Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
118 Cards in this Set
- Front
- Back
|
what am I:
chronic inflammatory dermatosis affecting the sebaceous gland and adjacent follicle |
acne vulgaris
|
|
|
What is the main type of acne?
|
acne vulgaris
|
|
|
What am I:
sebum plug of dilated hair follicle opening |
open comedone
|
|
|
What is another name for a blackhead
|
open comedone
|
|
|
what is another name for a whitehead
|
closed comedone
|
|
|
What am I:
sebum plug of closed hair follicle opening to skin surface |
closed comedone
|
|
|
What am I:
noninflammatory lesion |
comedone
|
|
|
What gives the blackhead a dark color?
|
melanin
|
|
|
What am I:
well defined, elevated lesion usually less than 1cm in diameter involves dermis and epidermis |
papule
|
|
|
What am I:
elevated cavity filled with purulent fluid |
pustule
|
|
|
What am I:
elevated, firm circular lesion occuring in the dermis and possibly into the hypodermis |
nodule
|
|
|
What classification am I:
comedones are the main lesions may have few papules and pustules |
mild
|
|
|
What classification am I:
10-40 papules, pustules and comedones may affect the trunk |
moderate
|
|
|
What classification am I:
greater than 40 papules, pustules and comedones has wide spread affected areas (face, chest, and back) can have occasional deep nodules |
moderately severe
|
|
|
What classification am I:
large painful nodules or pustules results in scarring smaller papules, pustules and comedones may also be present |
severe
|
|
|
What triggers inflammation associated with acne?
|
sebum production
karatinocyte sloughing P. acnes |
|
|
What increases sebum production?
|
androgens stimulation
|
|
|
What am I:
caused by increased sloughing of karatinocytes medium for P. acnes |
plugged follicle
|
|
|
What are the factors affecting acne?
|
genetics
climate diet environment stress physical activity cosmetic use hormones |
|
|
What are the medications contributing to acne?
|
Phenytoin
Isoniazid Phenobarbital Glucocorticoids Oral Contraceptives with high progestins Androgen Steroids Lithium |
|
|
What is the short term goal of acne therapy?
|
improve cosmetic appearance
|
|
|
What is the long term goal of acne therapy?
|
prevent scarring
|
|
|
How long can it take to see acne resolved?
|
8 weeks
|
|
|
True or False:
surface cleansers and scrubs can open pores and get into the follicles |
False
|
|
|
What non-drug therapy is recommended for acne treatment?
|
using gentle, non-drying cleansers while taking medications
|
|
|
What is the first line therapy for mild comedonal acne?
|
topical retinoid
|
|
|
What is the second line therapy for mild comedonal acne?
|
different topical retinoid, salicylic acid, or azelaic acid
|
|
|
What is the maintanence treatment for mild comedonal acne?
|
topical retinoids
|
|
|
What is the first line treatment for mild papular pustular acne?
|
topical retinoid and topical antimicrobial
|
|
|
What is the second line treatment for mild papular pustular acne?
|
different topical retinoid with another topical retinoid or azelaic acid
|
|
|
What is the maintenance therapy for mild papular pustular acne?
|
topical retinoid
|
|
|
What is the first line therapy for moderate papular pustular acne?
|
oral antibiotics plus topical retinoid with or without benzoyl peroxide
|
|
|
What is the second line treatment for moderate papular pustular?
|
differnt oral antibiotic plus another topical retinoid with or without benzoyl peroxide
|
|
|
Other than the first line therapy, what is an alternative therapy specifically for women with moderate papular pustular acne?
|
oral antiandrogen plus topical retinoid/azelaic acid
with or without topical antimicrobials |
|
|
What is the maintenance therapy for moderate papular pustular acne?
|
topical retinoids with or without benzoly peroxide
|
|
|
What is the first line treatment for moderate nodular acne?
|
oral antibiotic plus topical retinoid
with/without benzoyl peroxide |
|
|
What is the second line treatment for moderate nodular acne?
|
oral isotretinoin or another oral antibiotic plus another topical retinoid
with or without benzoyl peroxide/azelaic acid |
|
|
What is the maintenance therapy for moderate nodular acne?
|
topical retinoid with or without benzoyl peroxide
|
|
|
Other than the first line therapy, what isn an alternate therapy specifically for women with moderate nodular acne?
|
oral antiandrogen plus topical retinoid
with or without another topical retinoid |
|
|
resolve
|
decide; solve, settle, clear up; remove, annul; resolve, figure out
|
|
|
What is the second line therapy for severe acne?
|
oral antibiotic plus topicial retinoid and benzoyl peroxide
|
|
|
What is the maintenance therapy for severe acne?
|
topical retinoid with or without benzoyl peroxide
|
|
|
Other than the first line treatment, what other treatment is specifically for women with severe acne?
|
oral antiandrogen plus topical retinoid
with or without another topical antimicrobial |
|
|
What does adding benzoyl peroxide to the treatment of acne prevent?
|
P. acnes resistance
|
|
|
Topical retinoids, benzoyl peroxide, and antibiotics are considered what level of evidence?
|
level 1
|
|
|
systemic isotretinoin, tetracycline, macrolides, and bactrim are considered what level of evidence?
|
level 1
|
|
|
contraceptive agents are considered under what level of evidence?
|
level 1
|
|
|
spironolactone, antiandrogens, and oral corticosteroids fall under what level of evidence?
|
level 2
|
|
|
Intralesional steroids, chemical peels, and comedo removal fall under what level of evidence?
|
level 3
|
|
|
What am I:
OTC bactericidal agent with comedolytic activity increases sloughing rate of epithelia and loosens follicular plug has no known P. acnes resistance |
benzoyl peroxide
|
|
|
How should benzoyl peroxide be applied?
|
apply to cool, clean, dry skin no more than BID
start with Q48H, then to daily, then to BID |
|
|
When should benzoyl peroxide be discontinued?
|
if excessive irritation occurs
|
|
|
What are the side effects of benzoyl peroxide?
|
irritation
bleaching of hair and fabrics |
|
|
When should improvement be checked after continuous use of benzoyl peroxide?
|
~ 6 weeks
|
|
|
salicylic acid and sulfur and resorcinal are considered as this type of agent
|
karatolytics
|
|
|
What is less irritating?
a. benzoyl peroxide b. tretinoin c. keratolytics |
c. keratolytics
|
|
|
This topical therapy is a keratolytic agent with mild antibacterial properties
|
sulfur and resorcinol
|
|
|
What drug am I:
alternative topical agent have comedolytic, antiinflammatory and anitbacterial properties has skin lightening properties can try in patients who don't tolerate benzoyl peroxide ineffective in acne treatment |
azelaic acid
|
|
|
What drug am I:
alternative topical therapy only to be used in patients with severe inflammatory acne and only for short periods of time |
topical corticosteroids
|
|
|
What drug am I:
alternative topical agent that may help to reduce scarring and hyperpigmentation |
light chemical peels
|
|
|
What drug am I:
alternative topical agent with anitbacterial and antiinflammatory properties FDA approved for acne treatments in patients older than 12yrs |
topical dapsone 5% gel
|
|
|
List the alternative topical therapies
|
keratolytics
azelaic acid sulfacetamide topical corticosteroids light chemical peels topical dapsone |
|
|
Tretinoin, adapalene, and tazarotene fall under what drug category?
|
topical retinoids
|
|
|
What drug am I:
topical Vitamine A anlagoue topical retinoid |
tretinoin
|
|
|
What is the MOA of tretinoin?
|
increase cell turnover and decrease cell cohesiveness
extrudes existing comedones and inhibits formation of new comedones |
|
|
How should tretinoin be administered?
|
tirtrate frequency and dose up slowly to improve tolerance
may be used with antibiotics or benzoyl peroxide |
|
|
How long may it take before you see improvement in acne with tretinoin?
|
8-12 weeks
|
|
|
What is more irritating?
a. 0.05% solution of tretinoin b. 0.1% cream of tretinoin |
a. 0.05% solution of tretinoin
|
|
|
What drug am I:
3rd generation retinoid |
adapalene
|
|
|
True or False:
0.25% tretinoin gel is better tolerated than 0.1% adapalene gel |
False
|
|
|
True or False:
adapalene has less skin irritation and discoloration than other 1st generation topical tretinoins |
True
|
|
|
What drug am I:
synthetic acetylenic retinoid prodrug |
tazarotene
|
|
|
Which topical retinoid has a pregnancy category X?
|
tazarotene
|
|
|
What is the mechanism of tazarotene?
|
comedolytic, keratolytic and antiinflammatory
|
|
|
True or False:
0.25% tretinoin gel is better tolerated than 0.1% adapalene gel |
False
|
|
|
True or False:
adapalene has less skin irritation and discoloration than other 1st generation topical tretinoins |
True
|
|
|
What drug am I:
synthetic acetylenic retinoid prodrug |
tazarotene
|
|
|
Which topical retinoid has a pregnancy category X?
|
tazarotene
|
|
|
What is the mechanism of tazarotene?
|
comedolytic, keratolytic and antiinflammatory
|
|
|
How should tazarotene be administered?
|
use daily
use short contact applications to minimize peri-lesional irritation |
|
|
If administering tazarotene, when should pregnancy tests be done?
|
2 weeks before starting tazarotene
then every month while use tazarotene |
|
|
What antibiotics are available topically for the treatment of acne?
|
erythromycin
clindamycin |
|
|
Which topical antibiotic is only effective against inflammatory acne?
|
erythromycin (1-4%)
|
|
|
Which topical antiboitic inhibits P. acnes, has antiinflammatory and comedolytic effects?
|
clindamycin
|
|
|
What are the side effects of topical clindamycin?
|
rare diarrhea and colitis
|
|
|
How long is benzaclin-compound good for?
|
3 months
|
|
|
What type of dosage form can a patient with normal to dry skin tolerate?
|
creams and lotions
|
|
|
What type of dosage form can a patient wth normal skin tolerate?
|
gels, solutions, lotions, and creams
|
|
|
What type of dosage form can a patient with normal to oily skin tolerate?
|
gels, solutions and lotions
|
|
|
What are the most common side effects of topical treatment of acne?
|
burning
peeling dryness irritation erythema |
|
|
What type of acne are tetracyclines use for?
|
moderate to severe and resistanct forms of inflammatory acne
|
|
|
What are the side effects of tetracycline as a class?
|
candidiasis
GI upset photosensitivity (use sunscreen) resistant bacteria tooth discoloration inhibition of skeletal growth |
|
|
In what population should the use of tetracyline be avoided in?
|
pregnant women
children under 10 |
|
|
Which tetracylcine am I:
more effective than tetracycline greater lipid solubility and tissue penetration an amino acid side chain |
minocycline
|
|
|
What is the dose of minocycline for acne treatment?
|
100mg daily or 50mg BID
|
|
|
What are the side effects of minocycline?
|
serum sickness-like reactions
discoloration of skin, nail, and bone hepatitis lupus-like syndrome cutaneous hyperpigmentation more severe than tetratcycline |
|
|
Which tetracycline drug am I:
more effective and cause less resistance than tetracyline less severe side effects |
doxycycline
|
|
|
What are the side effects of doxycycline?
|
resistant bacteria
folliculitis candidiasis GI upset phototoxicity |
|
|
What is the dose of doxycycline for acne treatment?
|
100-200mg daily
take 30min before meals to increase effectiveness |
|
|
Which tetracycline am I:
least effective inexpensive |
tetracycline
|
|
|
How should tetracycline be taken?
|
500mg BID 1 hour before meals (on empty stomach)
decrease to 500mg daily after 1-2 months if acne improves continue therapy for 1-2 months |
|
|
What class of drugs should the use of tetracyclines not be used with due to an increased risk for developing intracranial hypertension?
|
retinoids
|
|
|
What type of acne are macrolides use for?
|
moderate papular pustular/nodular acne
|
|
|
What type of antibiotics are erythromycin and azithromycin?
|
macrolides
|
|
|
What type of acne are systemic isotretinoins use for?
|
severe recalcitrant nodular acne
|
|
|
What is the agent of choice for severe recalcitrant nodular acne?
|
systemic isotretinoin
|
|
|
Which of the following are not side effects of isotretinoin?<BR><BR>excessive drying of mucosa<BR>joint/muscle pain<BR>alopecia<BR>hypertriglyceridemia<BR>photosensitivity<BR>mood changes/suicidal ideation<BR>MI/stroke
|
MI/stroke
|
|
|
What are the relative contraindications of isotretinoin?
|
hyperlipidemia
diabetes mellitus severe osteoporosis |
|
|
What am I:
an oral potent teratogen used for severe acne |
oral isotretinoin
|
|
|
What acne drug requires participation in iPledge?
|
isotretinoin
|
|
|
What requirements must women meet in order to use isotretinoin as a treatment for acne?
|
have 2 negative pregnancy test before starting therapy
have a negative pregnancy test each month before receivng prescription select and commit to using 2 forms of contraception 1 month prior to starting and 3 months after stopping sign a consent form be counseled and documented on iPledge each month |
|
|
What am I:
systemic treatment with anti-androgen and decreased sebum production effects; contain estrogena nd progestrin |
estrogen-contaning oral contraceptives
|
|
|
What are the side effects of oral contraceptives?
|
N/V
breast tenderness headache breakthrough bleeding weight gain thromboembolism |
|
|
What is contraindicated in oral contracptives?
|
pregnancy
|
|
|
Which 2 oral contraceptives that are FDA approved for the treatment of acne?
|
norgetimate with ethinyl estradiol
norethindrone acetate with ethinyl estradiol |
|
|
What am I:
an antibiotic second line treatment for acne when other antibiotics cannot be used |
bactrim
|
|
|
What am I:
Second line treatment of acne with anti-androgen and 5a-reductase inhibition activity. Also reduce sebum production. |
spironolactone
|
|
|
What am I:
second line treatment of acne have antiinflammatory effects indicated for patienst with adrenal hyperandrogenism or acne fulminans |
oral corticosteroids
|
