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Dermatology - Clinical Medicine IV > Acne > Flashcards

Flashcards in Acne Deck (30)
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1

What is chronic inflammation of pilosebaceous unit?

acne vulgaris

2

What causes sebaceous glands to increase sebum production?

androgens

3

What acts on sebum to break down to fatty acids?

propionibacterium acnes

4

What does fatty acid create?

inflammatory response in pilosebaceous unit

5

What is p. acne?

preferential anaerobic
aerotolerant
diptheroid
gram +
rod shaped

6

What does plugging cause?

open and closed comedone

7

What does acne becomes when it ruptures into dermis?

papule, pustule, nodule

8

What is the patho of acne?

accumulate apithelial cells and keratin --> accumulation of shed keratin and sebum --> p. acnes proliferation (mild inflammation) --> marked inflammation

9

What are the key players in acne?

androgen excess
emotional stress
medications
mechanical - leaning face on hands

10

What are the different types of acne lesions?

papule, pustule, nodule/cyst

11

What are the type of acne scars?

pitted, hypertrophic, keloid

12

What is an open vs closed comedome?

open comedone = no skin layer
closed comedone = sealed by skin

no inflammatory response

13

What is a papule?

raised lesion, more inflammatory

14

What are pustules?

raised, purulent fluid, erythema

15

What is cysts and nodules in acne?

nodule - firm
cysts - fluid filled

lots of surrounding inflammation

16

What do pitted scars look like?

diffuse lesions with erythematous base, pitting present, concave shape

17

What are hypertrophic scars?

raised, firm, fibrosis

18

What are acne keloidalis nuchae?

more in AA, dark skin, excess over growth

19

Where are locations for acne?

face, neck, upper arms, trunk

20

What is the most common location for acne?

face

21

How to tell severity?

type of lesion, surface area, inflammatory response

22

What is the treatment for mild acne superficial, topical abx?

1. Erythromycin 2% solution, gel,ointment
2. Clindamycin 1% solution, gel, lotion
3. Sodium Sulfacetamide 10% gel, cream, lotion

23

What are some topical retinoids for mild acne?

1. Tretinoin (Retin A) solution,cream,gel
2. Tazarotene (Tazorac) cream, gel
3. Adapalene (Differin) cream, gel
4. Azalaic Acid (Finacea) gel

24

What are some OTC treatment for mild acne?

BPO

25

What make up needs to have?

noncomudogenic - doesn't clog your pores

26

What is the treatment for moderate to severe acne?

Add PO antibiotic:
Tetracycline
Minocycline
Doxycycline
Erythromycin
Oral Contraceptives
Anti-androgen effect

27

What are the dosing for ABX PO?

Tetracycline 250-500mg BID
Minocycline 50-100mg BID
Doxycycline 100mg BID
Erythromycin 250-500mg BID

28

What is used for recalcitrant acne?

isotretinoin (Accutane)
1mg/kg/day PO divided BID
15-20 wks

29

What are the side effects of isotretinoin?

teratogenic - preg test 2x, be on OCP
increase triglycerides - LFT at baseline then 1-2 wks until stable
Depression/suicide - screen monthly

30

What are some other acne treatments?

intralesion triamcinalone, acne surgery, cryotherapy, chemical peels, dermabrasion, laser