Understanding Acne and Skin Lesions

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Questions and Answers

What is lichenification primarily associated with?

Granulomatous inflammation

Chronic coalescence of papular lesions (correct)

Vascular changes in the skin

Acute dermatitis

Which condition is characterized by non-blanching skin discoloration due to blood extravasation?

Telangiectasia

Erosion

Purpura (correct)

Atrophy

What type of scar extends beyond the original wound site and may vary in size and shape?

Hypertrophic scar

Flat scar

Keloid (correct)

Atrophic scar

What is the defining feature of telangiectasia?

Dilated superficial blood vessels Signup and view all the answers

Which mechanism causes acanthosis in the skin?

Increased proliferative activity of basal cells Signup and view all the answers

What type of skin change is described as a thinning of the epidermis or dermis?

Atrophy Signup and view all the answers

Which treatment modality is commonly used for keloids?

Cryosurgery Signup and view all the answers

What is characterized by a combination of atrophy, hyperpigmentation, hypopigmentation, and telangiectasia?

Poikiloderma Signup and view all the answers

What actions can worsen acne?

Picking at pimples Signup and view all the answers

Which of the following is NOT a cause of acne?

Genetic tendency Signup and view all the answers

How long can acne take to clear up?

Several months Signup and view all the answers

What is one of the best ways to prevent acne?

Washing your face twice a day Signup and view all the answers

Which of the following types of acne is mentioned?

Cystic acne Signup and view all the answers

What should be avoided to prevent acne exacerbation?

Scrubbing the face vigorously Signup and view all the answers

Which drug is known to potentially cause acne?

Dexamethasone Signup and view all the answers

What is a common misconception about the sun and acne?

Tanned skin hides pimples effectively Signup and view all the answers

What is a common initial misdiagnosis for peri-oral dermatitis?

Acne Signup and view all the answers

What is the recommended treatment for peri-oral dermatitis?

Oral antibiotics Signup and view all the answers

Which of the following is NOT associated with the incorrect use of cosmetics?

Temporary improvement Signup and view all the answers

How many people in Australia are estimated to be affected by psoriasis?

About 3% of the population Signup and view all the answers

What might significantly trigger or worsen conditions like peri-oral dermatitis?

Topical steroids Signup and view all the answers

Which characteristic is most commonly associated with psoriasis?

Red scaly patches Signup and view all the answers

At what stages of life does psoriasis typically start?

Young adulthood and later in life Signup and view all the answers

What is a common impact of psoriasis on general health?

Psoriatic arthritis Signup and view all the answers

What characterizes a nodule in the skin?

A palpable solid lesion > 1.0 cm in diameter Signup and view all the answers

Which of the following describes a vesicle?

A circumscribed elevated lesion containing free fluid Signup and view all the answers

What is a bulla?

A raised lesion greater than 1.0 cm filled with fluid Signup and view all the answers

Which option describes a macule?

A circumscribed change in skin color without elevation Signup and view all the answers

What is the defining feature of a plaque?

It is a raised lesion with a greater area than elevation Signup and view all the answers

What does a wheal represent?

An elevated lesion formed by local dermal edema Signup and view all the answers

Which description fits the term 'scar'?

A hard plaque of dense fibrotic tissue Signup and view all the answers

What is the primary characteristic of an ulcer?

A loss of skin tissue from the surface downward Signup and view all the answers

What primary role does melanin pigment play in the skin?

Protects nuclear structures from UV damage Signup and view all the answers

Which vitamin is produced in the skin through the action of ultraviolet light?

Vitamin D3 Signup and view all the answers

What is the primary factor that determines skin pigmentation?

The amount of melanin transferred to keratinocytes Signup and view all the answers

How are melanocytes related to skin color differences among races?

Differences in melanocyte activity lead to pigmentation variation Signup and view all the answers

What effect does post-inflammatory hyperpigmentation have?

It causes darkening of the skin following injury or inflammation Signup and view all the answers

What are the two types of melanin mentioned in the content?

Eumelanin and pheomelanin Signup and view all the answers

What is required for the activation of vitamin D in the body?

Parathyroid hormone Signup and view all the answers

Which of the following describes the function of melanosomes in the pigmentary system?

Transfer melanin from melanocytes to keratinocytes Signup and view all the answers

Study Notes

Acne

Acne is not caused by chocolate, soda, greasy foods, dirt, sweat, or the sun
Picking pimples can worsen acne, leaving red spots
Acne is not curable and can take months to clear
Acne can be prevented with regular gentle washing with mild soap and warm water
Acne is common in teenage years and can also occur in women during their periods
Some medications can contribute to acne, including: ACTH, corticosteroids, dexamethasone, anabolic steroids, androgens, oral contraceptive pills, iodides, bromides, isoniazid, dantrolene, danazol, quinidine, lithium, and azathioprine
Acne can cause scarring

Types of Acne

Oily seborrhea is often associated with acne
Common types of acne include: comedone acne, papular acne, acne excoriee des jeunes filles, acne pustulosa, atrophic acne, indurated acne, cystic acne, acne cachecticorum, acne conglobata, acne keloidalis, tropical acne, acne neonatorum, and chloracne

Skin Lesions

Nodule: palpable solid lesion > 0.5 cm and less than 2 cm in diameter
Vesicle: circumscribed elevated lesion containing free fluid, ≤ 0.5 cm in diameter
Bulla: fluid-filled lesion > 1.0 cm diameter, usually elevated
Tumor: can refer to a nodule > 1.0 cm in diameter, a general term for any mass, benign or malignant
Pustule: discrete elevated vesicle or bulla containing purulent exudate (pus), may be superficial, deep-seated, follicular, grouped, etc.
Macule: circumscribed change in skin color without elevation or depression, flat (cannot be palpated)
Papule: solid elevated lesion, usually ≤ 0.5 cm in diameter
Plaque: raised lesion with a greater area than elevation, broad and palpable
Wheal: (hive) rounded or flat-topped elevated lesion formed by local dermal edema, broad flares of edematous skin

Secondary Lesions

Scar: hard plaque of dense fibrotic tissue covered by a thin epidermis, a mark of injury, fibrous tissue replacing normal skin
Atrophy: thinning of the epidermis, leaving a wrinkled and/or shiny surface
Ulcer: loss of skin tissue, leaving an uncovered wound that is slow to heal
Erosion: denuded skin, usually implying the loss of the epidermis
Fissure: a vertical splitting or separation of the skin
Crust: dried surface fluid, serum, purulent exudate, blood, with or without tissue debris ("scab")
Excoriation: a scratch mark, often with denudation of the skin to form a small ulcer, exposure of the corium by mechanical removal of the epidermis
Scale: a thin flake of epithelium separated from the underlying intact skin
Lichenification: thickening of the skin surface and an increase of skin markings, usually seen with chronic coalescence of papular lesions
Vegetating: a lushly growing, proliferating process, usually with elevated or exophytic features

Other Terms

Purpura: non-blanching erythema or violaceous color due to extravasation of blood into the tissue
Cyst: a sac containing liquid or semisolid material, usually in the dermis
Atrophy: a thinning of epidermis or dermis
Sclerosis: hardening or induration of the skin
Poikiloderma: a combination of atrophy, hyper and hypopigmentation, and telangiectasis
Telangiectasia: dilated superficial blood vessels, especially of the upper reticular dermal plexus

Scars

After skin injury, the healing process usually leaves a flat scar
Hypertrophic scars: thickened scars confined to the margin of the wound, often subside by themselves
Keloids: scars that extend and spread beyond the size of the original wound, can vary in size, shape, and location, more frequent in people with darker skin
Keloids may occur spontaneously or as a result of inflammation, surgery, body piercing, or burns
Keloids can be difficult to treat and tend to return, sometimes larger than before, may be itchy, tender, and painful

Lichenification

Lichenification: a thickening of the skin surface and an increase of skin markings, usually seen with chronic coalescence of papular lesions

Fissure

Fissure: a vertical splitting or separation of the skin

Excoriation

Excoriation: a scratch mark, often with denudation of the skin to form a small ulcer, exposure of the corium by mechanical removal of the epidermis

Ulcer

Ulcer: loss of skin tissue, leaving an uncovered wound that is slow to heal

Scale

Scale: a thin flake of epithelium separated from the underlying intact skin

More Terms

Acanthosis: thickening of the skin due to an increase in the number of prickle cells (keratinocytes)
Atrophy: thinning of the skin
Hyperkeratosis: thickening of the stratum corneum (outermost layer of the epidermis)
Vesiculation: formation of vesicles
Spongiosis: fluid accumulation within the epidermis
Exocytosis: migration of inflammatory cells into the epidermis
Erosion: denudation of the epidermis
Ulceration: loss of skin tissue resulting in an open wound

Peri-oral Dermatitis

Often misdiagnosed and treated with topical steroids which can worsen the condition
Important to recognize and avoid using steroids!
Treatment involves a long course of oral antibiotics (doxycycline or minocycline), topical antibiotics (metronidazole, erythromycin, or clindamycin)
Avoid inappropriate skincare products (occlusive, mineral oils, zinc cream)
Differentiate from eczema, seborrheic dermatitis, and rosacea

Psoriasis

Relatively common, about 3% of Australians
Main feature: red scaly area or patch
Lesions are usually raised, well-defined, pink or red, covered with silvery-white scale
Commonly affects knees, elbows, scalp, lower back, and legs
Can affect other areas including: genitals, palms, soles of feet, and nails
Affects both sexes and all races, can occur at any stage of life
Itching is usually mild
Rarely affects general health, but can occur with arthritis
A flare can impact overall well-being and daily activities
Melanin pigment in the skin protects against UV damage

Skin Functions

Temperature regulation
Important role in calcium homeostasis by contributing to the body's supply of vitamin D
Vitamin D3 is produced in the skin by the action of ultraviolet light on dehydrocholesterol
It is then hydroxylated in the liver and kidneys to 1,25 dihydroxycholecalciferol which increases calcium absorption and reabsorption

Pigmentary System

Epidermal melanin units: melanocyte supplies melanin pigment to a group of keratinocytes
Pigmentation is determined by the amount of melanin transferred to the keratinocytes
Melanocytes are dendritic cells located in the basal layer of the epidermis
Melanocytes originate from the neural crest as melanoblasts and migrate to the dermis, hair follicles, leptomeninges, uveal tract, and retina
Melanosomes are responsible for melanin synthesis and pigment transfer
Racial pigmentation is due to differences in melanocyte activity, not the number of melanocytes
Melanin protects the skin against UV radiation
There are two types of melanin: eumelanin (brown to black) and phaeomelanin (yellow-red)

Post-inflammatory Hyperpigmentation

Darkening of the skin after injury or certain skin disorders
More common and noticeable in darker skin
Inflammation stimulates pigment production
If the injury is deeper, the pigment will appear darker and be more resistant to treatment
Common and difficult to treat

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Description

Explore the various aspects of acne, its causes, and prevention methods in this quiz. Learn about different types of acne, including cystic and comedonal, as well as associated skin lesions. Enhance your knowledge on managing acne effectively.