Acne, Rosacea Flashcards
Acne vulgaris is a disease of the _________ unit
Pilosebaceous
What is the precursor for the clinical lesion of acne vulgaris
Microcomedo
Accumulation of what two things converts a microcomedo into a closed comedo
Increased sebum production
Follicular hyperkeratinzation
What contributes to the development of inflammatory lesions with an open comedo
Follicular rupture
What stimulates the growtn and secretory function of sebaceous glands in acne vulgaris
Androgens
______ can rupture comedos, causing inflammatory lesions
Mechanical trauma
Aka
Poppin’ that zit
What areas of the body does acne affect the most?
Face, neck, chest, upper back, upper arms
These areas have the largest, hormonally-responsive sebaceous glands
As nodules merge, what can form?
Sinus tracts
Rapid appearance of acne in conjunction with virilization suggests:
An underlying adrenal or ovarian tumor
Topical retinoids treat what type of acne lesions
Comedonal
Inflammatory
Topical antimicrobial therapies what type of acne lesions
Inflammatory
Benzoyl peroxide has what use in the treatment of acne
Decreases the emergence of antibiotic resistant bacteria
If someone has comedonal (noninflammatory) acne, what is the first line treatment?
Topical retinoid (topical tretinoin)
What is the treatment for MILD papulopustular and mixed acne
Benzoyl peroxide
Topical retinoid
+/- topical antibiotic
What is the treatment for MODERATE papulopustular and mixed acne
Topical retinoid
ORAL antibiotics
Benzoyl peroxide
What is the difference between treating mild, moderate, and severe papulopustular and mixed acne
ALL = benzoyl peroxide and topical retinoid
Mild = +/- topical abx (erythro, clinda)
Moderate = oral abx (tetracyclines)
Severe = oral abx (tetracyclines) OR isotretinoin monotherapy
When would you use oral isotretinoin monotherapy for acne
Severe
Which acne medication is SUPER CONTRAINDICATED in pregnancy
Retinoids are TERATOGENIC
Safe regimen for acne treatment in pregnancy
Oral erythromycin
Topical clindamycin
Topical azelaic acid
Acne rosacea is a chronic skin disorder of the:
Central face
The pathogenesis of rosacea is not well understood, but what are some reasons we think it happens
Abnormalities in immunity
UV damage
Vascular dysfunction
Inflammatory reactions
What are the 4 subtypes of Rosacea
Erythematotelangiectatic
Papulopustular
Phymatous
Ocular
Features of erythematotelangiectatic rosacea:
Chronic redness of central face
Flushing
Skin sensitivity
Dry appearance
Telangiectasias
Papulopustular rosacea features:
Papules and pustules of hte central face
Inflammation can be confluent
NO COMEDONES
Phymatous rosacea features:
Tissue hypertrophy causing irregular contours
Mostly nose but can involve cheeks, forehead, chin 👃🏽
Usually men
Ocular rosacea features
Usually presents WITH other types of rosacea
Dry eyes
Itching
Blurry vision
Photosensitivity
Blepharitis
Keratitis
Conjunctivitis
Stye
Triggers of rosacea
Hot/cold temperature 🔥❄️
Sunlight ☀️
Wind 🌬
Spicy Food 🌶
Alcohol 🍷
Emotions 😀😫😭
topical irritants 🧴
meopausal flushing 🥵
meds that promote flushing 💊
Do you need a biopsy to diagnose rosacea or is it a clinical dx
Clinical
But biopsy sometimes helpful for exclusion
Treatment for erythematotelangectatic rosacea
1st line: behabior mods (avoid triggers, wash face)
2nd line: laser therapy, topical brimonodine
Treatment for papulopustular rosacea
1st line: topical metronidzole, azelaic acid
2nd line: topical ivermectin or sulfacetamide-sulfur
Severe: oral tetracyclines or macrolides
Treatment of phymatous rosacea
Early : isotretinoin
Advanced: surgical debulking
Ocular: PUNT THAT BITCH TO OPHTHO
