Acneiform Lesions Flashcards
(21 cards)
Inflammation of the pilosebaceous units of certain body areas
Face, chest, back
Manifests itself as comedones, papulopustules, or nodules/cysts
Age of onset- puberty
Acne Vulgaris
What are the key factors for the development of acne vulgaris?
Key factors are follicular keratinization, androgens, and
Propionibacterium acnes
What are some contributary factors for the development of acne vulgaris?
Contributary factors are acnegenic mineral oils, drugs, emotional
stress, occlusion and pressure on the skin
excess skin cells or build up on the skin
Follicular keratinization
this bacteria lies deep within the pore and is anaerobic; over time it breaks down the heavy oil in the sebaceous gland, which causes inflammation which results in pimples and cysts
Propionibacterium acnes:
Comedones: Open (blackheads), Closed (whiteheads)
Papules and papulopustules
Nodules or cysts: 1-4 cm in diameter, “Undergrounders”
Acne Vulgaris
What is the treatment for mild acne vulgaris?
OTC:
Topical antibiotics (Clindamycin and Erythromycin
Benzoyl peroxide gels (2%, 5%, or 10%)
Topical retinoids
What is the treatment for moderate acne vulgaris?
Add “cyclines” 🡪 Minocycline is good for acne
Tetracycline an option
Women – add high dose estrogens + progesterone + antiandrogens
What is the treatment for severe acne vulgaris?
Accutane (Isotretinoin) is an option – most effective for cystic acne (Managed by a dermatologist, someone who is accredited)
Common chronic inflammatory acneiform disorder of the facial
pilosebaceous units, increased reactivity of capillaries leading to flushing and telangiectasia
Age of onset - 30-50 years with a peak incident between 40 and 50 years
Predominately in females
Rosacea
Rosacea is also called what?
adult acne
What stage of Rosacea is described below?
Persistent erythema with telangiectases
Stage I
What stage of Rosacea is described below?
Persistent erythema, telangiectases, papules, tiny pustules
Stage II
What stage of Rosacea is described below?
Persistent deep erythema, dense telangiectases, papules, pustules, nodules
Rarely persistent “solid” edema of the central part of the face
Stage III
Describe the early presentation of Rosacea
Capillaries undergo continual inflammation and dilation
Pathognomonic flushing (red face)
Tiny papules and papulopustules - Pustule often small (<1mm) and
on the apex of the papule
No comedones
Describe the late presentation of Rosacea
Red facies and dusky-red papules and nodules
Scattered, discrete lesions
Telangiectases
Marked sebaceous hyperplasia and lymphedema in chronic rosacea, causing disfigurement of the nose, forehead, eyelids, ears, and chin
What is the treatment for Rosacea?
Topical - Metronidazole gel or cream
Systemic - Minocycline or Doxycycline; Metronidazole
Chronic, suppurative, often cicatrical disease of apocrine gland-bearing skin in the axillae, anogenital region, and the scalp (rare)
Inflammatory changes to apocrine glands
Unique double comedones
Age of onset: puberty to climacteric
More common in females than males
More common in obesity and diabetes
Etiology is unknown
Hidradenitis Suppurativa
Intermittent pain and marked point tenderness related to abscess formation in axillae and/or anogenital area
Inflammatory nodules/abscesses of axillae, buttocks, inguinal region
Hidradenitis Suppurativa
Initial lesion - Very tender, Red, inflammatory nodule/abscess that may resolve or drain purulent/seropurulent material
Unique double comedones – double blackheads
Later lesions - pus drains from opening of abscess and sinus tracts
Hidradenitis Suppurativa
What are the treatment options for Hidradenitis Suppurativa?
Supportive/Watchful Waiting - some can resolve on their own
Intralesional glucocorticoids
Surgery
Oral antibiotics - Tetracycline, Erythromycin, Minocycline
isotretinoin
