Acne and rosacea Flashcards
What is a macule?
A flat well-defined hyper/hypo pigmented mark
Eg. freckle, petechiae
What is the difference between a patch and macule?
Patch is larger
What is a papule?
<1cm, elevated and well-defined
(Elevated due to increased thickness in the skin
Eg. cherry haemangioma, verruca, molloscum contagiosum
What is a plaque?
A larger papule
Eg. psoriasis, acne scarring, nummular dermatitis
What is a nodule?
Larger volume than papule
Often >2cm
Eg. lipoma, lymphoma cutis, neurofibroma
What is a vesicle?
Elevated, well-defined, primarily filled with clear fluid
<1cm
Eg. HSV, varicella
What is a bulla?
A large vesicle (>1cm), filled with clear fluid
Eg. friction blister, bullous pemphigoid
What is a pustule?
Elevated, well-defined, filled with purulent fluid
Eg. folliculitis, acne vulgaris, pustular psoriasis
What is a fissure is derm?
Break in the skin usually due to intense dryness. Often painful
Eg. dermatitis, sebopsoriasis
What is erosion in derm?
Partial loss of the epidermis
What is excoriation?
Caused by picking at the skin, causing damage to the epithelium
Eg. bites, atopic dermatitis
What is lichenification?
Thickening (acanthosis) of the skin
Eg. atopic dermatitis, lichen simplex chronicus
What is the pathophysiology of acne vulgaris?
Inflammation of the pilosebaceous units
1. excess sebum production
2. Clogged hair follicles
3. Bacteria (p.acnes)
4. Inflammation
What factors contribute to acne vulgaris?
Drugs
- lithium, Isoniazid, glucocorticoids, oral contraceptives, iodides, androgens
Other:
- Emotional stress, occlusion, and pressure on the skin
What are the clinical manifestations of acne vulgaris?
- Comedomes (open: whitehead, closed: blackhead)
- Papules and papulopustular
- Nodules or cysts
What are the treatment options for acne vulgaris?
Mild acne:
- Benzoyl peroxide (anti-bacterial)
- Topical retinoid (prevents clogging)
- Topical antibiotics Eg. clindamycin
Moderate:
- Oral antibiotics + topical therapy
Severe acne:
- Vitamin A derivate
What is rosacea?
A long-term inflammatory skin condition that causes reddened skin and a rash, usually on the nose and cheeks
What is the pathophysiology of rosacea?
- Neurovascular dysregulation
- Activation of immune system
- Demodex mite infestation
What is the clinical manifestation of rosacea?
- Fixed centrofacial erythema in a characteristic pattern that may periodically
intensify - No comedomes
What are the diagnostic criteria for rosacea?
- Flushing
- Papules and pustules
- Telangiectasia (dilation of capillaries)
- Ocular manifestations (light sensitivity, blepharitis, conjunctivitis)
What is the management of rosacea?
- Stay clear of triggers
- Sunscreen
- cosmetic camouflage
- Avoid irritating skin with cleansers
Treatment:
Erythema: brimonidine tartrate
Papules and pustules: topical antibiotics
Ocular: artificial tears
Flushing: propanolol
- Laser treatment and surgery may be an option
What is perioral dermatitis?
A rash that can resemble acne or rosacea
- Avoid topical glucocorticosteroids
- Avoid occlusive creams
Treat with oral or systemic antibiotics
What is actinic keratosis?
Rough scaly patches on the skin caused by UV damage
- Can turn into squamous cell skin cancer
Treatment: topical gels and creams. Cryotherapy and surgery to scrape away the patches
What is seborrhoeic dermatitis?
Scaly patches of inflamed skin usually on oily parts of the body
Cause: overgrowth of malassezia yeast triggering inflammation
Treatment: antifungal creams
What is atopic dermatitis?
AKA eczema
What is erysipelas?
Skin infection under the dermis layer, started by a cut on the skin usually
Cause: Group A strep
What are the features of a lupus facial rash?
A butterfly-shaped rash (malar rash)
It usually spares the sides of the nose
What is dermatomyositis?
An uncommon inflammatory disease marked by muscle weakness and rash
Cause: unknown
Treatment: corticosteroids
What is keratosis pilaris?
Skin becomes rough and bumpy
Cause: build up of keratin
