Acne

Question 1

What are the features of acne rosacea?

Answer 1

flushing is the first symptom, affects nose cheeks and forehead, telangiectasia, blepharitis may occur

Question 2

What is the management of acne rosacea?

Answer 2

1) topical metronidazole for mild symptoms
2) severe: oxytetracycline

high factor sunscreen
laser therapy

Question 3

What is the pathophysiology of acne vulgaris?

Answer 3

follicular epidermal hyperproliferation = keratin plug = obstruction of pilosebaceous follicle

colonisation by Propionibacterium acnes

inflammation

Question 4

What scarring may be seen in acne vulgaris?

Answer 4

ice pick scars

hypertrophic scars

Question 5

What is acne fulminans?

Answer 5

severe acne associated with systemic features e.g. fever. admit to hospital. give oral steroids.

Question 6

What are the categories of acne vulgaris?

Answer 6

mild: open/closed comedones without inflammation
moderate: papules, pustules, widespread non-inflammatory lesions
severe: extensive inflammatory lesions, nodules, pitting, scaring

Question 7

What is the management of acne vulgaris?

Answer 7

1) single topical therapy (topical retinoids, benzoyl peroxide)
2) topical combination therapy (topical antibiotic, benzoyl peroxide, topical retinoid)
3) oral antibiotics (oxytetracycline, doxycycline, 3,4m)
4) oral isotretinoin

Question 8

What is the complication of long term oral antibiotic therapy for acne vulgaris?

Answer 8

gram negative folliculitis

high dose trimethoprim is effective

Question 9

What are the side effects of isotretinoin?

Answer 9

suicidal thoughts/psychotic symptoms
dryness of skin, lips and eyes
increased sensitivity to sun (wear sunblock always)
decreased vision at night

Question 10

What drugs should you avoid while taking isotretinoin?

Answer 10

alcohol
tetracyclines
methotrexate

Question 11

How often should women get pregnancy tests while taking isotretinoin?

Answer 11

Each month

One month after finishing isotretinoin, you can get safely pregnant