Acne & Rosacea Flashcards
4 factors in acne pathogenesis
- Increased serum production under the influence of androgens in adolescence
- Follicular hyperkeratinization leading to comedone formation
- Abnormal proliferation of C. acnes (bacteria) in sebaceous follicles
- Inflammation
3 dietary factors that may contribute to acne
- High-glycemic load diet
- Whey protein and skim milk
- Vitamin B12
Another name for blackheads vs whiteheads
Blackheads: open comedone
Whiteheads: closed comedone
Characteristic primary lesion of acne
Comedones (they are not inflammatory!)
3 morphological classifications of acne
- Comedonal acne
- Papulopustular acne
- Nodulocystic acne
Medication for comedonal acne
Topical retinoid (e.g. tretinoin)
Medication for papulopustular acne
Topical retinoid + benzoyl peroxide +/- topical antibiotics
Alternatives to topical retinoids and benzoyl peroxide for acne treatment
Azelaic acid, salicylic acid or topical dapsone
What are the effects of topical retinoids?
Expulses existing comedones and prevents the formation of new ones.
Anti-inflammatory
Side effect of topical retinoids
Local irritation (erythema, dryness, peeling and scaling)
What is benzoyl peroxide
Potent bacterial agent that reduces C. acnes
Medications for nodulocystic acne (severe)
Oral antibiotics, topical retinoid +/- BPO
Alternative to oral antibiotic for severe acne
Oral isotretinoin
For very severe acne (i.e. acne conglobata/fulminans) - medication
We go straight to oral isotretinoin (may require concurrent corticosteroid)
Other options for acne management (4)
- Oral contraceptive pills
- Spironolactone
- Surgical comedo extraction
- Photodynamic therapy (lasers)
What medication can help improve acne scars?
Topical retinoids
What do we call adolescent acne?
Acne vulgaris
Which types of acne do not have comedones? (2)
Neonatal acne
Adult acne
Acne excoriee is often due to an underlying…
obsessive-compulsive or anxious disorder (has mainly secondary lesions, crusts and scars)
Severe form of nodulocystic acne that may have eruptive onset but without systemic manifestations
Acne conglobata
Most severe form of acne with abrupt nodular and suppurative acne lesions with systemic manifestations (fever, joint and muscle pain, hepatosplenomegaly)
Acne fulminans
Name a type of medication that can cause acne
Corticosteroids
How is drug induced acne different from acne vulgaris?
Acne vulgaris has more heterogeneous lesions. Drug-induced acne has monomorphous eruptions.
Fidler’s neck, where repetitive trauma from violin placement on the neck causes acne, is an example of…
acne mechanica
Chronic inflammatory condition affecting skin mainly of the central face
Rosacea
How is rosacea differentiated from acne?
Absence of comedones
Common rosacea triggers
Spicy food, alcohol, sunlight, heat, hot beverages, emotional stress, genetic susceptibility
Rosacea usually has its onset during…
middle age
2 causes of cutaneous inflammation in rosacea (both genetic and environmental)
- neurovascular disregulation
- aberrant innate immune response
Can you name (1) clinical sign helps you to differentiate papulopustular rosacea from acne?
absence of comedones
Rosacea that affects the nose
phymatous
Erythematotelangiectatic rosacea affects
face
Chronic inflammatory skin disease characterized by persistent or recurrent flares of inflamed painful nodules, sinuses and scars in the axilla, groin or both
Hidradenitis suppurativa
Clinical severity of hidradenitis suppurative is assessed by…
Hurley staging system
