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Dermatology > Lecture 2: Disorders of Sebaceous and Apocrine Glands > Flashcards

Lecture 2: Disorders of Sebaceous and Apocrine Glands Flashcards

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Dermatology Board Prep flashcards
1
Q

What are the factors associated with development of acne vulgaris?

A
  1. Increased sebum production
  2. Follicular hyperkeratinization
  3. Proliferation of cutibacterium acnes
  4. Inflammation
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2
Q

What triggers acne in puberty?

A
  • Androgen stimulation of pilosebaceous unit
  • Changes in keratinization at follicular orifice

Hormones and keratinization

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3
Q

Stages of acne image

A
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4
Q

When does the follicular ostium dilate in acne?

A

Comedo formation

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5
Q

When does rupture of the follicular wall occur in acne?

A

Nodule/cyst

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6
Q

What is a blackhead?

A

An open comedo

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7
Q

Which gender usually has more acne?

A

Women

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8
Q

Specifically in adult women, what kind of acne papules are found and where?

A

Deep seated & tender red papules along the mandibular jaw.

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9
Q

What are drug-induced acneiform eruptions usually composed of?

A

Monomorphic inflammatory papules and pustules

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10
Q

How is acne diagnosed?

A

Clinically

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11
Q

Image of acne severity scale

A
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12
Q

What could itchy acne be and what do we do then?

A
  • If itchy, could be papules that we can do KOH prep on.
  • Check for pityrosporum folliculitis (tx with keto shampoo)
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13
Q

MOA of a retinoid

A

Decreases cohesion and increases turnover of epidermal cells

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14
Q

MC SE of retinoids and pt education

A
  • Dryness
  • CI in pregnancy
  • Photosensitivity

Think accutane

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15
Q

Advantage of BPO in acne tx

A

No bacterial resistance

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16
Q

SEs of BPO

A
  • Skin irritation
  • Bleaching of hair/clothing
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17
Q

In what type of acne is topical abx indicated?

A

Papulopustular

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18
Q

1st line topical abx

A

Clindamycin or erythromycin

Often combined with BPO

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19
Q

What is topical clindamycin used with for acne?

A
  • with BPO
  • with tretinoin

BID or foam QD

20
Q

What is topical erythromycin used with for acne?

A

with BPO

BID

21
Q

When are oral abx indicated for acne?

A

Moderate acne: inflammatory papules or deep-seated lesions

22
Q

What are the oral abx for acne?

A
  • Doxycycline
  • Minocycline

100 mg BID with BPO and ret

Usually 3 month course, tapered to QD for 1-2 months

23
Q

MOA of oral abx for acne and main SEs

A
  • MOA: inhibition of C. acnes
  • SEs: upset stomach and photosensitivity

GI and sun

24
Q

First-line oral ABX for acne

A
  • Tetracyclines: (CI in pregnancy/youngins + photosensitivity)
  • Macrolides: increased resistance
25
Q

Second-line oral abx for acne?

A
  • Bactrim DS (SJS, TEN, mostly for severe, not for preggos)
  • Keflex (crappy, but relatively safe in preggos)
26
Q

When is isotretinoin used and what does it do?

A
  • Used for severe resistant nodular/cystic acne
  • Inhibition/decrease in C. acnes

Usually last resort, monotherapy

27
Q

MC SE of isotretinoin

A

Dryness of skin/mucous membranes

HAs, SI, LFTs, myalgia

28
Q

When isotretinoin CI?

A
  • DO NOT USE WITH AN ORAL TETRACYCLINE
  • PREGNANT
29
Q

What must be monitored for someone on accutane?

A
  • Baseline CMP/Lipid monthly: if over 700-800, stop/statin
  • Females: 2x negative pregnancy tests + no blood donation
30
Q

Acne tx image

A
31
Q

What age is rosacea MC in?

A

30-50

32
Q

Rosacea presentation

A
  • Facial flushing
  • Localized erythema
  • Telangiectasias
  • Papules
  • Pustules
  • Nose, cheeks, brow, chin
33
Q

MC demographic for rosacea

A
  • Lighter skinned (type 1-3)
  • Females at a younger age
34
Q

Subtypes of rosacea

A
  • Erythematotelangiectatic
  • Papulopustular
  • Phymatous
  • Ocular rosacea
35
Q

Describe erythematotelangiectatic rosacea

A
  • Persistent erythema of central face
  • Intermittent flushing
  • Telangiectasias
  • Stinging/burning
  • MC SUBTYPE
36
Q

Describe papulopustular rosacea

A
  • Acneiform papules and pustules predominate
  • Erythema and edema of central with sparing of periocular areas
  • (No open comedones, differentiates between acne)
37
Q

Describe phymatous rosacea

A
  • Chronic inflammation and edema + marked thickening with sebaceous hyperplasia
  • cobblestone appearance on nose is MC
  • MC in men

looks like a dwarf

38
Q

Describe ocular rosacea

A
  • Conjunctivitis, blepharitis, and hyperemia
  • Dry, irritated, itchy eyes
  • Keratitis, scleritis, and iritis potentially
  • Can occur without cutaneous findings!
39
Q

What medication can trigger rosacea?

A

Niacin/vit B3

40
Q

Tx of rosacea

A
  • Avoid triggers
  • Sunscreen
  • Camo makeup
  • Topical metronidazole, ivermectin, sodium sulfacetamide, azelaic acid gel, brimonidine gel, oxymetazoline
  • Systemic: tetracyclines, metro, azithromycin
41
Q

Tx of severe papulopustular rosacea

A

Isotretinoin

42
Q

What drugs/therapies can help with flushing in rosacea?

A
  • Clonidine BID
  • Intense pulsed light
  • BBs (nadolol)
43
Q

Tx of rosacea fulminans

A

Prednisolone as isotretinoin is started

44
Q

What is perioral dermatitis and MC demographic?

A
  • Discrete erythematous micropapules
  • MC in females
45
Q

RFs for perioral dermatitis

A
  • Topical fluorinated glucocorticoids + inhalers
  • Fluroinated toothpaste
  • OCP

Fluorine

46
Q

Tx for perioral dermatitis

A

D/C Steroids

Dermatology (12 decks)

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