Acne

Question 1

acne vulgaris has 4 primary contributing factors that can be addressed by medications:

Answer 1

• excess follicular proliferation and abnormal desquamation
• increased sebum production
• propionibacterium acnes proliferation
• inflammation

Question 2

acne can present as:

Answer 2

mild with comedonal acne without inflammation

mild papulopustular acne

mixed papulopustular/comedonal acne

moderate papulopustular or mixed acne

severe - nodular acne.

Question 3

initial treatment for mild with comedonal acne without inflammation

Answer 3

topical retinoid (preferred)
azelaic acid, salicyclic acid

Question 4

treatment for papules and pustular acne

Answer 4

benzoyl peroxide alone OR

benzoyl peroxide with topical retinoid or topical antibiotic

Question 5

severe acne

Answer 5

oral antibiotics are added

oral isotretinoin - need to be on 2 forms of contraception through therapy and one month after

Question 6

use of oral isotretinoin requires

Answer 6

oral isotretinoin - need to be on 2 forms of contraception through therapy and one month after

Question 7

oral antibiotics for treatment of mild acne include:

Answer 7

doxycycline, minocycline (drug induced SLE) and erythromycin as second line

remember can’t use doxycycline or minocycline in pregnant or potentially pregnant pts or to kids <8 yrs (teeth staining)

Question 8

oral of OCPs and acne

Answer 8

helps to regulate acne that is induced by hyperandrogism related to menstrual cycles.

Question 9

severe nodular acne treatment

Answer 9

oral isotretinoin

Question 10

open comedones

Answer 10

black heads

Question 11

closed comedones

Answer 11

white heads

Question 12

three types of acne

Answer 12

comedonal - open and closed comedones
inflammatory- papules and pustules
nodulocystic - nodules and cysts

Question 13

if using topical retinoids must also

Answer 13

wear sunscreen

tretinoin all retinoic acid

-vitamin A derivatives (idiopathic cerebral hypertension) - that act by normalize the desquamation of follicular epithelium to prevent formation of new comedones and promote clearing of existing ones

Question 14

benzoyl peroxide can be used because it

Answer 14

both antibacterial and comedolytic - generates free radicals that oxidases proteins in P acnes.

Question 15

adverse effects of benzyl peroxide:

Answer 15

bleaching of hair, colored fabric and may irritate the skin

if irritates the skin discontinue use

Question 16

if they use benzoyl peroxide must make sure they

Answer 16

wear a moisturizer

Question 17

severe nodular cystic acne needs to be

Answer 17

treated aggressively to prevent scarring.

Question 18

severe nodular cystic acne treatment

Answer 18

oral antibiotics, topical retinoids, benzoyl peroxidase topical antibiotics and dermatology referral so can prescribe oral isotretinoin if acne treatment fails.