Acne Flashcards
What is acne vulgaris?
An inflammatory disease of the pilosebaceous follicles that results in comedones, papules, and pustules, and can cause scarring.
Where are acne lesions most commonly located?
Face (99% of cases), chest (60%), and upper back (15%).
What are the traditional primary factors in the pathophysiology of acne?
altered sebum production
excess keratinization
colonization by Cutibacterium acnes
inflammation
What are the recently researched primary factors in the pathophysiology of acne?
imbalance in C. acnes phylotypes
alteration of the skin microbiome
What are the main types of lesions in acne vulgaris?
Comedones (open and closed), papules, pustules, nodules, and cysts.
How is acne severity classified according to NICE?
Mild to moderate: 1 or more non-inflammatory lesions, up to 34 inflammatory lesions, and up to 2 nodules.
Moderate to severe: 35 or more inflammatory lesions and 3 or more nodules.
What are common risk factors for acne?
Genetics
ethnicity
hormones (e.g., androgens, menstruation)
PCOS
environmental factors (diet, medications, stress, UV light)
skin care products
What is the role of Cutibacterium acnes in acne?
It is a Gram-positive, anaerobic bacterium that plays a protective role in healthy skin. In acne, there is a loss of C. acnes diversity and proliferation of certain phylotypes.
What are common self-care recommendations for acne management?
Avoid over-cleaning the skin
wash with a gentle, non-alkaline cleanser twice daily
Use non-comedogenic products
avoid oil-based products
remove makeup daily
avoid picking or squeezing lesions
maintain a healthy diet
What are the psychological and social impacts of acne?
It can lead to emotional distress, social withdrawal, low self-esteem, and potential long-term psychological effects.
How does acne differ in skin of color compared to white skin?
Patients with skin of color experience similar lesions but may have more intense inflammation and are more prone to post-inflammatory hyperpigmentation and scarring. White patients tend to have more redness and severe acne.
What are common differential diagnoses for acne?
Rosacea (central facial flushing and papules without comedones)
perioral dermatitis (itching, burning, and folliculitis)
drug-induced eruptions
Polycystic ovary syndrome
When should patients with acne be referred to a specialist?
When acne is severe, causing significant scarring or pigmentation issues, or when initial treatments fail. Early referral is also important for patients with skin of color to prevent long-term complications.
What are some medications used for acne treatment?
Topical retinoids
benzoyl peroxide
antibiotics (topical or oral)
hormonal treatments (e.g., oral contraceptives)
isotretinoin for severe cases.
What is the link between diet and acne?
While maintaining a healthy diet is recommended, there is insufficient evidence to support specific dietary changes for acne management.
