Acne vulgaris

Question 1

what is acne vulgaris?

Answer 1

disease of pilo-sebaceous unit, which becomes blocked due to abnormal keritinisation & increased sebum production

Question 2

where are common sites for acne vulgaris to start?

Answer 2

face, chest and back ie where sebaceous glands are very dense

Question 3

what is the pathogenesis of acne vulgaris?

Answer 3

blockage of follicle due to abnormal keratinization and increased production of sebum (comedones)

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overgrowth of Propionibacterium acnes

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inflammatory repsonse

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pustules, papules, nodules and cysts

Question 4

What do closed comedones look like?

Answer 4

Question 5

what are lesions in acne defined as?

Answer 5

• non-inflammatory – open comedones (blackheads) or closed comedones (whiteheads)
• inflammatory – papules, pustules, nodules and cysts

Question 6

what needs to try and be avoided when treating acne?

Answer 6

scarring

Question 7

what are the types of scarring that could form?

Answer 7

• Hypertrophic scarring
• Atrophic scarring
• Chiloid scarring

Question 8

• what is peak age for acne
• what is sex occurrence
• what can cause an acute flare up of acne?

Answer 8

• peak is teens (15-18 years)
• M=F, but M is more severe
• environmental conditions ie stress, weather etc

Question 9

What are topical treatments?

Answer 9

• retinoids
• benzoyl peroxide
• anti-biotics

Question 10

what is benzoyl peroxide, what is its’ effect & how is it used?

Answer 10

• an oxidising agent, which has antibacterial action
• has little effect on comedones alone
• used in conjunction with retinoids, as together they have a synergistic effect

Question 11

what anti-biotics are used and how should you use them?

Answer 11

• clindamycin, tetracycline, erythromycin
• used with Benzoyl peroxide as if used as monotherapy, resistance becomes an issue

Question 12

what are non-topical treatments?

Answer 12

• antibiotics
• anti-androgens –> oral contraceptive
• isotretinoin (roaccutane)
• light based treatments

Question 13

what are some features of isotretinoin?

Answer 13

• most effective CURE for acne (other treatments only control it)
• only prescibable by dermatologists
• is a retinoid
• used as single monotherapy

Question 14

what are some side effects of isotretinoin?

Answer 14

• highly teratogenic
• dry skin
• mood swings/ depression / abnormal LFTs/ HTG