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
