Acneiform Eruptions Flashcards
What is the medical name for common acne?
Acne vulgaris
How does the prevalence of acne change over time?
Nearly 90% of teenagers have acne, by age 40 only 1% of men and 5% of woman still have lesions
Who is at increased risk of acne?
- XYY genotype
- Polycystic ovarian syndrome
- Hyperandrogenism
- Hypercortisolism
Describe the pathogenesis of acne?
1) Early comedone
2) Later comedone
3) Inflammatory papule/pustule
4) Nodule/cyst
What are the different severities of acne?
Mild acne
Moderate acne
Severe acne
When is acne considered to be mild acne?
Open and closed comedones (skin coloured, small bumps (papules)):
- <20 comedowns
- <15 inflammatory lesions
- Or total lesions count <30
Is mild acne inflammatory or non-inflammatory?
Non-inflammatory
What are closed comedones known as?
Whiteheads
What are open comedones known as?
Blackheads
Why does black discolouration occur in open comedones?
- Black discolouration due to melanin deposition and lipid oxidation
Is moderate acne inflammatory lesions or non-inflammatory lesions?
- Papules, pustules, nodules and cysts
- 20-100 comedones
- 15-50 inflammatory lesions
- Or total lesion count 30-125
When is acne considered to be moderate acne?
- Papules, pustules, nodules and cysts
- 20-100 comedones
- 15-50 inflammatory lesions
- Or total lesion count 30-125
When is acne conisdered to be severe acne?
- >5 pseudocysts
- Total comedo count>100
- Total inflammatory count >50
- Or total lesion count >125
What are the long-term impacts of severe acne?
Causes permanent scaring and post inflammatory pigmentation
What are some different varients of acne?
- Acne fulminans
- Drug induced acne
- Acne excoriee
What is acne fulminans?
Most severe form of cystic acne
Characterised by abrupt onset of nodular and suppurative acne with systemic manifestations:
Fever, artralgias, myalgias, hepatosplenomegaly
What is the most severe form of cystic acne?
Acne fulminans
What is the clinical presentation of acne fulminans?
Characterised by abrupt onset of nodular and suppurative acne with systemic manifestations:
- Fever, artralgias, myalgias, hepatosplenomegaly
What is drug induced acne?
Seen as side effect of medication such as anabolic steroids, corticosteroids, phenytoin, lithium)
What are some drugs that can cause drug-induced acne?
Anabolic steroids
Corticosteroids
Phenytoin
Lithium
What is acne exoriee?
Papules and comedones are neurotically excoriated leaving crusted lesions that may scar
What should be asked about and checked for in the history and examination for acne?
What is the treatmen of acne?
- Topical retinoids
- Benzoyl peroxide
- Topical antibiotics
- Clindamycin/erythromycin
- Azelaic acid
- Antibiotic tablets
- Lymecycline, tetracyclin
- In woman, the combined oral contraceptive pill
- Isotretinoin tablets
What are some topical antibiotics that can be used for the treatment of acne?
- Clindamycin/erythromycin
What antibiotic tablets can be used for the treatment of acne?
- Lymecycline, tetracyclin
What is rosacea?
Long-term skin condition that typically affects the face. It results in redness, pimples, swelling, and small and superficial dilated blood vessels
How does rosacea affect your face?
Causes redness and visible blood vessels on your face
Who is rosacea most common in?
- Most common in fair-skinned people
In what age grup is rosacea most common?
- Occurs in 3rd and 4th decade of life
How does rosacea contrast acne?
- In contrast to acne, rosacea is not associated with seborrhoea
Describe the pathogenesis of rosacea?
- Causes uncertain
- In contrast to acne, rosacea is not associated with seborrhoea
- Damage to dermal connective tissue
- Sensitivity to noxious stimuli is increased
- Increased number of demodex folliculorum
What are the clinical features of rosacea?
- Polimorphic disease with several variant
- Affects central convex areas of the face
- Nose, forehead, cheeks, chin
- Onset marked by vascular changes, notably episodic flushing with no sweating
- Erythema with burning sensation is easily triggered by minor irritants
- Stress, hot drinks, alcohol, spices
- Papules and pustules in more advanced cases WITHOUT COMEDONES
- Persistant tissue thickening due to oedema, fibrosis and glandular hyperplasia
Where does rosacea usually affect?
Central convex areas of the face:
- nose, forehead, cheeks, chin
What is the onset of rosacea marked by?
- Onset marked by vascular changes, notably episodic flushing with no sweating
Describe the lesions due to rosacea?
- Erythema with burning sensation is easily triggered by minor irritants
- Stress, hot drinks, alcohol, spices
- Papules and pustules in more advanced cases WITHOUT COMEDONES
What are some different kinds of rosacea?
- Vascular rosacea
- Recurrent blush
- Telangiectasias begin for form, initially in nasal area
- Inflammatory rosacea
- Small papules and pustules to occasional deep cystic nodules
- Absence of comedones
- Deeper red colour when compared to acne
- Soft or solid facial oedema
- Phymatous rosacea
- Overgrowth of sebaceous glands
- Skin becomes swollen and smoother, pores become more apparent
- Gradually, a lumpy surface develops
- Occular rosacea
- Common, 50^% incidence in rosacea patients
- Symptoms range from sensation of dryness or tired eyes to oedema, tearing, pain, chalazia and corneal damage
What is the treatment of rosacea?
- Avoidance of obvious vasodilators and irritants
- Metronidazole cream or gel is a major topical therapy
- Azalaic acid cream or gel
- Ivermectin cream
- Tetracyclines are most prescribed oral medication
- Surgery for rhinophymas
What is the clinical presentation of vascular rosacea?
- Recurrent blush
- Telangiectasias begin for form, initially in nasal area
What is the clinical presentation of inflammatory rosecea?
- Small papules and pustules to occasional deep cystic nodules
- Absence of comedones
- Deeper red colour when compared to acne
- Soft or solid facial oedema
Describe the lesions due to inflammatory rosacea?
- Small papules and pustules to occasional deep cystic nodules
- Absence of comedones
What is the clinical presentation of phymatous rosacea?
- Overgrowth of sebaceous glands
- Skin becomes swollen and smoother, pores become more apparent
- Gradually, a lumpy surface develops
What is the clinical presentation of occular rosacea?
- Symptoms range from sensation of dryness or tired eyes to oedema, tearing, pain, chalazia and corneal damage
