Acne Vulgaris Flashcards
What is acne?
Acne is a disease of the pilosebaceous unit.
What types of lesions are seen in acne?
Several different types of acne lesions are usually seen in each patient.
What are comedones?
Comedones are due to a dilated sebaceous follicle.
What forms when the top of a comedone is closed?
If the top is closed, a whitehead is seen.
What forms when the top of a comedone is open?
If the top opens, a blackhead forms.
What happens when the follicle bursts?
Inflammatory lesions form when the follicle bursts, releasing irritants.
What are the types of inflammatory lesions?
The types of inflammatory lesions are papules and pustules.
What may result from an excessive inflammatory response?
An excessive inflammatory response may result in nodules and cysts.
What can the sequence of events in acne lead to?
This sequence of events can ultimately cause scarring.
What are the types of scars caused by acne?
The types of scars are ice-pick scars and hypertrophic scars.
What characterizes drug-induced acne?
Drug-induced acne is often monomorphic.
What is an example of drug-induced acne?
Pustules are characteristically seen in steroid use.
What is acne fulminans?
Acne fulminans is very severe acne associated with systemic upset.
What symptoms are associated with acne fulminans?
Symptoms may include fever.
What is often required for acne fulminans?
Hospital admission is often required.
How does acne fulminans usually respond?
The condition usually responds to oral steroids.
What is acne vulgaris?
Acne vulgaris is a common skin disorder that usually occurs in adolescence, affecting the face, neck, and upper trunk, characterized by the obstruction of pilosebaceous follicles with keratin plugs, resulting in comedones, inflammation, and pustules.
How is acne vulgaris classified?
Acne vulgaris may be classified into mild, moderate, or severe.
What characterizes mild acne?
Mild acne is characterized by open and closed comedones with or without sparse inflammatory lesions.
What characterizes moderate acne?
Moderate acne is characterized by widespread non-inflammatory lesions and numerous papules and pustules.
What characterizes severe acne?
Severe acne is characterized by extensive inflammatory lesions, which may include nodules, pitting, and scarring.
What is the first-line treatment for mild to moderate acne?
A 12-week course of topical combination therapy should be tried first-line, including:
- A fixed combination of topical adapalene with topical benzoyl peroxide
- A fixed combination of topical tretinoin with topical clindamycin
- A fixed combination of topical benzoyl peroxide with topical clindamycin
- Topical benzoyl peroxide may be used as monotherapy if other options are contraindicated.
What is the treatment for moderate to severe acne?
A 12-week course of one of the following options:
- A fixed combination of topical adapalene with topical benzoyl peroxide
- A fixed combination of topical tretinoin with topical clindamycin
- A fixed combination of topical adapalene with topical benzoyl peroxide + either oral lymecycline or oral doxycycline
- A topical azelaic acid + either oral lymecycline or oral doxycycline.
What are important points about oral antibiotic usage in acne treatment?
Tetracyclines should be avoided in pregnant or breastfeeding women and in children younger than 12 years. Erythromycin may be used in pregnancy. Minocycline is less appropriate due to the possibility of irreversible pigmentation. Only continue antibiotic treatment for more than 6 months in exceptional circumstances.
