11 - Derm - Acne - Mgmt of Acne Flashcards
1st 2nd and 3rd line?
1 - topical
2 - systemic treatment
3 - systemic retinoids
1st line - for what acne? 3 types?
in mild mod acne
top retinoids/antibacterials/antibiotics
topical retinoids - eg? mechanism? 4 SE?
isotretinoin
comedolytic
erythema, irritation, photosensitivity, teratogenic
topical antibacterials - do 2 things? eg? may cause what SE? how to get?
antibact + anti- inflam
benzoyl peroxide BPO
dryness, irritation
available otc
topical ABs - 2 eg? what is a problem? how to limit?
clindamycin, erythromycin
resistance - use for less than 6m
BPO combined reduces resistance
2 nd line - what acne? (3 things) a principle of this treatment line? 2 treatments?
in mod/sev - top treatment failure, scarring, back/chest involvement
combine and maintain remission with topical agents
systemic antibiotics and hormonal treatments
hormonal tx - esp when? caution if? eg?
OCP
esp if menstrual cycle related
caution if FHx/venous thrombosis risk
systemic ABs - dont do what? why? continue for how long?
dont mix ABs, to avoid resistance
6 weeks to assess effectiveness
systemic ABs - 3 lines? 1st line contraindications?
1 - clycines - doxy - CI - preg, breast feeding, children <12
2 - erythromycin
3 - trimethoprim
syst retinoids - mechanism? when used?
reduces seb gland size, sebum prod, and comedogenesis
used in tx res acne, nodulocystic, scarring, psych problems
syst retinoids SE
dry skin, dry eyes, dry mucosa, epistaxis
lipid and LFT disturbance
arthralgia, myalgia, depression
syst retinoids - length? relapse rate? teratogenic.. so what monitoring etc?
for 4-6 months
20-30% relapse
OCP req for 1 month either side and monthly preg tests
