Acne

Question 1

Which type of skin condition sees someones face become flushed or red?

Answer 1

Rosacea

Question 2

Does smoking have an impact on acneiform eruptions?

Answer 2

No, there is no link

Question 3

Does diet impact skin health?

Answer 3

There is little evidence to support this

Question 4

What information must be elicited from an acne history?

Answer 4

• Age of onset and problem duration
• Exacerbating factors - e.g. menstruating, anabolic steroids etc)
• Prior and current Tx
• Other health issues (PCOS)
• Other medications
• Effects skin has on other aspects of life

Question 5

What is the most common type of acne?

Answer 5

Acne Vulgaris

Question 6

Where are the common areas where acne vulgaris affects the skin?

Answer 6

Comedogenic areas of the;

1. Face
2. Back
3. Chest

Question 7

Which gender is more likely to develop acne vulgaris?

Answer 7

Males

Question 8

When is the peak incidence of acne vulgaris in males?

Answer 8

Between 18 and 19

Question 9

When is the peak age of acne vulgaris in females?

Answer 9

Between 16 and 18

Question 10

What are the common skin features of acne vulgaris?

Answer 10

Inflammatory papules and pustules

Question 11

What is acne keloidalis?

Answer 11

A type of acne scarring

Question 12

What is acne excoriee?

Answer 12

This is a variant of acne that is due to the patients’ persistent picking of the skin that produces disfiguring erosions

Question 13

What is the challenge with acne excoriee?

Answer 13

The acne itself is usually very mild but persistent. The challenge is breaking the patients’ habitual picking/excoriation of the skin.

Question 14

What is infantile acne?

Answer 14

Lesions that occur on the face within the first few months of life.

Question 15

What is acne conglobata?

Answer 15

This is a very severe form of acne seeing extensive nodulocystic acne with abscess formation.

Question 16

Who is most commonly affected by acne conglobata?

Answer 16

Males

Those who live in tropical climates

Question 17

Which parts of the body are most affected by acne conglobata?

Answer 17

• trunk
• face
• limbs

Question 18

What is acne fulminans?

Answer 18

Very severe form of acne that is associated with systemic features of malaise, fever and joint pains. This also produces nodulocystic acne and abscess formation.

Question 19

What is the name of the tool that we use to assess the psycho-social effects of acne on an individual?

Answer 19

The Assessment of the Psychological and Social Effects of Acne (APSEA)

Question 20

When is the use of oral retinoids indicated in someone with acne vulgaris?

Answer 20

• Moderate acne, unresponsive to conventional therapy or had a relapse after tried conventional therapy
• Sever acne
• Acne scarring
• Psychological effects from acne and scarring
• Unusual acne form

Question 21

What is the basic physiology of acne vulgaris?

Answer 21

It is the blockage and inflammation of the pilosebaceous unit

Question 22

People with mild-moderate acne should be offered a 12-week course of first line treatment. What are the 3 first line treatment options?

Answer 22

1. A fixed combination of topical adapalene with topical benzoyl peroxide (0.1% or 0.3% adapalene with 2.5% benzoyl peroxide).
2. A fixed combination of topical tretinoin with topical clindamycin (0.025% tretinoin with 1% clindamycin).
3. A fixed combination of topical benzoyl peroxide with topical clindamycin (3% or 5% benzoyl peroxide with 1% clindamycin).

Question 23

People with moderate-severe acne should be offered a 12-week course of first line treatment. What are the 4 first line treatment options?

Answer 23

1. A fixed combination of topical adapalene with topical benzoyl peroxide.
2. A fixed combination of topical tretinoin with topical clindamycin.
3. A fixed combination of topical adapalene with topical benzoyl peroxide, together with either oral lymecycline 408 mg or oral doxycycline 100 mg once daily.
4. Topical azelaic acid (15% or 20%) applied twice daily, with either oral lymecycline 408 mg or oral doxycycline 100 mg once daily.

Question 24

What are the features of mild acne vulgaris?

Answer 24

Predominantly non-inflamed lesions (open and closed comedones) with few inflammatory lesions

Question 25

What are the features of moderate acne?

Answer 25

More widespread with an increased number of inflammatory papules and pustules

Question 26

What are the features of severe acne?

Answer 26

Widespread inflammatory papules, pustules and nodules or cysts. Scarring may be present.