Acne

Question 1

What is the proper term for acne?

Answer 1

Acne Vulgaris

Question 2

What are some differentials for acne?

Answer 2

Acne Rosacea
Acne Fulminans
Dermatitis
Milia
Folliculitis (can be due to tetracyclines)

Question 3

Pathophysiology of Acne

Answer 3

There are an increase in androgens, which increases sebum production which blocks the ducts, bacteria infiltrate causing inflammation, pustule formation etc

Question 4

What are the features of acne?

Answer 4

Red, inflamed papules
Can have pustules
Can have scarring

Question 5

Who does acne commonly occur in?

Primary and Secondary

Answer 5

Teenagers
Cushing's disease
PCOS
Virilising Tumours
Drugs - steroids, progesterone pill

Question 6

When would you refer a patient with acne?

Answer 6

Severe - lots, resistant to treatment, scarring, painful
Social issues
Suspected to be secondary to something
Acne fulminans

Question 7

Complications of acne

Answer 7

Social

Scarring

Question 8

What are the treatments for acne?

Mild

Answer 8

1) Lifestyle - wash x 2 daily, clean everything, don’t touch face
2) Topical treatment - retinoid, benzyl peroxide
3) Add a topical antibiotic

Question 9

What are the treatments for acne?

Moderate

Answer 9

Moderate acne is more extensive, more at risk of scarring

Do all the things you would for mild acne

Then, add an oral antibiotic if have on back/shoudlers

Can try the COCP or anti-androgens

Question 10

What are the treatments for acne?

Severe

Answer 10

Very extensive, painful, pustular and scarring

Refer!
They may give oral isolretinoin (Roaccutane)
Cover them with something whilst they wait for their appointments