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dermatology > acne > Flashcards

acne Flashcards

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Dermatology Board Prep flashcards
1
Q

what is the aetiology of acne ?

A

androgens stimulate the sebaceous gland
causing sebaceous gland over - activity
associated with drugs - steroids and anticonvulsants
Dietary - dairy products and high glycaemic foods

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2
Q

what is the pathogenesis of acne ?

A
  • excess sebum production
  • follicular epidermal hyper proliferation with plugging of the follicle
  • presence of cutibacterium acnes
  • inflammation
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3
Q

black head vs a white head ?

A

black head is an open comedone
white head is a closed comedone

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4
Q

stages of acne ?

A

normal follicle
open comedone
closed comedone
papule
pustule

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5
Q

sign that triggers a patient to see the doctor ?

A

inflammation

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6
Q

tyoes of acne ?

A

white head
black head
cysts
pustules
papules
nodules

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7
Q

what is the grading of acne ?

A

mild - less than 20 comedones
moderate - 20-100 comedones
severe - more than 100 comedones
5 or more cysts, nodules

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8
Q

clinical manifestations of hyperandrogenism ?

A

acne
hirsutism
acanthosis
hair loss
irregular menses / infertility

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9
Q

what are the complications of acne ?

A

post inflammatory hyper pigmentation
scarring

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10
Q

targets of acne treatment ?

A

decrease sebum
desquamation
cutibacterium acnes
androgens
scarring

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11
Q

topical treatment for acne

A

benzoyl peroxide
Antibiotics
topical retinoids

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12
Q

1st choice treatment for acne

A

usually retinoids :
adaplene
treinoin
isotretinoin

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13
Q

systemic treatment for acne

A

AB
isotretinoin
anti-androgens - to reduce sebum production

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14
Q

treatment for miild papular pustular acne

A

topical retinoids along with topical anti microbial

adaplene + benzoyl peroxide
Isotretinoin + topical ab

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15
Q

moderate inflamm acne treatment

A

oral ab (tetracycline) or spironolactone ( anti androgen effect )
along with topical retinoids

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16
Q

alternative acne treatment for women with moderate acne and signs of androgenisation ?

A

dianette can be used and should bee reserved for moderate to severe acne
especially if there is any evidence of hyperandrogenosim

17
Q

what is dianette ?

A

co-cyprinderol

18
Q

mode of action of spironolactone ?

A

diuretic and has anti androgen effects

19
Q

treatment of severe acne

A

oral isotretinoin - Roaccutane

20
Q

side effects of oral isotretinoin - Roaccutane

A

dry skin
dry eyes
hoarse voice
chelitis - chronic inflamation of the lips
headaches
arthritis
teratogenicity
adverse psychiatric effects

21
Q

when are investigations required in acne patients ?

A

before prescribing isotretinoin :
-liver function
-lipid profile
-pregnancy test ( teratogenic )

Signs suggesting hyperandrogenism
Signs suggesting cushing syndrome

22
Q

treatment for acne scarring ?

A

laser
microneedling
subcision - used for valley scars

23
Q

what is the presentation of infantile acne ?

A

site : cheeks, forehead and chin

24
Q

causes of infantile acne ?

A

unknown
genetic
hormones - testosterone and androgens

no investigations needed

25
Q

how to treat infantile acne ?

A

mild/moderate - usually no treatment , reassurance

severe - topical ( benzoyl peroxide or erythromycin gel )

26
Q

side effects of tetracyclines

A

yellow staining of teeth

27
Q

folliculitis declavans

A

scarring alopecia characterized by redness and swelling
pustules around the hair follicle

28
Q

what micro organism can be isolated from pustules in folliculitis declevans

A

staph aureus

29
Q

management for folliculitis declevans ?

A

oral ab
oral steroidds
oral isotretinoin

30
Q

inflammatory disease of the apocrine glands …..

A

hidradenitis suppurativa

31
Q

sites where hidradenitis supprativa is commonly found

A

axilla
groin
under the breast

32
Q

C/P of hidradenitis supprativa

A

recurrent boil like nodules
abscess
sinusees
scarring

33
Q

other term used to describe hidradenitis suppurativa

A

acne inversa

34
Q

treatment for hidradenitis suppurativa ?

A

topical - clindamycin and benzoyl peroxide

systemic - AB for at least 3 months
Anti-androgens - Oral contraceptive pill
corticosteroids and retinoids

dermatology (15 decks)

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