Acne vulgaris

Question 1

when are people usually affected?

Answer 1

puberty and adolescence

Question 2

what is acne caused by?

Answer 2

chronic inflammation

with or without infection

Question 3

what part of skin is affected?

Answer 3

pilosebaceous unit

Question 4

what do pilosebaceous units contain?

Answer 4

hair follicles

sebaceous glands

Question 5

3 pathological changes in acne

Answer 5

increased sebum
trapping of keratin
blocked pilosebaceous unit

Question 6

change to pilosebaceous unit

Answer 6

swelling and inflammation

Question 7

why is acne exacerbated at puberty?

Answer 7

androgenic hormones increase production of sebum

Question 8

what are swollen and inflamed pilosebaceous units called?

Answer 8

comedones

Question 9

what bacteria plays a role in acne?

Answer 9

propionibacterium acnes

Question 10

presentation

Answer 10

red, inflamed and sore spots on skin

face, upper chest and back

Question 11

macules

Answer 11

flat marks on the skin

Question 12

papules

Answer 12

small lumps on the skin

Question 13

pustules

Answer 13

small lumps containing yellow pus

Question 14

comedones

Answer 14

skin coloured papules representing blocked pilosebaceous unit

Question 15

blackheads

Answer 15

open comedones with black pigmentation from oxidisation

Question 16

ice pick scars

Answer 16

small indentations in skin that remain after acne lesions heal

Question 17

hypertrophic scars

Answer 17

small lumps in skin remain after acne lesions heal

Question 18

3 types of scars

Answer 18

ice pick
hypertrophic
rolling

Question 19

treatment

Answer 19

education 
topical benzoyl peroxide + topical antibiotic
topical retinoid
oral antibiotics 
contraceptive pill
oral retinoids

Question 20

why are topical antibiotics always prescribed with benzoyl peroxide? example of antibiotic

Answer 20

clindamycin 1%

prevent antibiotic resistance

Question 21

example of oral antibiotic

Answer 21

lymecycline

Question 22

contraceptive pill used

Answer 22

co-cyprindol/dianette

high risk of VTE - discontinue after acne controlled

Question 23

what antibiotics to avoid?

Answer 23

macrolides eg erythromycin

p acnes resistance

Question 24

important to remember about roaccutane

Answer 24

teratogenic

reliable contraception

Question 25

side effects of oral isotretinoin/roaccutane

Answer 25

dry skin and lips
photosensitivity
depression, suicidal ideation, anxiety, aggression
SJS, TEN