Cases

Question 1

The triangle pathogenesis of acne

Answer 1

1. abnormal keratinisation leads to blocked hair follicle duct
2. Increased sebum causing follicle distension
3. Infection with P. acne leads to an inflammatory reaction and pustule formation

=> comedones = open/blackhead & closed/whitehead

Question 2

Main tx for acne

Answer 2

> Topical retinoids or benzoyl peroxide

> Antibiotics, either systemically or topically
DOXYCYCLINE; ERYTHROMYCIN (prego safe)
!poor fetal bone and tooth dev (tetracycline)

> Systemic retinoids (failure to respond to above >6mos and scarring and numerous inflamm lesions)
!cardio, neuro, and craniofacial abn

Question 3

Take home point of Abx prescribing in acne

Answer 3

Possible effects cannot conclude until 3mos; very long term implications

Question 4

Abx resistance with P. acne

Answer 4

Systemic antibiotic + Topical retinoid + Topical benzoyl peroxide

=

Decrease risk of resistance

Question 5

Sfx of oral isoretinoin

Answer 5

hypertriglyceridaemia
Liver funct derangement
Dry eyes and skin
Mood disturbances