acne and rosacea Flashcards
What is acne vulgaris
disease of the pilo-sebaceous unit - face, chest and back
Is a scarring condition
What happens in acne vulgaris
Keratinocytes become sticky and have an increased viscosity which leads to a follicle becoming blocked - (comedone)
This causes overproduction of propionibacterium acnes which causes inflammation
Once the inflammation begins, the papules, pustules, nodules and cysts are seen
What age is acne vulgaris more common
15-18
Which gender is acne vulgaris more common in
Same in both genders but it is more severe in males
Is acne vulgaris genetic
strong Family history does usually indicate that the patient will get acne vulgaris
What is a comedome
Blocked follicle
How does acne fulminans present
Sudden onset acneform eruptions
Feverish and unwell
joint pains
What is the treatment of acne fulminans
Low dose isotretinoin but cover with prednisolone
What is the treatment of acne vulgaris
Benzoyl peroxide acnecide - first line - it is a teratogen
topical Clindamycin and erythromycin may be used
combination therapy such as DUAC can be used which is benzyle peroxide acnecide with erythromycin
What is the systemic treatment for acne vulgaris
First line tetracyclines
first line in children - eythromycin
trimethoprim
What is isotretinoin
A retinoid - vitamin A analogue
Reserved for patients who have had no success with antibiotics and topical treatments
Taken once a day at 120mg/kg
Is the most effective treatment
When should isotretinoin be given
When the patient has already tried antibiotics and topical treatments without success or if there is severe scarring
What are the side effects of isotretinoin
Works by drying out the secretions and mucous membranes so will see dry skin and hair
It makes the skin sensitive and photosensitive so you are more at risk of burning
nail dystrophy
myalgia
mood disturbance
headaches
epistaxis - nose bleeds
When is isotretinoin contraindicated
It is a retanoid and therefore contraindicated pregnancy - it is a teratogen
What should isotretinoin not be prescribed with
Tetracycline antibiotics so they have to be stopped if going on isotretinoin - they end in cycline
How long after using isotretinoin should you wait before treating scarring
1 year
What is the treatment for scarring
Intralesional steroid
excision of ice pick scars
laser
dermabrasion
chemical peels
What is acne rosacea
Chronic inflammation
Pilosebacious unit affected
It has the ace of clubs distribution so affects the forehead and then spreads down to the cheeks
Who is acne rosacea most common in
30-50 year olds
Fair skinned with blue eyes
Which gender is acne rosacea more common in
females but it is more severe in males
What is erythemato-telengiectatic
quite marked redness to the face - subtype of acne rosacea
What is rhinophyma
Change to the architecture of the nose which develops over time - severe subtype of untreated acne rosacea
What is the treatment for acne rosacea
Topical tretments:
Metronidazole - rosex and metrogel
brimonidine - mirvaso - causes constriction which helps erythramato-talengiactatic
Oral antibiotics -
erythromycin and tetracyclines e.g doxycycline
Isotretinoin can be used if treatments fail
What is infantile acne
3 months to 1 year old
same treatment as adults and need to prevent scarring
What is hidradenitis suppuritiva
recurrent boils and abscesses commonly in the groin, perenerum and submammary
What is the treatment for hidradenitis suppuritiva
tetracylcine
