The nurse is providing education to a client about the role of hormones in acne development. Which statement by the client indicates a need for further teaching?

Explanation: The clinical manifestation described in option c (erythematous, raised plaques with silver scales) is not commonly seen in acne vulgaris. This description is characteristic of psoriasis, a chronic autoimmune skin condition. Acne vulgaris is characterized by the presence of comedones (blackheads and whiteheads), papules, pustules, nodules, and cysts on the skin, primarily affecting the face, neck, chest, and back.

Incorrect choices: a. Comedones (blackheads and whiteheads) - This choice is incorrect. Comedones are a hallmark clinical feature of acne vulgaris, and they occur when hair follicles become clogged with sebum and dead skin cells.

b. Papules and pustules - This choice is incorrect. Papules are small, red, inflamed bumps, while pustules are pus-filled lesions. Both are common manifestations of acne vulgaris.

d. Nodules and cysts - This choice is incorrect. Nodules and cysts are severe forms of acne vulgaris, characterized by larger, painful, and deeper lesions beneath the skin's surface. They are more likely to cause scarring and require medical intervention.

Explanation: The primary pathogenesis of acne vulgaris involves increased keratinization (abnormal skin cell turnover) and follicular plugging. Excess sebum production, along with dead skin cells and bacteria, can lead to the formation of comedones, which are a hallmark of acne vulgaris.

Incorrect choices: a. Excessive skin hydration - Excessive skin hydration is not the primary pathogenesis of acne vulgaris. In fact, excessive oil production contributes to the development of acne lesions.

c. Overproduction of melanin - Overproduction of melanin is not the primary cause of acne vulgaris. Melanin is responsible for skin pigmentation, but it does not directly contribute to acne formation.

d. Allergic reaction to environmental allergens - Acne vulgaris is not primarily caused by an allergic reaction to environmental allergens. While allergens can exacerbate skin conditions, they are not the underlying cause of acne vulgaris.