2.22 - Pharmacology for Acne and Rosea

Question 1

4 drug treatment targets for Acne Vulgaris

Answer 1

Follicular hyperproliferation and abnormal desquamation
- Topical and oral retinoids, benzoyl peroxide, and azeliac acid

Increased sebum production
- Oral contraceptives and isotretinoin

Proprionibacterium acnes proliferation
- Antibiotics (tetracycline), benzoyl peroxide, and azelaic acid

Inflammation
- Antibiotics

Question 2

First choice for Mild Acne (Comedonal)

Answer 2

Topical retinoid

Question 3

First Choice for Severe Acne (Nodular/conglobate)

Answer 3

Oral Isotretinoin

Question 4

Maintenance Therapy for Mild Acne

Answer 4

Topical Retinoid

Question 5

Maintenance Therapy for Moderate to Severe Acne

Answer 5

Topical Retinoid +/- BPO (benzoyl peroxide)

Question 6

Alternative Acne Tx for females (some alternatives are teratogenic)

Answer 6

Use OCPs because retinoid (vitamin A derivative) is teratogenic (Category X)

Question 7

How to prevent teratogenicity of isotretinoin

- Note: Tazarotene is another vitamin A derivative

Answer 7

iPLEDGE Program (High-level REMS)

Question 8

Drug used for Acne Rosacea + Treatment strategy

Answer 8

• Metronidazole (one of the drugs of choice)
• Strategy: Avoid triggers such as sun exposure, emotional stress, wind, etc. Consider isotretinoin if antibiotics are unsuccessful.

Question 9

Adverse effects (2) of Benzoyl Peroxide

Answer 9

Skin Irritation and bleaching of hair and clothes, etc.