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10. Year 2: Dermatology > Acneiform Eruptions > Flashcards

Acneiform Eruptions Flashcards

1
Q

What is the medical name for common acne?

A

Acne vulgaris

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2
Q

How does the prevalence of acne change over time?

A

Nearly 90% of teenagers have acne, by age 40 only 1% of men and 5% of woman still have lesions

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3
Q

Who is at increased risk of acne?

A
  • XYY genotype
  • Polycystic ovarian syndrome
  • Hyperandrogenism
  • Hypercortisolism
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4
Q

Describe the pathogenesis of acne?

A

1) Early comedone
2) Later comedone
3) Inflammatory papule/pustule
4) Nodule/cyst

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5
Q

What are the different severities of acne?

A

Mild acne

Moderate acne

Severe acne

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6
Q

When is acne considered to be mild acne?

A

Open and closed comedones (skin coloured, small bumps (papules)):

  • <20 comedowns
  • <15 inflammatory lesions
  • Or total lesions count <30
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7
Q

Is mild acne inflammatory or non-inflammatory?

A

Non-inflammatory

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8
Q

What are closed comedones known as?

A

Whiteheads

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9
Q

What are open comedones known as?

A

Blackheads

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10
Q

Why does black discolouration occur in open comedones?

A
  • Black discolouration due to melanin deposition and lipid oxidation
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11
Q

Is moderate acne inflammatory lesions or non-inflammatory lesions?

A
  • Papules, pustules, nodules and cysts
  • 20-100 comedones
  • 15-50 inflammatory lesions
  • Or total lesion count 30-125
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12
Q

When is acne considered to be moderate acne?

A
  • Papules, pustules, nodules and cysts
  • 20-100 comedones
  • 15-50 inflammatory lesions
  • Or total lesion count 30-125
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13
Q

When is acne conisdered to be severe acne?

A
  • >5 pseudocysts
  • Total comedo count>100
  • Total inflammatory count >50
  • Or total lesion count >125
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14
Q

What are the long-term impacts of severe acne?

A

Causes permanent scaring and post inflammatory pigmentation

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15
Q

What are some different varients of acne?

A
  • Acne fulminans
  • Drug induced acne
  • Acne excoriee
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16
Q

What is acne fulminans?

A

Most severe form of cystic acne

Characterised by abrupt onset of nodular and suppurative acne with systemic manifestations:

Fever, artralgias, myalgias, hepatosplenomegaly

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17
Q

What is the most severe form of cystic acne?

A

Acne fulminans

18
Q

What is the clinical presentation of acne fulminans?

A

Characterised by abrupt onset of nodular and suppurative acne with systemic manifestations:

  • Fever, artralgias, myalgias, hepatosplenomegaly
19
Q

What is drug induced acne?

A

Seen as side effect of medication such as anabolic steroids, corticosteroids, phenytoin, lithium)

20
Q

What are some drugs that can cause drug-induced acne?

A

Anabolic steroids

Corticosteroids

Phenytoin

Lithium

21
Q

What is acne exoriee?

A

Papules and comedones are neurotically excoriated leaving crusted lesions that may scar

22
Q

What should be asked about and checked for in the history and examination for acne?

A
23
Q

What is the treatmen of acne?

A
  • Topical retinoids
  • Benzoyl peroxide
  • Topical antibiotics
    • Clindamycin/erythromycin
  • Azelaic acid
  • Antibiotic tablets
    • Lymecycline, tetracyclin
  • In woman, the combined oral contraceptive pill
  • Isotretinoin tablets
24
Q

What are some topical antibiotics that can be used for the treatment of acne?

A
  • Clindamycin/erythromycin
25
Q

What antibiotic tablets can be used for the treatment of acne?

A
  • Lymecycline, tetracyclin
26
Q

What is rosacea?

A

Long-term skin condition that typically affects the face. It results in redness, pimples, swelling, and small and superficial dilated blood vessels

27
Q

How does rosacea affect your face?

A

Causes redness and visible blood vessels on your face

28
Q

Who is rosacea most common in?

A
  • Most common in fair-skinned people
29
Q

In what age grup is rosacea most common?

A
  • Occurs in 3rd and 4th decade of life
30
Q

How does rosacea contrast acne?

A
  • In contrast to acne, rosacea is not associated with seborrhoea
31
Q

Describe the pathogenesis of rosacea?

A
  • 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
32
Q

What are the clinical features of rosacea?

A
  • 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
33
Q

Where does rosacea usually affect?

A

Central convex areas of the face:

  • nose, forehead, cheeks, chin
34
Q

What is the onset of rosacea marked by?

A
  • Onset marked by vascular changes, notably episodic flushing with no sweating
35
Q

Describe the lesions due to rosacea?

A
  • Erythema with burning sensation is easily triggered by minor irritants
    • Stress, hot drinks, alcohol, spices
  • Papules and pustules in more advanced cases WITHOUT COMEDONES
36
Q

What are some different kinds of rosacea?

A
  • 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
37
Q

What is the treatment of rosacea?

A
  • 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
38
Q

What is the clinical presentation of vascular rosacea?

A
  • Recurrent blush
  • Telangiectasias begin for form, initially in nasal area
39
Q

What is the clinical presentation of inflammatory rosecea?

A
  • Small papules and pustules to occasional deep cystic nodules
  • Absence of comedones
  • Deeper red colour when compared to acne
  • Soft or solid facial oedema
40
Q

Describe the lesions due to inflammatory rosacea?

A
  • Small papules and pustules to occasional deep cystic nodules
  • Absence of comedones
41
Q

What is the clinical presentation of phymatous rosacea?

A
  • Overgrowth of sebaceous glands
  • Skin becomes swollen and smoother, pores become more apparent
  • Gradually, a lumpy surface develops
42
Q

What is the clinical presentation of occular rosacea?

A
  • Symptoms range from sensation of dryness or tired eyes to oedema, tearing, pain, chalazia and corneal damage

10. Year 2: Dermatology (11 decks)

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