Acne vulgaris Flashcards
Pathophysiology of acne vulgaris
Increased production of sebum, trapping of keratin (dead skin cells) and blockage of the pilosebaceous unit
Causes chronic inflammation in pilosebaceous units
Pilosebaceous
Dimples in the skin that contain the hair follicles and sebaceous glands
Function of sebaceous glands
Produce natural skin oils sebum
Why is acne exacerbated by puberty
Androgenic hormones increase the production of sebum
Presentation of acne vulgaris
Red, inflamed and sore “spots” on the skin,
- Macules - flat marks on the skin
- Papules - small lumps on the skin
- Pustules
- Open or closed Comedomes -blocked pilosebaceous units
Blackheads - open comedones
Ice pick scars
Hypertrophic scars
Rolling scars
Typical distribution of acne
Face, upper chest and upper back
Ice pick scars
Small indentations in the skin that remain after acne lesions heal
Hypertrophic scars
Small lumps in the skin that remain after acne lesions heal
Rolling scars
Irregular wave-like irregularities of the skin that remain after acne lesions heal
Management of acne vulgaris
- Topical benzoyl peroxide
- Oral antibiotics such as lymecycline or doxycycline
- Women - Oral contraceptive
- Topical retinoids
- Oral retinoids - roaccutane
Benzyl peroxidase
Reduces inflammation, helps unblock the skin and is toxic to the P. acnes bacteria
Topical retinoids
Vitamin A analogues
Slow the production of sebum
Precaution for retinoids
Women of childbearing age need to be on 2 forms of contraception as teratogenic
Ask about self harm and suicide
Contraception used in acne vulgaris
Co-cyprindiol (Dianette)
Precaution for dianette
Higher risk of thromboembolism
