acne vulgaris and rosacea

Question 1

what is acne vulgaris?

Answer 1

chronic inflammation, characterised by blockage and inflammation of pilosebaceous unit

common in people with increased sebum production

Question 2

what are the clinical signs?

Answer 2

comedones need to be present

suspect in non inflammatory lesions e.g whiteheads and blackheads and inflammatory lesions e.g papules and pustules

investigation not needed but if underlying cause suspected can refer to endicrinology

Question 3

how can it be treated in mild and moderate cases?

Answer 3

single topical treatment for mild acne

e.g benzoly perioxide is 1st line

moderate acne

oral abx e.g doxycycline for max of 2 months as well a topical retinoid e.g benzyol perixide

no response to medication (2 different courses of antibiotics)/ scarring = refer to dermatology.

can also consider oral contraceptives (combined) in women, to avoid antibiotic use, use UK eligibility criteria before prescribing

Question 4

what is acne rosacea?

Answer 4

inflammatory condition in fair skin people

flushing erythema, papules, pustules, conjunctivitis, skin burning/stinging. skin dryness and irritation

cheek, skin and forehead

flushing,

triggers = alcohol, spices,

Question 5

how is acne rosacea treated?

Answer 5

topical metronidazole gel

oral antibiotics if lots of papules and pustules

sun block

eye protection

refer to dermatology if persistent erythema and papules and pustules dont respond to management in primary care

Question 6

how do you differentiate vulgaris from rosacea?

Answer 6

vulgaris = open commidones

rosacea = no open commidones