Acne and Rosacea Flashcards
Define acne
Chronic inflammatory disease of the pilosebaceous unit
What are the 4 main points in the pathogenesis of acne?
Poral occlusion
Bacterial colonisation
Dermal inflammation
Increased sebum production
How does poral occlusion come about in acne?
Ductal hyper-cornifcation
Cosmetic
Pre-menstrual oedema
Which bacteria is most likely to cause acne?
Propionobacterium acnes
Followed by staph epidermidis, malassezia furfur
True or false
More bacteria on the skin causes a more severe acne
False
No linked between number of bacteria and severity of acne
How does dermal inflammation come about in acne?
P. acnes produces proteases which cause ductal rupture leading to inflammation
How does increased sebum production come about in acne?
Affected by hormones acting on the androgen receptor in the sebaceous unit
Increased production of hormones or increased productiveness may be at fault
The high sebum conc encourages p acnes colonisation
What is mild acne?
Scattered papules and pustules
What is moderate acne?
Numerous papules, pustules and mild atrophic scarring
What is severe acne?
Numerous papules, pustules, cysts, nodules and significant scarring
List the aggravating factors for acne
Menstruation Sweating UV radiation Job Stress
What is the management for mild acne?
Topical therapy alone
What is the treatment for moderate acne?
Oral abx
CCP
What is the treatment for severe acne?
Roaccutane
Which topical treatment is used in rosacea?
Metronidzaole
Which topical treatment is used in acne?
Benzyl peroxide
How does benzyl peroxide reduce acne?
Keratolytic to reduce duct occlusion and comedones
It is anti-comedonal, -inflammatory and -microbial
Which three antibiotics are used most in the treatment of acne?
Clindamycin
Tetracycline
Erythromycin
How do contraceptives help with acne?
Decreases the availability of free androgens to reduce sebum production
What is the criteria for use of Roaccutane?
Severe nodular-cystic Scarring Hypopigmentation Psychological effects Lack of response to other treatments
How does Roaccutane reduce acne?
Works by various mechanisms to reduce sebaceous gland activity
How is rosacea different from acne?
Normal sebum production
No comedones
How does rosacea present?
Papules, pustules, erythema Telangiectasia Occular inflammation Flushing Rhinophyma
How can rhinophyma be treated?
Laser treated
