Skin - Acne, Rosacea Flashcards
(17 cards)
What is acne? What are the difference types?
common inflammatory skin condition that leads to lesions that consist of
- non-inflammatory comedones
- inflammatory papules, pustules, nodules and cysts
acne vulgaris
acne conglobata
- severe form of nodulo-cystic acne with interconnecting sinuses and abscesses
acne fulminans
- very serious form of acne conglobata that is associated with systemic symptoms
What are the treatment options for acne vulgaris?
12 week course, 6-8 weeks to see effects
mild to moderate
- combined benzoyl peroxide with clindamycin
moderate to severe
- combined adapalene with benzoyl peroxide + oral lymecycline or doxycycline
- topical azelaic acid + oral lymecycline or doxycycline.
for acne of ANY severity
- adapalene with benzoyl peroxide
- tretinoin with clindamycin.
alternative antibacterial options
- trimethoprim (unlicensed) or a macrolide
Which acne treatments require the use of contraception?
adapalene
- females of childbearing potential should use effective contraception
tretinoin: highly teratogenic
- require effective contraception during and for at least 1 month after treatment.
What is the counselling points for adapalene?
avoid sun exposure
- if sun exposure is unavoidable, an appropriate sunscreen or protective clothing should be used.
to reduce the risk of skin irritation, treatment may be
- started with alternate-day or short-contact application (e.g. washing off after an hour) and progressed to standard application if tolerated
if severe irritation occurs
- the frequency of application should be reduced, or treatment temporarily discontinued or stopped altogether.
What is the counselling point for benzoyl peroxide?
avoid sun exposure
- if sun exposure is unavoidable, an appropriate sunscreen or protective clothing should be used.
to reduce the risk of skin irritation, treatment may be
- started with alternate-day or short-contact application (e.g. washing off after an hour) and progressed to standard application if tolerated
if severe irritation occurs
- the frequency of application should be reduced, or treatment temporarily discontinued or stopped altogether.
What is the MHRA warning for tretinoin?
tretinoin is highly teratogenic
- require ffective contraception during and for at least 1 month after treatment.
What is the MHRA warning for oral retinoids?
tretinoin, adapalene, tazarotene, and isotretinoin
- risk of neuropsychiatric reactions
- monitor patients for signs of depression or suicidal ideation and refer for appropriate treatment,
- patients should be advised to speak to their doctor if they experience any changes in mood or behaviour, and encouraged to ask family and friends to look out for any change in mood.
What is retinoid acid syndrome?
fever, dyspnoea, acute respiratory distress, pulmonary infiltrates, pleural effusion, hyperleucocytosis, hypotension, oedema, weight gain, hepatic, renal and multi-organ failure requires immediate treatment
When is tretinoin contraindicated?
patients with hypersensitivity to peanuts or soya (capsule filling contains soya-bean oil)
What is a red flag symptoms of tetracyclines?
lymecycline, doxycycline
headache and visual disturbances may indicate benign intracranial hypertension
- discontinue treatment if raised intracranial pressure develops
What is rosacea?
chronic skin condition
- redness (blushing) across your nose, cheeks, forehead, chin, neck and chest that comes and goes
- face may also feel warm, hot or painful
- usually lasting for a few minutes each time
- a burning or stinging feeling when using water or skincare products
other symptoms
- dry skin, swelling (esp eyes), thickened skin (mainly on nose)
What are the treatment options for rosacea?
brimonidine tartrate
- facial erythema in rosacea
topical azelaic acid, ivermectin or metronidazole
- pustules and papules of rosacea
oral oxytetracycline or tetracycline, or erythromycin
- 6-12 weeks course, intermittently repeated
What is the MHRA warning for rosacea?
systemic cardiovascular effects
- bradycardia, hypotension, and dizziness
- avoid application to irritated or damaged skin
risk of rosacea exacerbation
- start with a small amount of gel (less than the maximum dose) for at least 1 week, then increased gradually, based on tolerability and response
What is hirsutism? What are the causes?
excess hair most often noticeable around the mouth and chin
causes
- minoxidil, corticosteroids, anabolic steroids, androgens, danazol, and progestogens, phenytoin
What is the treatment for hirsutism?
eflornithine
co-cyprindiol
*metformin - unlicensed for women with PCOS
weight loss can reduce hirsutism in obese women
What is androgenic alopecia?
hair loss condition that primarily affects the top and front of the scalp
- due to excessive response to androgens
What is treatment for androgenic alopecia?
finasteride
- for men
- 3-6 months to see effects
minoxidil
