Acne Vulgaris Flashcards
What is acne vulgaris?
A common skin disorder typically affecting the face, neck and upper trunk. Characterised by obstruction of the pilosebaceous follicle with keratin plugs which results in comedones, inflammaton and pustules.
What is the epidemiology of acne vulgaris?
Affects 80-90% of teenagers
May persist beyond adolescence with 10-15% and 5% of males being affected.
What is the pathophysiology of acne vulgaris?
Follicular epidermal hyperproliferation resulting in the formation of a keratin plug obstructing the pilosebaceous follicle.
Colonisation propionibacterium acnes.
Inflammation.
How are comedones formed?
Due to dilated sebaceous follicle
Closed top - whitehead
Open top - blackhead
How do inflammatory lesions form?
Inflammatory lesions form when the follicles burst releasing irritants, this leads to the formation of papules and pustules.
What can an excessively inflammatory response lead to?
The formation of nodules or cysts
What sort of scarring can be seen in acne vulgaris?
Ice-pick scars
Hypertrophic scars
What can cause drug-induced acne and how can it appear?
Steroid use
Monomorphic - pustules
What is acne fulminans?
Very severe acne associated with systemic upset e.g. fever
Hospital admission may be required
How can acne be classified?
Mild: open and closed comedones with or without sparse inflammatory lesions
Moderate: widespread non-inflammatory lesions and numerous papules and pustules
Severe: extensive inflammatory lesions, may include nodules, pitting and scarring.
What are the management options for acne vulgaris?
Single topical therapy: topical retinoids, benzoyl peroxide.
Topical combination therapy: topical antibiotics, benzoyl peroxide, topical retinoid.
Oral antibiotics: Tetracyclines (e.g. doxycycline), 3 months.
COCP - particularly Dianette
Oral isotretinoin: specialist supervision.
What bacteria is found to contribute to the formation of acne?
Propionibacterium acnes
As anaerobic rod this means traditional beta-lactam antibiotics are ineffective in treating infections
