Acne Vulgaris Flashcards

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1
Q

what is it?

A

a chronic inflammatory disease of the pilosebaceous unit

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2
Q

who gets it?

A

really common in 95% of 16 year olds - only 20% go to the doctor about it
peak age is 14-17 in females and 16-19 in males

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3
Q

what causes it?

A

genetic susceptibility is a factor - increased androgens at puberty lead to increased androgen sensitivity of sebaceous glands
psychological stress - causes increased cortisol stimulating sebum secretion (acne can cause stress so vicious cycle)
cosmetics/make-up/headbands can block pores

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4
Q

pathogenesis

A

Keratin plugs the pilosebaceous unit causing closed comedones
Sebum [produced by the sebaceous gland] plugs the pilosebaceous unit causing closed comedones
Bacterial [corynebacterium acnes//P acnes] overgrowth on the keratin or sebum plugs can result in pustules [pimples]

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5
Q

How does it present?

A

Distribution - related to sites with the most sebaceous glands - face, upper back, anterior chest
Morphology - comedones [open = blackhead, closed = whitehead], pustules, papules, cysts, erythema
Secondary features - scars [atrophic], ice-pick scars, texture changes, hypertrophy

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6
Q

how is acne graded?

A

Mild: scattered papules and pustules, comedones
Moderate: numerous papules, pustules and mild atrophic scarring
Severe: cysts, nodules and significant scarring

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7
Q

what is the aim of treatment?

A

to control and prevent scarring

most acne will spontaneously resolve with time

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8
Q

how is it treated?

A

avoid oily substances - can trigger
topical treatment
systemic treatment
popping acne leads to scarring

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9
Q

what topical treatment is used?

A

Benzoyl peroxide: keratolytic antibacterial
Topical vitamin A derivatives: retinoid, has a drying effect
Topical antibiotics: antibacterial and anti-inflammatory

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10
Q

what systemic treatment is used?

A

Antibiotics: antibacterial and anti-inflammatory, need for at least 6 months
Isotretinoin: oral retinoid, effects sebaceous gland activity, lots of SIDE EFFECTS including initial aggravation of acne

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