The Dynamics of Secondary Comedo Formation

Abstract

Rupture, abscess formation and re-encapsulation is the key sequence which underlies the creation of secondary comedones. Secondary comedones can only arise when rupture is partial, generally not from large papules and certainly not from nodules. Substantial segments of epithelium must survive the inflammatory storm. Because focal ruptures and re-encapsulation may happen once or many times secondary comedones cannot be placed in such neat categories as primary ones; they are exceedingly variable in size and shape. They may look like closed or open comedones; they can be identified with certainty only by histological examination.