Acne

Question 1

clinical features

Answer 1

• pastules
• papules (raised lumps <1cm)
• comeodones - HALLMARK

Ina sebacous gland distribution

Question 2

Aetiology

Answer 2

three pathogenic factors

1. Seborrhoea

• sebacous glands targets of androgens
• excessive sensitivity of sebacous eng organs to androgens

2. Sebum retention

• hyperkeratinisation of infra infundibulum of sebanous duct
• many factors particularly chemical composition of sebum in acne and androgens responsible

3. inflammation
   * inflammatory role of numerous enzymes of proprioni bacterium acnes

Question 3

Grading system of acne

Answer 3

leeds

Question 4

Distrubution

Answer 4

• face
• chest
• back/shoulders
• ocassionaly legs, scalp

Question 5

Mild -moderate treatment

Answer 5

• topical retinoid
  
  • useful for comedonal part
  • isotertinoin
  • slows turnover of keratinocytes
  • cannot fall pregnant
• topical antibacterial
  
  • ertyhromycin, clindamycin
  • try use topical preparation first - resistance
  • use with benxoyl peroxide reduce bacterisa resistance = duac
• topical perparation
  
  • benzoyl peroxidase - first line
  • azaelic cid
  • side effects - bleaching irritates, photosensitizer

Question 6

Moderate treatment

Answer 6

Oral Abx

• reduce inflammation and P acne coonisation
• tetracuclin most common and safetly used

Dianette

• anti-androgen contraceptive i.e dianette
• hormonal treatment - reduced sebum production
• possible DVT risk

Question 7

Severe treatment

Answer 7

Oral retinoid

• reduce sebum production, inflam
• concentrated with vitamin A
• pharmacology
  
  • lmg/kg - 16 weeks
  • only subscribed by dermatologist
• side effects- derrangedd LFTs, teratogenic, do not give to rpegnant women
• pregnancy prevention programme