Acneiform Eruptions Flashcards
Name 2 types of acne.
- Acne vulgaris
- Acne rosacea
What is acne vulgaris?
Disease of the pilo-sebaceous unit (PSU) – face, chest, back
What causes inflammation in acne vulgaris?
Changes in commensal bacterial behaviour (propionobacterium acnes)
What is acne vulgaris characterised by?
- Sticky keratinocytes and increased albumin viscosity
- Comedones
- Papules, pustules, nodules, cysts and scar
What is a comedone?
Blocked follicles
Give another name for an open comedone.
Blackheads
Give another name for a closed comedon.
Whiteheads
What topical treatment is there for acne vulgaris?
- Retinoids
- Benzoyl peroxide (PO)
- Anti-biotics
- Other
Who is affected by acne vulgaris?
- Peak 15-18 years (90% incidence)
- Delayed onset in some females
- +ve family history
- M=F – but M more severe
What topical antibiotics are used in acne vulgaris?
- Clindamycin
- Tetracycline
- Erythromycin
What is the non-topical treatment for acne vulgaris?
- Anti-biotics
- Anti-androgens: OCP/Dianette
- Isotrtinoin/Roaccutane
- Light based treatments
What non-topical antibiotics can be used in the treatment of acne vulgaris?
- Tetracyclines
- Erythromycin
- Trimethoprim
What is the most effective treatment for severe/stubborn acne?
Isotretinoin
What is isotretinoin?
Really expensive retinoid that is only prescribable by skin specialists
How is isontretinoin administered?
- Simple monotherapy with a single daily dose
- 1mg/kg/day fro 16 weeks
- Better to use 0.5mg/kg/day fro 32 weeks
How effective is isotretinoin?
-Expect clearance & approx. 60-70% cure rate
What are the drawbacks of isotretinoin?
-HIGHLY teratogenic (pregnancy prevention programme)
-Many (potential) side-effects (dry skin (muco-cutaneous junctions)
hair loss, mood swings/depression/suicide, abnormal LFT’s, hypertriglyceridaemia)
-Expensive
What is acne rosacea?
Chronic inflammation involving the PSU and cutaneous vasculature
How does acne rosacea present?
-Usually an ace of clubs distribution most commonly on the face
Who does acne rosacea affect?
- Age 30-50 years
- F > M – but M more severe
- Fair skinned/Celts
What can occur with acne rosacea?
Flushing triggered by
- Alcohol
- Spices
- Emotion
- Hot drinks
What are the subtypes of acne rosacea?
- Erythemato
- Telangiectatic
- Papulo-pustular
- Phymatous (M»>F)
- Ocular
What is not present in acne rosacea?
Comedones
What topical management is there for acne rosacea?
- Anti-biotics – metronidazole
- Azeleic acid
- Ivermectin
- Brimonidine
