Acne, Eczema and Psoriasis Flashcards
Describe the aetiology of acne?
Keratin and cell build up
Androgen increase sebum production and viscosity
Natural skin bacteria (especially Propionibacterum acnes) proliferate and cause inflammation
If chronic, can cause scarring
Describe the clinical features of acne?
Papules Pustules Comodones - white heads and black heads Erythema If deep set may have nodules and cysts Scarring
Describe the distribution of acne?
Face most common
Chest/back/shoulders
Sometimes legs, scalp or buttocks
List the 7 subtypes of acne vulgaris?
Papulopustular
Nodulocystic
Comedonal
Steroid induced: rapid onset, normally trunk based.
Acne Fulminans: Rapid onset, may be systemically unwell, join pain, temperature, raised CRP.
Acne Rosacea: Papules and pustules, aggrevated by alcohol or spicy food.
Acne inversus: papules and pustules, found in groin, buttocks and areas of apocrine glands. May get discharge and pus.
List treatment options for acne?
Topical retinoid Topical benzoyl peroxidase Topical antibiotics - Erythromycin/clarythromycin Oral antibiotics - Erythromycin Oral isotretanoin OCP/dianette
What are side effects of oral isotretanoin?
MILD: Dry lips, skin and eyes. Nose bleeds. Myalgia.
More Serious: Deranged LFT, raised lipids, mood disturbance.
What is the PPP for those on isotretanoin?
girls must be on 2 forms of contraception e.g. OCP and condoms.
Must get pregnancy test every month before they get prescription.
Isotretanoin is a teratogen.
What is eczema?
Skin inflammation causing red, itchy, dry patches causing increased permeability and reduced antimicrobial function.
Describe the possible genetic component of eczema?
Inherited abnormality of filaggrin expression on Chromosome 1 may leads to disordered barrier function.
Fillagrens bind to keratin fibres in epidermal cells.
What conditions are associated with eczema?
Respiratory problem: asthma, allergic rhinitis, conjunctivitis, hayfever.
Describe the aeitiology of Atopic eczema?
IgE immunoglobulin mediated.
Family history
Describe the appearance of eczema?
Red, symmetrical, may see breaks in skin, may see yellow crusting (bacterial infection)
Common on face in infants
Flexor surfaces of elbows, knees, ankle, wrists
Describe complications of eczema?
Bacterial infection with Staph aureus Viral infection: Molluscum, warts, eczema herpeticum Tired (lost sleep) Growth reduction (in children) Psychological impact
List treatment options for eczema?
Emollienents: Dermol 500 Bandages Avoid exacerbating factors Antibiotics/antivirals: especially if herpes infection Topical steroid: hydrocortisone, clobetasone, betamethasone. Sedative anti-histamines Systemic drugs: MTX, ciclosporin Biologics: Dupilmub anti-IL4/13
What is contact dermatitis?
Skin inflammation precipitated by an exogenous agent.
