80 - Acne Variants and Acneiform Eruptions Flashcards
Neonatal acne can occur in up to _____% of healthy newborns
20
Neonatal acne lesions usually appear around _____ of age and resolved spontaneously within _____
2 weeks
3 months
_____, a normal commensal on human skin, may also play a role in neonatal acne
Malassezia sympodialis
Similar to neonatal acne but with widespread papulopustular lesions over face, scalp, upper chest and back, and shoulders
Neonatal cephalic pustulosis
Infantile acne presents at _____ of age classically with open and closed comedones over the cheeks and chin
3 to 6 months
Infantile acne is caused in part by the transient elevation of _____ produced by the immature adrenal gland
Dehyroepiandrosterone (DHEA)
During the first 6 to 12 months of life, boys may also have an increased level of _____ that stimulates testosterone production
Luteinizing hormone
Infantile acne usually resolves around _____ of age
1 to 2 years
Mid-childhood acne is defined as appearing between _____ of age
1 and 7 years
Severe form of nodular acne
Most common in teenage males
Acne conglobata
Also known as acute febrile ulcerative acne
Acne fulminans
Sudden appearance of inflammatory, tender oozing, friable plaques with hemorrhagic crusts
Occur primarily in teenage boys
Acne fulminans
(Acne conglobata/Acne fulminans):
More explosive
Nodules and polymorphous comedones are less common
Face is not involved as frequently
Neck is usually spared
Ulcerative and crusted lesions are unique
Systemic symptoms are more common
Acne fulminans
First-line treatment for acne fulminans
Systemic glucocorticoid therapy, along with intralesional glucocorticoids
Has been reportedly beneficial in the treatment acne fulminans associated with erythema nodosum
Dapsone in conjunction with isotretinoin
Isotretinoin-induced acne fulminans typically arises within _____ of treatment
The first month
SAPHO syndrome
Synovitis Acne Pustulosis Hyperostosis Osteitis
PAPA syndrome
Pyogenic arthritis
Pyoderma gangrenosum
Acne
PASH syndrome
Pyoderma gangrenosum
Acne
Hidradenitis suppurativa
PAPASH syndrome
Pyogenic arthritis
Acne
Pyoderma gangrenosum
Hidradenitis suppurativa
PAPA, PASH and PAPASH are a group os systemic autoinflammatory disorders resulting from dysregulation of the innate immune system and over production of
Interleukin-1
Variant of skin-picking disorder
Quite mild acne is systematically and neurotically excoriated, leaving crusted erosions that may scar
More common in females
Categorized under obsessive-compulsive disorders
Acne excoriee
Type of reactions from repetitive physical trauma to the skin: flare in acne with comedones and inflammatory papules
Acne mechanica
Type of reactions from repetitive physical trauma to the skin: follicular inflammatory lesions
Folliculitis mechanica
Rare and disfiguring variant of acne vulgaris
Woody edema of the mid third face with accompanying erythema and acne
Acne with solid facial edema or
Morbihan disease
_____ treatment in acne with solid facial edema is typically ineffective
Oral antibiotic
PCOS occurs in roughly _____% of women
5 to 10
PCOS should be suspected in women with any combination of
Oligomenorrhea
Clinical or biochemical hyperandrogenism
Polycystic ovaries on ultrasound scan
Premenarchal women with acne and hirsutism should be screened for PCOS with
Serum free testosterone level
Testing for PCOS should be deferred until _____ after menarche
2 years
Women with PCOS are at increased risk of
Infertility Impaired glucose tolerance Type 2 diabetes Dyslipidemia Endometrial cancer Cardiovascular disease
Combined _____ can be helpful in controlling acne and hirsutism
Oral contraceptives
Spironolactone
Autosomal recessive disorder caused by varying enzyme defects in the cortisol production pathway
Congenital adrenal hyperplasia
21beta-hydroxylase deficiency type:
Screened at birth
Typically present with ambiguous genitalia and salt wasting
Classic type
21beta-hydroxylase deficiency type:
Can present throughout childhood and adolescence
Normal cortisol levels but increased androgens
Nonclassic type
Values of _____ in the range of 4000 to 8000 ng/mL are suggestive of CAH
Dehydroepiandrosterone
Findings of _____ in males are often subtle and acne may be the only sign
CAH
As early as _____ after initiation of systemic glucocorticoids or corticotropin, folliculitis may appear
2 weeks
Drug-induced acne can be caused by
Phenytoin Lithium Isoniazid High doses of vitamin B complexes Halogenated compounds Certain chemotherapy medications
Halogenated compounds containing either bromides or iodides are often found in
Cold and asthma remedies Sedatives Radiopaque contrast material Kelp Other vitamin and mineral combinations
May cause a follicular-based eruption
Primarily used to treat non-small-cell lung cancer, colorectal cancer and breast cancer
Epidermal growth factor receptor inhibitors
The presence and severity of the acneiform eruption correlates with a (positive/negative) treatment response to EGFR inhibitors
Positive
Occupational acne caused from chlorinated hydrocarbons
Chloracne
The lesions of occupational acne are more common on
Covered areas with intimate contact to clothing saturated with the offending compound
Most common cause of industrial acne
Cutting oils
Exposure to the dioxin Agent Orange predisposes to
Invasive nonmelanoma skin cancer
Chlorinated hydrocarbons are found in
Fungicides
Insecticides
Wood preservatives
Chloracne classically affects the
Malar Retroauricular Mandibular Axillae Scrotum
May occur in patients with preexisting acne vulgaris treated with long-term oral antibiotics, especially the tetracylines
Initial success with oral tetracyclines followed by a worsening of their acne
Gram-negative folliculitis
Culture of gram-negative folliculitis lesions may reveal _____ in the papulopusutles or _____ in the nodules
Enterobacter, Klebsiella, or Escherichia spp.
Proteus spp.
Radiation acne begin to appear
As the acute phase of radiation dermatitis is resolving
Excessive exposure to UV radiation may produce a yellow, atrophic plaque studded with large open comedones
Favre-Racouchot syndrome
Favre-Racouchot syndrome has also been called
Solar comedones
Senile comedones
Nodular cutaneous elastosis with cysts and comedones
Nodular elastoidosis with cysts and comedones
In extreme heat, a severe acneiform folliculitis may develop
Major cause of dermatologic disability in military troops serving in tropical climates
Occurs mainly on the trunk and buttocks
Many deep, large, inflammatory nodules with multiple draining areas, resembling acne conglobata
Tropical acne
Secondary infection with _____ almost always ensues in tropical cane
Coagulase-positive staphylococci
Multiple, uniform, red, papular lesions seen after sun exposure
Acne aestivalis or
Mallorca acne
Acne aestivalis is caused by the effects of UV radiation, primarily
UVA
_____ are ineffective in speeding up the resolution of acne aestivalis
Oral antibiotics
Preadolescent patients develop comedones, milia, and acneiform red papules within the nasal crease
Can be familial or associated with the “allergic salute”
Pseudoacne of the nasal crease
Also known as acrocephalosyndactyly
Autosomal dominant disorder marked by the synostoses of the cranium, vertebral bodies and hands and feet
Caused by mutation in the gene encoding FGFR-2
Diffuse acneiform eruption that often involves the arms, buttocks and thighs
Apert syndrome
Small inflammatory papules and pustules group around the mouth in a typically well demarcated patter, with sparing of the lip margin
Perioral dermatitis
Small inflammatory papules and pustules group around the mouth in a typically well demarcated patter, with sparing of the lip margin
With involvement of the nose, eyes, or groin region
Periorificial dermatitis
Severe variant of periorificial dermatitis
Well delineated plaque around the mouth with more likely involvement of the periocular, perinasal, and groin areas
Periorificial granulomatous dermatitis
Variant of periorificial dermatitis characterized by uniform, granulomatous sarcoidal papules distributed over the typical periorificial areas
Involvement of the upper eyelids and helices of the ears
Facial Afro-Caribbean eruption (FACE)
