Acne Flashcards
who gets acne
over 80% teenagers
presentation of acne (mild/mod/severe)
mild- comedones with few scattered papules and pustules
moderate- more scattered papules and pustules
severe: multiple papules, pustules, nodules and cystic lesions
common areas affected
face, chest and upper back
when do you refer?
nodulocystic acne
acne with systemic features
failure to respond to multiple interventions
diagnostic uncertainty
treatment for mild acne (not general measures)
Topical therapies
- benzylperoxidase cream/gel/lotion
- topical retinoids
- topical abx e.g. clindamycin
treatment for moderate acne
oral antibiotics (lymecycline 1st line)
topical retinoids + benzylperoxidase (3 months)
COCP in females if indicated
treatment for severe acne
oral retinoids (isotretinoin or roaccutane)
indications for roaccutane
- nodulocystic acne
- failure of antibiotics
- rapidly progressive disease
- acne with systemic feature (fulminans)
side effects of roaccutane
inital acne flare dry skin and mucous membrane photosensitivity myalgia and arthralgia mood disturbance teratogenic- don't get pregnant
what is advised to women of child bearing age on roaccutane
don’t get pregnant
take 2 forms of contraception for entire duration and 1/12 after
offer regular pregnancy tests
what are the post-treatment complications of acne
post-treatment hyperpigmentation
scarring- ice pick scars and keloid scars
deformity
psychological effects
management of acne scarring
ice pick scars- excision, laser therapy, camouflage
keloid scars- topical/intralesional steroids
clinical features of rosacea
red papules and pustules (no comedones) with tendency for blushing, aggravated by sun, stress and spicy foods
where else might rosacea present?
- eyes: ocular rosacea
- nose: rhinophyma
how does ocular rosacea present?
dry irritated eyes, blepharitis
