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PHM PRAC 438 > Acne > Flashcards

Acne Flashcards

1
Q

Cause of acne

A

genetics, diet, gender

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2
Q

Acne pathophysiology

A

-increased androgens: increased sebum, colonization of bacteria, imflammation, follicular blockage

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3
Q

closed comedo

A

enlarged microcomedo
whitehead

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4
Q

open comedo

A

cells and sebum push to surface
blackhead

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5
Q

papule

A

raised, reddened area

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6
Q

pustule

A

papule with pus

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7
Q

nodule

A

small hard bump under skin

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8
Q

mild acne

A

-few papules
-occasional pustules, comedones

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9
Q

moderate acne

A

-many papules and pustules
-prominent scariing

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10
Q

exacerbating factors

A

-mechanical
-excoriation(picking)
-chlorine
-hydration
-occupational
-stress
-medications
-hormonal
-cosmetics

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11
Q

Rosacea

A

-inflammation on central part of face
-sets in in adulthood
-solid red papules/pustules
-no comedones
-need referral for treatment

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12
Q

Treatment for acne

A

-long term and consistent
-control, not cure
-topical therapy

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13
Q

Exclusions self treatment

A

moderate to severe
-exacerbating factors
pregnancy/lactation

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14
Q

acne prevention

A

-water based cosmetics
-no picking
-wash oily hair
-stay hydrated
-consider diet changes

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15
Q

cleanse skin

A

-2x/day
-warm water with mild soap
-avoid abrasive products

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16
Q

Adapalene gel

A

-first line topical
-1x daily

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17
Q

Adapalene gel MOA

A

-retinoid: comedolytic, keratolytic, anti-inflammatory

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18
Q

Adapalene gel onset

A

1-2 weeks
-8-12 weeks full effect

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19
Q

Adapalene gel side effects

A

redness, scaling, dryness, itching, burning
-usually diminish after first month
-cost

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20
Q

Benzoyl peroxide

A

-most widly used topical product

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21
Q

Benzoyl peroxide MOA

A

-antibacterial
-comedolytic
-keratolytic

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22
Q

Scaly dermatoses

A

-scaling od kin
inflammation: dandruff->seborrhea->psoriasis

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23
Q

Cyst

A

large, red, deep, filled with pus, painful

24
Q

Severe acne

A

-extensive pustule, papules
-multiple nodules on inflammed background

25
non pharma treatment acne
-mechanical: brushes, heat, scrubs, cleansing cloths -comedo extraction: nose trips, professional -light: visible, pulsed dye laser, photodynamic
26
Referral for adapalene gel
-lack of improvement in 3 months -allergic reaction
27
Benzyl peroxide onset
-5 days to 3 weeks -max effect 8-12 weeks
28
benzyl peroxide administration
-avoid cuts, scrapes, mucous membranes -small amount -lowest conc. -gradually increase contact time by 15 min increments -1x/daily for 1-2 weeks, up to 2-3x/daily -increase strength weekly
29
benzyl peroxide adverse effects
-transient stinging or burning -drying, peeling, erythema, edema: reduce strength and exposure -may bleach hair, clothes -photosensitivity -rare allergic contact dermatitis
30
Salicylic acid MOA
-comedolytic -anti-inflammatory
31
Salicylic acid administration
1-3x/day, gel or cleanser
32
Salicylic acid adverse effects
-dryness/peeling -possible drug interactions -salicylic acid toxicity 0contraindicated in diabetes, poor blood circulation
33
Benzyl peroxide and salicylic acid
-local hypersensitivity -active ingredients
34
Alpha hydroxy acids(AHA) MOA
exfoliate, simulate growth of new, smother skin
35
AHA administration
-cleansers, creams, lotions, cleansing cloth -use once acne is controlled -every 102 weeks, up to daily as tolerated
36
tea tree oil MOA
-antibacterial and antiinflamatory
37
mild acne product selection
-cleansing product -solutions and washes: large areas gel: most effective, on skin longest, astringent -gels and solutions: drying effect, irritation, contact dermatitis, oily skin -lotions and creams: dry, sensitive skin, cold, dry weather
38
scaly dermatoses symptoms
-epidermis -scaling of skin -erythema, inflammation, other changes -Inflammation: dandruff->seborrhea->psoriasis -nonprescription therapy: most dandruff and seborrheic, mild psoriasis
39
Dandruff pathophysiology
-hyperproliferative epidermal condition -turnover 2x
40
dandruff treatment
-wash with non-medicated shampoo every 1-2 days -medicated shampoos: massaged into scalp 3-5 min., daily 1 week, 2-3x/week, then every 1-2 weeks
41
Seborrheic dermatitis
-chronic inflammation of greatest sebaceous gland activity
42
Seborrheic dermatitis pathophysiology
-3x proliferation -increase sebaceous gland activity
43
Seborrheic dermatitis symptoms
-dull, yellowish, oily, scales on reddened skin, well defined -pruritis common -adults: scalp, face, trunk -infants: scalp, may extend -darker skinned: hypopigmentation, erythema may be difficult to see
44
Seborrheic dermatitis adult treatment
-non-medicated shampoo, mineral/olive oi, dishwashing liquid to remove scales -emollients -hydrocortisone up to twice daily
45
Types of medicated shampoos
--1st line: Pyrithione zinc, selenium sulfide, ketoconazole -2nd line: coal tar, salicylic acid, sulfur
46
Referal for Seborrheic Dermatitis
- less than 2 yrs -no response to topical steroid after 7 days -worsening/no improvement after 2 weeks
47
Psoriasis etiology
-unknown -genetics -triggers -proliferation 8x higher -inflammation
48
Psoriasis symptoms
-symmetrical -plaques: well defined, light pink/bright red, thick, silvery-white scale -localized or diffuse lesions -painful/itchy -involve nails and synovium -hypo or hyper pigmented skin
49
Psoriasis treatment limitations
-only mild cases can be treated -control not cure
50
Referal for Psoriasis
-lesions larger than a quarter -face -joint pain - <2 years -no response within 7 days(emollients and hydrocortisone) -worsening/o improvement after 2 weeks
51
Psoriasis non pharma
-avoid triggers -lose weight -remove scales -apply emollients liberally(4x/day)
52
Psoriasis OTC
-scalp: coal tar or salicylic acid shampoos -limbs. body: coal tar, hydrocortisone(1%) -acute localized: hydrocortisone, emollients -thick, scaled plaques: salicylic acid
53
Anti-Malassezia Agents
-Pyrithione zinc, selenium sulfide, ketoconazole
54
Anti-Malassezia Agents MOA
-decrease yeast count -decrease cell turnover and inflammmation
55
Ketoconazole
-MOA: antifungal -2x/week for 4 weeks, then weekly -12+ -improvement 2-4 weeks
56
Ketoconazole adverse effects
-hair loss -skin irritation -abnormal hair texture -dry skin -significant eye irritation
57
Coal tar
-MOA: cross-link with DNA, decrease cell turnover rate, cytostatic -treats seborrheic dermatitis and psoriasis

PHM PRAC 438 (29 decks)

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