Acne vulgaris Flashcards
What does a pilosebaceous unit consist of?
Hair follicle and sebaceous gland
What is acne vulgaris?
A chronic inflammatory skin condition that primarily affects the pilosebaceous unit.
What stimulates increased sebum production?
Androgens
Hyperkeratinisation is when excess keratin blocks the pilosebaceous duct forming _______
Comedones
What bacterium proliferates in the blocked pilosebaceous duct (comedone) and promotes inflammation?
Cutibacterium acnes (C. acnes)
Inflammation from C. acnes bacterium leads to the formation of…
Papules
Pustules
Nodules
Cysts
What do papules look like?
Small red bumps
What do pustules look like?
Small red bumps (papules) with visible pus
What do nodules look like?
Large, firm, painful lumps
What do cysts look like?
Deep, pus-filled lesions.
Often lead to scarring.
Blackheads are ____ comedones. Blocked pores with oxidised _____
open
melanin
Whiteheads are ____ comedones. Blocked pores without _____.
closed
oxidation
Which areas have high sebaceous gland density?
Face
Chest
Back
Shoulders
How severe is the acne with mostly comedones with a few papules or pustules?
Mild acne
How severe is the acne with more papules and pustules, with few nodules?
Moderate acne
How severe is the acne with numerous papules, pustules, nodules, or cysts, often with scarring?
Severe acne
What investigations can be done for acne vulgaris?
Hormonal testing (free and total testosterone, DHEA-S, LH-FSH ratio
Microbiology, swabs for atypical cases
What is first line management of acne vulgaris?
Retinoids
Benzoyl Peroxide
Combination therapy
+ Education
Treatments may take 6-8 weeks to show improvement.
Avoid over-washing the skin as increases irritation
What is the second-line management of vulgaris acne? (For moderate to severe acne, or resistant cases)
Oral antibiotics alongside topicals
Hormonal therapy in women (COCP)
Refer to dermatology
What oral antibiotics are commonly prescribed for second-line management of acne vulgaris?
Doxycycline
Lymecycline
What is the third-line treatment for severe or resistant cases of acne vulgaris?
Oral Isotretinoin (Roaccutane)
A highly effective retinoid prescribed by dermatologists
How does Roaccutane (an oral isotretinoin) work?
Reduces sebum production, comedogenesis and C. acnes proliferation.
What are side effects of Roaccutane?
Dry skin
Mood changes
Photosensitivity
