Pustular Disorders Flashcards
Acne Vulgaris
pathophys
4 components
- follicular hyperkeratinization
- increased sebum production
- Cutibacterium acnes overgrowth
- inflammatory response
Acne Vulgaris
dx
clinical
Acne Vulgaris
inflammatory skin condition associated w/
- papules & pustules
- which involve the pilosebaceous unit
Acne Vulgaris
classifications
5
- comedonal (open & closed)
- mild mixed acne
- moderate
- severe
- acne scars/hyperpigmentation
Acne Vulgaris
tx for comedonal
& advise pts?
- topical retinoid
- must treat whole face, NOT SPOT tx
Acne Vulgaris
how long until comedonal acne improves w/ tx?
4-6 wks
Acne Vulgaris
tx for mild mixed acne
2 components
- topical retinoid
- topical antimicrobial (clindamycin gel)
Acne Vulgaris
moderate tx
3 components
topical retinoid
topical antimicrobial
oral abx
Acne Vulgaris
severe tx
isotretinoin
Acne Vulgaris
most effective med for acne
isotretinoin (acutane)
Acne Vulgaris
PPP for isotretinoin
- teratogenic
- increased triglycerides
Acne Vulgaris
acne scars/hyperpigmentation tx
4 components
trichloroacetic acid
microneedling
retinoids
topical hydroquinone
Rosacea
triggers
- alcohol
- changes in weather
- spicy foods
- sun exposure
Rosacea
clinical presentation
5 components
- macular erythema
- telangiectasia
- possible papules or pustules
- possible: rhinophyma
- ocular sx
Rosacea
what is telangiectasia
small, widened blood vessels
Rosacea
what is rhinophyma
overgrowth of dermis and sebaceous glands on the nose
Rosacea
what ocular sx are present
5
- ocular erythema
- tearing
- foreign body sensation
- burning
- itching
Rosacea
most commonly affects who?
- adults
- lighter skinned individuals
Rosacea
diagnosis
clinical
Rosacea
tx
mild/moderate, severe, facial erythema, telangiectasia
- topical metronidazole + topical ivermectin + topical sulfacetamide
- oral abx (doxy) + topical agent
- topical brimonidine
- laser therapy
Milia
generally describe
skin eruption due to keratin retention & sebaceous material in the pilosebaceous follicles w/in the dermis
Milia
clinical manifestations
2 components (appearance/location)
- 1-3mm pearly white/yellow papules
- seen especially on cheeks, forehead, chin, nose
Milia
tx
observation
Milia
when/how to manually remove?
- cosmetic preferences
- w/ liquid nitrogen
Folliculitis
infection/inflammation where?
hair follicle
Folliculitis
most common bacteria?
S. aureus
Folliculitis
what to suspect w/ recent hot tub use?
Pseudomonas aeruginosa
Folliculitis
risk factors
3
- men
- prolonged abx use
- topical steroids
Folliculitis
clinical manifestations
- solitary or clusters of perifollicular papules/pustules
- surrounding erythema on hair bearing skin
Folliculitis
tx
first line- 3 meds
- topical mupirocin
- clindamycin + benzoyl peroxide
- erythromycin
Folliculitis
tx for severe
2
oral cephalexin or dicloxacillin
Perioral Dermatitis
commonly seen in who?
women ages 20 to 45 y/o
Perioral Dermatits
risk factors
2
- topical corticosteroid use
- fluoridated toothpaste
Perioral Dermatits
clinical manifestations
- erythematous group papules or pustules
- can confluence into plaques w/ scales
- spares the vermillion border
- may affect periorbital or paranasal skin
Perioral Dermatits
tx
first line- 3 options, 1 preventive measure
- topical pimecrolimus, metronidazole, or erythromycin
- elimination of topical corticosteroids or other irritants
Perioral Dermatits
tx- PO & when to use
tetracyclines
* use if extensive or refractory
