Acne Vulgaris Flashcards
What is acne vulgaris?
A chronic inflammatory skin condition of the pilosebaceous units, commonly seen in adolescents and young adults.
Characterised by comedones, papules, pustules, nodules and scarring. Typically occurs on the face, chest and back
At what age does acne vulgaris typically peak?
Peaks during adolescence (ages 12–24) but can persist into adulthood, especially in women.
What are the four key factors in the pathogenesis of acne vulgaris?
Increased sebum production.
Hyperkeratinization of the follicular epithelium.
Colonization by Cutibacterium acnes (formerly Propionibacterium acnes).
Inflammation due to immune response and release of pro-inflammatory mediators.
What role does Cutibacterium acnes play in acne?
It metabolizes sebum, produces inflammatory mediators, and contributes to comedone formation.
How does androgen excess contribute to acne?
Androgens increase sebum production by stimulating sebaceous glands.
What are the types of acne lesions?
Non-inflammatory lesions: Open (blackheads) and closed (whiteheads) comedones.
Inflammatory lesions: Papules, pustules, nodules, and cysts.
Which areas of the body are most commonly affected by acne?
Face, chest, back, shoulders, and upper arms—areas with high sebaceous gland density.
What factors can exacerbate acne vulgaris?
Hormonal changes (puberty, menstrual cycle, pregnancy).
Use of comedogenic skin products or cosmetics.
Medications (e.g., steroids, lithium, isoniazid).
Diet (high glycemic index foods, dairy).
Stress.
How is acne vulgaris diagnosed?
Clinical diagnosis based on the presence of characteristic lesions in sebaceous areas.
When should hormonal testing be considered in acne vulgaris?
In cases of severe, persistent, or late-onset acne with signs of androgen excess (e.g., hirsutism, irregular menses).
What are the main goals of acne treatment?
Reduce sebum production.
Normalize keratinization.
Reduce C. acnes colonization.
Minimize inflammation.
What are first-line topical treatments for mild to moderate acne?
Topical retinoids (e.g., tretinoin, adapalene): Normalize keratinization and reduce comedones.
Topical benzoyl peroxide: Antimicrobial and anti-inflammatory properties.
Topical antibiotics (e.g., clindamycin, erythromycin): Reduce C. acnes proliferation, usually combined with benzoyl peroxide to prevent resistance.
What are potential side effects of topical treatments?
Irritation, dryness, erythema, and photosensitivity (especially with retinoids).
When are oral antibiotics indicated for acne?
For moderate to severe inflammatory acne unresponsive to topical treatments.
What are the preferred oral antibiotics for acne vulgaris?
Doxycycline, minocycline, or erythromycin (used for limited durations to prevent resistance).
