Acne

Question 1

Acne vulgaris is a disorder of what?

Answer 1

the pilosebaceous units

Question 2

Acne incidence

1. Male ___ female (adolescence)
2. male ___ female (adult)

Answer 2

1. >

2. <

Question 3

Presentation acne

Non-inflammatory lesions consist of:

Answer 3

(a) Open comedones (blackheads)

b) Closed comedones (whiteheads

Question 4

Presentation acne

Inflammatory lesions

Answer 4

(a) Papules with visible central core of purulent material.
(b) Nodules may become suppurative (cysts) or hemorrhagic.
(c) Recurring rupture & re-epithelialization of cysts leads to epithelial-lined sinus tracks potential scarring.

Question 5

Treatment Guidelines

Comedonal (noninflammatory) acne

Answer 5

(a) Topical retinoid

Question 6

Treatment Guidelines

Mild comedonal + papulopustular acne

Answer 6

(a) Topical antimicrobial (BP alone or BP +/topical antibiotic)
(b) Topical retinoid
OR
(c) Topical antimicrobial (BP)
(d) Topical antibiotic (for patients who cannot tolerate retinoids)

Question 7

Treatment Guidelines

Moderate papulopustular and mixed acne

Answer 7

(a) Topical retinoid
(b) Oral antibiotic
(c) Topical Benzolyl peroxide

Question 8

Treatment Guidelines
Severe acne (nodulocystic acne)

Answer 8

Oral isotretinoin monotherapy

Question 9

Benzoyl peroxide:

1) Antibacterial properties and also comedolytic. Available as gels, lotions, creams, and is usually applied twice daily.
2) Visible improvement typically occurs within ______ weeks, with maximum results evident after 8 to 12 weeks.
3) Antibiotics may promote the appearance of resistant strains of ____ when used alone. Use with benzoyl peroxide.

Answer 9

2) three

3) C. acnes

Question 10

Topical antibiotics:

1) Reduce the numbers of _____ in the sebaceous follicles and suppress inflammation. All topical antibiotics may occasionally cause skin irritation.
2) ________________ — Most common topical antibiotics used for the treatment of acne.
3) Should not be used as monotherapy for acne. Use ____ with antibiotics to decrease the occurrence of bacterial resistance.

Answer 10

1) C. acnes
2) Erythromycin and clindamycin
3) BP

Question 11

Oral Acne Treatment

(a) Indicated for moderate to severe inflammatory acne and forms of inflammatory acne that are resistant to _____ treatment.
(b) Oral antibiotics improve inflammatory acne by inhibiting the growth of C. acnes within the __________ and have direct anti-inflammatory properties.
(c) Ideally, treatment is limited to _______ months, with simultaneous use of a topical retinoid to facilitate discontinuation of the antibiotic.
(d) _________ most frequently used oral antibiotics for acne therapy.

Answer 11

a) topical
b) pilosebaceous unit
c) three to four
d) Doxycycline and minocycline

Question 12

Oral isotretinoin (Accutane)

1) Severe _________ acne who are unresponsive to conventional therapy, including systemic antibiotics.
2) It is typically prescribed for a ___-week course.
3) Isotretinoin is a teratogen with a very high risk for severe birth defects if taken during pregnancy in any amount, even for a short period of time.
4) Isotretinoin can only be prescribed by clinicians who participate in a special restricted distribution program (iPLEDGE).
5) In female patients, ______________ can be beneficial.

Answer 12

1) recalcitrant nodular
2) 20
5) oral contraceptives

Question 13

What are some disposition considerations for acne

Answer 13

May require light duty based on treatment & sensitivity to sunlight