Acne

Question 1

Management of mild/moderate acne vulgaris

Answer 1

Topical treatment (3mnths)

• benzoyl peroxide
• topical antibiotic + benzoyl peroxide
• retinoid

If poor response
+ oral antibiotic e.g. doxycycline (6mnths)

Question 2

What is the difference between acne vulgaris and rosacea pathologically?

Answer 2

Acne vulgaris - chronic inflam of pilosabaceous unit

Acne rosacea - NOT chronic inflam of pilosabaeceous unit
- link to demodex mite

Question 3

Acne rosacea will present with open and closed comedones. True or false?

Describe acne rosacea appearance

Answer 3

False

Erythmateous rash across nose and cheeks, papules and sometimes pustules may be present

Question 4

What is the MoA of retinoid?

Answer 4

Vitamin A agonist

Question 5

What aggrevates roseacea?

Answer 5

Alcohol
Spicy food
Temperature

Question 6

What kind of drug is isotretinoin?

Female patients must also take what alongside?

Answer 6

Systemic retinoid - lots of side effects

Have to be on contraception - high teratogenic effect

Question 7

What deems acne to be severe?

Severe acne patients should be referred to dermatology. What should patients be given in the interim (same as treatment of moderate acne)?

What is the dermatologist likely to prescribe?

Answer 7

Presence of cysts

Oral antibiotic + topical benzoyl peroxide

Isotretinoin e.g. Accutane

Question 8

What drugs may be prescribed for female only patients?

Answer 8

Anti-androgenic meds.

Oral contraceptive pill for e.g.

Question 9

What should be investigated for females with presistent acne who are hirsute?

Answer 9

PCOS

Question 10

How is acne rosacea managed?

Answer 10

Avoid aggravating factors - wear high factor sunscreen
Topical metronidazole
Oral tetracycline - high dose

(active inflammation)