Acne Flashcards
The pathogenesis of acne vulgaris is
multifactorial
Key factor in acne is
Genetics
Acne develops as a reult of
interplay of the following four factors
–Release of inflammatory mediators into the ski
–Follicular hyperkeratinization with subsequent plugging of the follicle
–Cutibacterium acnes (c. acne) (formerly Propionibacterium acnes) follicular colonization (anaerobic organism present in acne lesions)
–Excess sebum production – regulated by a # of different hormones and mediators
Treatment is directted
Directed towards known pathogeneic factors
Follicular hyperproliferation
–Excess sebum
–Cutibacterium acnes (formerly Propionibacterium acnes) infection
–Inflammation.
the grad and severity of
The grade and severity of the acne help in determining which of the following treatments, alone or in combination, is most appropriate.
Give realistic
Give realistic expectations regarding timelines for improvement
two to three
Two to three months of consistent adherence to a regimen
acney typically
Acne typically reoccurs over years; maintenance therapy is important
treatment regimen should be
Treatment regimen realistic for patient
delivery system depnds on
Delivery system; depends on patient’s skin type
some gels have
Some gels – drying effect
creams and lotions are
Creams and lotions – moisturizing
solution sare
Solutions are drying, but cover large areas easier than other preparations
foams are
easy application to hair-bearing areas
pledgets are
single-use absorbents pads impregnated with medication
Treatment for Acne - Nondrug
–Cleansing
Treatment for Acne - Drug therapy
–Benzoyl peroxide–Antibiotics•Topical: Clindamycin•Oral: Tetracycline antibiotics, isotretinoin, hormonal agents–Retinoids•Tretinoin •Adapalene
Benzoyl peroxide - Decreases
Decrease # of C. acnes colonizing the skin
Benzoyl peroxide has what component
inflammatory component
Benzoyl peroxide used with
Used with a topical or oral anti-biotic decreases emergence of antibiotic resistant bacteria
Benzoyl peroxide is
Comedolytic
Benzoyl peroxide limit
Limit application of these products to one or two small affected areas during the initial three days of use to test for hypersensitivity
Topical Antibiotics - example
Clindamycin and erythromycin (most common*)
Topical Antibiotics - reduces
Reduce # of proinflammatory C. acnes colonizing the skin
