Follicular Disorders Flashcards

1
Q

Acne age

A

Usually between 11-30 years old, typical onset in adolescence

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2
Q

Acne long term effects

A

Permanent scarring, psychosocial withdrawals, decreased quality of life

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3
Q

Acne pathogenesis

A

Pilosebaceous unit obstruction, increased sebum production (hormonal influence), bacterial proliferation, inflammation

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4
Q

Acne triggers

A

Stres, hormonal fluctuation/menses, mechanical/occlusion, medications, pathologic androgen excess, diet

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5
Q

Acne stages - mild

A

Normal, open comedo (blackhead)

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6
Q

Acne stages - moderate

A

Closed comedo (whitehead), papule

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7
Q

Acne stages - severe

A

Pustule

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8
Q

Acne lesion types - active

A

Microcomedone, open comedone (blackhead), closed comedone (whitehead), papule, pustule, nodule/cyst/sinus tract

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9
Q

Acne lesion types - sequelae

A

Dypigmentation (post inflammatory hyperpigmentation), scarring (hypertrophic/keloidal, atrophic/pitting/ice pick)

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10
Q

Acne categorizing

A

Mild, moderate, severe, comedonal, inflammatory, nodulocystic, hormonal, with or without scarring, truncal involvement, impact on quality of life

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11
Q

Acne conglobata and acne fulminans morphology

A

Severe presentation, multiple connecting sinuses/tract, scarring

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12
Q

Acne conglobata and acne fulminans age

A

Usually teen males

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13
Q

Acne conglobata and acne fulminans associated diseases

A

May have systemic symptoms/body pain, associated auto inflammatory syndromes - pyogenic arthritis, pyoderma gangrenosum, cystic acne, hidradenitis suppuritiva

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14
Q

Acne conglobata and acne fulminans treatment

A

Very aggressive and needs referral

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15
Q

Acne excoriee definition

A

“Factitial dermatitis”, exogenous manipulation

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16
Q

Acne excoriee associated disease

A

Anxiety, OCD, body dysmorphic issues

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17
Q

Acne excoriee treatment

A

Topicals, recognize behavior and refer to behavioral health

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18
Q

Acne treatment - mild comedonal

A

Topical retinoid, salicylic acid, maybe benzoyl peroxide

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19
Q

Acne treatment - mild inflammatory or mixed

A

Combo topical therapy: benzoyl peroxide, antibiotic, retinoid

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20
Q

Acne treatment - moderate inflammatory or mixed

A

Benzoyl peroxide, antibiotic, retinoid, oral antibiotic, maybe hormonal treatment

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21
Q

Acne treatment - severe inflammatory or mixed

A

Benzoyl peroxide, antibiotic, retinoid, oral antibiotic, hormonal or isotretinoin treatment

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22
Q

Acne treatment - hormonal

A

OCP/spironolactone with or without topicals

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23
Q

Acne treatment - nodulocystic

A

Isotrentinoin or other

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24
Q

Postinflammatory dyspigmentation definition

A

Increased melanin deposition within epidermis, possibly worsened by sun exposure

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25
Q

Postinflammatory dyspigmentation treatment

A

Salicylic acid gel/cleanser, retinoids, azelaic acid, non-comedogenic sunscreen, cosmetic treatments if persistent

26
Q

Acne scarring types

A

Atrophic (ice pick/box car), hypertrophic (keloidal)

27
Q

Acne scarring treatments

A

Retinoids, IL steroid injections for hypertrophic, cosmetic procedures if persistent

28
Q

Neonatal acne morphology

A

Papule, pustules, no comedones

29
Q

Neonatal acne age

A

First weeks-months of life

30
Q

Neonatal acne causes

A

Possibly maternal hormonal influence or hypersensitivity to Malessezia species

31
Q

Neonatal acne treatment

A

No treatment required

32
Q

Infantile acne morphology

A

Comedones, papules, pustules, maybe nodulocysts

33
Q

Infantile acne age

A

3-6 months old

34
Q

Infantile acne causes

A

Possibly transient adrenal/gonadal androgen production

35
Q

Infantile acne treatment

A

Like teen acne, start with topicals, refer for further treatment

36
Q

Childhood acne morphology

A

More persistant/severe than infantile, comedones, papule, pustules, maybe nodulocysts

37
Q

Childhood acne age

A

6 months or older

38
Q

Childhood acne treatment

A

Like teen acne, start with topicals, usually need oral medications

39
Q

Childhood acne 2-7 years old

A

Endocrine referral necessary if severe, X-ray for bone age, look at DHEAS, testosterone, 17OH progesterone, LH, FSH, prolactin

40
Q

Hidradenitis suppuritiva definition

A

Chronic acneiform inflammatory condition

41
Q

Hidradenitis suppuritiva morphology

A

Painful, draining sinuses on body folds

42
Q

Hidradenitis suppuritiva age

A

Pubertal or adults

43
Q

Hidradenitis suppuritiva treatment

A

Similar to severe inflammatory acne

44
Q

Folliculitis definition

A

Inflamed hair follicles where they are most dense (scalp, neck, chest, back, groin) with or without infection

45
Q

Folliculitis morphology

A

Follicularly-centered papule or pustules, can be itchy or painful, can be exacerbated in areas of occlusion or friction

46
Q

Folliculitis causes

A

Pseudomonas, pseudofolliculitis barba (razor bumps), tinea (barber’s itch)

47
Q

Hair growth steps

A

Anagen, catagen, telogen, return to anagen

48
Q

Alopecia definition

A

Hair loss, disruption in normal hair cycle

49
Q

Alopecia subtypes - loss or decreased development

A

Areata, androgenetic, trichotillomania, inflammatory/scarring, genetic

50
Q

Alopecia subtypes - shedding

A

Telogen effluvium, anagen effluvium

51
Q

Alopecia areata definition

A

Localized (scalp) autoimmune phenomenon that may be associated with other autoimmune conditions

52
Q

Alopecia areata morphology

A

Geometric, clean patterning, totalis (whole scalp) or universalis (whole body)

53
Q

Androgenic alopecia - male pattern

A

Distinct patterning, higher 5-alpha reductase level, lower testosterone, higher free androgens, hair follicle diminishes and produces less

54
Q

Androgenic alopecia - female pattern

A

Hair follicle diminishes and produces less, diffuse thinning or part thickening

55
Q

Trichotillomania

A

Hair pulling behavior disorder, OCD spectrum, possible anxiety/depression

56
Q

Anagen effluvium

A

Insult to hair follicle impairing mitotic activity, diffuse shedding of actively growing hairs

57
Q

Telogen effluvium

A

Abrupt shift occurs so all telogens are in phase, postpartum, illness or stress induced, diffuse shedding all at once of resting hair, spontaneous regrowth

58
Q

Acne histology

A

Dilated hair follicles with keratin debris, open for blackheads, closed for whiteheads, inflammatory cells may be present

59
Q

Hidradenitis suppurativa histology

A

Increased inflammatory cells in the follicle, hyperkeratosis, no/few/small sebaceous glands, inflammation, draining sinuses leave tracts of excess secretion

60
Q

Folliculitis histology

A

Increased inflammation, increased neutrophils, disruption or breaking of hair follicle

61
Q

Alopecia areata histology

A

Increased inflammation centered on the hair bulb, increased lymphocytes attacking hair bulb

62
Q

Androgenetic alopecia histology

A

Hair follicles decrease in size until they disappear, hair bulbs now in the dermis layer, sebaceous glands still present