Acne & Rosacea

Question 1

Isotretinoin

Answer 1

Acne & Rosacea
Oral Retinoid (Vit A derivative)
INDICATIONS
- severe cystic acne vulgaris
EFFECTS
o decreases the size and secretion of the sebaceous glands
o normalizes follicular keratinization
o inhibits P. acnes growth
o exerts an anti-inflammatory effect
MOA
- unknown; however, works by altering DNA transcription. 
ADE
- neuropsych effects
- drying effects
- joint pain
- ** teratogenic
- iPLEDGE - crazy regimen/checkup for pregnancy if taking isotretinoin. 2 birth control

Question 2

Benzoyl peroxide

Answer 2

Acne & Rosacea
Topical agent
MOA
- antibacterial, comedolytic. 
Adverse Effects
- *Skin irritation; *bleaching of hair and clothing.

Question 3

Azelaic acid

Answer 3

Acne & Rosacea
Topical agent
INDICATIONS
- antimicrobial activity against Propionibacterium acnes and Staphylococcus epidermidis.
• A normalization of keratinization leading to an *anticomedonal effect

Question 4

Tazarotene

Answer 4

Acne & Rosacea
TOPICAL RETINOIDS
INDICATIONS
- noninflammatory and inflammatory acne,
- should be initial management of most patients
EFFECTS
- *normalization of follicular keratinization
- decreased cohesiveness of keratinocytes
- resulting in reduced follicular occlusion and microcomedone formation
ADE
- PREGNANCY CATEGORY X!

Question 5

Metronidazole

Answer 5

Acne & Rosacea
antimicrobial
INDICATIONS
• One of drugs of choice for rosacea tx (via topical gel, applied to affected areas of face QDay or BID)

Question 6

tetracycline, Doxycycline, minocycline

Answer 6

Acne & Rosacea
Oral Antibiotics
INDICATIONS
- moderate to severe inflammatory acne
EFFECTS
- antibacterial and anti-inflammatory properties
ADE
- PREGNANCY CATEGORY D
- Can stain teeth of unborn child, bone abnormalities