Acneiform Lesions

Question 1

define acne rosacea

Answer 1

a chronic inflammatory skin condition affecting convexities of the centrofacial region

Question 2

describe the characteristic signs of acne rosacea

Answer 2

recurrent episodes of facial flushing
persistent erythema
telangiectasia
papules + pustules

Question 3

triggers of acne rosacea

Answer 3

smoking
heat or cold ambient temps
spicy foods
alcohol

Question 4

risk factors of acne rosacea

Answer 4

increased age
female sex
photosensitive skin type
smoking

Question 5

conservative management of acne rosacea

Answer 5

avoid triggers
regular sunscreen use
use of camouflage creams
avoid products requiring solvent removal use

Question 6

medical management of acne rosacea

Answer 6

topical antibiotic (e.g. metronidazole)
topical alpha-adrenergic agonist 
azelaic acid (2%)

Question 7

management of acne rosacea involving papules

Answer 7

oral antibiotic +/- topical ivermectin

e.g. doxycycline (40mg 1x 8-12wks)

Question 8

definition of acne vulgaris

Answer 8

a chronic inflammatory skin condition that occurs due to inflammation and blockage of the pilosebaceous unit

Question 9

risk factors of acne vulgaris

Answer 9

male sex 
adolescence 
\+ve FH of acne vulgaris 
high glycemic index diets 
PCOS

Question 10

classification of mild acne vulgaris

Answer 10

non-inflammatory lesions with sparse inflammatory lesions

Question 11

classification of moderate acne vulgaris

Answer 11

widespread non-inflammatory lesions with numerous papules + pustules

Question 12

classification of severe acne vulgaris

Answer 12

widespread inflammatory papules, pustules, nodules and cysts

Question 13

clinical features of acne vulgaris

Answer 13

seborrhoea (greasy skin)
comedones, papules and pustules
scarring
post-inflammatory depigmentation or hyperpigmentation

Question 14

conservative management of acne vulgaris

Answer 14

wash face with soap and warm water 2x daily
avoid fragrant skin products
avoid greasy/heavy skin products

Question 15

medical management of mild acne vulgaris

Answer 15

topical retinoid +/- benzoyl peroxide
topical anitbiotic
azelaic acid

Question 16

medical management of moderate acne vulgaris

Answer 16

oral antibiotic (e.g. tetracycline)

if patient female:
- oral anti-androgen

Question 17

medical management of severe acne vulgaris

Answer 17

oral retinoid (e.g. isotretinoin)

Question 18

side effects of oral retinoids (e.g. isotretinoin)

Answer 18

dry mucous membranes
dry skin
headaches
hair thinning/loss

Question 19

define folliculitis

Answer 19

an inflammation of hair follicles that causes formation of papules/pustules

Question 20

causative organisms of folliculitis

Answer 20

staph aureus
pseudomonas
gram +ve bacteria

Question 21

risk factors of folliculitis

Answer 21

male sex 
adolescence 
physical trauma/irritation 
long-term antibiotic or corticosteroid treatment 
tight clothing

Question 22

clinical features of folliculitis

Answer 22

small pustules/papules in areas of hair growth

• often itchy, erythematous and tender
• lack hair shaft

Question 23

indications for investigations in folliculitis

Answer 23

if recurrent, culture swab

if atypical response to treatment, consider punch biopsy

Question 24

conservative management of folliculitis

Answer 24

use antibacterial soaps and maintain good skin hygiene
wear looser clothing
avoid high humidity environments
practice good shaving technique

Question 25

medical management of superficial folliculitis

Answer 25

topical antiseptic

e.g. triclosan or clorhexidine

Question 26

medical management of deep folliculitis

Answer 26

topical or oral antibiotic

oral: fluclox (500mg 1wk)
topical: cephalosporin