SM_264a: Acne, Rosacea, and Related Disorders Flashcards Preview

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Flashcards in SM_264a: Acne, Rosacea, and Related Disorders Deck (46)
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1

Acne pathogenesis involves ____, ____, ____, and ____

Acne pathogenesis involves follicular epidermal hyperproliferation, excess sebum production, inflammation (IL-1), and Cutibacterium acnes

 

 

(cells become abnormally adherent, excess sebum, increased pro-inflammatory cytokines, bacteria)

2

Sebum production is regulated by ____ and involves ____

Sebum production is regulated by androgens and involves androgen receptors

 

 

(holocrine secretion as the sebaceous gland matures - contents go into sebaceous gland and then sebaceous duct)

3

Describe Cutibacterium acnes

Cutibacterium acnes

  • Gram +, anaerobic, microaerobic
  • Resident flora of follice
  • Acne patients have more than controls
  • Promotes inflammation: antibodies to cell wall activate complement, produces lipases / proteases / hyaluronidases, binds TLR2 increasing proinflammatory cytokines

(feeds off sebum)

4

This is a ____

This is a closed comedone

 

(non-inflammatory, palpable)

5

This is an _____

This is an open comedone 

 

(clinically inflammed lesions - raised, elevated, red)

6

This is an ____

This is an acne papule

 

(dilation of follicle, extrustion of material in follice into dermis, nodules)

7

This is an ____

This is an acne pustule

8

This is an ____

This is an acne nodule (and cysts)

9

These are ____

These are acne sinus tracts

10

This is ____

This is post-inflammatory hyperpigmentation

11

This is ____

This is acne scarring

 

(boxcar scars, rolling scars, no medication can reduce scarring)

12

This is ____ acne

This is drug-induced acne 

13

This is acne related to ____

This is acne related to polycystic ovary syndrome

 

(hyperandrogenism due to increased levels or increased sensitivity to androgen)

14

This is ___

This is acne fulminans

 

(sudden onset of very severe acne, can have systemic symptoms, acne + arthritic symptoms)

15

Describe acne treatment

Acne treatment

  • Early
  • Adequately aggressive for severity
  • Algorithmic approach
  • Target pathogenic factors: often involves combined topicals and orals
  • Patient education is critical

16

___ are first line treatment for comedonal acne

Retinoids are first line treatment for comedonal acne

 

(tretinoin, adapalene, tazarotene)

17

Inflammatory acne topic treatment involves ____ and ____

Inflammatory acne topic treatment involves retinoids and benzoyl peroxide

 

(no resistance to benzoyl peroxide, also antibiotics such as clindamycin, dapsone, and sodium sulfacetamide and sulfur)

18

Describe systemic treatment of acne

Systemic treatment of acne

  • Moderate to severe inflammatory
  • Minocycline > doxycycline >> tetracycline
  • Sarecycline: antimicrobial, anti-inflammatory, reduces free fatty acid levels
  • Erythromycin (pregnancy, kids < 8 yo)
  • TMP/SMX
  • Isotretinoin: reduces sebum production, decreases androgen synthesis, induces cell cycle arrest and apoptosis in sebocytes

19

____ is used with antibiotics to minimize resistance

Benzoyl peroxide is used with antibiotics to minimize resistance

20

____ is first line treatment for acne fulminans

Isotretinoin is first line treatment for acne fulminans

21

Hormonal therapy of acne involves ____ and ____

Hormonal therapy of acne involves combination birth control pills and spironolactone

 

  • Combination birth controls: decrease LH and androgen production, increase hepatic sex-hormone binding globulin levels which decreases free testosterone levels
  • Spironolactone: androgen receptor blocker, 5alpha-reductase inhibitor

22

____ is the main indication for hormonal therapy of acne

Hyperandrogenemia is the main indication for hormonal therapy of acne

23

___ is used to generate reactive oxygen species to destroy acne

Photodynamic therapy is used to generate reactive oxygen species to destroy acne

24

Rosacea pathogenesis involves ____, ____, and ____

Rosacea pathogenesis involves neurovascular instability and increased reactivity, innate immunity abnormality, and inflammation of follicle and surrounding dermis

 

(inflammatory signaling, vascular signaling and response leading to hyperreactivity of vessels, sensory response, exogenous triggers, and endogenous risk factors)

25

____ are found on the skin in increased amounts in rosacea due to increased amounts of ____

Cathelecidins are found on the skin in increased amounts in rosacea due to increased amounts of demadex mites

 

(cathelecidins are antimicrobial peptides)

26

27

This is ____ rosacea

This is erythematotelangiectatic rosacea

28

This is ____ rosacea

This is papulopustular rosacea

29

This is ____ rosacea

This is phymatous rosacea

 

(on nose, brow, and cheek)

30

This is ____ rosacea

This is ocular rosacea

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