acne and rosacea

Question 1

What is acne vulgaris

Answer 1

disease of the pilo-sebaceous unit - face, chest and back

Is a scarring condition

Question 2

What happens in acne vulgaris

Answer 2

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

Question 3

What age is acne vulgaris more common

Answer 3

15-18

Question 4

Which gender is acne vulgaris more common in

Answer 4

Same in both genders but it is more severe in males

Question 5

Is acne vulgaris genetic

Answer 5

strong Family history does usually indicate that the patient will get acne vulgaris

Question 6

What is a comedome

Answer 6

Blocked follicle

Question 7

How does acne fulminans present

Answer 7

Sudden onset acneform eruptions

Feverish and unwell

joint pains

Question 8

What is the treatment of acne fulminans

Answer 8

Low dose isotretinoin but cover with prednisolone

Question 9

What is the treatment of acne vulgaris

Answer 9

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

Question 10

What is the systemic treatment for acne vulgaris

Answer 10

First line tetracyclines
first line in children - eythromycin
trimethoprim

Question 11

What is isotretinoin

Answer 11

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

Question 12

When should isotretinoin be given

Answer 12

When the patient has already tried antibiotics and topical treatments without success or if there is severe scarring

Question 13

What are the side effects of isotretinoin

Answer 13

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

Question 14

When is isotretinoin contraindicated

Answer 14

It is a retanoid and therefore contraindicated pregnancy - it is a teratogen

Question 15

What should isotretinoin not be prescribed with

Answer 15

Tetracycline antibiotics so they have to be stopped if going on isotretinoin - they end in cycline

Question 16

How long after using isotretinoin should you wait before treating scarring

Answer 16

1 year

Question 17

What is the treatment for scarring

Answer 17

Intralesional steroid
excision of ice pick scars
laser
dermabrasion
chemical peels

Question 18

What is acne rosacea

Answer 18

Chronic inflammation
Pilosebacious unit affected

It has the ace of clubs distribution so affects the forehead and then spreads down to the cheeks

Question 19

Who is acne rosacea most common in

Answer 19

30-50 year olds

Fair skinned with blue eyes

Question 20

Which gender is acne rosacea more common in

Answer 20

females but it is more severe in males

Question 21

What is erythemato-telengiectatic

Answer 21

quite marked redness to the face - subtype of acne rosacea

Question 22

What is rhinophyma

Answer 22

Change to the architecture of the nose which develops over time - severe subtype of untreated acne rosacea

Question 23

What is the treatment for acne rosacea

Answer 23

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

Question 24

What is infantile acne

Answer 24

3 months to 1 year old

same treatment as adults and need to prevent scarring

Question 25

What is hidradenitis suppuritiva

Answer 25

recurrent boils and abscesses commonly in the groin, perenerum and submammary

Question 26

What is the treatment for hidradenitis suppuritiva

Answer 26

tetracylcine