Acne

Question 1

NonInflammatory lesions

Answer 1

Noninflammatory lesions:
open comedone- black head
closed comedone- white head

Question 2

Inflammatory lesions

Answer 2

Papule- <5 mm
pustules- visible central core
nodules - cysts- > 5mm

Question 3

describe a Nodule

Answer 3

CYST
>5mm
can be suppuritive- pus
or hemorrhagic - raised red

rupture of these can lead to epithelial lined sinus tracts and cause bad scars

Question 4

Describe a papule

Answer 4

inflammed <5 mm
(compared to a nodule >5mm)

can classify as papulepustular

Question 5

Describe a pustule

Answer 5

inflamed visible central core

Question 6

what bacteria is the cause of acne

Answer 6

Cutibacterium

formerly know as Propionibacterium

Question 7

MOA of Isotreinoin

Answer 7

shrikage of the sebum glands = decrease oil production permently
Kertolytic

Question 8

General and severe adverse reaction to isotreinoin

Answer 8

General:
cheilitis, dry skin and mucous membranes, epistaxis, desquamation, photosensitivity, and pruritus. Dry eyes- decreases production of tear ducts, depression/suicide, muscle aches, premature bone closure

Severe:
elevated liver enzymes, cheilitis, xerosis, acne flare(usually last 1 week), photophobia, and Stevens-Johnson syndrome

Question 9

rarely irotreinoin can induce a severe form of acne

Answer 9

Acne fulminans

Question 10

what percent of babies have been born with abnormalities

Answer 10

20-30%

most embryo abnormalities include learning disabilities more so than physical deformities

Question 11

while on acutanne do not take these two medicaitons

Answer 11

Tetracycline- it uses the same pathway as accutane and can cause a intercrainal hemorrhemorrhage

Vitamin A- will increase risk of all the side affects

Question 12

patient education with accutane

Answer 12

1. side affects
2. take medication with 50grams of fat
3. acne can flare
4. do not share medication or donate blood

Question 13

if patient is sexually active important to go over what with isotrenion

Answer 13

needs a form of birth control

needs to start a form of BC one month before starting and one month after completion of isotreinoin

Question 14

What forms of Birth control is helpful for acne?

Answer 14

Only the pill
- Yaz & Ortho-tricyline 777

-other forms: ring, IUD are not helpful in the use of acne

Question 15

How to advise a girl starting Isotreionion

Answer 15

Blood draw today that includes- hcg & LFTs
wait 30 days then redraw Hcg & LFTs - if normal dont test again. need a pregnancy test every month for 5 months.
Stop all topical medicaiton unless its a gentle cleanser
-no laser treatments, chemical peels, etc.