Pustular Disorders

Question 1

Acne Vulgaris

pathophys

4 components

Answer 1

1. follicular hyperkeratinization
2. increased sebum production
3. Cutibacterium acnes overgrowth
4. inflammatory response

Question 2

Acne Vulgaris

dx

Answer 2

clinical

Question 3

Acne Vulgaris

inflammatory skin condition associated w/

Answer 3

• papules & pustules
• which involve the pilosebaceous unit

Question 4

Acne Vulgaris

classifications

5

Answer 4

1. comedonal (open & closed)
2. mild mixed acne
3. moderate
4. severe
5. acne scars/hyperpigmentation

Question 5

Acne Vulgaris

tx for comedonal

& advise pts?

Answer 5

• topical retinoid
• must treat whole face, NOT SPOT tx

Question 6

Acne Vulgaris

how long until comedonal acne improves w/ tx?

Answer 6

4-6 wks

Question 7

Acne Vulgaris

tx for mild mixed acne

2 components

Answer 7

• topical retinoid
• topical antimicrobial (clindamycin gel)

Question 8

Acne Vulgaris

moderate tx

3 components

Answer 8

topical retinoid
topical antimicrobial
oral abx

Question 9

Acne Vulgaris

severe tx

Answer 9

isotretinoin

Question 10

Acne Vulgaris

most effective med for acne

Answer 10

isotretinoin (acutane)

Question 11

Acne Vulgaris

PPP for isotretinoin

Answer 11

• teratogenic
• increased triglycerides

Question 12

Acne Vulgaris

acne scars/hyperpigmentation tx

4 components

Answer 12

trichloroacetic acid
microneedling
retinoids
topical hydroquinone

Question 13

Rosacea

triggers

Answer 13

• alcohol
• changes in weather
• spicy foods
• sun exposure

Question 14

Rosacea

clinical presentation

5 components

Answer 14

• macular erythema
• telangiectasia
• possible papules or pustules
• possible: rhinophyma
• ocular sx

Question 15

Rosacea

what is telangiectasia

Answer 15

small, widened blood vessels

Question 16

Rosacea

what is rhinophyma

Answer 16

overgrowth of dermis and sebaceous glands on the nose

Question 17

Rosacea

what ocular sx are present

5

Answer 17

1. ocular erythema
2. tearing
3. foreign body sensation
4. burning
5. itching

Question 18

Rosacea

most commonly affects who?

Answer 18

• adults
• lighter skinned individuals

Question 19

Rosacea

diagnosis

Answer 19

clinical

Question 20

Rosacea

tx

mild/moderate, severe, facial erythema, telangiectasia

Answer 20

1. topical metronidazole + topical ivermectin + topical sulfacetamide
2. oral abx (doxy) + topical agent
3. topical brimonidine
4. laser therapy

Question 21

Milia

generally describe

Answer 21

skin eruption due to keratin retention & sebaceous material in the pilosebaceous follicles w/in the dermis

Question 22

Milia

clinical manifestations

2 components (appearance/location)

Answer 22

1. 1-3mm pearly white/yellow papules
2. seen especially on cheeks, forehead, chin, nose

Question 23

Milia

tx

Answer 23

observation

Question 24

Milia

when/how to manually remove?

Answer 24

• cosmetic preferences
• w/ liquid nitrogen

Question 25

# Folliculitis infection/inflammation where?

Answer 25

hair follicle

Question 26

# Folliculitis most common bacteria?

Answer 26

*S. aureus*

Question 27

# Folliculitis what to suspect w/ recent hot tub use?

Answer 27

*Pseudomonas aeruginosa*

Question 28

# Folliculitis risk factors | 3

Answer 28

1. men 2. prolonged abx use 3. topical steroids

Question 29

# Folliculitis clinical manifestations

Answer 29

* solitary or clusters of perifollicular papules/pustules * surrounding erythema on hair bearing skin

Question 30

# Folliculitis tx | first line- 3 meds

Answer 30

* topical mupirocin * clindamycin + benzoyl peroxide * erythromycin

Question 31

# Folliculitis tx for severe | 2

Answer 31

oral cephalexin or dicloxacillin

Question 32

# Perioral Dermatitis commonly seen in who?

Answer 32

women ages 20 to 45 y/o

Question 33

# Perioral Dermatits risk factors | 2

Answer 33

* topical corticosteroid use * fluoridated toothpaste

Question 34

# Perioral Dermatits clinical manifestations

Answer 34

1. erythematous group papules or pustules 2. can confluence into plaques w/ scales 3. spares the vermillion border 4. may affect periorbital or paranasal skin

Question 35

# Perioral Dermatits tx | first line- 3 options, 1 preventive measure

Answer 35

* topical pimecrolimus, metronidazole, or erythromycin * elimination of topical corticosteroids or other irritants

Question 36

# Perioral Dermatits tx- PO & when to use

Answer 36

tetracyclines * use if extensive or refractory