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FITZPATRICK'S DERMATOLOGY 9TH EDITION (SHAMMY) > 31 - 207 - COSMECEUTICALS AND SKIN CARE > Flashcards

31 - 207 - COSMECEUTICALS AND SKIN CARE Flashcards

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1
Q

SC skin barrier is composed of a bilayer lipid membrane formed from what 3 primary groups of compounds?
What is the ratio?

A

(1) ceramides,
(2) fatty acids, and
(3) cholesterol

(1:1:1)

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2
Q

When assessing the face for the presence of sebum, it is important to wait ____ minutes after the patient washes because that is how long it takes the sebaceous glands to generate enough sebum to be visualized and accurately measured on the skin’s surface

A

20 minutes

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3
Q

The following are true regarding the bilayer lipid membrane skin barrier, except:

A. The SC skin barrier is composed of a bilayer lipid membrane formed from 3 primary groups of compounds

B. These 3 groups are: ceramides, hyaluronic acid and cholesterol

C. The ratio of the 3 groups is 1:1:1

D. None of the above

A

B

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4
Q

Good choices of fatty acids for gentle cleansers include the following except:

A. Stearic acid

B. Linoleic acid

C. Oleic acid

D. None of the above

A

C

Stearic acid (Shea butter) - better barrier repair

Linoleic Acid (safflower oil, argan oil) - has antiinflammatory property

AVOID Oleic acid (olive oil) - can cause membrane disruption

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5
Q

Which of the following is true?

A. Occlusive are substances added to immediately soften and smooth the skin.

B. Emollients, such as naturally occurring sebum and exogenously applied ingredients, often contain lipids and coat the surface of the skin

C. Humectants are ingredients with high water

absorption capabilities that are able to attract water from the atmosphere.

D. The choice of cleanser does not influence the need for a moisturizer.

A

C

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6
Q

At this time, the only cosmeceutical ingredients that have demonstrated a role in regulating AQP3 are

A

Ajuga turkestanica and glycerin

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7
Q

Ingredients with barrier repair properties

A

■ Ceramides

■ Cholesterol

■ Fatty acids

■ MLE technology

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8
Q

Ingredients with Occlusive properties

A
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9
Q

Ingredients with humectant properties

A

■ Glycerin

■ α-Hydroxy acids

■ Heparan sulfate

■ Hyaluronic acid

■ Propylene glycol

■ Sugars

■ Urea

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10
Q

This ingredient has both occlusive and humectant property

A

Propylene Glycol

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11
Q

This acid should be avoided because it can cause membrane disruption because its fatty acid hydrophobic tails project at an angle that disrupts the bilayer membrane’s natural structure

A

Oleic acid (found in olive oil)

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12
Q

substances added to immediately soften and smooth the skin

A

Emollients

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13
Q

They function by filling the spaces between desquamating corneocytes to create a smooth surface, which makes the skin reflect light better and impart immediate visible improvement

A

Emollients

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14
Q

Ingredients with the highest occlusive properties

A

petrolatum and oils

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15
Q

These agents are only effective while present on the skin; once removed, the TEWL returns to the previous level

A

Occlusive

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16
Q

ingredients with high water absorption capabilities that are able to attract water from the atmosphere

A

Humectant

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17
Q

Humectants are most effective when the atmospheric humidity is greater than how many percent?

A

> 80%

Although humectants may draw water from the environment to help hydrate the skin, in low-humidity conditions they may absorb water from the deeper epidermis and dermis, leading to increased skin dryness.

For this reason, they are more effective when combined with occlusives

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18
Q

the barrier repair properties of __________ and its ability to traverse AQP3 channels give it longerlasting effects than other humectants.

A

glycerin (also known as glycerol and glycerine)

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19
Q

What medications have been shown to decrease sebum secretion

A

oral ketoconazole,
oral spironolactone,
oral contraceptives,
oral retinoids,
injected botulinum toxin type A

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20
Q

defined as skin that rarely exhibits signs of sensitivity, which include acne lesions, redness, itching, flushing, stinging, and urticaria

A

Resistant skin

Sensitive skin, on the other hand, is characterized by frequent incidence of these characteristics of inflammation.

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21
Q

4 types of sensitive skin

A

(1) acne type (prone to developing acne lesions such as papules, pustules, comedones, and cysts);

(2) rosacea type (featuring a tendency toward recurrent flushing, facial redness, and experiencing hot sensations);

(3) stinging type (predilection to stinging or burning sensations); and

(4) allergic type (more likely to exhibit erythema, pruritus, and skin flaking on contact with allergens and irritants).

22
Q

Skin-care regimens for acne take how many months to yield results?

A

8 - 12 weeks

23
Q

Nonprescription Acne Treatments

A
24
Q

Nonprescription acne treatments that Decrease P. acnes

A

Benzoyl peroxide

Silver

Blue light (415 nm)

Antimicrobials

25
Q
A
26
Q

Burning, stinging, or itching caused by application of a cosmetic or topical medicament without detectable visible or microscopic change is termed

A

Sensory irritation

27
Q

A “holiday” from tyrosinase inhibitors every _____ months to prevent tachyphylaxis

A. 2-3

B. 2-4

C. 3-4

D. 3-6

A

D

Many authors recommend a “holiday” from tyrosinase inhibitors every 3 to 6 months to prevent tachyphylaxis although the need for this is anecdotal

28
Q

Melasma patients should be counseled that changes in these measurements and in photos are not usually seen until ______ weeks to prevent discouragement

A. 4

B. 8

C. 12

D. 16

A

C

29
Q

ingredients with comedogenic property

A
  • isopropyl myristate
  • isopropyl palmitate
  • coconut oil
30
Q

Examples of Tyrosinase inhibitors

A

vitamin C, hydroquinone, kojic acid, arbutin, mulberry extract, and licorice extract

31
Q

This tyrosinase inhibitor has a different structure than the others so it can be used during the holiday period

A

Ascorbic acid

32
Q

most effective tyrosinase inhibitor

A

Hydroquinone

but unfounded public concerns about hydroquinone safety 67 have popularized the use of similar derivatives such as kojic acid and arbutin

33
Q

Examples of PAR-2 blockers

A

Soy and Niacinamide

34
Q

enzyme synthesized by the white-rot tree fungus Phanerochaete chrysosporium that breaks down lignin in decaying trees

A

Lignin Peroxidase

35
Q

Treatment regimen for pigmented skin.

How long does it last?

A

(1) daily broad-spectrum SPF;

(2) twice-daily tyrosinase inhibitor;

(3) nightly retinoid;

(4) a PAR-2 blocking agent in either a sunscreen, serum, or moisturizer; and

3 - 4 months

36
Q

Maintenance regiment for pigmented skin.

How long does it last?

A

The maintenance regimen should not have tyrosinase inhibitors (with the exception of ascorbic acid) but should include

(1) daily broad-spectrum SPF;

(2) an antioxidant such as ascorbic acid;

(3) a PAR-2 blocking agent in either a sunscreen, serum, or moisturizer;

(4) lignin peroxidase; and

(5) an exfoliating cleanser

used for at least 1 month or until pigmentation begins to return, at which time the treatment regimen will be resumed for another 4 months

The back-and-forth cycle will continue until the dyspigmentation clears. This may take 1 to 6 treatment cycles but clearing will occur in almost all cases if the patient is compliant with the regimen and lifestyle advice.

37
Q

The only antiaging technologies that have been proven in vivo to improve skin appearance with long-term use

A

daily sunscreen, hydroxy acids, ascorbic acid, and retinoids

38
Q

Ingredients that have data to substantiate claims of wrinkle prevention

A

sunscreens and retinoids

39
Q

Ingredients that have plausible claims that they prevent skin aging

A

ascorbic acid, through its collagenstimulating and antioxidant properties, and green tea because of its antioxidant and antiinflammatory properties

40
Q

The only ingredients that have convincing peer-reviewed data about their ability to improve wrinkles

A

hydroxy acids, ascorbic acid, and retinoids

41
Q

Ingredients that have qualities that suggest they improve skin aging but need more proof

A

growth factors such as transforming growth factor-β, epidermal-derived growth factor, hyaluronic acid, and heparan sulfate

42
Q

Ingredients that have minimal to no published peer-reviewed scientific data on photoaging

A

stem cells, collagen, products to prevent or reverse glycation, and ingredients that claim to upregulate sirtuin or lengthen telomeres

43
Q

Ingredients with Antioxidant property

A

argan oil, vitamins C and E, ferulic acid, coenzyme Q10 , green tea, phloretin, pycnogenol, resveratrol, silymarin, and idebenone

44
Q

Ideal healthy skin type

A

ORNT or oily, resistant, nonpigmented, and tight

45
Q
A
46
Q

The maintenance regimen for melasma treatment should include the ff. Except:

A. Tyrosinase inhibitors

B. Antioxidant such as ascorbic acid

C. PAR-2 blocking agent

D. Lignin peroxidase

A

A

47
Q

_________ is a tyrosinase inhibitor that has a different structure than the others so it can be used during the holiday period.

A. Vitamin C

B. Hydroquinone

C. Kojic acid

D. Arbutin

A

A

48
Q

Topical skin care for rosacea is primarily geared toward the following except:

A. Vasoconstrictive

B. Antimicrobial

C. Antifungal

D. Antiinflammatory

A

C

49
Q

Skin-care regimens for acne take about ______ weeks to yield results,

A. 4-8

B. 8-12

C. 12-16

D. 16-20

A

B

50
Q

Patients with the rosacea type of sensitive skin do well with soothing antiinflammatory ingredients such as the following except:

A. Coconut oil

B. Chamomile

C. Niacinamide

D. Colloidal oatmeal

A

A

FITZPATRICK'S DERMATOLOGY 9TH EDITION (SHAMMY) (122 decks)

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