acne Flashcards
(34 cards)
what is the aetiology of acne ?
androgens stimulate the sebaceous gland
causing sebaceous gland over - activity
associated with drugs - steroids and anticonvulsants
Dietary - dairy products and high glycaemic foods
what is the pathogenesis of acne ?
- excess sebum production
- follicular epidermal hyper proliferation with plugging of the follicle
- presence of cutibacterium acnes
- inflammation
black head vs a white head ?
black head is an open comedone
white head is a closed comedone
stages of acne ?
normal follicle
open comedone
closed comedone
papule
pustule
sign that triggers a patient to see the doctor ?
inflammation
tyoes of acne ?
white head
black head
cysts
pustules
papules
nodules
what is the grading of acne ?
mild - less than 20 comedones
moderate - 20-100 comedones
severe - more than 100 comedones
5 or more cysts, nodules
clinical manifestations of hyperandrogenism ?
acne
hirsutism
acanthosis
hair loss
irregular menses / infertility
what are the complications of acne ?
post inflammatory hyper pigmentation
scarring
targets of acne treatment ?
decrease sebum
desquamation
cutibacterium acnes
androgens
scarring
topical treatment for acne
benzoyl peroxide
Antibiotics
topical retinoids
1st choice treatment for acne
usually retinoids :
adaplene
treinoin
isotretinoin
systemic treatment for acne
AB
isotretinoin
anti-androgens - to reduce sebum production
treatment for miild papular pustular acne
topical retinoids along with topical anti microbial
adaplene + benzoyl peroxide
Isotretinoin + topical ab
moderate inflamm acne treatment
oral ab (tetracycline) or spironolactone ( anti androgen effect )
along with topical retinoids
alternative acne treatment for women with moderate acne and signs of androgenisation ?
dianette can be used and should bee reserved for moderate to severe acne
especially if there is any evidence of hyperandrogenosim
what is dianette ?
co-cyprinderol
mode of action of spironolactone ?
diuretic and has anti androgen effects
treatment of severe acne
oral isotretinoin - Roaccutane
side effects of oral isotretinoin - Roaccutane
dry skin
dry eyes
hoarse voice
chelitis - chronic inflamation of the lips
headaches
arthritis
teratogenicity
adverse psychiatric effects
when are investigations required in acne patients ?
before prescribing isotretinoin :
-liver function
-lipid profile
-pregnancy test ( teratogenic )
Signs suggesting hyperandrogenism
Signs suggesting cushing syndrome
treatment for acne scarring ?
laser
microneedling
subcision - used for valley scars
what is the presentation of infantile acne ?
site : cheeks, forehead and chin
causes of infantile acne ?
unknown
genetic
hormones - testosterone and androgens
no investigations needed
