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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
Q

non pharma treatment acne

A

-mechanical: brushes, heat, scrubs, cleansing cloths
-comedo extraction: nose trips, professional
-light: visible, pulsed dye laser, photodynamic

26
Q

Referral for adapalene gel

A

-lack of improvement in 3 months
-allergic reaction

27
Q

Benzyl peroxide onset

A

-5 days to 3 weeks
-max effect 8-12 weeks

28
Q

benzyl peroxide administration

A

-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
Q

benzyl peroxide adverse effects

A

-transient stinging or burning
-drying, peeling, erythema, edema: reduce strength and exposure
-may bleach hair, clothes
-photosensitivity
-rare allergic contact dermatitis

30
Q

Salicylic acid MOA

A

-comedolytic
-anti-inflammatory

31
Q

Salicylic acid administration

A

1-3x/day, gel or cleanser

32
Q

Salicylic acid adverse effects

A

-dryness/peeling
-possible drug interactions
-salicylic acid toxicity
0contraindicated in diabetes, poor blood circulation

33
Q

Benzyl peroxide and salicylic acid

A

-local hypersensitivity
-active ingredients

34
Q

Alpha hydroxy acids(AHA) MOA

A

exfoliate, simulate growth of new, smother skin

35
Q

AHA administration

A

-cleansers, creams, lotions, cleansing cloth
-use once acne is controlled
-every 102 weeks, up to daily as tolerated

36
Q

tea tree oil MOA

A

-antibacterial and antiinflamatory

37
Q

mild acne product selection

A

-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
Q

scaly dermatoses symptoms

A

-epidermis
-scaling of skin
-erythema, inflammation, other changes
-Inflammation: dandruff->seborrhea->psoriasis
-nonprescription therapy: most dandruff and seborrheic, mild psoriasis

39
Q

Dandruff pathophysiology

A

-hyperproliferative epidermal condition
-turnover 2x

40
Q

dandruff treatment

A

-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
Q

Seborrheic dermatitis

A

-chronic inflammation of greatest sebaceous gland activity

42
Q

Seborrheic dermatitis pathophysiology

A

-3x proliferation
-increase sebaceous gland activity

43
Q

Seborrheic dermatitis symptoms

A

-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
Q

Seborrheic dermatitis adult treatment

A

-non-medicated shampoo, mineral/olive oi, dishwashing liquid to remove scales
-emollients
-hydrocortisone up to twice daily

45
Q

Types of medicated shampoos

A

–1st line: Pyrithione zinc, selenium sulfide, ketoconazole
-2nd line: coal tar, salicylic acid, sulfur

46
Q

Referal for Seborrheic Dermatitis

A
  • less than 2 yrs
    -no response to topical steroid after 7 days
    -worsening/no improvement after 2 weeks
47
Q

Psoriasis etiology

A

-unknown
-genetics
-triggers
-proliferation 8x higher
-inflammation

48
Q

Psoriasis symptoms

A

-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
Q

Psoriasis treatment limitations

A

-only mild cases can be treated
-control not cure

50
Q

Referal for Psoriasis

A

-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
Q

Psoriasis non pharma

A

-avoid triggers
-lose weight
-remove scales
-apply emollients liberally(4x/day)

52
Q

Psoriasis OTC

A

-scalp: coal tar or salicylic acid shampoos
-limbs. body: coal tar, hydrocortisone(1%)
-acute localized: hydrocortisone, emollients
-thick, scaled plaques: salicylic acid

53
Q

Anti-Malassezia Agents

A

-Pyrithione zinc, selenium sulfide, ketoconazole

54
Q

Anti-Malassezia Agents MOA

A

-decrease yeast count
-decrease cell turnover and inflammmation

55
Q

Ketoconazole

A

-MOA: antifungal
-2x/week for 4 weeks, then weekly
-12+
-improvement 2-4 weeks

56
Q

Ketoconazole adverse effects

A

-hair loss
-skin irritation
-abnormal hair texture
-dry skin
-significant eye irritation

57
Q

Coal tar

A

-MOA: cross-link with DNA, decrease cell turnover
rate, cytostatic
-treats seborrheic dermatitis and psoriasis

PHM PRAC 438 (29 decks)

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