Acne vulgaris 1A

Question 1

What unit does acne affect

Answer 1

pilosebaceous unit

Question 2

Acne can be clinically characterised by the following ….?

Answer 2

comedomes, papules, pustules, nodules and cyst

Question 3

In a plugged follicle, what bacteria and type is stimulated due to it being filler with sebum?

Answer 3

propinobacterium acnes (an anaerobic bacteria)

Question 4

Sebum production is increased by …?

Answer 4

androgens

Question 5

Which conditions increases androgens and thus exacerbate acne?

Answer 5

PCOS and pregnancy

Question 6

An open comedome is also called?

Answer 6

blackhead

Question 7

A closed comedome is called?

Answer 7

whitehead

Question 8

Inflammatory acne presents as?

Answer 8

papules, pustules, nodules and cyst

Question 9

Pustules are colloquially referred to as..?

Answer 9

pimples

Question 10

Sebaceous rich areas are?

Answer 10

Face, chest and back

Question 11

Differential diagnosis for acne are?

Answer 11

acne rosacea, steroid acne

Question 12

Classical presentation of steroid acne ?

Answer 12

monomorphic appearance

Question 13

What can be prescribed for female patients following advice such as washing 2x a day and use of emollient if skin is dry?

Answer 13

use of anti androgens

Question 14

Female patients requiring contraceptions should receive what type of contraception and avoid what?

Answer 14

oestrogen containing pill due to its anti-androgen effect and avoid norethistherone

Question 15

An alternative anti-androgen is?

Answer 15

spirinolactone

Question 16

What medication can be used in women of childbearing age which contains both oestrogen with anti-androgen cyproterone?

Answer 16

diannete aka co-cyprindiol

Question 17

In terms of the stepwise management of acne what can be used for mild acne?

Answer 17

single topical agent e.g. benzoyl peroxide or azeleic acid

Question 18

What is the mechanism of action of benzoyl peroxide

Answer 18

peeling off agent which is antibacterial, anti-inflammatory and comedolytic

Question 19

What is the next line of therapy following topical agent and an example?

Answer 19

combination therapy e.g. topical antibiotics (clindamycin or erythromycin) and topical agent benzoyl peroxide or topical agent + topical retinoids e.g. isotretoin

Question 20

What is the 3rd step in medical management of acne and it’s indication?

Answer 20

Oral antibiotics for its anti inflammatory effect more than its antibacterial effect and can be used with topical agent but not topical antibiotics for moderate acne

Question 21

Indications for oral isotretoin?

Answer 21

Severe acne (cyst and nodules) and if oral abx are ineffective

Question 22

Mechanism of oral isotretoin and its side effects?

Answer 22

reduces sebum production and SE include dry skin and lips, teratogenic and depression