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Dermatology > Acneiform Eruptions > Flashcards

Acneiform Eruptions Flashcards

1
Q

Two types of acne

A

Acne Vulgaris

Acne Rosacea

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2
Q

What is acne vulgaris?

A

Disease of the pilo-sebaceous unit (PSU)

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3
Q

Where does acne vulgaris effect?

A

Face
Chest
Back

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4
Q

Pathology of acne vulgaris

A

“Sticky” keratinocytes + increased sebum viscosity
Formation of keratin plug causing obstruction of pilosebacous follicle
Blocked follicles called comedones
Changes in commensal bacterial behaviour (Propionibacterium acnes) = inflammation

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5
Q

Presentation of acne vulgaris

A 
Papules
Pustules
Nodules
Cysts
Scars
1. Comedones (due to dilated sebaceous follicle)
- top closed = whitehead 
- top open = blackhead 
2. Inflammatory lesions form when follicle bursts releasing irritants - papules, pustules 
3. Excessive inflammatory response may result in nodules or cysts 
4. Can cause scarring
- ice pick scars
- hypertrophic scars
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6
Q

Peak age to get acne vulgaris

A

15 - 18 years old (90% incidence)

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7
Q

Which gender may have delayed onset of acne vulgaris?

A

Females

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8
Q

Which gender gets acne vulgaris?

A

M = F

But males more severe

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9
Q

Does acne run in families?

A

Yes

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10
Q

What is acne roasacea?

A

Chronic inflammation of

  • PSU
  • Cutaneous vasculature
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11
Q

Distribution of acne roasacea

A

Ace of clubs distribution

Nose, cheeks and forehead

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12
Q

What age gets acne roasacea?

A

30 - 50 y/o

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13
Q

Which gender gets acne roasaecea?

A

F > M

But male more severe

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14
Q

Who gets acne rosaecea?

A

Fair skinned / celts

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15
Q

Presentation of acne rosaecea

A 
Flushing
- alcohol 
- spices
- emotion 
- hot drinks 
"Sensitive Skin"
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16
Q

Subtypes of acne rosacea

A

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

17
Q

Do you get comedones in acne rosacea?

A

NO

18
Q

Do you get comedones in acne vulgaris?

A

Yes

19
Q

What are comedones?

A

Skin coloured small bumps (papules) frequently found on the forehead and chin on those with acne
A single lesion is a comedo

20
Q

What are open comedones?

A

Blackheads

21
Q

What are closed comedones?

A

Whiteheads as the follicle is completely blocked

22
Q

In blackheads, what causes the black colour?

A

Surface pigment (melanin)

23
Q

Treatment of acne vulgaris

A 
Topical 
- retinoids
- benzoyl peroxide (BPO)
- Antibiotics (clindamycin, tetracycline, erythromycin)
Antibiotics 
- tetracyclines
- erythromycin 
Anti-androgens
- oral contraceptives
- dianette
Isotretinoin/roaccutane
24
Q

What is the most effective treatment for severe/stubborn acne?

A

Isotretinoin

25
Q

What type of drug is isotretinoin?

A

Retinoid

26
Q

What is the cure rate for isotretinoin?

A

60-70%

27
Q

Side effects of isotretinoin

A 
HIGHLY teratogenic 
Dry skin (muco-cutaneous junction)
Hair loss
Mood swings/depression/suicide
Abnormal LFTs 
Hypertriglyceridemia
28
Q

Treatment for acne rosacea

A 
Topical 
- antibiotics (metronidazole)
- azelaic acid
- ivermectin 
- brimonidine 
Antibiotics 
- tetracyclines 
Isotretinoin 
Light based treatments 
Daily application of high factor suncream
Laser
- if prominent telangiectasia
29
Q

Can acne roasacea be cured?

A

No

30
Q

Presentation of acne roseacea

A 
Flushing (often 1st symptom)
Telangiectasia 
Later
- persistent erythema with papules and pustules 
Ocular involvement 
- blepharitis 
Rhinophyma
31
Q

What is rhinophyma?

A

Development of a large, bulbous nose associated with granulomatous infiltration, commonly due to untreated rosacea

32
Q

Adverse effects of isotretinoin

A

Teratogenicity (2 forms of contraception)
Dry skin, lips, eyes and mouth
Low mood
Raised triglycerides
Hair thinning
Nose bleeds (due to dryness of nasal mucosa)
Intracranial HTN (not to be used with tetracyclines)
Photosensitivity

33
Q

What is the most common side effect of isotretinoin?

A

Dry skin, eyes and lips/mouth

34
Q

First line treatment of moderate - severe acne rosacea

A

Oxytetracycline

35
Q

Treatment of mild acne rosacea

A

Topical metronidazole

36
Q

What is the bacteria known to contribute to the development of acne?

A

Propionibacterium acnes

Dermatology (11 decks)

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