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Flashcards in Acne Deck (91)
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1

Types of topicals from most drying to most moisturizing

Solutions
Gels
Lotions
Creams
Ointments

2

Percent involvement- head and neck

9%

3

Percent involvement anterior thorax

18%

4

Percent involvement posterior thorax

18%

5

Percent involvement each arm

9%

6

Percent involvement each leg

18%

7

Percent involvement genital area

1%

8

Percent involvement area of the palm of hand

1%

9

Mild acne

Predominantly comedonal or mixed comedonal and inflammatory
Few to several papules or pustules
No nodules

10

Moderate acne

Several to many papules or nodules
Few to several nodules

11

Severe acne

Numerous or extensive papules or pustules
Many nodules

12

1st line tx for mild acne

Benzoyl Peroxide (BP)
or Topical retinoid
or Topical combination therapy
BP + antibiotic or
Retinoid + BP
or Retinoid + BP + antibiotic

13

Alternative tx for mild acne

Add topical retinoid or BP (if not on already)
or consider alternate retinoid
or consider topical Dapsone

14

1st line tx for moderate acne

Topical combination therapy
BP + antibiotic
or retinoid + BP
or retinoid + BP + antibiotic
or oral antibiotic + topical retinoid + BP
or oral antibiotic + topical retinoid + BP + topical antibiotic

15

Alternative tx for moderate acne

Consider alternate combination therapy or
consider change in oral antibiotic or
add combined oral contraceptive or oral spironolactone (females) or
Consider isotretinoin

16

1st line tx for severe acne

Oral antibiotic + topical combination therapy
BP + antibiotic or
Retinoid + BP or
Retinoid + BP + antibiotic or
Oral isotretinoin

17

Alternative tx for severe acne

Consider change in oral antibiotic or
Add combined oral contraceptive or oral spironolactone (females) or
Consider oral isotretinoin

18

Acne f/u

Sx should begin to improve in 6-8 wks
F/u with PCP if sx worsen or don't improve in 6-8 wks with proper medication adherence

19

Benzoyl peroxide contraindications

Should not be used in pts who have shown hypersensitivity to benzoyl peroxide or to any of the other ingredients in the products

20

Benzoyl peroxide adverse effects/toxicities

Hypersensitivity rxns, contact sensitization rxns, excessive erythema, and peeling

21

Benzoyl peroxide pediatric use

Safety and effectiveness have not been established in children <12 yoa

22

Contraindications of salicylic acid

Known sensitivity to salicylic acid or any other ingredient in the formulation

23

Adverse effects/toxicities of salicylic acid

Hypersensitivity rxns, salicylate toxicity, excessive erythema, and scaling

24

Other issues with salicylic acid

Cumulative irritant or drying effect. If excessive dryness occurs, use only 1 topical medication unless directed by a clinician

25

Interactions with salicylic acid

Acidifying agents, anticoagulants, antidiabetic agents, ASA, corticosteroids, diuretics, methotrexate, pyrazinamide, sulfur, and uricosuric agents

26

Pediatric use- salicylic acid

6% cream, lotion, and gel and 15% plaster not recommended in children < 2 yoa. Increased risk of salicylate toxicity with prolonged, excessive use in children <12 yoa. Varicella and influenza-like illness is associated with risk of Reye syndrome

27

Adverse drug effects of topical retinoids

Local erythema
Peeling
Dryness
Pruritis
Burning
Scaling
Stinging
Xerosis

28

Adapalene
Differin

Topical retinoids
Available as cream- 0.1%
Gel- 0.1%, 0.3%
Solution- 0.1%
Lotion- 0.1%
Category C
Available in combo with benzoyl peroxide
FDA-approved for those greater than or equal to 9 yoa
Best tolerated
Photo-stable

29

Tazarotene
Avage
Fabior
Tazorac

Topical retinoids
Cream-0.05%, 0.1%
Foam-0.1%
Gel- 0.05%, 0.1%
Category X
Photo-stable
May be the most effective
Most irritating

30

Tretinoin
Atralin
Avita
Retin-A

Topical retinoids
Cream-0.025%, 0.05%, 0.1%
Gel-0.01%, 0.025%
Gel (micronized)- 0.05%
Microsphere gel- 0.04%, 0.1%
Polymerized cream- 0.025%
Polymerized gel- 0.025%
Category C
FDA-approved for those greater than or equal to 10 yoa