Acne Rosacea and Related Disorders Flashcards
Papular or pustular eruption that is located on the face, chest, and back with variable severity.
Acne vulgaris
What are the causes of acne?
Excess oil production
Plugged hair follicle
Skin and sebum collection
inflammation
bacterial infection
pimple
Oil + air = ?
(closed comedones)
Blackhead (dark plug)
Oil + skin covering = ?
(open comedones)
Whitehead
A type of acne with papules, pustules, and cysts
Inflammatory acne
A type of acne with open comedones (whiteheads) or closed comedones (blackheads)
Non-inflammatory acne
An inflammatory acne lesion that is less than 5mm. Appear red and have no material that can be extracted
Papules
An inflammatory acne lesion that have a visible central core of purulent material
Pustules
An inflammatory acne lesion that is greater than 5mm. Can be suppurative (with pus-cysts) or hemorrhagic
Nodules
What are the primary treatments for Acne?
Retinoids
Benzoyl Peroxide
Antibiotics:
Oral - doxycycline
Topical - Clindamycin (maybe erythromycin)
What should you always use when giving antibiotics for acne in order to reduce drug resistance?
Benzoyl Peroxide
What are some secondary treatments for acne?
Salicylic acid
Azelaic acid
Sulfur washes
Oral Contraceptives
Spironolactone (adult women)
What is the primary treatment for cystic acne?
Isotretinoin
Adverse affects of isotretinoin and some things to consider
Teratogenic (must be prescribed with birth control)
Men should not father children while on it
Possible acne flare
Prescribing isotretinoin
20 weeks
Monthly pregnancy test
Monthly labs (Liver Function and WBC)
May cause delayed healing
Treatment for acne in women over 25
Spironolactone
Oral Contraceptives
Retinoids
Multiple erythmatous grouped small inflammatory papules, papulopustules, or papulovesicles or erythematous scarring around the mouth, nose, or eyes. Clear zone around the vermillion border.
Perioral Dermatitis
Risk factors for perioral dermatitis
History of topical corticosteroid use
25-45 year old women
Fluorinated toothpaste
Oral contraceptive therapy
Perioral dermatitis treatment
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
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).
Rosacea
Triggers of rosacea
alcohol
hot or cold weather
hot drinks
hot baths
spicy foods
sun exposure
Ocular erythema and tearing. Patients may state they have red eye lids from rubbing and say their eyes feel gritty and itchy.
Ocular Rosacea
Rosacea treatment
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
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.
Hidradenitis suppurativa
Hidradenitis suppurativa risk factors
Obesity
Insulin resistance
Smoking
Female (20 to 40 years old)
Appearance of hidradenitis suppurativa
BLACKHEAD WITH TWO OPENING
boil
sinus tract involvement
deep dermal inflammation
scarring
Hidradenitis suppurativa treatment
Tetracycline or Doxycycline
TNF-a inhibitor (Adalimumab)
Intralesional Corticosteroids
