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2nd shift lecs > anti acne > Flashcards

anti acne Flashcards

1
Q

Common dermatological disorder of the pilosebaceous unit

A

acne

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2
Q

Sebaceous gland attached to a hair follicle

A

acne

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3
Q
  • Sebum
  • Androgens
  • Hyperkeratinization
  • Propionibacterium acnes
  • Inflammation, immune reaction
A

contributing factors to acne

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4
Q

contributes to increased sebum

A

androgens

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5
Q

Excess keratin is not sloughed off

A

Hyperkeratinization

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6
Q

Accumulation of keratin and sebum provide a good medium for P. acnes
proliferation

A

Propionibacterium acnes

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7
Q

P. acnes is a bacteria → Immune response → Inflammation

A

inflammation, immune reaction

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8
Q
  1. Early comedo
  2. Later comedo
  3. Inflammatory papule/pustule
  4. Nodule/cyst
A

pathogenesis

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9
Q
  • Hyperkeratosis and ↑ corneocytes cohesiveness
    in the upper sebaceous follicle, which lead to
    microcomedo formation
  • Androgen stimulation of sebum production
A

Early comedo

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10
Q
  • Accumulation of shed keratin and sebum
  • Formation of whorled lamellar concretions
A

Later comedo

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11
Q

Comedo may be:

A
  • Closed/whiteheads (no obvious follicular opening)
  • Open/blackheads (dilated follicular opening; keratin plug darkens due to oxidized lipids & melanin)
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12
Q
  • P. acnes proliferation, which upregulated innate immune responses (e.g. via TLRs)
  • Mild inflammation (primary neutrophils), which increases upon rupture of the comedo wall
  • Sebaceous lobule regression
A

Inflammatory papule/pustule

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13
Q
  • Marked inflammation (primarily T cells)
  • May lead to scarring
A

Nodule/cyst

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14
Q

Types of acne

A
  • non-inflammatory lesions
  • inflammatory lesions
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15
Q

Consists of open and closed comedones, which are not inflamed and red because follicle walls are intact

A

NON-INFLAMMATORY LESIONS

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16
Q
  • Known as open comedones
  • Follicles that have wider openings filled with sebum and dead cells
  • Dark color caused by exposure of the top of the comedo to oxygen (oxidized)
A

Blackheads

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17
Q
  • Known as closed comedones
  • Follicle opening is closed, and have normal skin color
    >Traps dead cells and sebum
  • More likely to progress into inflammatory lesion
A

Whiteheads

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18
Q
  • Closed comedo becomes larger and packed due to
    debris and inflammation from P. acnes
  • When follicle ruptures, white blood cells and red blood cells migrate to contain rupture, and lesion turns red
A

INFLAMMATORY LESIONS

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19
Q

INFLAMMATORY LESIONS

A
  1. Papules
  2. Pustules
  3. Nodule
  4. Cyst
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20
Q
  • First stage of severe acne
  • Primary inflammatory lesions
    >Slightly inflamed
  • Small, raised, usually red, and tender bumps under the skin
    >Tender bumps - slight pain with touch
A

Papules

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21
Q
  • Also called pimple
  • Red, tender bumps with white pus at the tip
    >Pus - presence of bacteria
A

Pustules

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22
Q

Deep lesion that are hard to touch, more painful, and deep red, or purple in color

A

Nodules

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23
Q
  • Large pus-filled lesion resulting from severe
    inflammatory reaction
  • Final stage
  • May leave scars
A

Cyst

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24
Q

Grading of Acne

A
  1. Mild acne
  2. Moderate acne
  3. Severe acne
25
Q
  • Limited to face
  • Characterized by presence ofnon-inflammatory closed and open comedones with few inflammatory lesions
A

Mild acne

26
Q
  • Increased number of inflammatory papules and
    pustules on the face and affects other body
    parts
    >Back, neck, and chest area also
A

Moderate acne

27
Q
  • Presence of nodules and cysts
  • Facial lesions accompanied by widespread disease on the neck, chest, and back
A

Severe acne

28
Q

TOPICAL TREATMENTS

A
  • Benzoyl peroxide (BPO)
  • Salicylic acid (SA)
  • Resorcinol and sulfur
  • Topical retinoids
  • Topical antibiotics
  • Azelaic acid
29
Q
  • Non-antibiotic antimicrobial agent that kill bacteria by producing reactive oxygen species within clogged pores
    > oxidation reaction
  • Increases cell turnover, cleans pores, desquamates skin, and has anti -inflammatory properties
  • Mainstay treatment of mild to moderate acne, in combination with antibiotics and/or retinoids
  • Topical OTC at 2.5 to 10% concentration as creams, gels, lotions, and facial wash
  • Irritation resolves with continued use trying 1st
    month of treatment
A

Benzoyl peroxide (BPO)

30
Q
  • Peeling - important to use sunblock to protect the skin
  • Dryness,
  • Burning,
  • Redness of the skin
A

Side effects of Benzoyl peroxide (BPO)

31
Q
  • Can be used in cosmetics (depends on concentration); known as beta hydroxy acids
  • Desquamation and comedolytic properties
  • Less potent and better tolerated than topical retinoids
  • OTC products at concentrations of 0.5 to 2% as lotions, creams, foams, facial wash gels, toners,
    and cleansing pads
  • Peeling occurs because it desquamates
A

Salicylic acid (SA)

32
Q
  • Skin dryness,
  • Redness,
  • Scaling,
  • Itching,
  • Burning
A

Salicylic acid (SA)
side effects

33
Q
  • Available as creams, masks, ointments, and soap bars
  • Can also cause peeling (sulfur cannot cause
    peeling)
  • Sulfur - antibacterial
A

Resorcinol and sulfur

34
Q
  • Vitamin A derivatives that normalize abnormal desquamation in sebaceous follicles, decrease
    coherence of follicular keratinocytes, and
    prevent formation of new microcomedones
  • May be used as monotherapy for the
    management of mild noninflammatory
    comedonal acne with maximum benefit after 3
    to 4 months, and as maintenance therapy
  • Include tretinoin, adapalene, tazarotene (drugs)
  • Prescription drug available as cream, gel, liquid, and microsphere formulations
  • Negative effects can be prevented by using lower concentrations of active ingredients or modifying the vehicle
A

retinoids

35
Q
  • Transient skin irritation
  • Burning sensation,
  • Redness,
  • Itching, and
  • Peeling
A

side effects of retinoids

36
Q
  • Used for mild or moderate acne with inflammatory lesions
  • Include clindamycin and erythromycin
  • With bacteriostatic and anti-inflammatory
    properties
  • Available as gels, creams, lotions, foams,
    toners, and pads
  • Continuous use can cause bacterial resistance
A

Topical antibiotics

37
Q
  • BPO/Benzoyl Peroxide (minimize bacterial resistance) and
  • Retinoids (synergistic comedolytic and anti-inflammatory properties)
A

Combined with topical antibiotics

38
Q
  • Considered as a drug
  • Alternative to retinoids
  • With comedolytic, antimicrobial, and anti-inflammatory properties
A

Azelaic acid

39
Q
  1. Oral antibiotics
  2. Hormonal therapy
  3. Isotretinoin
A

SYSTEMIC TREATMENTS

40
Q
  • With antimicrobial and anti-inflammatory effects
  • Include doxycycline, minocycline, tetracycline,
    and erythromycin
A

Oral antibiotics

41
Q
  • Upset stomach,
  • Dizziness, or
  • Skin discoloration
A

Side effects of oral antiobiotics

42
Q

may cause sun sensitivity

A

Doxycycline

43
Q

can cause teeth discoloration

A

Tetracycline

44
Q

can cause skin
hyperpigmentation

A

Minocycline

45
Q
  • Adjunct therapy in women with moderate to severe acne
  • Reduces and/or prevents outbreaks, but not effective for existing lesions
    >Can be combined with topical products to address existing lesions
A

Hormonal therapy

46
Q
  • Combination oral contraceptives suppress ovarian androgen production
  • Androgen receptor blockers block effect of androgens on the sebaceous
    gland (spironolactone, cyproterone, and flutamide)
A

Hormonal therapy

47
Q
  • Headache,
  • Breast tenderness,
  • Nausea
  • Depression
A

Side effects of hormonal therapy

48
Q
  • Heart disease,
  • High blood pressure,
  • Blood clots
A

increased risks of

49
Q
  • Diff from tretinoin (all-trans retinoic acid)
  • Oral retinoid for treatment of moderate to severe acne that does not respond to other treatments
    >last line therapy
  • Targets all major components in acne
    development, and may be used as monotherapy
A

Isotretinion

50
Q
  • Dryness of skin, eyes, mouth, lips, and nose;
  • Itching;
  • Nosebleeds;
  • Muscle aches;
  • Sun sensitivity;
  • Poor night vision
A

Side effects of isotretinoin

51
Q

May increase:
- Blood levels of triglycerides
and cholesterol
- Liver enzyme levels

Teratogenic
- cause malformation of developing fetus

A

Isotretinion

52
Q
  1. Chemical peels
  2. Comedo extraction
  3. Optical therapies
  4. Herbal and alternative therapies
  5. Dietary restriction
A

OTHER TREATMENTS

53
Q
  • AHAs desquamate the SC and give a smoother
    appearance
  • Glycolic acid has moderate growth inhibitor and
    bactericidal effect on P. acnes
A

Chemical peels

54
Q

By squeezing with fingertips and using a comedo extractor

A

Comedo extraction

55
Q

Exposure to electromagnetic radiation to facilitate treatment

A

Optical therapies

56
Q
  • Broad-spectrum continuous-wave visible light,
  • Intense pulsed light,
  • Pulsed dye lasers,
  • Photodynamic therapy (PDT),
  • Pulsed diode laser
A

Optical therapies

57
Q
  • Aloe vera,
  • Fruit-derived acids, and
  • Tea tree oil
A

Herbal and alternative therapies

58
Q
  • Less oil
  • Dairy
  • Added sugars
  • Peanuts
A

dietary restrictions

59
Q
  1. Use all of the medicine in your treatment plan
  2. Reduce acne flares with gentle skin care
  3. Keep all follow-up appointments with your
    dermatologist
  4. Follow your maintenance plan
A

4 WAYS TO REDUCE HOW LONG YOU TAKE AN ANTIBIOTIC

2nd shift lecs (21 decks)

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