Acne Flashcards
(93 cards)
What is acne?
A skin condition that occurs where there’s a hair follicle
Teenagers are prone to acne but so are adults (there is also neonatal acne)
90-100% of people experience acne at some point in their life
What are the peak ages for acne?
14-19 years
Does acne resolve?
Most of the time it will resolve before the age of 25 but it can persist
Where do lesions appear?
Face, neck, check, back (upper back and upper chest)
What are aggravating factors of acne?
Stress/emotions (range of extreme emotions)
Family history
Diet (possibly - low glycemic index, low levels of processed sugar, more protein may lead to less acne)
Medications (occlusive agents)
Environmental factors
Hormones
How does acne affect people?
It can have significant psychological morbidity
It’s a visible condition so people are often self-concious about it
Describe the pathology of acne?
There are 4 major stages:
- Increased follicular keratinization (sticky plug that forms at the top of the follicle and blocks it)
- Increased sebum production (due to hormone changes)
- Bacterial (Propionibacterium acnes) lipolysis of sebum triglycerides to free fatty acids
- Inflammation (redness and swelling)
What are the non-inflammatory lesions?
Closed comedones (whitehead) Open comedones (blackhead)
Describe a blackhead
Open comedone - the sebum is exposed to oxygen and light, which turns it dark
The follicle is still open
Describe a whitehead
There’s a layer of tissue or epithelial cells cover the trapped sebum underneath
How long does it take before a close comedone appears?
5 months
What are the inflammatory lesions?
Papules
Pustules
Nodules
Cysts
What is a papule?
It involves the epidermis and the dermis
This lesions extends deep within the layers of the skin
It is often a small, pink/reddish bump that is tender to the thouch (they’ve gone nerve deep)
The opening is still closed
What is a pustule?
A pus-filled papule
Often red and inflamed at the base
What are the 3 types of acne scars?
Depressed (classic icepick, boxed, rolling)
Hypertropic (aka keloidal; it’s a raised scar due to hyperproliferation)
Atrophic
There can also be pigmentary alteration
What are the different types of acne?
Drug-induced acne Neonatal acne Acne conglobata Acne fulminans Contact acne Endocrine acne Acne mechanica Acne excoriee Acne rosacea
Describe drug-induced acne
It can be a side effect (ask patients if they’ve been on any new medications recently)
It often has a very consistent presentation (there isn’t a variety of close and open comedones, there isn’t a variety in size)
Describe neonatal acne
Presents usually in the first 2-3 months of life
Affects more boys than girls
Might be due to the transfer of maternal androgens
We do not treat this (self-limiting)
Infants who have neonatal acne may have more severe form of acne when they’re in their teens
Describe acne conglobata
A very serious form of acne
Nodulocystic
Can be extremely painful
Describe acne fulminans
Very serious form of acne
The nodules and cysts ulcerate
There are often systemic symptoms (joint pain, fever, muscle pains)
Describe contact acne
Can occur when you come into contact with an occlusive agent (e.g., oil-based cosmetic, hair bangs, industrial agents such as aerosolized oils)
Describe endocrine acne
Related to a syndrome in which there’s androgen production or an off balance of hormone production
Sometimes occurs in females with polycystic ovarian syndrome
Describe acne mechanica
Localized acne from physical stress (e.g., bangs, bike helmet, etc.)
Describe acne excoriee
The patient will pick at the comedones that it actually ends up in chronic erosions