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Dermatology > Acneiform Eruptions > Flashcards

Acneiform Eruptions Flashcards

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Dermatology Board Prep flashcards
1
Q

What is acne vulgaris?

A

Disease of the pilo-sebaceous unit (PUS) - face, chest and back
Sticky keratinocytes and increased sebum viscosity
Blocked follicles - comedones
Inflammation - change in commensal bacterial behaviour

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2
Q

What is the appearance of acne vulgaris?

A

Papules, pustules, nodules, cysts and scars

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3
Q

What blocks the follicle in acne vulgaris?

A

Sebum in sebaceous gland with follicle

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4
Q

What is a whitehead and a blackhead?

A

Closed comedo - whitehead
Open comedo - blackhead
Blockage causes inflammation

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5
Q

Who does acne vulgaris affect?

A

Peaks at 15-18years
Delayed onset in females
Positive family history
Male=Females but males more severe
Psychological impact

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6
Q

What is comedomal acne?

A

Skin coloured bumps and blackheads scattered
Increased sebum production
Blockage of sebaceous duct and follicle and inflammation caused

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7
Q

What are some types of acne vulgaris?

A

Comedomal acne, nodular cystic, acne fulminans acne and papulo-pustular acne

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8
Q

What is the topical treatment for acne vulgaris?

A

Benzoyl peroxide (BPO) - acnecide
Antibiotics - Clindamycin (Dalacin T lotion) and Erythromycin (Zyneryt)
Retinoids - Adapalene
Combination
Others - Azaleic acid and Nicatinamide gel

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9
Q

What are the combination topical treatments for acne vulgaris?

A

Duac - BPO and Clindamycin
Treclin - Tretinoin and Clindamycin
Epiduo - Adapalene and BPO

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10
Q

What are some systemic medications for acne vulgaris?

A

Antibiotics - Tetracyclines, erythromycin and trimethoprim
Anti-androgens - combined oral contraception pill
Isotretinoin
UVB
Dapsone

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11
Q

What is isotretinoin?

A

Retinoid medication - vitamin A derivative
Most effective treatment but reserved for treatment failure, severe acne, acne fulminans and evidence of scarring

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12
Q

How is isotretinoin prescribed?

A

By dermatologists and dispensed by hospital pharmacy
Weight based treatment - 120mg/kg
60-70% clear and remain clear
Can have multiple treatment courses if needed

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13
Q

What are the risks of isotretinoin?

A

Teratogenic
Risk of low mood
Can raise triglycerides
Dry skin, epistaxis, dry brittle hair, nail dystrophy, reduction in night time vision, myalgia, skin sensitivity, photosensitivity and headaches

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14
Q

Describe acne fulminans

A

Sudden onset acneiform eruption
Feverish and unwell
Joint pains
Start low dose isotretinoin but cover with prednisolone

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15
Q

What are the types of scarring?

A

Atrophic, Boxcar (linear indentation), ice pick ( more prominent indentation), keloid and hypertrophic

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16
Q

What is the treatment for scarring?

A

Treat inflammation first
If isotretinoin then wait 1 year before looking for treatment for scarring - intralesional steroid, laser, excision of ice pick scars, dermabrasion and chemical peels

17
Q

Describe acne rosacea

A

Chronic inflammation which effects PSU and cutaneous vasculature
Ace of clubs distribution
Unusual on non-facial sites
No comedomes

18
Q

Who is acne rosacea likely to affect?

A

Age 30-50 years
More females then males but males more severe
Flushing - alcohol, spices, emotion and hot drinks
Sensitive skin

19
Q

What are the subtypes of acne rosacea?

A

Erythemato-telangiectatic
Papulo-pustular
Phymatous (more males)
Ocular

20
Q

What is the topical treatment for acne rosacea?

A

Metronidazole - Rosex and Metrogel
Azeleic acid - Finacea
Ivermectin - Soolantra
Brimonidine - Mirvaso

21
Q

What is the systemic treatment for acne rosacea?

A

Oral antibiotics - tetracyclines and erythromycin
Isotretinoin - low dose
Light based treatments
Laser

22
Q

Describe infantile acne

A

3months - 1 year
Comedomes, papules, pustules and cysts
Same treatment as adults - need to prevent scarring
If greater than 1 year look for signs of virilization

23
Q

Describe Hidradenitis suppuritiva

A

Recurrent boils and abscesses
Sinus tract formation
Axillae, groin and perineum and sub-mammary
Flexural site
Follicular occlusion tetrad

24
Q

What is the treatment for Hidradenitis suppuritiva?

A

Lifestyle modification, topical wash, tetracycline, topical, dapsone, adalimumab and ciclosporin

25
Q

Describe acne keloidalis nuchae

A

Most common skin type V and VI
Chronic folliculitis, scarring and hair loss
Inflammation and secondary bacterial infection

26
Q

What is the treatment for acne keloidalis nuchae?

A

Topical steroid, antimicrobial wash, oral antibiotics, isotretinoin and laser hair removal

Dermatology (10 decks)

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