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Derm 2020 > Chemical Peels > Flashcards

Chemical Peels Flashcards

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Dermatology Board Prep flashcards
1
Q

Medium depth peels penetrate the epidermis to upper papillary dermis

A

F - upper reticular dermis (however JAAD article states to papillary dermis)

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2
Q

Deep peels reach the mid-reticular dermis

A

T

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3
Q

70% Glycolic acid + 35% TCA =Coleman Peel

A

T

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4
Q

Pre-treatment with tretinoin and/or AHA’s for at least 4-6wk before procedure is very important for success of a chemical peel

A

True

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5
Q

Even after re epithelialisation has occurred following a peel, tretinoin should be avoided for a further 2-4 weeks

A

False - can restart with low concentration

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6
Q

Glycolic acid cruises epidermolysis though lysis of desmosomes

A

True

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7
Q

Hydroquinone inhibits conversion of DOPA to melanin by inhibiting the tyrosinase enzyme

A

True

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8
Q

Hydroquinone causes depigmentation of surrounding skin

A

True

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9
Q

Superficial peels can eliminate fine lines and actinic keratoses

A

False = not usually , need medium depth

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10
Q

Medium depth but not superficial peels helpful in treating acne and may improve malasma

A

False - superficial helpful

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11
Q

Wood lamp can help reliably predict response to superficial peel

A

False - dermal melasma can be masked by more superficial melasma

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12
Q

Acetone is preferred agent for degreasing prior to a peel

A

False - due to flammability. Other agents preferred -= Septisol , alcohol

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13
Q

Always treat infraorbital region with saturated cotton tipped applicators regardless of agent

A

True

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14
Q

TCA has systemic toxicity at high concentrations

A

False - no known systemic toxicity

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15
Q

TCA is stable for 1-2 years in amber bottles at room temperature

A

False 23 weeks

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16
Q

TCA needs to be refrigerated in a dark room

A

False - not heat or light sensitive

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17
Q

Salicylism is unlikely even with a peel of large area

A

True, though possible

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18
Q

Rubbing and pressure do not determine response to the peel

A

False

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19
Q

The number of coats further determine response of peel

A

True

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20
Q

Isotretinoin produces atrophy of the pilosebaceous gland

A

True

21
Q

Light peels can be performed fortnightly and not more frequently

A

True - biweekly

22
Q

Salicylic acid is an alpha hydroxy acid

A

False beta hydroxy acid

23
Q

There is significant discomfort immediately following sal acid procedures

A

False - due to anaesthetic property of salicylic acid

24
Q

Salicylic acid peels have a strong comedolytic effect

A

True

25
Q

Factors affecting penetration of AHA’s?

A
  • acid concentration pH
  • bioavailability
  • degree of buffering
  • volume of agent applied
  • duration of time acid remains on skin
  • condition of epidermal barrier
  • extent of degreasing
26
Q

Tretinoin is not UV sensitive

A

False - decomposes on UV exposure thus should be applied late int he day

27
Q

Topical tretinoin imparts a pinkish discolouration after application - makes it easier to visualise treatment

A

False - yellowish

28
Q

Course, more sun damaged skin reacts faster and requires more heavily applied acid

A

False - reacts slower

29
Q

Chemical peels are very effective in mx of melasma and can be used as first treatment for mild, mod , severe or resistant melasma

A

False - should NEVER be the first treatment although it is effective

30
Q

Phytic acid is a component of plant seed

A

True

31
Q

Disadvantage of phytic acid is when acting at low pH , there is stinging and irritation

A

False - advantageous as no stinging or irritation at low pH

32
Q

If frosting is patchy , do not retreat

A

False. - can retreat with a minimally saturated cotton-tipped applicator.

33
Q

Jessner’s + TCA —> TCA is applied first followed by Jessner’s solution

A

False other way around

34
Q

Make up can be worn 2-3 days after chemical peel

A

False 7-10 days

35
Q

Erythema fades between 5-7 days after peel

A

False 2-4 weeks

36
Q

Using botox pre peel reduces the result of the peel

A

False - enhances —> new collagen is formed over stationary areas

37
Q

What is the Baker Gordon formula

A

Baker Gordon (3 pigs and 2 dogs ate septisol soap and 3 croutons) 3mL Phenol and 2mL Distilled water 8 drops Septisol and 3 drops croutons

  • phenol 88% 3mL
  • distilled water 2mL
  • septisol liquid soap 8 drops
  • croton oil 3 drops
38
Q

Medium depth peels - desquamation usually complete within 5-7days

A

True

39
Q

Medium depth oedema occurs within the first 2 hours

A

False first 24 hr

40
Q

Most important complications of phenol based peels is cardio toxicity

A

True

41
Q

Phenol is directly toxic to myocardium

A

True

42
Q

Hypopigmentation can be a complication of any peel

A

False - only deep peels.

43
Q

Intradermal naevi hypopigment not hyperpigment after a deep peel

A

False , can hyperpigment

44
Q

Bacteria and fungal complications in chemical peels are common

A

False - rare

45
Q

Chemical peels can cause toxic shock syndrome

A

True

46
Q

Milia occur in a negligible number of patients after chemical peels

A

False up to 20%

47
Q

Milia occur rapidly within 2-3 weeks post peel

A

False, 2-4 months

48
Q

Scarring is the worst complication of chemical peels

A

True

49
Q

Acneiform dermatitis after chemical peels is not rare

A

True

Derm 2020 (59 decks)

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