Common Skin Disorders Flashcards
Define Acne Vulgaris
Inflammation of pilosebaceous units of certain body parts
Clinical Presentation of Acne Vulgaris
Lesions on the skin
Pain in lesions Lesions include: comedones, papulopustules, nodules, and cysts
4 Factors Involved in Acne Vulgaris
Follicular hyperkeratinization
Increased sebum production
P. acnes within the follicle
Inflammation
Acne Vulgaris Grade I
Minimal blackheads
Few papules
Acne Vulgaris Grade II
10+ blackheads, papules, & pustules
Redness
Inflammation
Acne Vulgaris Grade III
15-20+ blackheads, papules, & pustules
Redness
Inflammation
Acne Vulgaris Grade IV
Severe case
Extreme amount of pustules
Extreme edema
Diagnosis of Acne Vulgaris
Clinical
Female patients with dysmenorrhea or hirsutism: total/free testosterone, DHEA-S, LH, FSH
Treatment of Acne Vulgaris
OTC 1st line: Topical retinoids 2nd line: Topical antibiotics Oral therapies Oral isotretinoin
OTC Treatment for Acne Vulgaris
Benzoyl peroxide
Salicylic acid
Topical Retinoid Treatment for Acne Vulgaris
1st line
Adapalene (Differin)
Tretinoin (Retin-A)
Tazarotene (Tazorac)
Topical Antibiotic Treatment for Acne Vulgaris
2nd line
Clindamycin
Erythromycin
Oral Therapies for Acne Vulgaris
Doxycycline
Minocycline (Minocin)
Oral Isotretinoin Treatment for Acne Vulgaris
For severe treatment failure
Register in iPLEDGE program
Teratogenic
Monitor: CBC, LFTs, & transaminases
Define Rosacea
Chronic acneform disorder of facial pilosebaceous units
Increased reactivity of capillaries to heat
Exacerbating Factors of Rosacea
Hot liquids Spicy foods Alcohol Exposure to sun & heat Cold Exercise Emotions Menopausal flushing
Clinical Presentation of Rosacea
Redness to the cheeks, nose, & chin
Burning or stinging with episodes
4 Types of Rosacea
Erythematotelangiectatic rosacea
Papulopustular rosacea
Phymatous rosacea
Ocular rosacea
Treatment of Rosacea
Minimize precipitating factors 1st line mild to moderate: topical antibiotics Moderate to severe: systemic antibiotics Laser treatment for telangiectasia Pulsed-light therapy for erythema Cleansers Photodynamic therapy
Topical Antibiotics for Rosacea
Azalea Acid Metronidazole Erythromycin Clindamycin Brimonidine
Systemic Antibiotics for Rosacea
Tetracycline
Doxycycline/Minocycline
Erythromycin
Complications of Rosacea
Eye involvement
Gram negative folliculitis
Permanent telangiectasias
Rhinophyma
Define Rhinophyma
Soft tissue hypertrophy related to vasodilation
Define Folliculitis
Infection of the hair follicles
Common Bugs of Folliculitis
Staphylococcus aureus
Pseudomonas
Yeast: exception
Symptoms of Folliculitis
Red pimples with a hair in the center
May itch or burn
Treatment of Folliculitis
Warm compresses 3 times daily
Avoid shaving in areas
Topical antibiotics: Mupirocin (Bactroban)
Define Pseudobarbae Folliculitis
Razor bumps
How does pseudobarbae folliculitis occur?
When free ends of tightly coiled hairs reenter skin & cause a FB inflammatory response
Treatment of Pseudobarbae Folliculitis
Stop shaving Laser hair removal Adjunctive medical therapy Warm compresses Remove hair with tweezers
Adjunctive Medical Therapy for Pseudobarbae Folliculitis
Topical retinoids
Low potency corticosteroids
Topical antimicrobials
Define Furuncles (Boils)
Skin abscesses caused by staphylococcal infection of a hair follicle
Define Carbuncles
Cluster of furuncles
Common Areas for Furuncles/Carbuncles
Buttocks Axillae Neck Face Waist
Predisposing Factors for Furuncles/Carbuncles
DM Malnutrition Obesity Hematologic disorders Hot, humid climates Occlusion of anatomy
Treatment of Furuncles/Carbuncles
Hot compresses
I&D
Packing may be necessary
Systemic antibiotics
Systemic Antibiotics for Furuncles/Carbuncles
Bactrim
Clindamycin
Cephalexin (Keflex)
Common Bugs for Impetigo
Staph
Strep
Describe Impetigo
Red lesions that can break open, ooze
Develop a yellow-brown crust (honey colored)
Where do impetigo sores usually appear?
Mouth
Nose
Treatment of Impetigo
2% Bactroban ointment or cream
Severe: oral clindamycin or erythromycin
Clinical Characteristics of Junctional Nevi
Light brown to nearly black
Usually flat but may be slightly elevated
1-10 mm
Clinical Characteristics of Compound Nevi
Light brown to dark brown
May be slightly or considerably elevated
3-6mm