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Yr 3 - Dermatology > Acne vulgaris > Flashcards

Acne vulgaris Flashcards

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Dermatology Board Prep flashcards
1
Q

What is acne vulgaris?

A

Acne vulgaris is the common form of acne, characterised by a mixed eruption of inflammatory and non-inflammatory skin lesions

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2
Q

Why is acne often most severe during teenage years?

A

There are higher levels of sex hormones after puberty than in younger children.

Sex hormones are converted in the skin to dihydrotestosterone (DHT), which stimulates sebaceous (oil) glands at the base of hair follicles to enlarge.
The sebaceous glands produce sebum. Changes in sebum composition may lead to acne lesions.

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3
Q

What percent of men and women will have acne as adults?

A

15% women
5% men

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4
Q

What is the cause of acne?

A
  1. Genetics
  2. Hormones
  3. high humidity
  4. Cosmetic products
  5. Pressure from headbands/chin straps
  6. Excessive dairy products
  7. Certain medication
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4
Q

What is the physiology of acne?

A

Individual lesions are centred on the pilosebaceous unit, ie the hair follicle and its associated oil gland. Several types of acne spots occur, often at the same time. They may be inflammatory papules, pustules and nodules; or non-inflamed comedones and pseudocysts.

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5
Q

What are 3 types of superficial lesions?

A
  1. Open and closed comedones (blackheads and whiteheads)
  2. Papules (small, tender red bumps)
  3. Pustules (white or yellow “squeezable” spots)
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6
Q

What are 2 types of deep lesions?

A
  1. Nodules (large painful red lumps)
  2. Pseudocysts (cyst-like fluctuant swellings)
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7
Q

What are 4 types of secondary lesions?

A
  1. Excoriations (picked or scratched spots)
  2. Erythematous macules (red marks from recently healed spots, best seen in in fair skin)
  3. Pigmented macules (dark marks from old spots, mostly affecting those with dark skin)
  4. Scars of various types
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8
Q

How long do individual acne lesions usually last for?

A

Individual acne lesions usually last less than 2 weeks but the deeper papules and nodules may persist for months. Many acne patients also have oily skin (seborrhoea).

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9
Q

Who is pomade acne most common in?

A

People with skin of colour

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10
Q

What is pomade acne?

A

Pomade acne is a type of acne that occurs around the hairline and temples due to the use of oily or waxy hair products that clog the pores and cause inflammation in the skin

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11
Q

Who is keloid scarring most common in?

A

Keloid scarring is more common in skin of colour following acne lesions, particularly along the jawline, chest, and upper back.

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12
Q

What is defined as mild acne?

A

<20 comedones
<15 inflammatory lesions
Or, total lesion count <30

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13
Q

What is defined as moderate acne?

A

20–100 comedones
15–50 inflammatory lesions
Or, total lesion count 30–125

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14
Q

What is defined as severe acne?

A

> 5 pseudocysts
Total comedo count >100
Total inflammatory count >50
Or, total lesion count >125

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15
Q

What are 3 complications of acne vulgaris?

A
  1. Postinflammatory hyperpigmentation
  2. Scarring, including keloid scars
  3. Psychological effects of acne
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16
Q

What are pilosebaceous units?

A

tiny dimples in the skin which contain hair follicles and sebaceous glands

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17
Q

What do sebaceous glands produce?

A

sebum (natural skin oil)

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18
Q

Describe the pathophysiology of acne vulgaris:

A

an increased production of sebum, trapping of keratin and subsequent blockage of the pilosebaceous unit leads to swelling and chronic infection of the pilosebaceous unit

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19
Q

Why is it that puberty exacerbates acne vulgaris?

A

androgenic hormones such as testosterone increase the production of sebum

20
Q

What is the name given to swollen and inflamed pilosebaceous units?

A

comedomes

21
Q

What bacteria is known to exacerbate acne in excessive growth?

A

Propionibacterium acnes

22
Q

What is a macule?

A

a flat lesion that differs in colour from surrounding skin

23
Q

What is a papule?

A

small elevation of the skin that contains no fluid and may develop pus

24
Q

What is a pustule?

A

An infected papule with fluid inside

25
Q

What is a comedone?

A

Mass of hardened sebum and skin cells in a hair follicle (skin coloured)

26
Q

What is a blackhead?

A

an open comedone with black pigmentation at the centre

27
Q

What is an icepick scar?

A

a small indentation in the skin that remains after acne lesions heal

28
Q

What is a hypertrophic scar?

A

a small lump in the skin that remains after acne lesions heal

29
Q

What is a rolling scar?

A

an irregular wave like irregularity of the skin the remains after the acne lesion has healed

30
Q

Give 3 medication types that may be given for mild acne:

A

1) topical benzoyl peroxide
2) topical antibiotics
3) topical retinoids

31
Q

Give three ways in which topical benzoyl peroxide helps treat acne:

A

1) reduces inflammation
2) helps unlock pilosebaceous units
3) toxic to P. acnes

32
Q

Give an example of a topical antibiotic used to treat mild acne:

A

clindamycin

33
Q

What vitamin are retinols related to?

A

vitamin A

34
Q

How do topical retinoids treat mild acne?

A

they slow the production of sebum and can breakdown comedones

35
Q

Give 2 medication serves used to treat moderate/severe acne:

A

1) oral antibiotics
2) oral contraceptive pill (in women)

36
Q

Give an example of an oral antibiotic used to treat moderate/severe acne:

A

iymecycline

37
Q

What specific oral contraceptive pill is effective in treating acne?

A

co-cyprindiol (Dianette)

38
Q

Why is co-cyprindiol particularly effective in treating acne?

A

it has anti-adrenergic effects

39
Q

What is a key risk associated with long term co-cyprindiol ?

A

thromboembolism

40
Q

What is the last line treatment for severe acne?

A

oral retinoids

41
Q

Give an example of an oral retinoid used to treat severe acne:

A

isotretinoin (roaccutane)

42
Q

How does isotretinoin (roaccutane) treat severe acne?

A

it reduces production of sebum, reduces inflammation and reduces bacterial growth

43
Q

True or false: retinoids are teratogenic

A

True

44
Q

What precaution must be made when prescribing oral retinoids to women of child bearing age?

A

they must have effective contraception and must stop use at least a month before becoming pregnant

45
Q

Give 4 side effects associated with isotretinoin (roaccutane):

A

1) dry skin and lips
2) photosensitivity of skin to sun light
3) depression, anxiety, aggression and suicidal ideation
4) toxic epidermal necrolysis (rare)

46
Q

What should be screened for before prescribing isotretinoin?

A

mental health issues (depression, anxiety, suicidal ideation)

47
Q
A

Yr 3 - Dermatology (15 decks)

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