Acne Vulgaris Overview
45 Questions
3 Views

Choose a study mode

Play Quiz
Study Flashcards
Spaced Repetition
Chat to lesson

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What is the recommended starting percentage for topical benzoyl peroxide to minimize irritation?

  • 6%
  • 4% (correct)
  • 8%
  • 2%

    • What is one of the common side effects of doxycycline?

  • Photosensitivity (correct)
  • Renal insufficiency
  • Hyperkalemia
  • Irregular menses

    • Which type of patients is oral antibiotics recommended for?

  • Females over 35
  • Patients allergic to all antibiotics
  • Individuals under 8 years old
  • Patients with moderate to severe acne (correct)

    • Which hormonal option is known to inhibit ovarian androgen production?

    <p>Oral contraceptive pills</p> Signup and view all the answers

    What is a contraindication for the use of spironolactone?

    <p>Renal insufficiency</p> Signup and view all the answers

    How often should potassium levels be monitored in patients taking spironolactone?

    <p>Every 3-6 months</p> Signup and view all the answers

    What is a common side effect of minocycline?

    <p>Hyperpigmentation of scars</p> Signup and view all the answers

    Which contraceptive is FDA-approved for the treatment of acne?

    <p>Yaz</p> Signup and view all the answers

    What contributes to the effectiveness of combining topical antibiotics with benzoyl peroxide?

    <p>Reduction of bacterial resistance</p> Signup and view all the answers

    In which situation do the risks of hormonal treatment outweigh the benefits?

    <p>Age over 35 and smoker</p> Signup and view all the answers

    What age range sees the highest percentage of people affected by Acne Vulgaris?

    <p>12-24 years</p> Signup and view all the answers

    Which factor is primarily responsible for the increased oil production in Acne Vulgaris?

    <p>Increased sebum production</p> Signup and view all the answers

    How does Propionibacterium acnes contribute to Acne Vulgaris?

    <p>By thriving in an oily environment</p> Signup and view all the answers

    What role do inflammatory mediators such as IL-1 and TNF-alpha play in Acne Vulgaris?

    <p>They induce inflammation</p> Signup and view all the answers

    Which of the following is a recommended action when consulting with a patient suffering from Acne Vulgaris?

    <p>Inquire about their current skincare regimen</p> Signup and view all the answers

    What demographic shows the prevalence of Acne Vulgaris in adults?

    <p>15-35% of adults</p> Signup and view all the answers

    Which lifestyle factor is specifically noted to have a mild association with increased acne incidence?

    <p>High skim milk intake</p> Signup and view all the answers

    What is the recommended frequency for applying topical retinoids when starting treatment for acne?

    <p>Every other night</p> Signup and view all the answers

    Which of the following triggers can aggravate Acne Vulgaris?

    <p>Certain medications like anabolic steroids</p> Signup and view all the answers

    Which type of acne is typically treated with topical antimicrobials?

    <p>Mild to moderate inflammatory acne</p> Signup and view all the answers

    Which of the following statements is true about abnormal keratinization in Acne Vulgaris?

    <p>It contributes to thicker and stickier skin cells</p> Signup and view all the answers

    What is the main action of topical retinoids in acne treatment?

    <p>Comedolytic, decreases hyperproliferation, and has anti-inflammatory effects</p> Signup and view all the answers

    What psychosocial repercussions can result from suffering from Acne Vulgaris?

    <p>Depression and anxiety</p> Signup and view all the answers

    Which of the following is a contraindication for using topical retinoids?

    <p>During the first trimester of pregnancy</p> Signup and view all the answers

    What is the recommended moisturizer for acne patients to apply in the evening?

    <p>A non-comedogenic moisturizer</p> Signup and view all the answers

    Which area is NOT typically examined during the physical evaluation of acne vulgaris?

    <p>Scalp</p> Signup and view all the answers

    How should patients wash their face when treating acne?

    <p>With warm water twice a day</p> Signup and view all the answers

    What is a common side effect of topical antimicrobials?

    <p>Dryness and redness</p> Signup and view all the answers

    What is the main goal of using a moisturizer with SPF 30+ in the morning?

    <p>To prevent post-inflammatory hyperpigmentation (PIH)</p> Signup and view all the answers

    Which of the following is a recommended gentle cleanser for acne management?

    <p>CeraVe</p> Signup and view all the answers

    What is the primary mechanism through which oral retinoids work on acne?

    <p>Decreasing sebaceous gland size</p> Signup and view all the answers

    Which patient demographic is typically prescribed isotretinoin?

    <p>Individuals with moderate-severe or recalcitrant acne</p> Signup and view all the answers

    Which of the following is a common side effect of oral retinoids?

    <p>Cheilitis</p> Signup and view all the answers

    What is a key contraindication for the use of isotretinoin?

    <p>Pregnancy or intention to become pregnant</p> Signup and view all the answers

    What monitoring is required for all patients taking oral isotretinoin?

    <p>Lipid panels and liver function tests</p> Signup and view all the answers

    What is the cumulative dose range for isotretinoin treatment?

    <p>120-150 mg/kg</p> Signup and view all the answers

    Which treatment is typically added for moderate acne management?

    <p>Oral antibiotics and topical retinoids</p> Signup and view all the answers

    Why are female patients prescribed isotretinoin required to use two forms of birth control?

    <p>Due to the risk of craniofacial and cardiac defects</p> Signup and view all the answers

    What category of acne is typically treated with topical retinoids?

    <p>Moderate and mild acne</p> Signup and view all the answers

    Which behavior is recommended to avoid while taking isotretinoin?

    <p>Avoiding alcohol</p> Signup and view all the answers

    Match the following types of acne with their descriptions:

    <p>Comedonal Acne = Characterized by open or closed comedones (blackheads and whiteheads) Inflammatory Acne = Includes papules and pustules with redness and swelling Cystic Acne = Severe form of acne that results in painful, deep cysts Hormonal Acne = Often occurs in relation to hormonal changes, commonly seen in women</p> Signup and view all the answers

    What is a common contributing factor to the development of Acne Vulgaris?

    <p>Hormonal changes</p> Signup and view all the answers

    What is the primary cause of acne vulgaris?

    <p>Hormonal changes</p> Signup and view all the answers

    What are common causes of Acne Vulgaris? (Select all that apply)

    <p>Hormonal changes</p> Signup and view all the answers

    What is a common cause of Acne Vulgaris?

    <p>Hormonal changes</p> Signup and view all the answers

    Study Notes

    Acne Vulgaris

    • A common pilosebaceous disorder affecting 85% of people aged 12-24 and 15-35% of adults.
    • Clinical presentations range from mild comedonal acne to severe nodulocystic acne.
    • Psychosocial repercussions, including depression, anxiety, and social withdrawal, should be considered.

    Pathogenesis

    • (Diagram showing stages from microcomedo to nodule/cyst)

    Acne Vulgaris: 4 Main Factors

    1. Abnormal Keratinization

    • Keratinocytes proliferate too rapidly.
    • Keratinocytes are more cohesive and thicker than normal.
    • Top layer of skin cells are thicker and stickier than normal.

    2. Increased Sebum Production

    • Increased androgen levels cause increased sebum production.
    • "A change in hormones causes more oil production."

    3. Propionibacterium acnes Overgrowth

    • P. acnes loves an oily environment.
    • The bacteria loves the excess oil.

    4. Inflammation

    • P. acnes activate toll-like receptor 2 on keratinocytes and macrophages.
    • This causes a release of inflammatory mediators (IL-1, IL-8, IL-12, TNF-alpha).
    • Increased bacteria causes inflammation.

    Additional Triggers

    • Stress
    • Personal care products (foundations, hair spray, pomades) are recommended to use mineral-based, noncomedogenic products.
    • Mechanical triggers (sports gear, masks, musical instruments)
    • Medications (anabolic steroids, prednisone, bromides, lithium, progesterone-only contraceptives).
    • Diet (mild association between skim milk intake and increased acne; recommend healthy, whole foods and decrease sugar intake).

    Acne Vulgaris: Evaluation and Treatment

    History

    • Sex (consider transgender identity).
    • Age.
    • Lifestyle, hobbies, occupation.
    • Current and previous treatments (including OTC products).
    • Use of personal care products.
    • Menstrual history, birth control.
    • Medications.
    • Family history of acne.

    Physical Exam

    • Distribution of acne (face, neck, chest, back, upper arms).
    • Degree of involvement (mild, moderate, severe).
    • Lesion morphology (comedones, inflammatory papules and pustules, nodules and cysts, scarring).

    Acne Vulgaris: Treatment

    • Wash face with warm water twice daily (CeraVe, Cetaphil, Vanicream).
    • Depending on type of acne use benzoyl peroxide, sulfur, or salicylic acid washes.
    • Apply moisturizer with SPF 30+ every morning.
    • Apply non-comedogenic moisturizer in the evening after washing/applying topical treatments.

    Topical Retinoids

    • How: comedolytic, decreases hyperproliferation, has anti-inflammatory effects.
    • Who: works well for comedonal acne to moderate-severe inflammatory acne.
    • When: every other night, gradually increasing to nightly.
    • Contraindicated in pregnancy.
    • Side effects: redness, dryness, photosensitivity, retinoid dermatitis.
    • Examples: Retin-A, Tretinoin, Adapalene.

    Topical Antimicrobials

    • How: decreases P. acnes.
    • Who: appropriate for mild to moderate inflammatory acne.
    • When: once or twice daily, depending on the type and severity.
    • Side effects: dryness, redness, irritation.
    • Examples: Benzoyl Peroxide (BPO), Clindamycin 1% lotion.

    Oral Antibiotics

    • How: anti-inflammatory at lower doses, antimicrobial at higher doses.
    • Who: patients over 8 years with moderate-to-severe acne, especially if back, chest, or arms are involved.
    • When: once or twice daily, typically used for 3-6 months.
    • Examples: Tetracyclines (Doxycycline or Minocycline).
    • Side effects: GI issues, photosensitivity, hyperpigmentation, discoloration of teeth, vertigo.
    • Contraindicated in pregnancy and under 8 years old. Alternatives: Azithromycin, erythromycin, or bactrim if allergies exist.

    Hormonal

    • How: inhibits ovarian androgen production, decreasing sebum production.
    • Who: females with acne on the jawline, flares with menstruation.
    • When: once daily.
    • Examples: OCPs (Ortho Tri-Cyclen, Yaz, Estrostep).
    • Contraindications: risks outweigh benefits if over 35 and a smoker; history of HTN, diabetes, venous thromboembolism, ischemic heart disease, stroke, current breast cancer, or other malignancy.

    Antiandrogen (Oral)

    • How: androgen antagonist, decreases sebum production.
    • Who: hormonal acne, typically females with jawline acne.
    • When: 50-200 mg/day.
    • Example: Spironolactone.
    • Contraindications: renal insufficiency, hyperkalemia, pregnancy, and history of breast cancer.
    • Side effects: urinary frequency, orthostatic hypotension, hyperkalemia, irregular menses, breast tenderness, gynecomastia
    • Potassium monitoring, if needed, should be done every 3-6 months.

    Oral Retinoid

    • How: works on all components of acne, decreases the size of sebaceous glands.
    • Who: moderate-to-severe acne, or recalcitrant acne.
    • When: daily for 6 months approximately (0.5-1 mg/kg/day; cumulative dose 120-150 mg/kg).
    • Example: Isotretinoin ("Accutane").
    • Side effects: cheilitis, mucosal dryness (nose/eyes), xerosis, headaches, slow healing.
    • Contraindications: pregnancy, intending to become pregnant, hypertriglyceridemia, history of severe depression, personal or family history of IBD.

    Oral Isotretinoin

    • Teratogen—craniofacial and cardiac defects
    • Female patients require two forms of birth control and monthly pregnancy tests.
    • Fasting lipid panel and LFTs are monitored.
    • Recommend avoidance of alcohol and following a healthy diet.
    • All patients must register with iPledge.

    Treatment Summary for Different Severity Levels

    • Mild, moderate, and severe acne, and appropriate treatment plan

    Studying That Suits You

    Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

    Quiz Team

    Related Documents

    Acne Vulgaris Treatment and Evaluation PDF

    Description

    This quiz explores the characteristics, pathogenesis, and main factors influencing Acne Vulgaris. Learn about its prevalence, clinical presentations, and the impact it has on individuals, alongside the key elements that contribute to its development. Test your understanding of this common skin disorder.

    More Like This

    Use Quizgecko on...
    Browser
    Open
    Browser
    Browser