Acneiform Disorders Flashcards Preview

Week 44: Rash > Acneiform Disorders > Flashcards

Flashcards in Acneiform Disorders Deck (19)
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1

3 types of pilosebaceous units

Terminal follicles (long hairs)
Vellus follicles (miniature hairs)
Sebaceous follicles (no visible hair shaft)

2

Sebum

Fatty liquid produced by sebaceous follicles
No known physiological function in humans (possibly involved in hydration, antimicrobial, and anti-oxidant)

3

How do
1. Androgens
2. Retinoids
regulate sebum production

1. Increase sebum production
2. Inhibit sebum production

4

Acne vulgaris

Chronic inflammation of the pilsebaceous unit that is associated with comedones
Primarily affects adolescents
Can persist well into adulthood

5

4 parts in the pathogenesis of acne

Abnormal follicular keratinization
Increased sebum production
Overgrowth of follicular bacterium (propionibacterium)
Inflammation

6

Mild acne characteristics

Mostly comedones
Few inflammatory lesions (papules or pustules)
No nodules
Minimal or no scarring

7

Mild acne therapy

1. Reducing comedones (topical retinoids, benzoyl peroxide)
2. Reducing sebum production (topical retinoids)
3. Reducing bacterial growth and inflammation (topical clinda or erythro, others)

8

Topical retinoids

Reduces comedones by promoting keratinocyte desquamation
Reduces sebum production
For mild acne
Slow onset of action
Adverse effects: redness, desquamation, burning sensation

9

Topical antibiotics

Reduction of P. acnes/anti-inflammatory
Often used with benzoyl peroxide to decrease antibiotic resistance
Used for inflammatory lesions

10

Topical benzoyl peroxide

Gel and body wash
Unclear MOA but used for antimicrobial/anti inflam
Side effects: irritant or allergic contact dermatitis

11

Topical azelaic acid

Gel or cream
MOA: antibacterial, promotes keratinocyte desquamation, decreases hyperpigmentation
Adverse effects: redness, desquamation, burning sensation

12

Moderate acne therapies

Systemic antibiotics
Systemic hormonal therapies
Systemic isotretinoin
Intralesional steroid injection

13

What ABx are used systemically for acne?

Tetracycline/Doxy/Minocycline

14

Severe acne therapies

Systemic anti inflammatory antibiotics plus topical therapy
Systemic isotretinoin (most effective!)

15

Isotretinoin

Inhibits sebum production
Causes atrophy of sebaceous glands
Most effective therapy for acne
Side effects are common but easily manageable (teratogen, dry skin/lips)

16

3 indications for isotretinoin

Nodulo-cystic acne
Scarring acne
Refractory moderate acne

17

Rosacea definition

Chronic inflammatory and vaso-dilatory skin disorder characterized by facial flushing and erythema

18

4 subtypes of rosacea

1. Erythematotetangiectatic rosacea
2. Papulopustular rosacea
3. Phymatous rosacea
4. Ocular rosacea

19

Treatments for the 4 types of rosacea

1. Lasers
2. Topical (metronidazole) or oral (tetracyclines, isotretinoin)
3. Surgical reconstruction
4. Opthamologists - topical steroids or oral tetracyclines