Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

PC Ado > Acne > Flashcards

Acne Flashcards

(57 cards)

Start Studying
1
Q

Describe the cause of acne vulgaris to an adolescent patient.

A
  • Follicular keratinocytes become sticky & form a keratin plug

→

  • Occlusion of the follicle & sebum trapped

→

  • Trapped sebum causes inflammation and impaction

→

  • Rupture of the follicle causes bacterial invasion of the follicle and surrounding tissue
  • That’s why you should not pick*
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are available treatment options for acne in an ado?

A

Benzoyl Peroxide

Topical retinoids

Dapsone

Antibiotics

OCPs

Isotretinoin (Accutane)

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

How could you describe pathophys of acne to an ado?

A

follicle looks like a wine bottle with the neck. sticky skin cells stay near top of bottle – like a cork. Disrupt the cork, will get trapped inside

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

Is acne more prevalent in males or females?

A

Depends!

  • Adolescents: Male >Female
  • Adults: Females > Males
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Types of acne

A

comedonal

inflammatory

mixed

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

Acne: what do you look for on PE?

A

Type and distribution of acne lesions

Ht, Wt, growth curve (d/t hormonal issues?)

BP (elevated - androgen prob?)

SMR

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

What are some signs of PCOS or androgen excess?

A

irregular periods (oligomenorrhea), hirsutism, obesity? (not always), acanthosis nigricans (insulin resistance)

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

Does genetics influence acne?

A

yes!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Do hormones influence acne?

A

Yes!

Hormones: estrogen is protective – E drops around period

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

Does menstruation affect acne?

A

Yes! hormones!

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

Does emotional stress affect acne?

A

Yes!

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

Does glycemic load affect acne?

A

maybe? Higher = more likely

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

Does chocolate affect acne?

A

no evidence for chocolate or dairy!

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

What is sebum?

A

product of the sebaceous glands and is secreted into the hair follicle via the sebaceous duct. Increased production in adolescents from increased androgen production

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

What is a keratin plug?

A

keratin is the protein secreted by keratinocytes

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

What are some microbial skin flora?

A

*Propionibacterium acnes, Staphylococcus epidermidis, Pityrosporum ovale

Acne is Not an infection. A common skin flora that likes sebum

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

Types of mild / noninflammatory acne lesions

A
  • Microcomedo (acne precursor): bumpy texture
  • Open comedone (black head)
  • Closed comedone (white head)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Types of Moderate to Severe Inflammatory acne lesions

A
  • Papules
  • Pustules
  • Nodules: hard painful lumps under skin. Nothing typically comes out but can cause scarring – “ice pick scars”
  • Cysts: softer. Lots of pus inside. Spills, causes redness and irritation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How does benzoyl peroxide work?

A
  • Lipophilic and penetrates the stratum corneum to enter the pilosebaceous unit
    • generates free radicals that oxidize the cell wall proteins of P. Acnes
    • Mild comedolytic and anti-inflammatory properties
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Side effects of benzoyl peroxide

A

bleaching of hair & fabric. Increased risk of sunburn, dryness, erythema, peeling, allergy (1:500)

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

Concentrations of Benzoyl Peroxide

A

2.5% to 10%

no evidence that higher concentrations are more effective (but more SEs! So start low, go slow)

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

How does benzoyl peroxide work best?

A

Combo therapy

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

How do topical retinoids work?

Study These Flashcards
A

Normalize desquamation of follicular epithelium, prevent the formation of new microcomedones (precursors of both comedones and inflammatory lesions), promote clearing of microcomedones, and some have anti-inflammatory activity

24
Q

3 topical retinoids on the market?

Study These Flashcards
A

Tretinoin, Adapalene, Tararotene

mono or combo therapy

25
What severities of acne are topical retinoids used for?
all
26
Side effects of topical retinoids
tinging, dryness, burning, scaling
27
How to reduce SEs of topical retinoids
* Begin with lowest strength * using 3x per week * moisturizer & sunscreen
28
Which topical retinoid is photostable?
Adapalene - the only one that does not get deactivated by sunlight
29
What is Dapsone?
topical synthetic sulfone
30
How does dapsone work?
Antimicrobial and anti-inflammatory effects P. acne reduction
31
When is Dapsone most effective?
with inflammatory lesions and when combined with a topical retinoid
32
Side effects of Dapsone
erythema, dryness, temporary orange staining if used with benzoyl peroxide
33
Why use antibiotics with acne?
Reduce P. acnes colonization of skin and follicles by inhibiting bacterial protein synthesis and decreasing inflammation
34
What topical antibiotics are available for acne?
Clindamycin & erythromycin
35
Disadvantages of topical antibiotics for acne
Slow onset and potential for resistance
36
Recommendations for topical antibiotics used for acne
* _Use with benzoyl peroxide_ preferably with fixed combo product
37
What oral antibiotics are available for the Tx of acne?
Tetracycline 500 mg BID, doxycycline 50-100 QD or BID or 150mg QD, minocycline IR 50-100 mg QD-BID ER 1mg/kg QD (start low)
38
What makes oral antibiotics effective?
Greater lipophilicity augments follicular penetrations Lower resistance *than topical*
39
What side effects should you assess for if Rxing antibiotics for acne?
dizziness, vision changes, headaches, photosensitivity, esophagitis (doxy – at least an hour before bed w/full glass water), hypersensitivity, lupus-like syndrome (arthralgias, no lupus rash)
40
On PO antibiotics with vision changes, HAs, what are you worried about?
pseudotumor cerebri, esp minocycline
41
Initial Tx for mild acne
Option 1 - *microcomedones, not inflammatory* * Benzoyl peroxide or * Topical Retinoid or * (Dapsone) * Option 2 *– more comprehensive* * Topical Combination Therapy * Benzoyl peroxide + antibiotic or * Retinoid + Benzoyl peroxide or * Retinoid + Antibiotic + Benzoyl per
42
Mild acne: what if you get inadequate results w/initial tx?
* Proper use? Adherence? Side effects? * Consider changing concentration, type or formulation or combination therapy if inadequate results
43
Initial tx for moderate acne
* Topical Combination Therapy * Retinoid + benzoyl peroxide Or * Retinoid + (benzoyl peroxide + antibiotic) Or * Retinoid + Antibiotic + benzoyl peroxide OR Oral antibiotic + Topical Retinoid + benzoyl peroxide Or Topical Retinoid + Antibiotic + benzoyl peroxide Consider OCPs *for ladies. If on tetracycline, remember will reduce efficacy* Consider Dermatology Referral / Isotretinoin
44
Moderate acne: What if you get an inadequate response w/initial tx?
* ? Correct and consistent use * Side effects * Able to get rx *(copays may be high- strategize. Maybe fancy new combo product won’t work)* * Change retinoid concentration, type and/or formulation * Change topical combination therapy AND/Or * Add or change oral antibiotic * Consider hormonal therapy * Consider Isotretinoin
45
OCPs for acne: how do they work?
* suppression of androgen production and gonadotropin levels * decrease in free testosterone (­ SHBG)\*\*, inhibition of 5-α-reductase and androgen receptor binding
46
What works best for OCPs?
Low androgen progestin component work best ## Footnote *depo could cause flare!*
47
How long should you wait w/OCPs to see results in reduction of acne?
3-6mths
48
Initial Tx for severe acne
* Combination Therapy * Oral Antibiotic + * Topical Retinoid + * Benzoyl peroxide +/- * Topical antibiotic
49
Severe acne: what if you get an inadequate response to the initial tx?
* Consider changing oral antibiotic * Consider Isotretinoin * Female adolescents consider hormonal therapy
50
What is special about the MOA of accutane (Isotretinoin)?
Only acne treatment that _addresses all 4 pathogenic factors_ * Normalization of epidermal differentiation * Sebum excretion decreased by 70% * Anti-inflammatory * Reduces the presence of *P acnes*
51
what do you need to monitor for if ado is on isotretinoin?
**Pregnancy** * **Teratogen** *- must sign forms* * Birth Control: 2 forms for females **Side Effects** * ?Physical—bone effects, IBD * ??Mental **Monthly Labs** * CBC * Hepatic function: Transaminases * Serum pregnancy test: *before initiation. Maybe every time in.*
52
Important counseling points for teens with acne: length of tx
* DOES NOT WORK OVERNIGHT!! * 4 – 8 weeks * May need to try many different combinations
53
Important counseling points for teens with acne: cleaning face
* Gentle Cleansing * No over scrubbing * Hygiene : *emphasize acne not d/t dirty*
54
Important counseling points for teens with acne: diet
* Food does not cause acne *– girls often think this b/c eating more of this stuff before period*
55
Important counseling points for teens with acne: cosmetics
* *they can wear makeup! Noncomedogenic* * Oil free * Moisturizers * Sunscreen *– everyone but esp if can make photosensitive*
56
What do you need to consider before Rxing tx for a teen with acne?
Their thoughts, opinion! * Concerned? * Want treatment? *If not – hard sell.* * What have they tried? Heard?
57
What are some sequelae to acne in teens?
* Dyspigmentation * hyper * hypo * Scarring * Psychological * Poor Self Esteem * Social Isolation * Depression * Economics * OTC Products (multiple products) * Prescriptions

PC Ado (9 decks)

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