Acne & Rosacea Flashcards

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1
Q

What is the key clinical sign for acne vulgaris?

A

Comedones, pustules/papules, cysts, erythema

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2
Q

What are the common sites of acne?

A

Face, back, anterior chest

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3
Q

Describe the pathogenesis of acne

A
  1. Increased androgen during puberty
  2. Shedding and accumulation of keratinocytes within the lumen of the infundibulum
  3. Stimulation of sebum production and proliferation of propionibacterium acnes
  4. Due to narrow opening sebum, corneocytes and bacteria accumulate in pilosebaceous unit
  5. Rupture leads to inflammation (neutrophils & T cells)
  6. Up regulation of genes coding of cytokines
  7. Pustule & papule formation
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4
Q

What is the difference between open and closed comedones?

A

Closed - white heads

Open - black heads

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5
Q

What are comedones?

A

Non-inflamed early lesions of acne

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6
Q

State the main long term consequence of acne

A

Scars - atrophic, ice-pick, texture changes

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7
Q

Define mild acne

A

Scattered papules and pustules

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8
Q

Define moderate acne

A

Numerous papules and pustules with mild scarring

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9
Q

Define severe acne

A

Cysts, nodules and scarring

OR non responsive to non isotretinoin treatment

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10
Q

What is the first line treatment for acne?

A

Topical benzoyl perxoide

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11
Q

If topical benzoyl peroxide fails what other topical treatments can be given?

A

Retinoids

Antibiotics

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12
Q

What are the two oral options for acne treatment?

A

Antibiotics
Females - oestrogen only contraceptive pill (anti-androgen)
Isotretinoin

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13
Q

In females prescribed isotreinoin what is required?

A

Two forms of contraception one of which is a barrier form e.g contraceptive pill and condoms

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14
Q

What is the key difference between acne and rosacae?

A

Rosacae has no comedones

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15
Q

What are the common sites of rosacea?

A

Nose, chin, cheeks and forehead

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16
Q

Describe the aetiology of rosacea

A

Cause is unknown but triggers include temperature, alcohol, spicy food

17
Q

How does rosacea present?

A

Recurrent facial flushing, visible blood vessels, pustules and thickening of skin

18
Q

What two changes lead to rhinophyma?

A

Hypertrophy & lymphedema

19
Q

What is the pathology of rosacea?

A
  1. vascular ectasia (dilation)
  2. patchy inflammation with plasma cells
  3. pustules
  4. perifollicular granulomas
20
Q

How is rosacea managed?

A
  • reduce aggravating factors
  • topical therapies (metronidazole)
  • oral (tetracycline or isotretinoin)
  • telangiectasia treated with laser surgery
  • rhinopehyma treated with laser shaving