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RB Y2 Dermatology > Acne and Rosacea > Flashcards

Acne and Rosacea Flashcards

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Dermatology Board Prep flashcards
1
Q

what is acne vulgaris

A

chronic inflammatory disease of the pilosebaceous unit

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2
Q

define pilosebaceous unit

A

The structure consisting of hair, hair follicle, arrector pili muscles and sebaceous gland is an epidermal invagination known as a pilosebaceous unit.

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3
Q

acne pathophysiology

A

thickening of keratin lining and obstruction of sebaceous duct results in closed and open comedones (white and black heads)

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4
Q

what is the difference between white and black heads

A

none, black are open comedones

black colour due to melanin???

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5
Q

what happens to sebum secretion in acne

A

increased

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6
Q

what bacteria is increased in colonisation in acne

A

Propionibacterium acne (Corynebacterium)

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7
Q

where does inflammation occur during acne

A

around sebaceous gland

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8
Q

is acne more common in males or females

A

males

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9
Q

spots seen in acne

A
  • Several types of acne spots occur, often at the same time e.g. inflamed papules, pustules and nodules, or non-inflamed comedones and pseudocysts
    • Open and closed comedones are black and white heads
    • Pustules are white or yellow ‘squeezable spots’
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10
Q

secondary lesions in acne

A
  • Scars
  • Excoriations (picked or scratched spots)
  • Erythematous macules (red marks from recently healed spots, best seen in fair skin)
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11
Q

mild acne

A

scattered papules and pustules, comedones

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12
Q

moderate acne

A

numerous papules, pustules and mild atrophic scarring

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13
Q

severe acne

A

cysts, nodules, significant scarring

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14
Q

what beneficial effect do cleansers have on mild acne

A

dissolve the keratin plug of the comedones, mild acne may respond well to these

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15
Q

topical treatment ladder for acne

A
  • Benzoylperoxide – bacteriostatic effects
    • Keratolytic and anti-bacterial
  • Topical vitamin A derivative (retinoid) – drying effect
    • Anti-inflammatory and comedolytic
  • Topical antibiotics (with one of the above)
    • Antibacterial and anti-inflammatory
    • Clindamycin and erythromycin
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16
Q

what is the effect of the topical vitamin A derivative

A

drying

17
Q

systemic treatment ladder for acne

A
  • ABx - tetracycline
    • antibacterial and anti inflammatory
  • isotretinoin (oral retinoid)
    • anti inflammatory and sebum reducing properties
18
Q

how long must oral tetracycline be taken for

A

6 months

19
Q

where does isotretinoin act on

A

sebaceous glands

20
Q

what is the effect of tetracycline

A

anti bacterial and also has an anti inflammatory effect after a few weeks

21
Q

side effects of oral retinoid (isoretinoin)

A
  • initally aggravates acne
  • severe dry skin and lips, dryness of eyes - conjuncivitis
  • dryness of mucous membanes
  • teratogenic - women must be on contaception
22
Q

what drugs can cause an exacerbation of acne

A

oral steroids

23
Q

rosacea

A
  • Chronic rash involving the central face that most often affects those aged 30 to 60. It may be transient, recurrent or persistent
24
Q

what is rosacea characterised by

A

facial flushing, persistent erythema, pustules, oedema, inflammatory papules, telangiectasia

no comedomes

25
Q

aetiology

A
  • Genetic, environmental, vascular and inflammatory factors
  • Skin damage due to chronic exposure to UV radiation is implicated
  • Cathelicidins are observed in high concentrations in rosacea
26
Q

what can happen in chronic rosacea

A

rhinophyma

27
Q

what is rhinophyma

A

skin texture become coarse resulting in gross thickening and hypertrophy

commonly seen in men

28
Q

what mites are inc in number in rosacea

A

demodex mites in sebaceous ducts

29
Q

what are the pathological features of rosacea

A

vascular ectasia, patchy inflammation, pustules, perifollicular granulomas

30
Q

name some other associated features of rosacea

A

conjunctivitis, blepharitis, eyelid oedema

31
Q

what are some pre rosacea features

A

flushing may precede the other signs by some years – flushing is exacerbated by stress, alcohol and spices. As the disease progresses the flushing may be replaced by permanent redness.

32
Q

what are some topical therapies for rosacea

A

metronidazole, ivermectin (dermodex mite)

33
Q

what is the purpose of ivermectin

A

to reduce dermodex mite

34
Q

oral therapy for rosacea

A

tetracycline long term, isotretinoin low dose if severe

35
Q

what is the first line treatment for rosacea

A

topical metronidazole gel

RB Y2 Dermatology (22 decks)

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