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acne and rosacea Flashcards

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1
Q

vitamin a derivatives that act by normalizing desquamation of follicular epithelium to prevent formation of new comedones and promote the clearing of existing comedones

A

topical retinoids (tretinoin, trans retinoic acid)

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2
Q

adverse effects of topical retinoids

A

dryness, pruritus, erythema, scaling, photosensitivity

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3
Q

when applying topical retinoids do you combine with other treatments

A

no, you do not apply at the same time as benzoyl peroxide, but you should wear sunscreen

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4
Q

which retinoid is cat x

A

tazarotene

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5
Q

which retinoid is cat c

A

tretinoin and adapalene

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6
Q

topical medication w/ both antibacterial and comedolytic properties that acts via the generation of free radicals that oxidize proteins in the P acnes cell wall

A

benzoyl peroxide

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7
Q

adverse effects of benzoyl peroxide

A

bleaches hair and fabric, can irritate skin

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8
Q

reduces the number of P. acnes and reduces inflammation in inflammatory acne

A

topical abx

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9
Q

adverse effects of topical abx

A

irritating, dry skin

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10
Q

what should you instruct your pt to do when using topical abx

A

(1) when using w/ retinoids or benzoyl peroxide, use on alternating days (2) use a moisturizer

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11
Q

topical abx that comes in solution or gel

A

erythromycin 2%

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12
Q

topical abx that comes in solution, gel, lotion, or foam

A

clindamycin 1%

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13
Q

what can you use w/ topical abx to reduce the risk of abx resistance

A

benzoyl peroxide

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14
Q

which lesions should acne treatment target

A

new lesions, not present ones

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15
Q

most common cause of acne tx failure

A

lack of adherence (topical agents take 2-3 months to take effect) due to dryness, itching, etc., so have them use a ceramide containing moisturizer

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16
Q

how long should acne tx go on for until you can evaluate it

A

8 weeks at least

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17
Q

does diet effect acne

A

potentially yes

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18
Q

should pts using prescribed acne meds use OTC products too (like astringents, abx soaps, etc)

A

NO

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19
Q

what do you prescribe for moderate to severe inflammatory acne

A

tetracycline, doxycycline, minocycline + benzoyl peroxide (to prevent abx resistance)

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20
Q

adverse effects of oral tetra/doxy/mino-cyclines

A

GI upset, photosensitivity, + minocycline causes vertigo/dizziness and hyperpigmentation

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21
Q

oral tetra/doxy/mino-cycline contraindications

A

preggos, kids under 8

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22
Q

how should a pt take oral tetra/doxy/mino-cycline

A

with food/ milk/ full glass of water (to prevent GI side effects and esophageal erosions)

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23
Q

brown or blue grey skin pigmentation on the alveolar ridge, palate and sclera

A

hyperpigmentation caused by minocycline

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24
Q

what do you prescribe for refractory severe nodulocystic acne

A

oral isotertinoin

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25
retinoic acid derivative that targets all 4 pathophysiologic factors involved in acne
oral isotretinoin
26
adverse effects of oral isotretinoin
xerosis (dry skin), chelitis (chapped lips), elevated liver enzymes, hypertriglyceridemia
27
what drug does the pt need to do the iPLEDGE program w/ b/c its toxic AF to preggos
oral isotretinoin
28
w/ iPLEDGE, how long, and what type of contraception does someone need to take
2 forms of contraception for at least one month after tx has ended
29
comedones w/ few inflammatory lesions
mild acne
30
tx for mild acne
topical retinoid or benzoyl peroxide or combo therapy (topical retinoid + benzoyl peroxide +/- topical abx)
31
comedones with marked number of inflammatory lesions
moderate acne
32
tx for moderate acne
combo therapy (topical retinoid + benzoyl peroxide +/- topical abx)
33
acne between the ages 1 and 7
mid childhood acne, rare
34
what is mid childhood acne caused by
excess androgens (adrenal tumors/ gonadal tumors/ congenital adrenal hyperplasia/ cushings/ precocious puberty)- need to see endocrinologist
35
acne from birth to 6 weeks
neonatal acne, self limiting, no comedones
36
acne from 6 weeks to 1 year
infantile acne, true acne w/ comedones
37
acne from 7-12 years
preadolescent acne
38
acne from 12-19 years
adolescent acne
39
how do you tx mid-childhood acne
same was as adults EXCEPT NO TETRACYCLINES
40
PCOS must have ?/3 sxs, and what are they?
2/3... (1) oligo/anovulation (2) hyperandrogenism (3) polycystic ovaries on US
41
women w/ PCOS can have a greater degree of insulin resistance which can cause
acanthosis nigricans
42
increased circulating androgens in PCOS can cause ___ and ___
hormonal acne and hirsutism
43
location of hormonal acne lesions
perioral and along jaw line
44
when do women w. hormonal acne report a flare
pre-menstrual
45
who should you consider hormonal acne in
pt w/ severe sudden onset/ hirsutism/ irregular menses
46
how do you tell acne rosacea apart from acne vulgaris
acne rosacea has no comedones
47
presents w/ flushing, erythema, papules, pustules, and/or phymatous changes
acne rosacea
48
what are acne rosacea triggers
ETOH, sun, hot beverages, spicy food, stress, NOT HORMONES
49
many patients w/ acne rosacea have ___ involvement
ocular
50
acne rosacea tx
topical and oral tx, sunscreen, avoid triggers
51
how do you tell periorificial dermatitis apart from acne vulgaris
periorificial dermatitis has no comedones
52
erythematous papules and pustules w/ scaling located around the mouth, nose, and eyes (occasionally the rest of the face)
periorificial dermatitis
53
periorificial dermatitis presents w/ what other sxs and hx
pruritis, burning, hx of topical steroids
54
commonly used treatments for hormonal acne
spironolactone and oral contraceptives
55
side effects of spironolactone
diuresis, hyperkalemia, irregular menses, feminization of male fetus
56
side effects of oral contraceptives
N/V, abnormal menses, weight gain, breast tenderness, clots
57
open and closed comedones, papules, pustules nodules and cysts
acne vulgaris
58
what must you include when describing acne
severity and presence of scarring
59
related to presence of androgens, excess sebum production, activity of P. acnes, and follicular hyperkeratinization
acne vulgaris
60
location of acne vulgaris
face, neck, upper trunk, upper arms
61
open comedones aka
blackheads
62
closed comedones aka
whiteheads
63
4 factors involved in the pathogenesis of acne vulgaris
(1) increased sebum production b/c of androgens (2) comedone formation (3) p-acnes proliferation (4) inflammatory response
64
what causes comedone formation in acne vulgaris
keratin and sebum plug the hair follicle and accumulate
65
what causes the release of pro-inflammatory cytokines in acne vulgaris
P. acnes proliferates in the sebacous follicle and releases enzymes

Derm (8 decks)

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