Acne vulgaris Flashcards
when are people usually affected?
puberty and adolescence
what is acne caused by?
chronic inflammation
with or without infection
what part of skin is affected?
pilosebaceous unit
what do pilosebaceous units contain?
hair follicles
sebaceous glands
3 pathological changes in acne
increased sebum
trapping of keratin
blocked pilosebaceous unit
change to pilosebaceous unit
swelling and inflammation
why is acne exacerbated at puberty?
androgenic hormones increase production of sebum
what are swollen and inflamed pilosebaceous units called?
comedones
what bacteria plays a role in acne?
propionibacterium acnes
presentation
red, inflamed and sore spots on skin
face, upper chest and back
macules
flat marks on the skin
papules
small lumps on the skin
pustules
small lumps containing yellow pus
comedones
skin coloured papules representing blocked pilosebaceous unit
blackheads
open comedones with black pigmentation from oxidisation
ice pick scars
small indentations in skin that remain after acne lesions heal
hypertrophic scars
small lumps in skin remain after acne lesions heal
3 types of scars
ice pick
hypertrophic
rolling
treatment
education topical benzoyl peroxide + topical antibiotic topical retinoid oral antibiotics contraceptive pill oral retinoids
why are topical antibiotics always prescribed with benzoyl peroxide? example of antibiotic
clindamycin 1%
prevent antibiotic resistance
example of oral antibiotic
lymecycline
contraceptive pill used
co-cyprindol/dianette
high risk of VTE - discontinue after acne controlled
what antibiotics to avoid?
macrolides eg erythromycin
p acnes resistance
important to remember about roaccutane
teratogenic
reliable contraception
side effects of oral isotretinoin/roaccutane
dry skin and lips
photosensitivity
depression, suicidal ideation, anxiety, aggression
SJS, TEN
