Acne/random skin stuff Flashcards

1
Q

Open comedones are called?

A

blackheads

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2
Q

Closed comedomes are called?

A

whiteheads

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3
Q

in acne - causative bacteria which colonizes in hair follicle?

A

Propionobacterium acnes

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4
Q

Risk factors for acne ?

A

Age 12-24
FHx
Greasy skin
Endocrine stuff: PCOS, hyper androgenism

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5
Q

Agg factors for acne ?

A

Stress
sweating
PMS

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6
Q

acne distribution?

A

face chest upper back

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7
Q

chronic acne complications ? (2)

A

scars:
atrophic (ice pick scars)
hypertrophic (keloid scars)

skin hyperpigmentation

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8
Q

Acne severity:

if scattered comedomes, papules and pustules?

A

MILD

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9
Q

acne severity:

If numerous papules, pustules and mild atrophic scarring

A

MODERATE

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10
Q

acne severity:

Numerous papules, pustules, mild atrophic scarring, cysts, nodules and significant scarring

A

SEVERE

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11
Q

Acne treatment:

If mild - T?

A

Topical therapy only:
Retinoid + Benzylperoxidase +/- antibiotic
(erythromycin or clindamycin)

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12
Q

moderate acne - T?

A

Topical therapy + oral antibiotic

Erythromycin or oxytetracycline or lymecycline

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13
Q

Tetracycline ABs are 1st line in moderate acne - when would you not use these however ?

A

If pregnant or <12 y/o

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14
Q

If pregnant/ <12y/o and need oral AB for moderate acne - use what ?

A

erythromycin

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15
Q

acne treatment option in women alone who want contraception?

A

COCP

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16
Q

Severe acne treatment ?

A

Topical therapies + isotretinoin (roaccutane)

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17
Q

topical retinoid side effects?

A

stinging, irritation and erythema

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18
Q

cautions with topical retinoids?

A

should use at night

dont use in pregnancy

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19
Q

side effects of benzyl peroxidase? also does what which is annoying?

A

erythema and peeling

can bleach your clothes

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20
Q

oral ABs side effects?

A

GI upset, thrush, heaptitis

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21
Q

duration of treatment with oral ABs?

A

3-6 months with 80% seeing response by 6 mths. NEED to continue topical therapy when taking

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22
Q

isotretanoin/roaccutane side effects?

A

dry skin/lips, depression, hepatitis, TERATOGENIC, headaches

23
Q

When starting roaccutane/isotretinoin patient must be on what if female?

A

contraception prior to starting therapy and needs pregnancy tests during duration of use

Also need LFT FBC and lipids checked regularly

24
Q

dont give isotretinoin/roaccutane along with what- because risk of IIH?

A

tetracyclines

25
Q

woman aged 30-40 with facial flushing triggered by alcohol and develops rash on nose cheeks chin and forehead (sparing of naso labial folds)?

A

acne rosacea

facial flushing can occur long before onset of rash

26
Q

triggers for acne rosacea?

A

alcohol, hot drinks, spicy food, stress

27
Q

acne rosacea morphology?

A

erythema with papules and pustules

28
Q

2 main complications of acne rosacea?

A

telangectasia

rhinophyma

29
Q

1st line treatment of acne rosacea?

A

topical metronidazole

30
Q

2nd line treatment for acne rosacea?

3rd line?

A

topical therapies + oral ABs (doxycycline/oxytetracycline)

3rd line = isotretanoin

31
Q

if telangectasia/rhinphyma developed due to acne rosacea - treatment ??

A

laser therapy

32
Q

Post viral rash, most commonly seen in teenagers and young adults. Sudden onset over a few weeks, began with oval shaped patch on trunk (large) and then smaller oval shaped lesions developed on the trunk and extremities?

A

Pityriasis rosea

33
Q

Pityriasis rosea (spontaneous inflammatory rash) (post viral) first presents with what lesion?

A

Herald patch

34
Q

Herald patch - describe?

A

Large oval lesion erythematous and scaly on trunk or neck and is larger than sunsequent developing lesions

35
Q

following herlad patch subsequent rash in pityriasis rosea described as having what appearance ?

A

christmass tree appearance

smaller oval shaped scaly lesion on trunk and extremities - spread out along skin cleavages (tree appearnace)

36
Q

pityriasis rosea treatment ?

A

Nil
self limiting
(can give emoillients and anti histamines for symptoms)

37
Q

Intensly itchy purple flat topped papules/plaques that are rhomboid/polyangular shaped +/- white lacy markings that develop on the flexor surfaces of wrist/forearm ankles, legs and oral mucosa?

A

Lichen planus

38
Q

white lacy markings seen in rash of lichen planus?

A

wickmans striae

39
Q

oral lesions seen in lichen planus?

A

lacy white lesions on inside of cheek

40
Q

lichen planus ass with what condition?

A

Hep C

41
Q

where else can lichen planus develop typically ?

A

sites of trauma (koebners)

42
Q

Lichen planus management?

A

topical steroid + anti histamine

43
Q

high temperature and widespread maculopapular rash?

A

roseola

44
Q

widespread maculopapular rash no fever ?

grey/white mucosal spots in mouth - koplicks spots that develop before the rash

A

measles

45
Q

“Target shaped” lesions (annular/ring shaped macules that are raised with a red rim and red centre and then a wedge of normal skin inbetween) - Dx?

A

erythema multiforme

46
Q

Erythema multiforme can be present in minor or major form. major form considered to be what?

A

SJS (steven johnston syndrome) or TEN (toxic epidermal necrolysis)

erythem multiforme major (mucosal involvement)

47
Q

infective causes of erythema multiforme?

A

herpes simplex, mycoplasma, hep B, EBV, CMV

48
Q

drugs that can cause erythema multiforme?

A

thiazide diuretics, anti-malarials, sulphonylureas, penicillins, allopurinol

49
Q

management of erythema multiforme?

A

supportive care + treat underlying cause

50
Q

SJS and TEN variants of same disease:

a) if less than 10% of skin involved - Dx ?
b) if more than 30% of skin involved - Dx>

A

SJS

TEN

51
Q

What is SJS/TEN?

A

Potentially life threatening condition - widespread erythema and blistering of the skin and mucosal surfaces

52
Q

what can happen to the blisters in SJS/TEN?

A

they can merge, necrose and large sheets of skin can be lost

53
Q

most common causes of SJS/TEN?

A

most commonly = drug reactions

Penicillins, NSAIDs, anti-convulsants (lamotrigine, valproate)

54
Q

management of SJS/TEN?

A

cessation of causative drug
supportive care
emoillients
IV Ig