring. However, a small number of patients develop large inflammatory cysts and nodules, which may drain and result in significant scarring.

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TUBERCULOSIS

Tuberculosis is one of the oldest diseases known to affect humans and it is caused by bacteria belonging to the Mycobacterium tuberculosis. The disease usually affects the lungs, although in up
to sixty percent of cases other organs are involved. If properly treated, tuberculosis caused by drug-susceptible strains is curable in virtually all cases. If untreated, the disease may be fatal within five years in more than half of cases. Transmission usually takes place through the airborne spread of droplet nuclei produced by patients with infectious pulmonary tuberculosis.
Mycobacterium belongs to the family Mycobacteriaceae and the order Actinomycetales. Of the pathogenic species belonging to the M. tuberculosis complex, the most frequent and important agent
of human disease is M. tuberculosis. The complex includes M. bovis (the bovine tubercle bacillus, once an important cause of tuberculosis transmitted by unpasteurized milk and currently the cause of a small percentage of cases in developing countries), M. africanum (isolated from cases in West, Central, and East Africa), M. microti (the “vole”bacillus, a less virulent and rarely encountered organism), and M. canettii
(A very rare isolate in African cases).
M. tuberculosis is a rod-shaped, non-spore-forming, thin aerobic bacterium measuring 0.5 micrometer by 3 micrometer. Mycobacteria, including M.tuberculosis, are often neutral on Gram’s staining. However, once stained, the bacilli cannot be decolorized by acid alcohol, a characteristic justifying their classification as acid-fast bacilli. Acid fastness is due mainly to the organisms’ high content of mycolic acids, long-chain cross-linked fatty acids, and other cell-wall
Lipids