Acne and Rosacea

Question 1

What is acne

Answer 1

chronic inflammatory disease of the pilosebaceous unit

Question 2

what are the different pathogenic mechanisms in acne

Answer 2

increased sebum production
poral occlusion from increased androgens
infection with P. acnes

Question 3

symptoms and signs of acne

Answer 3

comedones
papules 
nodules 
cysts 
pustules
erythema

Question 4

Management of acne

Answer 4

topical: benzoyl peroxide, antibiotics, retinoids
PO: tetracycline antibiotics, COCP, isotretinoin

Question 5

why can isotretinoin only be prescribed by dermatologists

Answer 5

it is highly teratogenic

Can cause liver problems, and low mood

Question 6

features of rosacea

Answer 6

erythema
papules 
Rhinophyma 
telangiectasia 
pustules
facial flushing 
ocular inflammation - blepharitis

Question 7

there is presence of comedones in rosacea, true or false

Answer 7

FALSE

Question 8

RFs for rosacea

Answer 8

Female 
30-40s 
alcohol 
stress 
sunlight 
spicy food

Question 9

Management of rosacea

Answer 9

Topical metronidazole
avoid triggers
PO tetracyclines long term
isotretinoin if severe

Question 10

whiteheads are closed/open comedones

Answer 10

closed

Question 11

blackheads are closed/open comedones

Answer 11

open

Question 12

complications of acne

Answer 12

scarring - atrophic (ice pick) and hypertrophic (keloid)
post inflammatory hyperpigmentation
psychological stress

Question 13

what caues acne excoriee

Answer 13

stress

no comedones are present

Question 14

management of mild acne

Answer 14

topical treatment

Question 15

management of moderate acne

Answer 15

topical treatment and PO antibiotics or dianette

Question 16

management of severe acne

Answer 16

isotretinoin

Question 17

features of benzoyl peroxide

Answer 17

anti inflammatory
anti microbial
keratolytic
(can cause irritation and erythema)

Question 18

side effects of tetracyclines

Answer 18

teeth staining
photosenstivity
raised intracranial pressure
LFT derangement

Question 19

side effects of erythromycin

Answer 19

Nausea

Liver upset

Question 20

Mechanism of isotretinoin

Answer 20

reduces sebaceous gland activity

Question 21

side effects of isotretinoin

Answer 21

very drying: lips, eyes, skin
Nosebleeds 
increased skin fragility - avoid waxing 
teratogenicity 
hyperlipidaemia 
abnormal LFTs
low mood 
arthralgia 
raised intracranial hypertension (especially with tetracycline)
Photosensitivity

Question 22

how does rosacea differ from acne

Answer 22

no comedones

normal sebum production