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4th year passmedicine by topic > Acne > Flashcards

Acne Flashcards

1
Q

Acne vulgaris is a common skin disorder which usually occurs in adolescence. It typically affects

A

the face, neck and upper trunk

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2
Q

Acne vulgaris pathophysiology

A

the obstruction of the pilosebaceous follicle with keratin plugs which results in comedones, inflammation and pustules.

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3
Q

Acne vulgaris Epidemiology?

A

affects around 80-90% of teenagers, 60% of whom seek medical advice
acne may also persist beyond adolescence, with 10-15% of females and 5% of males over 25 years old being affected

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4
Q

Activity of sebaceous glands may be controlled by

A

androgen

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5
Q

acne vulgaris has colonisation by which bacteria?

A

anaerobic bacterium Propionibacterium acnes

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6
Q

Androgen levels are high in patients with acne vulgaris

A

false

levels are often normal in patients with acne

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7
Q

Acne is a disease of which part of the skin?

A

pilosebaceous unit

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8
Q

Comedones are due to a

A

dilated sebaceous follicle

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9
Q

Comedones:
if the top is closed ? is seen
if the top opens ? forms

A

if the top is closed a whitehead is seen

if the top opens a blackhead forms

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10
Q

In acne vulgaris Inflammatory lesions form when?

A

follicle bursts releasing irritants - papules and pustule formation
An excessive inflammatory response may result in: nodules, cysts

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11
Q

What type of scars do you get in acne vulgaris?

A

ice-pick scars

hypertrophic scars

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12
Q

Drug induced acne is associated with which drug

A

steroid use

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13
Q

Drug induced acne is monomorphic/polymorphic

A

monomorphic

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14
Q

What is acne fulminans?

A

very severe acne associated with systemic upset (e.g. fever).

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15
Q

acne fulminans mx?

A

Hospital admission is often required and the condition usually responds to oral steroids

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16
Q

Mild acne vulgaris?

A

mild: open and closed comedones with or without sparse inflammatory lesions

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17
Q

Moderate acne vulgaris?

A

moderate acne: widespread non-inflammatory lesions and numerous papules and pustules

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18
Q

Severe acne vulgaris?

A

severe acne: extensive inflammatory lesions, which may include nodules, pitting, and scarring

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19
Q

A simple step-up management scheme often used in the treatment of acne - describe

A

Single topical therapy
Topical combination therapy
Oral antibiotics/COCP
Oral Isotretinoin

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20
Q

Diet is useful in controlling acne

A

false

There is no role for dietary modification in patients with acne.

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21
Q

Examples of single topical therapy?

A

topical retinoids, benzoyl peroxide

22
Q

Examples of topical combination therapy?

A

topical antibiotic, benzoyl peroxide, topical retinoid

23
Q

Which oral antibiotics are useful in acne vulgaris?

A

tetracyclines: lymecycline, oxytetracycline, doxycycline

24
Q

Which antibiotic may be used in pregnancy?

A

erythromycin

25
Q

When should tetracyclines be avoided?

A

tetracyclines should be avoided in pregnant or breastfeeding women and in children younger than 12 years of age

26
Q

Why is minocycline is now considered less appropriate in mx acne v?

A

possibility of irreversible pigmentation

27
Q

a single oral antibiotic for acne vulgaris should be used for a maximum of

A

three months

28
Q

Why should a topical retinoid or benzoyl peroxide always be co-prescribed with oral antibiotics

A

to reduce the risk of antibiotic resistance developing.

29
Q

Topical and oral antibiotics should not be used in combination

A

true

30
Q

complication of long-term antibiotic use?

A

Gram-negative folliculitis

31
Q

mx Gram-negative folliculitis

A
  • high-dose oral trimethoprim is effective if this occurs
32
Q

combined oral contraceptives (COCP) are an alternative to oral antibiotics in women acne vulgaris

A

true

33
Q

COCP can be prescribed alone in acne vulgaris

A

False

as with antibiotics, they should be used in combination with topical agents

34
Q

WHat is Dianette (co-cyrindiol)? It is sometimes used in acne vulgaris because?

A

COCP

used as it has anti-androgen properties.

35
Q

Dianette has an increased risk of?

A

venous thromboembolism compared to other COCPs

36
Q

When should dianette be used used?

A

it should generally be used second-line (COCP)

only be given for 3 months

women should be appropriately counselled about the risks

37
Q

oral isotretinoin should only under specialist supervision

A

true

38
Q

Contraindication retinoids?

A

pregnancy is a contraindication to topical and oral retinoid treatment

39
Q

Acne rosacea is a chronic skin disease of unknown aetiology.

A

true

40
Q

sx acne rosacea?

A

typically affects nose, cheeks and forehead
flushing is often first symptom
telangiectasia are common
later develops into persistent erythema with papules and pustules
rhinophyma
ocular involvement: blepharitis

41
Q

What can exacerbate sx acne rosacea?

A

Sunlight

42
Q

Step wise mx of acne rosacea?

A

topical metronidazole/topical brimonidine gel

systemic antibiotics e.g. Oxytetracycline

laser therapy

43
Q

More specifically (in acne rosacea) when is topical metronidazole used?

A

may be used for mild symptoms

i.e. Limited number of papules and pustules, no plaques

44
Q

More specifically (in acne rosacea) when is topical brimonidine gel used?

A

may be considered for patients with predominant flushing but limited telangiectasia

45
Q

More specifically (in acne rosacea) when is laser therapy used?

A

laser therapy may be appropriate for patients with prominent telangiectasia

46
Q

patients with a rhinophyma should be referred to dermatology

A

true

47
Q

recommend daily application of a high-factor sunscreen in acne rosacea

A

true

48
Q

Adverse effects retinoids?

A 
teratogenicity
dry skin, eyes and lips/mouth
low mood
raised triglycerides
hair thinning
nose bleeds
intracranial hypertension
Photosenstivity
49
Q

In severe acne. wo-thirds of patients have a long-term remission or cure following a course of oral isotretinoin.

A

true

50
Q

females should ideally be using one form of contraception if on retinoids

A

false

using TWO forms of contraception (e.g. Combined oral contraceptive pill and condoms)

51
Q

the most common side-effect of isotretinoin

A

dry skin, eyes and lips/mouth

can lead to nose bleeds

52
Q

isotretinoin treatment should not be combined with tetracyclines for what reason

A

intracranial hypertension

4th year passmedicine by topic (96 decks)

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