Acne

Question 1

Acne Bacterium and Types of Comedones

Answer 1

• Propionobacterium acnes
• Open (blackhead)
• Closed (whitehead)

Question 2

Acne Epidemiology

Answer 2

• Genetic factor
• Affects boys more than girls
• May occur from exogenous testosterone or Cushing’s

Question 3

Acne Presentation

Answer 3

• Greasy skin
• Comedones, papules, pustules
• Nodulocystic acne

Question 4

Acne Differentials

Answer 4

• Acne rosacea
• Folliculitis
• Milia
• Perioral dermatitis

Question 5

Acne Investigations

Answer 5

• Usually none
• Unless underlying cause
• Skin lesion culture if no response

Question 6

Acne Management

Answer 6

• Topical retinoid
• Topical antibiotic if inflammation present
• Topical dapsone second line
• Apply to whole area not just affected area e.g. whole face
• If moderate and inflammation give oral antibiotic
• If severe, oral retinoid
• COCP or spironolactone if hormonal
• Topical clindamycin or erythromycin if pregnant

Question 7

Acne Referral

Answer 7

• If severe psychological problems
• Risk of scarring
• Persistent acne
• Endocrine cause
• Systemic symptoms