Questions and Answers
What is the main reason for the contraindication of topical steroids?
What is the common dosing for intralesional steroids such as Kenalog?
Which of the following is NOT a treatment option for severe acne?
Which factor is associated with the pathogenesis of rosacea?
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What percentage of rosacea cases are familial?
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What is a common mode of transmission for dermatophyte infections?
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Which genera of dermatophytes is known to infect the hair?
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Which of the following conditions is characterized by annular scaling patches with central clearing?
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What is the primary clinical diagnostic tool for dermatophyte infections?
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Which oral antifungal is commonly used to treat extensive or resistant dermatophyte infections?
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Which variant of Tinea Pedis is characterized by fluid-filled blisters?
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In children, what is the most common dermatophyte responsible for Tinea Capitis in the US?
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Which symptom is associated with Tinea Capitis?
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What is the primary factor influencing adolescent acne development?
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Which type of acne lesion is characterized by a dilated follicular ostium?
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Which of the following describes a primary lesion associated with acne?
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How does increased sebum production contribute to acne formation?
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Which therapeutic option is most helpful in addressing acne and discoloration concerns if used for 3 months?
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The clinical presentation of a painful rash with fever, chills, and hot swelling is most consistent with what condition?
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Which acne pattern is typically associated with the lower face and mandible region?
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In cases of cellulitis, which pathogen is most commonly responsible?
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What is a common complication associated with inflammatory acne lesions?
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What is a key characteristic of erysipelas as compared to other skin conditions?
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Which of the following factors should be considered when diagnosing acne?
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Which topical treatment is commonly utilized for bacterial skin infections?
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What type of acne lesion results from the extension of inflammation deeper into the dermis?
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Which type of scarring can occur as a result of severe acne?
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Which of the following is least likely to be associated with a painful facial rash in older adults?
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Which combined treatment option includes both a topical and an oral medication for severe acne cases?
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What is a key factor to consider in the treatment of acne?
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Which condition is characterized by painful swelling and hot feelings, along with swollen lymph nodes in adults?
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Which topical treatment is classified as an androgen receptor blocker?
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What is a significant advantage of using benzoyl peroxide concurrently with antibiotics?
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Which of the following is true regarding topical retinoids?
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What is a potential side effect of using Dapsone with benzoyl peroxide?
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Which topical treatment is known to help lighten post-inflammatory hyperpigmentation?
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What is the primary reason for subantimicrobial dosing of doxycycline?
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Which topical antibiotic is known for potentially causing bacterial resistance?
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Which of the following is NOT a characteristic of benzoyl peroxide?
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Study Notes
Acne
- Chronic inflammatory disease affecting the pilosebaceous unit, commonly seen in adolescents aged 12-25.
- Most prevalent skin condition, associated with significant physical and psychosocial impacts.
- Acne pathogenesis involves follicular hyperkeratinization, increased sebum production, bacterial proliferation (Cutibacterium acnes), and inflammation.
Acne Lesions
- Microcomedo: Plug formed by epithelial cells, sebum, and bacteria; subclinical.
- Comedones: Expansion of microcomedo leads to papule formation; can be open (blackhead) or closed (whitehead).
- Papules and pustules: Result from inflammation around the pilosebaceous unit, presenting as erythematous lesions.
- Nodules and cysts: Deeper inflammation can cause painful lesions with scarring potential.
Acne Patterns
- T-Zone: Forehead and central face, typical for early acne.
- Hormonal Acne: Lower face acne, especially along the mandibles and chin.
- Truncal Acne: Occurs on shoulders, chest, and back.
- Acne Excoriee: Result of trauma from scratching or picking.
Acne Complications
- Pigment Alterations: Includes post-inflammatory erythema and hyperpigmentation.
- Scarring Types: Atrophic, hypertrophic, and keloidal scars resulting from acne lesions.
Acne Diagnosis and Treatment Considerations
- Diagnosis is clinical, with consideration of factors like hormonal influences (e.g., PCOS) and medications (e.g., steroids).
- Treatment involves evaluating lesion types, hormonal factors, psychosocial impact, and previous treatment adherence.
Topical Treatment Options
- Topical Retinoids: Comedolytic, mildly anti-inflammatory (e.g., Tretinoin, Adapalene).
- Topical Antibiotics: Anti-inflammatory and antibacterial properties (e.g., Clindamycin, Erythromycin).
- Benzoyl Peroxide: Antibacterial and mildly comedolytic; reduces risk of bacterial resistance.
- Azelaic Acid: Antibacterial, mildly comedolytic, and improves post-inflammatory hyperpigmentation.
- Dapsone: Anti-inflammatory for moderate to severe acne, with caution of yellow staining when used with benzoyl peroxide.
- Clascoterone: Androgen receptor blocker, indicated for patients over 12.
Systemic Treatment Options
- Oral Antibiotics: Doxycycline and minocycline are effective anti-inflammatory options. Use of subantimicrobial dosing for reduced resistance.
- Intralesional Steroids: For emergencies; risk of atrophy and dyspigmentation.
Rosacea
- Chronic inflammatory disorder typically affecting adults aged 30-50; familial in 10-20% of cases.
- Pathogenesis may involve vascular dysfunction, UV light exposure, genetic factors, and immune response issues.
Dermatophyte Infections
- Caused by fungi needing keratin for survival; include Trichophyton, Microsporum, and Epidermophyton.
- Transmission methods include human-to-human, animal-to-human, soil-to-human, and fomites.
- Clinical presentations vary by infected area: Tinea Corporis (body), Tinea Pedis (feet), Tinea Capitis (scalp), etc.
Tinea Pedis
- Most common dermatophyte infection with various subtypes: interdigitial, moccasin distribution, inflammatory, ulcerative, and bullous presentations.
Tinea Capitis
- Scalp infection primarily from Trichophyton tonsurans; common in children aged 3-7, notably in children of African heritage.
- Clinical signs include scaly patches, inflammation, and posterior cervical adenopathy.
Diagnostic and Treatment Approaches
- Diagnosis based on clinical examination and KOH testing.
- Treatment for localized disease includes topical antifungals; systemic therapy for extensive cases.
- Oral antifungals such as Terbinafine or Itraconazole may be prescribed as needed.
Case Discussions
- Presented clinical cases for analysis and treatment recommendations, underscoring the importance of tailored therapeutic approaches based on patient specifics.
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Description
This quiz explores the chronic inflammatory skin condition known as acne, prevalent in adolescents. It covers the pathogenesis of acne, the types of acne lesions, and various patterns of acne presentation. By answering these questions, you will enhance your knowledge about this common skin disorder and its implications.
