Acne

Question 1

Acne etiology

Answer 1

• increased testosterone levels
• the epithelial cell lining changes and this affects the lining of the cells
• this blocks oil from getting out of the hair follicle
• propionic bacteria then proliferates in the oil
• causing local inflammation
• pus forms bursting along the skin surface

Question 2

Acne differential diagnosis

Answer 2

Rosacea
Dermatitis
POS (poly cystic ovary syndrome)

Question 3

Self care advice acne

Answer 3

• avoid over cleaning the skin
  -maintain a healthy diet
• avoid picking and squeezing
  (All in the bnf)

Question 4

Acne severity: mild to moderate

Answer 4

1 or more of:
34 inflammatory lesions
2 nodules

Question 5

Acne severity: moderate to severe

Answer 5

Either/both:
35 or more inflammatory lesions
3 or more nodules

and/or
Acne is on the chest or back

Question 6

When to refer acne

Answer 6

When it’s moderate to severe
OTC treatment has failed
Over 25 and first presentation
There is diagnostic uncertainty.
They have acne conglobata.
They have nodulo-cystic acne

Question 7

Which treatments for acne are POM

Answer 7

All treatments are POM apart from benzoyl peroxide which is a P

Question 8

What complications can occur if acne is not treated

Answer 8

Scarring
Self esteem issues
Hyperpigmentation
Lesions

Question 9

What is the MOA of isotretinoin for acne

Answer 9

Inhibits keratinisation
It is cytotoxic to p acne’s
Reduces inflammation by reducing AP-1

Question 10

What monitoring requirements for isotretinoin

Answer 10

• Measure hepatic function 1 month after and then every 3 months
  -Pregnancy prevention programme
• regular pregnancy test

Question 11

what must be present for an acne diagnosis?

Answer 11

comedones must be present for an acne diagnosis

Question 12

what is isotretinoin used for

Answer 12

Isotretinoin Is a oral retinoid used to treat severe acne and reduces the size on the glands in the skin thus reducing the amount of oil.