Acne & Rosacea Flashcards
What is acne?
A common skin condition that causes spots to develop on the skin, it affects most people at some point
Who gets acne?
Usually starts in adolescence
Can continue into 20s and 30s
Some people are affected much worse than others
Clinical features of acne?
Greasy skin Comedones: open and closed Papules Pustules Nodules Cysts
Seen on the face, chest, neck, back (anywhere where there are many sebaceous glands)
What is a comedone?
A clogged hair follicle in the skin, causing a ‘spot’
Can either be closed: whitehead
or open: blackhead
What is the difference between an open and a closed comedone?
Open = blackhead
The follicle is open, in it are a few dead skin cells
Closed = whitehead
Follicle is blocked with pus
What is a papule?
When a closed comedone (whitehead) is blocked for a long time and an inflammatory response begins to occur, WBCs attack the infection
What is a pustule?
When a papule hasn’t resolved and more and more inflammation occurs creating more swelling
What’s the pathogenesis of acne?
Increased sebum production by sebaceous glands
This blocks the Pilosebaceous follicles
Blockages provide an ideal site for bacterial infection
Infection causes inflammatory response
All this causes spots, erythema, inflammation
What bacteria infects blocked Pilosebaceous follicles?
Propionibacterium acnes
Management of acne?
Conservative:
- advise washing face daily
- often self-limiting
Topical:
- benzoyl peroxide
- azeliac acid
- antibiotics
- retinoids
Systemic:
- antibiotics
- isotretinoin
- anti-androgens (OCP)
Which antibiotics are usually given topically and systemically in acne?
Topically:
- erythromycin
- clindamycin
Systemically:
- (oxy)tetracycline
- clindamycin
How do retinoids help in acne?
They reduce inflammation
What do you need to be wary of when prescribing isotretinoin?
Possible link with psychiatric illness
Monitor liver
It is teratogenic: must use 2 forms of contraception
What is rosacea?
Erythematous rash of skin, butterfly shape rash on the face
No comedones
Papules and pustules
Who gets rosacea?
Anyone, more commonly women
Links with autoimmune disease, SLE
Links with polycythaemia vera
