Acne Flashcards
2 Clinical features of Acne vulgaris
Inflammatory pustules, papules + nodules
Non-inflammatory comedones + pseudocysts
What are singular acne lesions centred on?
Pilosebacious unit
4 contributory factors in acne pathogenesis
Sebaceous gland hyperplasia + excess sebum
Retention + accumulation of keratinocytes
Cultibacterium acnes (gram +ve)
Inflammation + immune response
Which endocrine disorder may contribute to acne vulgarisms?
Hyperandrogenism
What causes development of comedones in acne?
Obstruction of pilosebaceous unit with keratin plugs
Whitehead: closed, skin over top
Blackhead: open, exposure to air > black
3 subtypes of acne vulgaris
Comedonal: normal
Papule-pustular: deeper, more painful
Nodulo-cystic: big, painful, scarring
Tx for mild acne with inflammation?
Topical Retinoid e.g. Tretinoin
Topical Abx e.g. Clindamycin / Topical Benzoyl Peroxide
Tx for moderate-severe acne?
Topical Retinoid + Benzoyl Peroxide
Abx e.g. Lymecycline/ Doxycycline PO
Tx for severe acne? Why can only a dermatologist prescribe this?
Isotretinoin
3/12, max 12/12
Teratogenic- must do pregnancy test, recommend OCP
What are the side effects of Isotretinoin?
DR CHAT PM Dry skin Raised lipids + hepatitis Chelitis; inflammation peri-orally Headache Arthritis Teratogenicity Psychiatric effects: depression, suicidality Muscle aches
How does rosacea differ from acne?
No blackheads
Skin dry + peeling, not greasy
No scarring
4 features of rosacea
Flushing
Dilated prominent telangiectases (primarily on face)
Persistent facial erythema
Inflammatory papules + pustules on peri-orificial face.
Describe the course of rosacea
Chronic relapsing + remitting
3 triggers for rosacea
Environment: temperature/ UV
Stress
DIet: alcohol, spice
What is a common ocular manifestation of rosacea?
Foreign body sensation in eye
Tearing
Pain
Blurring of vision
What characterises severe rosacea?
Phymatous changes
Thickening of skin, irregular surface nodularities
Often affecting the nose rhinophyma
Tx for rosacea
Avoid triggers
Topical alpha-adrenergic agonist e.g. brimonidine
Topical Ivermectin/ Metronidazole for papules/ pustules
Tx for severe papular/ phymatous rosacea
Topical ivermectin (papules/ pustules) Doxycycline PO
