Acne Flashcards
What is chronic inflammation of pilosebaceous unit?
acne vulgaris
What causes sebaceous glands to increase sebum production?
androgens
What acts on sebum to break down to fatty acids?
propionibacterium acnes
What does fatty acid create?
inflammatory response in pilosebaceous unit
What is p. acne?
preferential anaerobic aerotolerant diptheroid gram + rod shaped
What does plugging cause?
open and closed comedone
What does acne becomes when it ruptures into dermis?
papule, pustule, nodule
What is the patho of acne?
accumulate apithelial cells and keratin –> accumulation of shed keratin and sebum –> p. acnes proliferation (mild inflammation) –> marked inflammation
What are the key players in acne?
androgen excess
emotional stress
medications
mechanical - leaning face on hands
What are the different types of acne lesions?
papule, pustule, nodule/cyst
What are the type of acne scars?
pitted, hypertrophic, keloid
What is an open vs closed comedome?
open comedone = no skin layer
closed comedone = sealed by skin
no inflammatory response
What is a papule?
raised lesion, more inflammatory
What are pustules?
raised, purulent fluid, erythema
What is cysts and nodules in acne?
nodule - firm
cysts - fluid filled
lots of surrounding inflammation
What do pitted scars look like?
diffuse lesions with erythematous base, pitting present, concave shape
What are hypertrophic scars?
raised, firm, fibrosis
What are acne keloidalis nuchae?
more in AA, dark skin, excess over growth
Where are locations for acne?
face, neck, upper arms, trunk
What is the most common location for acne?
face
How to tell severity?
type of lesion, surface area, inflammatory response
What is the treatment for mild acne superficial, topical abx?
- Erythromycin 2% solution, gel,ointment
2. Clindamycin 1% solution, gel, lotion
3. Sodium Sulfacetamide 10% gel, cream, lotion
What are some topical retinoids for mild acne?
- Tretinoin (Retin A) solution,cream,gel
2. Tazarotene (Tazorac) cream, gel
3. Adapalene (Differin) cream, gel
4. Azalaic Acid (Finacea) gel
What are some OTC treatment for mild acne?
BPO
What make up needs to have?
noncomudogenic - doesn’t clog your pores
What is the treatment for moderate to severe acne?
Add PO antibiotic: Tetracycline Minocycline Doxycycline Erythromycin Oral Contraceptives Anti-androgen effect
What are the dosing for ABX PO?
Tetracycline 250-500mg BID
Minocycline 50-100mg BID
Doxycycline 100mg BID
Erythromycin 250-500mg BID
What is used for recalcitrant acne?
isotretinoin (Accutane)
1mg/kg/day PO divided BID
15-20 wks
What are the side effects of isotretinoin?
teratogenic - preg test 2x, be on OCP
increase triglycerides - LFT at baseline then 1-2 wks until stable
Depression/suicide - screen monthly
What are some other acne treatments?
intralesion triamcinalone, acne surgery, cryotherapy, chemical peels, dermabrasion, laser
