Acne Rosacea and Related Disorders

Question 1

Papular or pustular eruption that is located on the face, chest, and back with variable severity.

Answer 1

Acne vulgaris

Question 2

What are the causes of acne?

Answer 2

Excess oil production
Plugged hair follicle
Skin and sebum collection
inflammation
bacterial infection
pimple

Question 3

Oil + air = ?
(closed comedones)

Answer 3

Blackhead (dark plug)

Question 4

Oil + skin covering = ?
(open comedones)

Answer 4

Whitehead

Question 5

A type of acne with papules, pustules, and cysts

Answer 5

Inflammatory acne

Question 6

A type of acne with open comedones (whiteheads) or closed comedones (blackheads)

Answer 6

Non-inflammatory acne

Question 7

An inflammatory acne lesion that is less than 5mm. Appear red and have no material that can be extracted

Answer 7

Papules

Question 8

An inflammatory acne lesion that have a visible central core of purulent material

Answer 8

Pustules

Question 9

An inflammatory acne lesion that is greater than 5mm. Can be suppurative (with pus-cysts) or hemorrhagic

Answer 9

Nodules

Question 10

What are the primary treatments for Acne?

Answer 10

Retinoids
Benzoyl Peroxide
Antibiotics:
Oral - doxycycline
Topical - Clindamycin (maybe erythromycin)

Question 11

What should you always use when giving antibiotics for acne in order to reduce drug resistance?

Answer 11

Benzoyl Peroxide

Question 12

What are some secondary treatments for acne?

Answer 12

Salicylic acid
Azelaic acid
Sulfur washes
Oral Contraceptives
Spironolactone (adult women)

Question 13

What is the primary treatment for cystic acne?

Answer 13

Isotretinoin

Question 14

Adverse affects of isotretinoin and some things to consider

Answer 14

Teratogenic (must be prescribed with birth control)
Men should not father children while on it
Possible acne flare

Question 15

Prescribing isotretinoin

Answer 15

20 weeks
Monthly pregnancy test
Monthly labs (Liver Function and WBC)
May cause delayed healing

Question 16

Treatment for acne in women over 25

Answer 16

Spironolactone
Oral Contraceptives
Retinoids

Question 17

Multiple erythmatous grouped small inflammatory papules, papulopustules, or papulovesicles or erythematous scarring around the mouth, nose, or eyes. Clear zone around the vermillion border.

Answer 17

Perioral Dermatitis

Question 18

Risk factors for perioral dermatitis

Answer 18

History of topical corticosteroid use
25-45 year old women
Fluorinated toothpaste
Oral contraceptive therapy

Question 19

Perioral dermatitis treatment

Answer 19

discontinuation of topical corticosteroids
avoid skin irritants
self-limiting

Mild: topical Calcineurin, Metronidazole, or Erythromycin

Extensive or Refractory: oral tetracyclines or erythromycin in children under 8 and pregnant women

Question 20

A chronic acneiform skin condition with a vascular and inflammatory component. Centro-facial erythema and telangectasias. An absence of comedones are and the patient may have a red enlarged nose (rhinophyma).

Answer 20

Rosacea

Question 21

Triggers of rosacea

Answer 21

alcohol
hot or cold weather
hot drinks
hot baths
spicy foods
sun exposure

Question 22

Ocular erythema and tearing. Patients may state they have red eye lids from rubbing and say their eyes feel gritty and itchy.

Answer 22

Ocular Rosacea

Question 23

Rosacea treatment

Answer 23

avoid extreme temperatures
use mineral based sunscreen
do NOT apply topical steroids

Mild: topical Metronidazole (gel or cream), Azelaic acid, or Ivermectin. topical Brimonidine for erythema

Moderate-Severe: sub-microbial doxycycline

Telangectasias: laser therapy

Question 24

Painful inflammatory skin disease that affects apocrine sweat gland bearing skin in the axillae, groin, and under the breasts. It is characterized by recurrent boil-like nodules and abscess that culminate in pus-like discharge that is foul smelling.

Answer 24

Hidradenitis suppurativa

Question 25

Hidradenitis suppurativa risk factors

Answer 25

Obesity
Insulin resistance
Smoking
Female (20 to 40 years old)

Question 26

Appearance of hidradenitis suppurativa

Answer 26

BLACKHEAD WITH TWO OPENING
boil
sinus tract involvement
deep dermal inflammation
scarring

Question 27

Hidradenitis suppurativa treatment

Answer 27

Tetracycline or Doxycycline
TNF-a inhibitor (Adalimumab)
Intralesional Corticosteroids