Skin Conditions II

Question 1

Difference between white head and black head?

Answer 1

• White head
  
  • accumulation of sebum and keratinous material converts a microcomedone into a closed comedone (skin cover)
• Black head

Question 2

1. Infantile acne occurs as a result of ?
2. The difference of infantile acne in boys vs. girls?
3. When does infantile acne cease?

Answer 2

1. Infantile acne occurs as a result of elevated levels of androgens
2. Produced by immature adrenal glands in girls and immature adrenal glands and testes in boys
3. Androgen levels fall by age 1-2 and acne improves

Question 3

How is insulin resistance related to acne vulgaris?

Answer 3

Insulin resistance may stimulate androgen production and is associated with increased levels of insulin like GF-1

Question 4

Describe the three classifications of acne vulgaris?

Answer 4

• Comedonal acne
  
  • Non inflammatory- can be closed or open (no redness)
• Inflammatory acne-
  
  • papules pustules and nodules
• Nodular acne (NOT CYSTIC ACNE)
  
  • worst kind

Question 5

What are some considerations when treating and managing a patient with acne vulagaris?

Answer 5

• type and severity
• skin type
• prescene of scaring
• prescence of post-inflammatory hyperpigmentation
• menstural history and hyperandrogenism
• current skin regimen
• hx of acne-promoting cosmetic products and meds
• psychological impact on patient

Question 6

What are some special considerations when using a topical retinoid?

Answer 6

• use once daily at bed time
• local skin irritations, sun sensitivity
• don’t use Atralin if you have fish allergy

Question 7

What are the oral antibiotics used to treat acne vulgaris?

Answer 7

• tetracycline 500mg BID
• doxycycline 50-100mg BID or 100mg QD
• minocycline 50mg QD-TID
• erythromycin 500mg BID
• trimethoprim-sulfamethozazole 160mg/800mg BID
• azithromycin intermittent dosing

Question 8

What hormonal agents and oral retinoids are used to treat acne vulgaris?

Answer 8

• hormonal agents
  
  • combo oral contraceptives
  • spironolactone 25-220mg daily
• oral retinoid
  
  • isotretinoin 0.5mg/kg/QD
  • accutane -total of 120-150mg/kg over 20 weeks
    
    • very strict mointering dont give to women of child bearing age