Acne Flashcards
(23 cards)
What is acne?
An inflammatory disease of the pilosebaceous follicle
How common is acne?
Over 80% of teenagers are affected by it.
What is the pathophysiology of acne?
Androgen conversion in puberty stimulates the sebaceous glands to produce sebum, which then blocks the glands.
There is inflammation and some secondary bacterial infection of the glands.
Does FHx have an impact on acne?
Yes - positive FHx increases risk of having it, and it being earlier in presentation and more severe.
Does acne affect girls and boys equally?
No, M>F.
When might a girl have a flare-up of acne?
When they are premenstrual.
With which gynaecological/endocrine condition is acne associated?
PCOS
How does acne present on the skin?
Greasy skin
Comedones
Papules
Pustules
When does acne present?
Usually at or just after start of puberty
Which areas of the body are affected by acne the most?
Face = 99% of cases
Back 60%
Chest 15%
What is severe acne with cysts called?
Nodulocystic acne
Which form of acne presents later in life?
Acne rosacea
A teenager presents to the GP quite distressed because of a recent onset of greasy skin with blackheads and pustules on the face and back.
Other than acne vulgaris, form a list of differentials.
Acne rosacea (middle/later life)
Folliculitis and boils
Milia (look similar to whiteheads)
Perioral dermatitis
Are any investigatons usually performed to investigate acne vulgaris?
No, not in a typical case.
What special circumstances might warrant further investigation into acne?
If there might be an underlying cause e.g. if an older pt develops acne they may have PCOS, virilising tumour etc.
If lesions look infected and treatment is needed.
When should a pt with acne vulgaris be referred to dermatology?
If the acne is severe and/or is having a large psychological impact
What lifestyle advice can be given to pts with acne?
Keep face/back/chest clean.
Sunshine in moderation can help with acne in some people.
Avoid triggers if any have been noted e.g. some foods.
How long do topical treatments for acne need to be used to produce effect?
6 weeks at least
What topical therapies are available for mild acne vulgaris?
- Benzoyl peroxide
- Topical abx
- Topical retinoids
What do topical retinoids do for acne?
They break down comedones and have anti-inflammatory effect.
When would oral therapies be used for acne?
In moderate to severe acne
What oral therapies can be used to treat acne?
- Oral abx
- Oral anti-androgen for females
- Oral retinoids
What complications can occur secondary to acne?
- Post-inflammatory hyperpigmentation
- Scarring
- Deformity
- Psychological and social effects
