Acne vulgaris Flashcards
what is acne vulgaris?
disease of pilo-sebaceous unit, which becomes blocked due to abnormal keritinisation & increased sebum production
where are common sites for acne vulgaris to start?
face, chest and back ie where sebaceous glands are very dense
what is the pathogenesis of acne vulgaris?
blockage of follicle due to abnormal keratinization and increased production of sebum (comedones)
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overgrowth of Propionibacterium acnes
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inflammatory repsonse
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pustules, papules, nodules and cysts
What do closed comedones look like?
what are lesions in acne defined as?
- non-inflammatory – open comedones (blackheads) or closed comedones (whiteheads)
- inflammatory – papules, pustules, nodules and cysts
what needs to try and be avoided when treating acne?
scarring
what are the types of scarring that could form?
- Hypertrophic scarring
- Atrophic scarring
- Chiloid scarring
- what is peak age for acne
- what is sex occurrence
- what can cause an acute flare up of acne?
- peak is teens (15-18 years)
- M=F, but M is more severe
- environmental conditions ie stress, weather etc
What are topical treatments?
- retinoids
- benzoyl peroxide
- anti-biotics
what is benzoyl peroxide, what is its’ effect & how is it used?
- an oxidising agent, which has antibacterial action
- has little effect on comedones alone
- used in conjunction with retinoids, as together they have a synergistic effect
what anti-biotics are used and how should you use them?
- clindamycin, tetracycline, erythromycin
- used with Benzoyl peroxide as if used as monotherapy, resistance becomes an issue
what are non-topical treatments?
- antibiotics
- anti-androgens –> oral contraceptive
- isotretinoin (roaccutane)
- light based treatments
what are some features of isotretinoin?
- most effective CURE for acne (other treatments only control it)
- only prescibable by dermatologists
- is a retinoid
- used as single monotherapy
what are some side effects of isotretinoin?
- highly teratogenic
- dry skin
- mood swings/ depression / abnormal LFTs/ HTG
