Section 1- Glands Flashcards
Key factors in the development of acne vulgaris
Follicular keratinization
Androgens
Proprionibacterium acnes
Blackheads are called
Open comedones
Whiteheads are called
Closed comedones
Neonatal acne is related to
Glandular development
Usually occurs in young women
Associated with extensive excoriations and scarring from emotional and psychological problems
Acne excoriée
Flares of acne on cheeks, chin and forehead due to leaning and pressure of sport gears
Acne mechanica
Severe cystic acne with more involvement of the trunk than the face
Coalescing nodules, cysts, abscesses and ulceration
Acne conglobata
Occurs primarily in teenage boys
Acute onset
Severe cystic acne with suppuration and ulceration
Malaise, fatigue, fever, elevated ESR
Acne fulminans
Acne like conditions are not diagnosed as acne because they do not have:
Comedones
If systemic isotretinoin treatment is required, these lab tests should be ordered beforehand
AST ALT
Triglycerides
Cholesterol levels
Long term goal of therapy for acne
Prevent scarring
Goal of therapy for acne
Remove plugging
Reduce sebum production
Treat bacterial colonization
Most effective oral antibiotic for moderate acne
Minocycline 50-100mg/day
This drug for acne inhibits sebaceous gland function and keratinization
Isotretinoin
Indications for oral isotretinoin
Moderate, recalcitrant and nodular acne
Concurrent tertracycline and isotretinoin may cause thid condition
Pseudotumor cerebri (benign intracranial swelling)
Contraindication for use of isotretinoin
Pregnancy (teratogenic)
Treatment for mild acne
Topical antibiotics (clinda, erythro) Benzoyl peroxide gel (2,5,10%)
Topical retinoids (retinoic acid, adapalene, tazarotene) -gradual increase 0.01-0.025-0.05%
Treatment for moderate acne
Topicals plus oral antibiotics
Minocycline 50-100mg/day
Doxycycline 50-100mg BID
Oral isotretinoin
Treatment for severe acne
Topicals plus systemic isotretinoin 0.5-1mg/kg (cystic, conglobate, refractory to treatment)
Most clear within 20 weeks
Common chronic inflammatory acneiform disorder of the facial pilosebaceous units
Increased reactivity of capillaries leading to flushing and telangiectasia
Rosacea
What stage of rosacea (Plewig and Kligman classification)
Persistent erythema with telangiectases
Stage I
What stage of rosacea (Plewig and Kligman classification)
Persistent erythema, telangiectasia, papules and tiny pustules
Stage 2
What stage of rosacea (Plewig and Kligman classification)
Persistent deep erythema, dense telangiectasia, papules, pustules and nodules
Rarely persistent “solid” edema on central face
Stage 3
Prevention of rosacea
Marked reduction or elimination of alcohol and caffeine
Topical treatment for rosacea
Metronidazole gel or cream 0.75 or 1% OD or BID
Ivermectin cream
Systemic treatment of rosacea
Minocycline or doxycycline 50-100mg OD or BID
Tetracycline 1-1.5g/day until clear then 250-500mg OD
Metronidazole 500mg BID
Maintenance treatment for rosacea
Minocycline or doxycycline 50mg OD or on alternate days
For severe rosacea not responding to antibiotics, this can be given
Isotretinoin 0.5mg/kg per day
For massive demodex infestation in rosacea, this drug can help:
Ivermectin 12mg PO single dose
Treatment for periorificial dermatitis
Avoid topical glucocorticoids
Metronidazole 0.75% gel BID or 1% gel OD
Erythromycin 2% gel BID
Systemic- minocycline or doxycycline 100mg OD
Tetracycline 500mg BID until clear
Sweat retention disorder
Excessive sweating —maceration and blockage of eccrine ducts
Miliaria
Gustatory sweating where disrupted nerves for sweat abberrantly connect with salivsry nerves
Frey syndrome
Management of hidradenitis suppurativa
Intralesional triamcinolone
Incision and drainage
Oral antibiotics- erytho, tetra, mino, clinda + rifampin
Oral isotretinoin- prevents follicular plugging
Skin colored follicular pruritic papules in the axilla from plugging
Fox Fordyce disease
