Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Senior - Derm 1 > 6 - Acne > Flashcards

6 - Acne Flashcards

(94 cards)

Start Studying
1
Q

What is acne vulgaris?

A

Disease of the pilosebaceous unit

  • onset w puberty
  • both sexes
  • hereditary tendencies
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Acne vulgaris pt population?

A

89% - 12-24 y/o (40 mil)
8% - 24]5-34 y/o (3.2 mil)
3% - 35-44 y/o (1.2 mil)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Morphologic variations w acne vulgaris?

A

Noninflammatory

  • open comedones
  • closed comedones

Inflammatory (1+ of)

  • papules
  • pustules
  • nodules/cysts
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Where is acne vulgaris usually located?

A

Sebaceous areas

  • face
  • chest
  • back
  • upper arms
  • groin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Pathogeneous of acne vulgaris?

A

Excess sebaceous gland secretion

Pilosebaceous duct obstruction

Bacterial colonization and inflammation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What bacteria causes acne?

A

Proliferation of propionibacterium acne (P. Acnes)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Action of p acnes?

A

Breaks down sebum (chol/trig) to free fatty acids (FFA) which are

  • irritating
  • inflammatory
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Management of acne vulgris?

A

Skin care modification

  • mild soap + water frequently
  • mild exfoliant (scrubbing, masks, peels, acid washes)
  • avoid occlusion (makeup etc)
  • keep hands away from face
  • avoid stress, caffeine, sugar
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Acne vulgaris therapeutic targets?

A

Comedonegenis
P. Acnes
Sebum production
Inflammation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Meds for comedogenesis?

A 
Retinoids
Benzoyl peroxide
Salicylic acid
Azelaic acid
Alpha hydroxy acid
Isotretinoin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Meds for P acnes

A

Antibiotics
Retinoids
Benzoyl peroxide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Meds for Sebum production

A

Retinoids
Antiandrogens
- low dose OC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Meds targeting inflammation?

A

Oral antibiotics

Retinoids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

When treating acne there is no quick fix and you must start with benign tx and go up. How long do you need to try a therapy before moving on?

A

6-8 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Comedonal acne tx (noninflammatory)

A

Start w retinoid (low dose)
- tretinoin 0.025% @ bedtime

4-8 weeks add benzoyl peroxide/topical abx
- benzacilin (combo tx)

Increase strength of retinoid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Mild inflammatory acne txt?

A

Start w retinoid and/or benzoyl peroxide or topical abx
- alternate days x 2-4 wks

Adust dose prn

Add oral abx if pustules remain

  • doxycycline 100 mg qd
  • tetracycline 500 mg bid
  • minocycline 100 mg bid
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Abx for mild acne should be tried for a min of?

A

3 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Moderate to sever inflammatory acne txt?

A

1st topical antibiotic or benzoyl peroxide
- benzaClin or Duac (combo drugs)

If >10 pustules - oral abx
- doxy, TCN, mino (taper 2-4 mo)

Later
- topical retinoid

Intralesional steroid injection
- triamcinolone 2.5-5mg/ml

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

If normal moderate - severe acne tx fails?

A

Culture pustules/cysts
- start ampicillin

Accutane (isotretinoin)

  • effective but side effects
  • iPLEDGE program

Women

  • OCP
  • spironolactone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Alternate or 2nd line acne txt?

A 
Adapalene (differin)
- 3rd gen topical retinoid
Azelaic acid (azelex
Oral prednisone
Acne surgery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Morphology of NoduloCystic acne?

A 
Sig inflammation
Papules
Pustules
Nodules
Cysts 
Scarring 
Sinus tracts 
Mild facial edema
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Subtypes of nodulocystic acne

A

Cystic acne
Pyoderma faciale
- face only
Acne fulminans
- ulcerative, necrotic acne w arthralgias, myalgias and bone pain
Acne conglobata
- H inflammatory, double comedones, cysts, sinus tracts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

____ is MC’ly found in Females

____ is MC’ly found in Males

A

Pyoderma faciale
- MC in 13-40 y/o females

Acne fulminans
- MC in adolescent white males

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Which type of acne leads to atrophic or keloidal scarring?

A

Acne conglobata

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Clinical presentation of NoduloCystic acne
Family history No response to typical tx Embarrassing Locations - face - neck - chest - back
26
Nodulocystic acne management?
Isotretinoin (accutane) - reduces size and activity of sebaceous glands - normalizes keratinization - very effective - sig SE profile
27
While isotretinoin affects all four sources of acne it is only approved for which types of acne?
Nodular acne | Recalcitrant acne
28
What needs to be done pre isotretinoin?
Is pt reliable and able to be followed x 6 months? Stop TCN x 4 wks before tx Stop all topical meds Review labs Fam hx of colitis DC all vitamins esp vit a
29
Labs for isotretinoin?
``` CBC UA LFT Lipids HCG - before and monthly ```
30
Pt instructions for isotretinoin?
``` Lubricate eyes, lips Bactroban nose Oil free moisturizer/sunscreen NO blood donations Moos swing are common Freq follow ups required Low fat diet (rise in lipids) Avoid ETOH (LFTs) ```
31
Reproductive age women should only be given ___ of isotretinoin?
1 month at a time
32
Stop isotretinoin if?
HA - not relieved by tylenol - w visual changes Mood swings w SI/HI Concern is Papilledema - pseudotumor cerebri
33
Tx plan for isotretinoin?
20 week course w q 4 week f/u Dose: 40mg bid - increase till effective Cumulative dose of 120-150 mg/kg x 160 days - higher for chest and back Must come from derm
34
Morphology of pomade acne and acne cosmetica?
Small non-inflamed papules and comedones in pts who apply products that increase plugging (oils/creams) Location: - forehea - temples - sides of face
35
Area that is spared by pomade acne and acne cosmetica?
Spares the sebaceous areas
36
Management of pomade acne and acne cosmetica?
``` Change habits Stop all oils/creams x 1 month Add - tretinoin 0.025% - BP 10% (if tolerated) - topical antibiotics ``` Avoid PO antibiotics
37
Clinical presentation in adult female acne?
Women mid 20’s-30’s Hormonal sensitive Flares w menses Occasionally begin w pregnancy Lesions - Tender - few (qty) - slow healing
38
Morphology of adult female acne?
Very inflamed Red Papules Comedomes Sometimes: Small non-scarring cyst
39
Location for adult female acne?
Chin Jawline Neck (sometimes)
40
Management of adult female acne?
Oral contraceptives Tretinoin (2nd line) Erythromycin 250mg - strong anti-inflammatory action (3rd line)
41
Location of steroid acne?
MC - chest - neck - back Sometimes - face - arms
42
Morphology of steroid acne?
Follicular papules and pustles Uniform size and symmetric distribution Non-scarring
43
Clinical presentation of steroid acne?
Sudden onset - 2-4 wks after PO corticosteroids Teens/adults Often puritic Heals w/o scarring
44
I got steroid acne, can i still take my steroids?
It is not a C/I for continued or future use of PO corticosteroids
45
Management of steroid acne?
DC oral corticosteroids - clears rapidly Topical tx - benzolyl peroixide - sulfacetamide/sulfur lotion Hydroxyzine (atarax) Diphenhydramine (for itch)
46
MC infectious folliculitis?
Staphylococcus folliculitis
47
Morphology of staph folliculitis?
Lone or grouped small pustules Mild-moderate surrounding erythema
48
Location of folliculitis
Face - around nares - lower face Chest (anywhere w hair)
49
Staph folliculitis associated sx?
Tenderness Low grade fever Injury (from shaving or similar)
50
Causes of staph folliculitis?
infection around follicles by S. Epidermidis or S. Aureus Complication of occlusive topical steroid therapy
51
If staph folliculitis is persistent or recurrent?
Poss nasal carrier - seeded skin by contact - health care workers
52
Management of staph folliculitis?
Isolated - erythromycin - diclox Recurrent/persistent - cephalexin - rifampin - bactroban to nares - wash w hibiclens - change towel and pillowcase daily
53
Perioral dermatitis is MC in?
Women
54
Clinical presentation of perioral dermatitis?
young women - fair, delicate skin Mildly pruritic Recurrent
55
Etiology of perioral dermatitis?
UKN - proposed - skin intolerance reaction to chronic dry skin Associted w - habitual use of moisturizing creams - Previous topical steroid use - topical irritants (tretinoin, BP, Etoh based)
56
Morphology of perioral dermatitis?
Small papules and pustules (resembles acne) Typically confined to: - chin - nasolabial folds Pustules on cheeks adjacent to nasolabial folds (highly characteristics) Occasionally red and scaly Clear zone around vermilion border
57
Management of perioral dermatitis
Doxycycline 100mg PO - 2-4 wks (sometimes longer) Topical metronidazole (not as effective as doxy) 1% HC cream DC facial moisturizers and cosmetics
58
Acne rosacea etiology?
Unknown | - demodex folliculorum
59
Acne rosacea morphology
Erythema (transient/nontransient) Telangiectasia Papules/pustules Rhinophyma Swelling of cheeks and forehead
60
What is rhinophyma?
Enlarged nose
61
Clinical presentation of acne rosacea?
``` Fair skinned More sebaceous activity - mid face (malar area) - eyelid involvment - chin (severe) ``` Easily flushed - vasodilation - ETHO increases erythema - hot spicy foods - hot drinks/caffiene - hot climate/exercise - emotions - sun Mid 30’s-40’s persistent o old age
62
Management of mild to moderate acne rosacea?
Meds - metronidazole 1% topical BID (active against mite) - doxycycline bid - erythromycin - minocycline ($$) Sunscreen Avoid triggers
63
Management of persistent/severe acne rosacea?
Accutane Rhinophyma - specialty surgery
64
What is hidradentitis suppurativa?
Chronic suppurtative scarring dz of skin and subQ tissue
65
Etiology of hidradentitis suppurativa
Family tendency for scarring acne Hyperkeratosis over apocrine gland w secondary bacterial infection
66
Clinical presentation of hidradenitis suppurativa
``` 20’s-40’s (always after puberty) F>M Obesity Chronic Painful Debilitating ```
67
Locations for hidradenitis suppurativa
Axilla Groin (anogenital region) - suprapubic and anal Under breasts
68
Morphology of hidradenitis suppuraiva?
``` Mild-sever - erythema - cysts - abscesses (Progressive and self perpetuating) ``` Double-comedone - blackhead w 2+ communicating surface openings Sinus tracts develop as disease developes Scarring - healing permanently alters dermis (Cordlike band of scar tissue)
69
Management of hidradenitis suppurativa?
no smoking ``` Mild dz - long term abx (mainstay) —(TCN, doxy, e-mycin, minocycline) - hot compress - I/D large cysts/abscesses ``` Extensive dz - surgical excision and grafts - isotretinoin 1mg/kg/day x 20 wks
70
Etiology of pseudofolliculitis barbae (PFB)
Foreign body reaction causes inflammation Chronic distortion of follicle
71
Clinical presentation of PFB?
Tightly curled hair, cut short 50-70% of blacks 3-5% of whites
72
Morphology of PFB?
Inflammation Papules and pustules Post-inflammatory hyperpigmentation Scarring and keloids
73
Management of PFB? | Techniques
Modify shaving technique - hydrate and soften beard - brush hair w toothbrush - wash w benzoyl peroxide - glycolic acid or aveeno shaving cream x 5 min - shave w grain - bump fighter razor q
74
Management of PFB | Meds
Rx - Topical abx after shaving - Retin-a 0.025% - Po abx if pustules develop Additional - Medicated after shave lotion - temp profile x 3 mo - laser hair removal
75
What is acne keloidalis nuchae (AKN)?
Chronic scarring folliculitis of ukn etiology Men only Black>>white
76
Morphology of AKN?
Process same as PFB Coexists w PFB Nape more prone Occasionally over scalp
77
Management of acne keloidalis nuchae?
No short/shaved haircuts Pustular or exudative - culture - txt up to 3-6 mo
78
3 step plan for control AKN
Topical clina bid (cleocin) Fluocinonide (lidex) Tretinoin 0.05% - DC steroid after 3-6 mo everything else x 12 mo
79
Add on therapy for AKN?
Oral steroids Intralesional steroid inj Laser therapy Excisional surgery
80
Epidermal inclusion cyst (EIC)
Derived from upper part of follicle - occluded and dysfunctional - implanted under epidermis due to trauma Follicle becomes filled w sebum and swells rapidly
81
Morphology for EIC?
- Round protruding smooth-surfaced mass - soft - mobile - few mm to several cm - visible but dysfunctional pore
82
Clinical presentation of EIC?
- Present after puberty - MC in oily skin ppl - acne-prone fam tendency for cysts - typically asymptomatic - non-inflamed lesion may spontaneously resorb and resolve - can spontaneously rupture
83
Management of EIC?
No tx if asymptomatic/cosmetically acceptable Remove non-inflamed lesions Inflamed cyst - intralesional inj kenalog - then remove Ruptured inflamed cyst - excise after I/D
84
Clinical presentation of milia?
Small epidermal cyst w/o openings Response to sun damage/other Any age
85
Morphology of milia?
Tiny, white pea shaped cyst Asymptomatic Solitary/multiple
86
Location of milia?
MC face Esp around eyelids Can occur anywhere
87
Management for Milia?
Solitary - incise over lesion - extraction Multiple - tretinoin 0.025% - 0.5% cream
88
Miliaria is?
Heat rash
89
Morphology of miliaria?
``` Multiple Diffusely scattered 1mm papules/vesicles Skin colored - miliaria crystallina Red - miliaria rubra ```
90
Location of miliaria?
Anywhere but esp: - forehead - cheeks - trunk
91
Clinical presentation of miliaria
``` “Prickly heat” “heat rash” Sweat retention Hot/humid weather Profound sweating Young babies Stinging or pruritic ```
92
Morphology of pilar cyst (wen)?
Multiple, firm, smooth, Movable 1-3cm sub q cysts Asymptomatic 30% solitary Tough lining Keratinizes differently from EIC Produces a compact homogenous material that can calcify
93
Location of pilar cysts?
90% are in scalp
94
(Spoken by a horse) | “Its derby weekend and guess who has a blemish”
“Things nayyyver go my way”

Senior - Derm 1 (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions