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Intro to D&D Final > Pathophys - Acne > Flashcards

Pathophys - Acne Flashcards

1
Q

true or false

bacteria causes acne

A

FALSE

they get trapped in the mass of skin cells and sebum, allowing growth more rapidly, but it is NOT THE PRIMARY CAUSE

primary cause is abnormal growth of skin cells and collection of sebum

bacteria get TRAPPED in these skin cells and sebum, allowing them to grow more rapidly. they’re a CONSEQUENCE, or secondary cause

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2
Q

true or false

acne is chronic

A

true

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3
Q

acne is a chronic skin disorder of ______ that occurs why?

A

chronic disorder of HAIR FOLLICLES

occurs due to a blockage by SKIN CELLS AND SEBUM

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4
Q

acne occurs when……

A

dead skin cells and oil (sebum) from the skin clogs hair follicles

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5
Q

what is a comedone?

A

a hair follicle that has been clogged by dead skin cells and sebum

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6
Q

how are comedones important in the development of acne

A

they allow the excess growth of CUTIBACTERIUM ACNES – a commensal skin bacteria

this moist environment is ideal for bacteria to grow

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7
Q

true or false

the commensal bacteria, cutibacterium acnes, is responsible for the formation of a comedone and the start of acne

A

FALSE

the cause is a hair follicle clogged by SKIN CELLS AND SEBUM

the bacteria gets trapped AFTER THIS CLOG

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8
Q

true or false

cutibacterium acnes is a commensal bacteria

A

true

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9
Q

comedones start as what and progress to what?

A

starts as microcomedones and they enlarge to form PIMPLES

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10
Q

name 2 different types of pimples and why they present this way

A

whiteheads and blackheads

white heads are the result of a DEEP microcomedone that is closed

black heads are a SUPERFICIAL microcomedone that is open to air, and allows the oxidation of melanin – that’s why it has a black color

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11
Q

explain how acne can cause skin scarring and pus-filled raised areas (pimples)

A

when the microcomedone gets a lot of sebum and bacteria trapped inside, the bacteria can invoke the inflammatory process – causing the formation of a pus-filled raised pimple as well as tissue damage and scarring of the skin

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12
Q

what is the major risk factor for acne

A

GENETICS

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13
Q

true or false

the risk of developing acne is largely inherited

A

true

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14
Q

explain how acne is genetically linked

A

genetics control ANDROGEN PRODUCTION

androgens regulate the formation of sebum. if too many – too much sebum production

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15
Q

______ traps _______- in _______ to form a comedone

A

sebum traps dead skin cells in hair follicles to produce a comedone

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16
Q

what can cause increased sebum production

A

androgens

17
Q

true or false

acne is likely of polygenic inheritance

A

true

18
Q

acne is associated with ___ syndrome

why

A

XYY syndrome

“super male” - extra Y chromosome

there is high rate and severity of acne, as well as hair growth on the edge of the ear

19
Q

name 2 hormones that seem to be the principle drivers in acne formation

A

androgens
growth hormone

20
Q

name 2 androgens that are involved in acne formation

A

testosterone
DHT - dihydrotestosterone

21
Q

acne still develops in those with androgen insensitivity

what can you conclude from this?

A

androgens are not the lone essential cause for acne – another main cause is IGF-1 (insulin like growth factor)

22
Q

true or false

both males and females produce androgens and estrogens

A

true - just in varying amounts

23
Q

where are androgens and estrogens made

A

in the adrenal cortex

24
Q

how can increased androgens cause acne

A

they stimulate the growth of skin cells and increased production of sebum – cause hair follicle to clog and bacteria can get trapped too

25
Q

how is it that the onset of acne is typically at puberty

A

increase in hormones!! (androgens and insulin like growth factor)

clogs follicles through increased sebum production and growth of skin cells

26
Q

explain the role of cutibacterium acnes in acne

A

it is COMMENSAL – normally grows on the skin and has protective function

it is ANEAROBIC - does not need oxygen to grow

therefore, when trapped in sealed comedone with sebum and dead cells, it can easily grow even without oxygen

27
Q

how are mites related to the formation of acne

A

infections with mites (particularly demodex) is associated with formation of comedones and acne

28
Q

true or false

some strains of c. acnes are associated with normal skin and other strains are associated with acne

A

true

29
Q

what kind of professionals often have an increased risk in formation of acne and why

A

athletes

causes by the mechanical obstruction of hair follicles – obstructed bc of the equipment they wear such as helmets

30
Q

true or false

mechanical obstruction of the skin is not thought to play a role in acne

A

false - it is

ie: athletes and their equipment (helmets)

31
Q

name 6 types of drugs that have been shown to worse pre existing acne

what are they all associated with?

A

testosterone
bromides
glucocorticoids
hydantoin
iodides
isonaizid

all associated with cell growth

32
Q

the blockage of hair follicles occurs due to ___ events:

A

4 events:

increased sebum production
excessive deposition of keratin
comedone formation
colonization of the follicle by bacterium (usually C. acnes)

33
Q

what is at the heart of developing acne?

what is the overarching event?

A

the 4 events that lead to the blockage of hair follicles – increased sebum production, excessive deposition of keratin, comedone formation, colonization of follicle by c. bacterium

OVERARCHING EVENT IS CHANGES IN HORMONE PRODUCTION

34
Q

what is DHEA-S

A

a hormone whose levels are increased by the adrenal glands at puberty

leads to increased sebum production and growth of skin bacteria (C. acnes) and skin cells

35
Q

true or false

while bacteria is NOT the cause of acne, it can enlarge the damage

A

TRUE

bc it invokes the inflammatory response – bc it binds and activates TLRs (toll like receptors) and increases secretion of cytokines like IL-1A
TNFa, IL8, LTB4

also the bacteria themselves produce enzymes that can damage tissue and form scars

36
Q

as mentioned, bacteria invokes the inflammatory response and causes an increase in cytokines

what are 3 results of this

A

increased skin cell production
trapping of cells in the sebum
excessive growth and trapping = COMEDONE FORMATION

37
Q

true or false

the bacteria themselves do not cause injury, but only indirectly through invoking the inflammatory process

A

FALSE - they can cause injury by releasing enzymes themselves that damage tissue

enzymes can cause phagocytes to release metalloproteases which damage tissue

38
Q

what is squalene and its role in acne development

A

a component of sebum

when it is oxidized, it activates NFKB, which secretes IL-1A AND increases 5-lipooxygenase activity

this leads to increase in LKB4 (leukotriene B4) — a promoter of inflammation

inflammation causes local tissue death and scarring

39
Q
A

Intro to D&D Final (22 decks)

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