Pilosebaceous Unit Flashcards
pilosebaceous unti segments
- keratinized follicular infundibulum
- hair
- sebaceous gland
- sebaceous duct (connects gland w/ infund)
what does sebum contain?
free FA wax sterol esters TGs squalene
acne vulgaris
patho: 1) abnorm keratinization-inc corneocytes –> microdomes
2) microcomedone expands, sebac lobule regresses –> raised comedone created by accum of sebum and keratinocytes
3) comedones rupture –> inflam; pustules, papules, nodules, cysts may form
clin: non inflam: open and closed comedones
inflam: usually start w/ comedome formation
treat: topical retinoids (comedones, prevent), topical anti-inflam and anti-bio, oral antibiotics (reduce inflam), hormonal agents, incise and drain, chemical peels, steroid injection, laser and light treatment
acne fulminans
severe cystic acne
men 13-16 years
systemic manifestations: fever, malaise, arthralgias, myalgias, hepatosplenomegaly
acne conglobata
eruptive acne w/o systemic manifestations
follicular occlusion tetrad
acne mechanica
acne from mechanical and frictional obstruction of pilosebaceous unit
linear and geometric distribution
acne excorice
acne as a result of excoriation or manipulation
may treat w/ antidepressants and psychotherapy in addition to acne treatment
drug induced acne
common offenders: anabolic steroids, corticosteroids, lithium, phenytoin, isoniazid, iodides, bromides
abrupt, monomorphous eruption of inflam papules
infantile acne
acne persists beyond 3 months
mild hormonal imbalance (poss. inc. DHEA)
deep cystic lesions and pustules may be seen
rosacea
patho: history often includes easy blushing, inflam acneiform papules of cheeks/nose
- triggers: food, meds –> vasodilation, UV, wind, cold weather, humidity, emotional stress, heat, alcohol, spicy food
clin: flushing, erythema, telangiectasias, papules/pustules, no comedones
2* features: burning, stinging, xerosis on central face, edema, ocular issues, rhinophyma
treat: topical or oral antibiotics, laser and lights
periorificial dermatitis
- variant of rosacea
- small erythematous papillose in perioral or periocular region, spares vermillion border
- exacerbated by topical corticosteroids, cinnamon, mint
pyoderma faciale (rosacea fulminans)
acute eruption of inflamed papillose and pustules in centrofacial region
steroid rosacea
use of topical or systemic corticosteriods exacerbated rosacea
controlled by systemic antibiotics to topical calcineurin inhib
apocrine sweat glands
axillary, anogenital
olfactory communication
Hidradenitis suppurativa (HS)
epi: more common in women, poss genetic
patho: results from occlusion of apocrine glands (foll. infund. occlusion followed by rupture of follicles)
follicular occlusion tetrad
clin: tender nodules and papules at first, recurrent boils, and draining sinus tracts –> scarring, drainage, odor, pain
treat: weight reduction
topical: antibiotics, absorbing powder, antiseptic soap, aluminum Cl
systemic: prednisone, retinoids, antibiotics
surgery: intralesional steroid injection, incise and drain, laser
follicular occlusion tetrad
aka: acne inversa
patho: related to follicular hyperkeratinization
acne conglobata
HS (hidradenitic supperativa)
dissecting cellulitis of scalp
pilonidal cyst
lead to permanent scarring
dissecting cellulitis
perofollicular pustules, nodules, abscesses, ans sinuses that evolve into hair loss (scarring alopecia)
pilonidal cyst
cyst or bases near or on the natal cleft of the butt
eccrine gland
palms, soles, axillae
activated by emotional and thermal stimuli, activity controlled by sweat center in hypothal (ACh)
thermoregulation, electrolyte balance, moisten st. corn., drug delivery
hyperhidrosis treatments
Alum Cl - plug
oral anti cholinergics - reduce sim of sweat glands as part of sym. nerve response, e.g. glycopyrrolate
botulinum toxin (botox) - prevent ACh release at NMJ
surgical sympathectomy - only for palms, cut sym fibers
