Acne and Rosaea Lecture Powerpoint

Question 1

___% of young adults have acne

Answer 1

85

Question 2

Acne vulgaris is not a physically threatening condition, but rather affects patients….

Answer 2

…psychologically

Question 3

Hormone that controls sebum production

Answer 3

Androgens

Question 4

Acne vulgaris pathophysiology mech of action (also state the organism responsible for the condition)

Answer 4

-androgens drive sebum production -anormal desquamation obstructs the opening to the folliculosebaceous apparatus -intrafollicular bacteria proliferate (propionibacterium acnes) -proinflammatory mediators result in the development of an inflammatory lesion

Question 5

Is acne caused by dirt or poor hygiene?

Answer 5

NO!

Question 6

Is acne exaggerated by stress?

Answer 6

YES

Question 7

Open comedones vs closed comedones

Answer 7

Black headed pimples come from open comedones resulting from oxidation darkening the color, while white heads come from closed comedones

Question 8

Papules and pustules presentation in acne vulgaris and how are they different from comedones?

Answer 8

Erythematous papules or yellow pustules from obstructed hair follicle with surrounding inflammation more likely to scar (nodular presentation), they are different from comedones in the level of inflammation present

Question 9

3 classifications of acne presentation

Answer 9

Mild - noninflammatory lesions only, low risk of scarring Moderate - more extensive comedones and inflammatory lesions Severe - Moderate but also spread to back and other parts of body (or distressing), or nodulocystic lesions with scarring

Question 10

It is important to stress to the patient receiving acne treatment that…

Answer 10

…it can take at elast 6-8 weeks to notice significant improvement

Question 11

Acne vulgaris treatment options (5)

Answer 11

-benzoyl peroxide -topical retinoids -salicylic acid (ASA) -oral antibiotics -hormonal therapy

Question 12

Bonzoyl peroxide for acne treatment mech of action

Answer 12

-antibacterial thru oxidizing activity on proteins of P. acnes, and comedolytic to treat mild to moderate acne

Question 13

Topical antibiotics (erythromycin, clindamycin) for acne treatment mech of action

Answer 13

Used alongside benzoyl peroxide to prevent antibiotic resistance, decreases total number of P. acnes organisms

Question 14

Topical retinoids (vit A derivatives) for acne treatment mech of action

Answer 14

-normalizes desquamation of folicular epithelium preventing formation of new comedones and clearing existing ones

Question 15

Topical retinoids are contraindicated in…

Answer 15

…pregnancy

Question 16

Oral antibiotics (minocycline) for acne treatment mech of action and ADR

Answer 16

-indicated for moderate or severe acne that doesn’t respond to topical therapy by inhibiting the inflammatory process and decreases P. acnes colonization -vertigo is the big ADR with minocycline

Question 17

Tetracyclines are contraindicated in…

Answer 17

…children under 8 or in pregnancy

Question 18

Hormonal therapy (estrogens) for acne treatment mech of action

Answer 18

-used in females who have failed standard acne therapies or demonstrate hirsutism to inhibit androgen synthesis and thus decrease sebum production

Question 19

Oral retinoids (accutane) for acne treatment mech of action

Answer 19

-reserved for severe or nodulocystic acne, acts as an analogue to vit. A and is a teratogen and pregnancy category X

Question 20

Placing a patient on oral retinoids requires that they undergo a…

Answer 20

…risk management program

Question 21

Acne at home skin care recommentations (3)

Answer 21

-use water based lotions and products opposed to oil which are comedogenic -do not pick at lesions -daily moisturizer when using drying topical products

Question 22

Most common cause of treatment failure for acne vulgaris

Answer 22

lack of patient compliance

Question 23

Steroid acne, mechanical acne, and perioral dermatitis

Answer 23

-occurs due to oral steroid ingestion and appears similar to acne -appears from rubbing of clothes and such -occurs in young women and resembles acne but may actually be rosacea

Question 24

Hidradenitis suppurativa

Answer 24

Chronic suppurative subcutaneous process that occurs in areas of skin to skin contact (often in groin, axilla, parianal region) where follicle occlusion and sweating create abscesses that are not infectious, take a long time to diagnose

Question 25

Rosacea

Answer 25

Chronic, idiopathic skin disorder with many manifestations but typically occuring at the center of the face in fair skinned individuals

Question 26

4 main subtypes of rosacea

Answer 26

-erythematotelangiectatic rosacea -papulopustular rosacea -phymatous -ocular

Question 27

Erythematotelangiectatic rosacea

Answer 27

Recurrent episodes of facial flushing of the nose or medial cheeks and telangiectasias on cheeks with skin stinging or burning in affected areas, most common form of it

Question 28

Papulopustular rosacea

Answer 28

Presence of papules and pustules localized to the central face that may be mistaken for acne vulgaris but lacks COMEDONES as inflammation can extend beyond follicular unit

Question 29

Phymatous rosaces

Answer 29

Causes tissue hypertrophy and thickened skin often in adult men on the nose, chin, forehead and cheeks and can be markedly disfiguring

Question 30

Occular rosacea

Answer 30

A subtype of rosacea that occurs in over 50% of patients with other rosacea, will manifest with eye issues such as conjunctival hyperemia, foreign body sensations, or abnormal tearing

Question 31

Rosacea diagnosis

Answer 31

Clinical assessment is sufficient

Question 32

Rosacea treatments (3) and what is one to avoid

Answer 32

-metronidazole -skin moisturizer -cosmetic camoflage -avoid topical steroids as they aggrivate the condition

Question 33

How do you distinguish papulopustular rosacea with acne vulgaris?

Answer 33

A lack of comedomes in papulopustular rosacea

Question 34

What condition is this?

Answer 34

Sever acne

Question 35

What condition is this?

Answer 35

Hidradenitis suppurativa