Acne and Rosacea

Question 1

bacterium associated with acne

Answer 1

proprionibacterium acnes

Question 2

hormones that increase the basal keratinocyte proliferation in the pilosebaceous unit (acne)

Answer 2

androgens and corticotrophin releasing hormones

Question 3

comodones are…

Answer 3

black and white heads which block secretions –> papules, nodules, cysts and scars

Question 4

most with acne have increased androgens - TRUE/FALSE

Answer 4

FALSE - however the sebaceous glands are more sensitive to androgens particularly in puberty

Question 5

mild acne can be described as…

Answer 5

mainly facial comedones

Question 6

mild acne can be treated with…(3)

Answer 6

topical - benzyl peroxide, retinoids, antibiotics (doxycyline)

Question 7

How long can acne treatment take to be effective?

Answer 7

8 weeks

Question 8

moderate acne can be described as…

Answer 8

inflammatory lesions dominate (papules and pustules) affecting the face +/- the torso

Question 9

treatment for moderate acne (3)

Answer 9

topical antibiotic combined with benzoyl peroxide, topical retinoid, oral antibiotic with topical benzoyl peroxide for 6 months (doxycycline or tetracycline, erythromycin if pregnant)

Question 10

Severe acne can be described as…

Answer 10

nodules, cysts, scars and inflammatory papules and pustules and should be referred

Question 11

treatment for severe acne

Answer 11

isotretinoin - hospital only prescribing

Question 12

treatments for acne which should be avoided in pregnancy

Answer 12

isotretinoin and some antibiotics

Question 13

side effects of isotretinoin

Answer 13

initial flare up for 2-3 weeks, skin and mucosal dryness, depression

Question 14

success rate of isotretinoin

Answer 14

~65% have permanent clear up

Question 15

mechanism of action of isotretinoin

Answer 15

decreased sebum production and pituitary hormones

Question 16

rosacea can be described as…

Answer 16

a chronic relapsing and remitting disorder of blood vessels and pilosebaceous units in the central facial areas typically in fair skinned people

Question 17

areas commonly affected by rosacea

Answer 17

nose, chin, cheeks, forehead

Question 18

groups commonly affected by rosacea

Answer 18

30-60years, males and females

Question 19

rosacea has papules, pustules, erythema and comedones - TRUE/FALSE

Answer 19

FALSE - rosacea has papules, pustules and erythema but NO comedones

Question 20

pre-rosacea features include…(3)

Answer 20

flushing caused by stress, alcohol and spices

Question 21

signs of rosacea (4)

Answer 21

central facial rash with erythema, inflammatory nodules and facial lymphoedema, blepharitis and conjunctivitis, rhinophyma in men

Question 22

what is rhinophyma?

Answer 22

swelling and soft tissue overgrowth of the nose

Question 23

Things to avoid in the treatment of rosacea (2)

Answer 23

avoid exacerbating factors, avoid topical steroids

Question 24

treatment for rosacea

Answer 24

topical metronidazole, ivermectin (to reduce demodex mite), oral tetracyclines long term

Question 25

treatment for more resistant rosacea

Answer 25

isotretinoin, lasers for telangiectasia and rhinophyma