Acne/Rosacea

Question 1

What is acne?

Answer 1

Disease of the pilo-sebaceous unit (PSU) - face, chest,back
Sticky keratinocytes + increased sebum viscosity
Blocked follicles = comedones
Change in commensal bacterial behaviour (proprionobacterium acnes) = inflammation

Question 2

What are the risk factors/causes of acne?

Answer 2

Peak 15-18 (90% incidence)
Delayed onset in some females
+ve family history
M=F but more severe in M

Question 3

What are the symptoms/signs of acne?

Answer 3

Papules, pustules, nodules, cysts, scars

Question 4

What are the treatments for acne?

Answer 4

Topical

• retinoids
• benzoyl peroxide (BPO)
• antibiotics - clindamycin, tetracycline, erythromycin

Non-topical

• anti-biotics - tetracyclines, erythromycin, trimethoprim
• anti-androgens - oral contraceptives, dianette
• isotretinoin
• light based treatments

Question 5

What are some side effects/concerns with isotretinoin?

Answer 5

Highly teratogenic - pregnancy prevention programme

Many potential side effects - dry skin, hair loss, mood swings, abnormal LFTs, hypertriglyceridaemia

Question 6

What is rosacea?

Answer 6

Chronic inflammation
Involves PSU and cutaneous vasculature
No comedones

Question 7

What are the risk factors/causes of rosacea?

Answer 7

Age 30-50
F > M but M more severe
Fair skinned/celts
Flushing - alcohol, spices, emotion, hot drinks
Sensitive skin

Question 8

What are some subtypes of rosacea?

Answer 8

Erythema-telangiectatic
Papulo-pustular
Phymatous (M»>F)
Ocular

Question 9

How is Rosacea treated?

Answer 9

Control not cure
Topical
- antibiotics - metronidazole
- azeleic acid
- ivermectin
- brimonidine

Non-topical

• anti-biotics - tetracyclines, erythromycin, metronidazole
• isotretinoin
• light based treatments