Acne & Rosacea

Question 1

Which antibiotic can be used to treat acne?

Answer 1

Doxycycline (6 months)

Question 2

Retinoids (e.g. isotretinoin) may be prescribed by GPs. True/false?

Answer 2

False - hospital only prescribing

Question 3

What are side-effects of retinoids (e.g. isotretinoin)? (2)

Answer 3

• VERY teratogenic (termination required)

- Initial worsening of acne

Question 4

Acne vulgaris is a chronic inflammatory disease of the ___________________

Answer 4

Pilosebaceous unit

Question 5

Scarring typical to acne is termed

Answer 5

Ice-pick scarring

Question 6

Someone with numerous papuoles, pustules and mild scarring would be said to have which grade of acne?

Answer 6

Moderate

Question 7

A patient with cysts and significant scarring has which stage of acne?

Answer 7

Severe

Question 8

What is a lifestyle treatment patients can make to treat acne?

Answer 8

Avoid oily substances / trigger foods

Question 9

Name 3 topical treatments for acne & their MoAs (3)

Answer 9

1) Benzyl peroxide (a keratolytic antibacterial)
2) Topical vitamin A derivatives (AKA retinoids which are drying)
3) Topical antibioitcs (antibacterial and anti-inflammatory, e.g. tetracycline?)

Question 10

Name 2 systemic / oral treatments for acne (2)

Answer 10

1) Antibiotics (for at least 6 months)

2) Isotretinoin (oral retinoid)

Question 11

Rosacea may be triggered/worsened by (5)

Answer 11

1) Rapid changes in temperature
2) Alcohol
3) Spicy food
4) Sunlight
5) Topical steroids

Question 12

Which antibiotic is useful in an active inflammatory flare-up of rosacea?

Answer 12

Metronidazole topically, tetracycline PO

Question 13

Rosacea typically presents with papules, pustules and comedones. True/false?

Answer 13

False - it has papules and pustules but NO comedones (not a disease of the pilosebaceous unti)

Question 14

What are 2 complications of rosacea?

Answer 14

• Rhinophyma

- Conjunctivitis

Question 15

What is the cause of rosacea?

Answer 15

Unclear - may be related to demodex mite

Question 16

Topical therapies for rosacea include (2)

Answer 16

• Metronidazole

- Ivermectin

Question 17

Telangectasia in rosacea can be treated with which surgical procedure?

Answer 17

Vascular laser ablation

Question 18

Rhinophyma can be treated how?

Answer 18

CO2 laser

Question 19

How do retinoids work?

Answer 19

Reduce sebum production

Question 20

How are acne and rosacea differentiated?

Answer 20

Acne has comedones and won’t respond to rosacea triggers (e.g. heat, spice)

Question 21

An open comedone is AKA….

Answer 21

Blackhead

Question 22

A closed comedone is AKA…

Answer 22

Whitehead

Question 23

What is the underlying pathophysiology of acne?

Answer 23

Block pore in skin leads to bacterial colonisation, inflammation and increased sebum production

Question 24

Triggers for rosacea include

Answer 24

Alcohol, spice, temperature changes

Question 25

Treatments for rosacea (3)

Answer 25

1) Avoid triggers
2) Topicals (ivermectin, metronidazole)
3) Oral (long-term tetracycline, isotretoin if severe)