Acne Vulgaris Flashcards
what is it?
a chronic inflammatory disease of the pilosebaceous unit
who gets it?
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
what causes it?
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
pathogenesis
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]
How does it present?
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
how is acne graded?
Mild: scattered papules and pustules, comedones
Moderate: numerous papules, pustules and mild atrophic scarring
Severe: cysts, nodules and significant scarring
what is the aim of treatment?
to control and prevent scarring
most acne will spontaneously resolve with time
how is it treated?
avoid oily substances - can trigger
topical treatment
systemic treatment
popping acne leads to scarring
what topical treatment is used?
Benzoyl peroxide: keratolytic antibacterial
Topical vitamin A derivatives: retinoid, has a drying effect
Topical antibiotics: antibacterial and anti-inflammatory
what systemic treatment is used?
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
