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Clinical > Acne > Flashcards

Acne Flashcards

1
Q

risk factors

A 
age - teens 
genetic 
environment 
hormones
stress
diet
medications
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2
Q

how is acne formed

A

increased follicular keratinization forms a keratotic plug at the top of the gland preventing sebum release
increased sebum production causes it to build up
p.acnes feeds of sebum and causes lipolysis of triglycerides into free fatty acids
immune system cause inflammation

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3
Q

what are the two types on non-inflammatory lesions

A

open comedone - black head

closed comedone - white head

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4
Q

what are the 4 types of inflammatory lesions

A

papules
pustules
nodules
cysts

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5
Q

what are the 3 types of acne scars

A

atrophic
hypertrophic
depressed

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6
Q

drug induced acne

A

all at same stage

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7
Q

neonatal acne

A

babies

dont treat

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8
Q

acne conglobata

A

large area

deep nodules and cysts

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9
Q

acne flumanins

A

brown dots

systemic

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10
Q

contact acne

A

cosmetics
hair
oily skin

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11
Q

endocrine acne

A

large area

excessive gluticocorticoids or antigens

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12
Q

acne machanica

A

mechanical pressure such as a helmet

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13
Q

what is mild acne

A

mostly comedones with a few papules and pustules

no more than 50% of the affected area involved

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14
Q

what is moderate acne

A

numerous comedones, papules, and pustules
maybe a nodules or scarring
more than 50% of the affected area

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15
Q

what is severe acne

A

numerous, extensive comedones, papules, pustules
nodules, cysts, and scarring
entire area covered

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16
Q

red flags for acne

A 
moderate-severe
drug induced
atypical - later in life 
infection 
scarring
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17
Q

what acne is self treatable

A

mild to moderate acne vulgaris, acne mechanica, contact acne
if typical, onset between 12-25, and no scarring

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18
Q

4 goals of therapy

A

alleviate symptoms by reducing number and severity of lesions
limit duration and recurrance
alleviate psychological distress
prevent scarring and hyperpigmentation

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19
Q

4 non pharms

A

wash with mild soap 1-2 times daily
avoid picking, poppin, or manipulating lesions
avoid aggravating factors
minimize stress

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20
Q

gel formulations

A

most efficient
acetone/alcohol for oily skin
water based for more sensitive oily skin

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21
Q

when to use lotions, why are they better

A

large, hairy areas
good for all types of skin, especially sensitive
second best efficacy
less side effects

22
Q

what is cream good for

A

dry skin but less effective

23
Q

bar/wash formulations

A

all skin but least effective

24
Q

why are microsphere formulations good for sensitive skin

A

they localize at the hair follicle and relase the medication over time, less medication on the skin

25
Q

non prescription acne products

A 
benzoyl peroxide
salicylic acid 
sulfur
resorcinol 
glycolic acid
26
Q

how does salycilic acid .5-2% work for acne and when should it be used

A

comedolytic and keratolytic

when BPO not tolerated

27
Q

how does benzoyl peroxide work

A

an antibiotic wiht no resistance because releases oxygen (p.acnes is anaerobic)
antiinflammatory
normalizes follicular keratinization

28
Q

what are the strengths of benzoyl peroxide

A

non prescription 2.5-5%

pr 5%

29
Q

what is first line treatment for mild inflammatory acne or non inflammatory acne

A

benzoyl peroxide once or twice daily to the entire infected area

30
Q

treatment for mild-moderate acne

A

topical antibody
topical retinoid
benzoyl peroxide

31
Q

treatmeent for moderate and severe acne

A

oral antibody
topical retinoid
benzoyl peroxide

32
Q

side efects of BPO

A

itching
redness
scaling
drying

33
Q

what is the treatment approach for acne

A

6-8 weeks after each product if no improvement then switch, may take 8-12weeks for full effect

  1. BPO water based 2.5%
  2. water based 5% BPO
  3. acetone/alcohol based BPO
  4. refer
34
Q

application of topical acne products

A 
wash hands before and after 
wash with mild soap 
pat dry 
apply pea sized amount 
ensure stays on for one hour, and no other products for an hour
35
Q

prescription acne products

A 
BPO >5% 
axelaic acid 
topical retinoids and retinoid analogue
topical antibiotics 
oral antibiotics 
isotretinoin
36
Q

uses of topical retinoids

A

comedonal only acne
in combo
maintence therapy - use long term

37
Q

application adn side effects of topical retinoids

A

once saily

redness, stinging, peeling

38
Q

why do you avoid use of topical antibiotics on their own and for long periods of time

A

causes resistance

39
Q

what acne products can pharmacists prescrive

A

clindamycin

BPO

40
Q

duration of use and side effects of oral antibiotics

A

6 months

GI upset, NV, diarrhea, headahce

41
Q

contraindications for tetracyclines

A

pregnant
under 8
dairy products

42
Q

indications for oral contraceptives

A

mild-moderate in women who desire contraception
adult acne that didnt respond to previous therapies
severe acne for females on isotretinoin

43
Q

indication for androgen receptor blockers

A

females with adult onset that oother treatments didnt works or acne from too many androgen hormones

44
Q

idications for isotretinoin

A

severe nodulocystic acne
relapsing
scarring
treatment failure

45
Q

treatment duration for iso

A

12-16 weeks
can take 2-3 months
will get worse first week

46
Q

why should women be put on oral contraceptives when on iso

A

causes serious birth defects

47
Q

side effects of isotret

A

redness
dry eyes,nose, mouth
depression

48
Q

tests and monitoring for isotret

A 
pregnancy 
lipid and blood glucose levels
complete blood count and diferential 
hepatic function 
depression
49
Q

what should you avoid when using isotret

A 
alcohol 
vit a and beta carotene
giving blood transfusions
use in under 12 
tetracyclines
other acne products
50
Q

recommendations for maintanence therapy

A

for mild-moderate: topical retinoid

moderate- severe: topical retinoid and BPO

51
Q

treatment for pregnany patients

A

non pharms

refer to doctor

52
Q

monitoring

A

lesions improve in 2-4 wekks
comedones resolve in 3-4 months
inflammation resolves within a couple weeks
anxiety improves in 2-4 months

Clinical (16 decks)

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