Acne Vulgaris and Acne Rosacea - Westra Flashcards
No staging questions! So I guess just forget about those ones. Just skim them!
Most common life periods for acne?
Neonatal
PUBERTY
MId-late teens
What should you avoid in the diet to stop acne from occurring?
Diet actually should not affect acne
What is the pathophysiology of acne?
Excessive Sebum Production
Follicular Plugging
Colonization of Sebaceous Follicle with Propionibacterium acnes
Immune Response with Inflammation
When and where does sebum production increase?
Related to hormones - thats why its big during puberty
Most sebaceous glands on face, upper neck, and chest
Medications that trigger acne?
Anabolic steroids Corticosteroids Isoniazid Lithium Phenytoin
How would you classify acne grades 1-4?
GRADE ISuperficial Non-Inflammatory
- Open and closed comedones
- Flesh colored papules
- NO inflammation
- NO pustules
- NO nodules
- NO scars
GRADE 2 Superficial Inflammatory *Open and closed comedones *Inflammation *Papules/pustules-few to several *NO nodules *NO scars
GRADE 3 Deep Inflammatory *Moderate to severe *Open and closed comedones *Papules/pustules *Few nodules *Little to no scar present
GRADE 4 Severe Nodulocystic *Deep/Inflammatory *Open and closed comedones *Papules/pustules *Extensive nodules *Variable degree scar
What are you trying to accomplish with acne treatment?
Decrease sebaceous gland activity
Decrease follicular keratinization
Decrease follicular bacteria
Anti-inflammatory effect
Grade 1 acne treatment?
First Line Topical Retinoids Topical Benzoyl Peroxide Products Physician directed extraction (q3-6 weeks) Consider: Alpha hydroxy-Acid Products Salicylic Acid
Grade 2 acne treatment?
First Line Topical Retinoids Benzoyl Peroxide Topical Antibiotics Consider: Azelaic Acid
Grade 3 acne treatment?
First Line Topical Retinoid Oral Antibiotics Second Line Benzoyl Peroxide Intralesional corticosteroid injections Women: hormone therapy Oral Isotretinoin
Grade 4 acne treatment
First Line Oral Isotretinoin Oral Contraceptives for Women Second Line Intralesional corticosteroid injections Incision and Drainage
Systemic antibiotic of choice is usually:
Doxycycline
What kinds of hormone therapy can be used to treat acne?
Estrogen
Oral contraceptives
Glucocorticoids
What medication is the only drug to suppress acne over the long term?
Important considerations involved with this drug?
Isotretinoin (acutane)
Pregnancy category X - teratogen!
2 forms of contraception suggested
Use liver function tests, triglycerises
What is the classic hallmark of acne rosacea?
TELANGIECTASIA
also usually have some pustules and papules
