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27 Cards in this Set
- Front
- Back
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1. In whom is severe acne more prevalent?
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a. Men, due to higher levels of circulating androgens.
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2. Pathophysiology of acne vulgaris?
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a. Obstruction of sebaceous follicles (by sebum) leads to the proliferation of Pionibacterium acnes (anaerobic bacterium) in the sebum
b. This obstruction can lead to either noninflammatory comedones “pimples” or, if severe inflammatory papules and pustules. c. Both noninflammatory and Inflammatory lesions are present in most patients with acne |
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3. Risk factors for acne vulgaris?
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a. Male sex
b. Puberty c. Cushing's syndrome d. Oily complexion e. Androgens (due to any cause) f. Medications |
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4. 2 classifications of acne?
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i. Obstructive
ii. Inflammatory |
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5. Obstructive acne?
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a. Closed comedones (whiteheads) or open comedones (blackheads)
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6. Inflammatory acne?
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a. Lesions progress from papules last pustules to nodules, then cysts, then scars.
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7. Note: there is no proven link between acne and diet (e.g., chocolate, fatty foods)
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7. Note: there is no proven link between acne and diet (e.g., chocolate, fatty foods)
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8. What meds can alternatively help with acne?
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a. Oral contraceptives (especially some of the newer oral contraceptive pills)
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9. Gen. treatment guidelines for acne vulgaris?
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a. Instruct patient to:
1. Keep affected area clean (vigorous washing is unnecessary) 2. Reduce or discontinue acne promoting agents (certain makeups, creams, oils, steroids, androgens) b. It takes about 6 weeks to notice the side effects of medications (skin make it worse before it gets better) c. Start with one drug to assess efficacy. |
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10. Treatment of mild to moderate acne?
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a. Begin with topical benzoyl peroxide (2.5%)-should be applied once or twice daily
b. Add topical retinoids if the above fails. c. I topical erythromycin or topical clindamycin-both act to suppress P. acnes. |
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11. MOA of topical benzoyl peroxide?
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a. He destroys acne-causing bacteria and prevents plugging of pores by drying the skin.
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12. MOA of topical retinoids?
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a. A cause peeling of the skin, which prevents clogging of pores
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13. Treatment of moderate to severe nodular pustular acne?
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a. Prescribe systemic antibiotic therapy:
1. Tetracycline 2. Minocycline 3. Doxycycline 4. Erythromycin 5. Clindamycin 6. TMP-SMX b. At oral retinoids (e.g., isotretinoin) for severe cystic acne that is not responsive to the above treatments. |
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14. Risk with oral retinoids
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a. Oral retinoids are teratogenic
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15. Note: do not give systemic antibiotics unless the patient is already on topical benzoyl peroxide, topical tretinoin, and topical antibiotics and the response is inadequate.
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15. Note: do not give systemic antibiotics unless the patient is already on topical benzoyl peroxide, topical tretinoin, and topical antibiotics and the response is inadequate.
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16. Rosacea?
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a. A chronic condition resulting in reddening of the face (mainly the forehead, nose, and cheeks)
b. Mostly affects Caucasian women between 30-50 years of age. |
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17. Most common skin findings with rosacea?
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a. Erythema
b. Telangiectasia c. Papules d. Pustules of redness e. Unlike acne vulgaris, there are no comedones. |
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18. Presentation of severe rosacea?
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a. In severe cases, skin can become thickened and greasy
b. – on the nose, the creates a bulbous appearance c. This is called rhinophyma (mostly seen in men). |
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19. What may help reduce the symptoms of rosacea?
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a. Avoiding alcoholic or hot beverages, as well as extremes of temperature
b. Reducing emotional stressors |
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20. Treatment of rosacea?
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a. Topical metronidazole (gel form) is effective is applied BID for several months
b. Systemic antibiotics (e.g., tetracycline) are used for maintenance therapy c. If the patient does not experience an appropriate response, prescribe isotretinoin for daily use. |
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21. Seborrheic dermatitis?
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a. A chronic, idiopathic, inflammatory skin disorder
b. Very common problem (effects 5% of the population), especially in patients with oily skin. |
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22. Seborrheic dermatitis exacerbating factors?
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a. Anxiety
b. Stress c. Fatigue d. Hormonal factors |
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23. Common locations of seborrheic dermatitis?
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a. Scalp (dandruff)
b. Hair line c. Behind ears d. External ear canal e. Folds of skin around nose f. Eyebrows g. Armpits h. Under breasts i. Groin area (skin folds) |
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24. What may complicate seborrheic dermatitis?
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a. May be complicated by secondary bacterial infection.
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25. Clinical features of Seborrheic Dermatitis?
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a. Mild cases manifest as dandruff
b. Scaly patches with surrounding areas of mild to moderate erythema c. Usually asymptomatic, but pruritus can occur |
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26. Treatment of Seborrheic Dermatitis?
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a. Sunlight exposure often helps
b. Dandruff shampoo (OTC) is usually adequate c. Topical ketoconazole (to decreased yeast on the skin) has been found to be effective d. Topical steroids are appropriate in severe cases |
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27. Prognosis of Seborrheic Dermatitis?
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a. Seborrheic Dermatitis is a chronic condition with no cure
b. Therapy may be needed indefinitely for control symptoms |
