Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

PHM 604- Dermatology and Glaucoma > Acne > Flashcards

Acne Flashcards

(67 cards)

Start Studying
1
Q

Patho of acne

A

Blockage in hair follicle of dead skin –> excess keratin in the hair shaft mixes with excess sebum and creates a plug of cells and oil –> bacteria rush to the site –> WBCs rush in to respond and inflammation occurs –> pocket of pus forms

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

Other factors that can cause acne

A

Makeup, sweat, other external factors

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

Factors in acne pathogenesis

A

Follicular keratinization, androgens, sebum formation, C. acnes, inflammation

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

Signs/symptoms of mild acne

A

Few to several papules/pustules (<10), no nodules

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

Signs/symptoms of moderate acne

A

Several to many papules/pustules (10-40) along with comedones (10-40) and few to several nodules

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

Sign/symptoms of severe acne

A

Numerous or extensive papules/pustules and many nodules

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

pH of healthy skin

A

4.7-5.7

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

Medications to treat acne

A 
Topical retinoids
Azelaic acid
Topical antimicrobials
PO ABX
Salicylic acid
Sulfur
AHAs
Tea tree oil
PO isotretinoin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Types of topical retinoids

A

Tretinoin (Atralin)
Adapalene (Differin)
Tazarotene (Tazorac)

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

When are topical retinoids used?

A

Used as initial management

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What do topical retinoids do?

A

Normalize follicular hyperkeratosis and improves inflammatory acne

Also enhances penetration of other topical acne medications and decreases hyperpigmentation of acne scars

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

How long does it take for topical retinoids to work?

A

8-12 weeks

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

Counseling on topical retinoids

A

At night: clean skin, pat dry, apply the retinoid, apply moisturizer

Acne may get worse before it gets better

Avoid OTC irritating products

START LOW AND GO SLOW

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

ADEs of topical retinoids

A

Skin irritation, skin flaking, dryness, “photosensitivity”

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

When should topical retinoids be avoided?

A

Pregnancy and in patients with fish allergies (Atralin/Tretinoin)

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

Topical antimicrobial products

A

Benzoyl peroxide, clindamycin, erythromycin, dapsone, minocycline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What do topical antimicrobials do?

A

Decrease C. acnes colonizing skin and decreases inflammatory response

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

What should topical antimicrobials be combined with to make them more effective?

A

Topical retinoid

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

Benefits of benzoyl peroxide

A

Comedolytic and antibacterial

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

How long does it take for benzoyl peroxide to be effective?

A

Benefits within 3 weeks, but max effects in 12 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Dosing for benzoyl peroxide

A

Apply daily, then increase to twice or three times daily after 2 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Strength titration for benzoyl peroxide

A

Start at 2.5%, increase weekly as needed to 5%, then 10%

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

ADEs of benzoyl peroxide

A

Erythema, scaling, xerosis, stinging/burning, bleaching of hair and clothing, rare hypersensitivity

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

Least irritating topical retinoid

A

Adapalene

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Properties of azelaic acid
Antimicrobial, comedolytic, mild anti-inflammatory properties
26
Benefits of azelaic acid
Can improve acne-induced post-inflammatory hyperpigmentation
27
Dosing frequency of azelaic acid
QD
28
ADEs of azelaic acid
Burning, itching, redness, hives and anaphylaxis rare
29
How to reduce resistance to PO ABX
Limit duration, avoid changing too soon, restart same ABX if still effective and it was stopped, don't combine MoAs, use with benzoyl peroxide or topical retinoids
30
PO ABX products
TTC*, doxycycline*, minocycline, sarecycline, erythromycin, Bactrim, azithromycin
31
Salicyclic acid properties
Comedolytic effects, mild anti-inflammatory properties
32
Salicyclic acid has a synergistic effect with what other acne medication?
Benzoyl peroxide
33
What class does salicylic acid belong to according to the makeup industry?
BHAs (0.5%-2% available commercially)
34
Properties of sulfur
Keratolytic effect, inhibits proliferation of C. acne | Not used as often anymore due to the odor
35
Properties of AHAs
Improve post-inflammatory hyperpigmentation and diminishes signs of aging skin
36
AHAs may work synergistically with what acne medication?
Retinoids
37
Properties of tea tree oil
Antimicrobial and anti-inflammatory properties
38
When should a patient seek a provider for acne?
Comedogenic drugs Moderate-severe acne Pregnancy Treatment doesn't work
39
When can you use hormonal agents for acne?
Moderate-severe acne in women who aren't trying to get pregnant Benefits adult women who present with inflammatory acne following lower face/neck with premenopausal flares
40
Hormonal acne agents
Ethinyl estradiol/progestin | Spironolactone and drospirenone
41
What can happen to a male fetus if spironolactone is taking during pregnancy?
Feminization of the fetus
42
Minimum amount of therapy required for evaluation of hormonal acne therapy efficacy
3-6 months
43
COC ADE
thromboembolism (especially in smokers)
44
Spironolactone ADEs
Breast tenderness, menstrual irregularities, GI upset, orthostatic hypotension, HA, dizziness, fatigue
45
Spironolactone dosing for acne
50-100mg PO BID
46
Spironolactone CIs
renal failure, liver dysfunction
47
Spironolactone monitoring
Serum K+, make sure patient is on concomitant BC
48
Brand names for PO isotretinoin
Zenatane, Amnesteem, Claravis, Sotret, Absorica, Absorica LD is micronized form
49
Indications for PO isotretinoin
Moderate-severe, recalcitrant, nodular acne
50
MoA of PO isotretinoin
Shrinks sebaceous glands
51
Dosing for standardized PO isotretinoin
0.5-1 mg/kg/day in divided doses with food
52
Alternate dosing for standardized PO isotretinoin
0.5mg/kg/day x1 month, then 1 mg/kg/day
53
Micronized PO isotretinoin dosing
0.4-0.8 mg/kg/day in divided doses for 15-20 weeks MAX
54
PO isotretinoin CIs
PREGNANCY, psychiatric conditions (taking it is associated with depression and suicide), use with tetracyclines
55
What should you avoid taking while on isotretinoin?
Vitamin A supplements
56
Lab monitoring for PO isotretinoin
LFT and FLP
57
If LFTs and FLPs are normal, what happens next?
Take again in 2 months; if it's still normal after that, no monitoring needed unless there's a dose increase
58
If LFTs and FLPs are elevated, what happens?
If it's x3 ULN, D/C
59
What should you avoid for ≥6 months after stopping isotretinoin?
Dermabrasion, laser epilation
60
ADEs of PO isotretinoin
Night blindness, skin photosensitivity, eczema-like rash, dry lips, eyes, nasal passages; muscle pain, calcification of ligaments and tendons, hair thinning, headache, stunted growth, bone marrow suppression
61
iPLEDGE program
Program that prevents patients from getting pregnant while taking isotretinoin and prevents pregnant patients from taking it
62
Who must be enrolled in iPLEDGE?
Patient, provider, and pharmacy
63
How should a doctor write a script for isotretinoin?
No more than a 30 days supply with no refills
64
What happens if a patient needs a refill on isotretinoin?
Get a new script, but have to verify that they're not pregnant
65
When do you put the isotretinoin back in inventory when the patient hasn't picked it up?
Patients who can't get pregnant: >30 days Patients who CAN get pregnant: >7 days
66
Number of pregnancy tests to take over the course of isotretinoin treatment
N+4, with N being the number of months the patient is on treatment
67
How many forms of BC should a patient be on while taking isotretinoin?
At least 2

PHM 604- Dermatology and Glaucoma (9 decks)

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