acne vulgaris

Question 1

aetiology of acne

Answer 1

FHx
androgens - testosterone, dehydroepinandrosterone - stimulate sebaceous gland activity
age
diet, stress, pollutants

Question 2

what structure does acne vulgaris affect

Answer 2

pilosebaceous unit

Question 3

features of acne

Answer 3

• comedones - whitehead/blackhead
• when follicle bursts and releases irritants - papules/pustules
• nodules
• cysts
• scarring - ice pick scars / hypertrophic scars

Question 4

appearance of drug induced acne

Answer 4

monomorphic - steroids

Question 5

what is acne fulminans

Answer 5

very severe acne
systemic upset
hospital admission needed - responds to oral steroids

Question 6

Answer 6

severe - some cysts

Question 7

Answer 7

comedones

Question 8

classification of acne

Answer 8

1. mild: open and closed comedones with or without sparse inflammatory lesions
2. moderate acne: widespread non-inflammatory lesions and numerous papules and pustules
3. severe acne: extensive inflammatory lesions, which may include nodules, pitting, and scarring

Question 9

mx of acne

Answer 9

1. topical retinoid / benzoyl peroxide
2. topical combination therapy (topical antibiotic, benzoyl peroxide, topical retinoid)
3. oral tetracycline (erythromycin in pregnancy) max 3mo
4. always co-prescribe topical retinoid or benzyl peroxide
5. COCP - dianette
6. oral isotretinoin