Facial Rashes

Question 1

(Open/Closed) comedones are referred to as blackheads

Answer 1

Open comedneo (follicular opening with oxidized lipids)

Question 2

(Open/Closed) comedones are referred to as whiteheads

Answer 2

Closed comedones (no follicular opening)

Question 3

the formation of comedones, papules, pustules, nodules, and/or cysts as a result of obstruction and inflammation of pilosebaceous units (hair follicles and their accompanying sebaceous gland); a fancy word for acne

Answer 3

Acne vulgaris

Question 4

Pathogenesis of Acne Vulgaris

Answer 4

Androgens–> sebaceous gland activity–> plugging of hair follicle–> P. acnes metabolizes lipids to FFAs to cause inflammation

Question 5

Bacteria thought to be involved with acne

Answer 5

Cutibacterium acnes (formerly P. acnes)

Question 6

Topical treatment takes ____ weeks to determine efficacy

Answer 6

6-8

Question 7

Treatment for comedones

Answer 7

Topical retinoid +/- topical BPO

Question 8

If oral/topical antibiotics are added for acne treatment, they are ____used alone

Answer 8

NOT (other topical treatment is given along with antibiotics)

Question 9

Treatment for hormonal acne

Answer 9

OCP, spironolactone

Question 10

Treatment for nodulocystic acne

Answer 10

Isotretinoin (teratogenic!)

Question 11

CHRONIC facial erythema on nose and cheeks with telangiectasia (spider veins) and SOMETIMES papules or pustules but NO comedones (different from acne) and NO scale (different from dermatitis); may also have rhinophyma (hyperplasia of nose) and ocular rosacea; flares with alcohol, sunlight and spicy foods

Answer 11

Rosacea

Question 12

Rosacea is seen in all skin types but more often in lighter/darker skin patients

Answer 12

lighter

Question 13

Comedones are (absent/present) in rosacea

Answer 13

Absent (different from acne)

Question 14

Sebaceous gland hyperplasia of the nose; sometimes seen in Rosacea

Answer 14

Rhinophyma

Question 15

Rosacea is caused by complex innate immune response that involves increased ______ which is an antimicrobial peptide and increased TLR2 response to ______.

Answer 15

• Cathelicidin

- Demodex (mite)/S. epidermidis

Question 16

Treatment for Rosacea

Answer 16

1. Lasers/light for erythema
2. Topical antibiotics (metronidazole) or oral antibiotics (tetracycline) for papulopustular
3. Topical ivermectin for demodex
4. Surgery for rhinophyma
5. Oral tetracycline for ocular rosacea

Question 17

Treatment for Rosacea is typically medical except for __________________ which needs surgery

Answer 17

Rhinophyma

Question 18

Pinpoint pink papules around nose, mouth, maybe eyes; can last up to months but not long-term like rosacea; can be triggered by aerosolized steroids and worsened by topical steroids

Answer 18

Perioral Dermatitis

Question 19

Treatment for perioral dermatitis

Answer 19

similar to tx for papulopustular rosacea: topical metronidazole + oral antibiotics (doxy or minocycline)

Question 20

a very common chronic skin disease due to inflammatory response to Malassezia (fungi); diffusely through areas of high sebum production (scalp, ears, central chest); erythema with overlying greasy yellow scale; infantile type is called “Cradle Cap”; hypopigmentation in darker skin

Answer 20

Seborrheic Dermatitis

Question 21

Severe disease of _____ can be seen in untreated HIV or parkinson disease

Answer 21

Seborrheic Dermatitis

Question 22

Treatment for Seborrheic Dermatitis

Answer 22

topical steroids (for flares) and ketoconazole (for Malassezia)

Question 23

aka. razor bumps; seen along jaw line and neck; pink papules, pustules, firm flesh-colored papules caused by curly hair which penetrates the skin and leads to inflammatory response to hair keratin; more common in darker skin

Answer 23

Pseduofolliculitis Barbae (PFB)

Question 24

Treatment for PFB

Answer 24

stop shaving, topical antibiotic or steroids if needed