Questions and Answers
What is acne?
Pores of the skin become clogged, inflamed, and sometimes infected.
Which of the following is NOT a contributing factor to the pathogenesis of acne?
Which topical agent is considered the single most effective comedolytic agent?
Tretinoin has a pregnancy category of A.
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Which of the following is a potential side effect of topical retinoids?
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Benzoyl peroxide is often considered the mainstay therapy for __________ acne.
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What is the mechanism of action of Clindamycin?
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Which medication competes with PABA to inhibit folic acid synthesis?
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What is the main function of Azelaic acid?
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Salicylic acid is known for its keratolytic properties.
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Study Notes
What is Acne?
- Condition characterized by clogged, inflamed, and potentially infected skin pores.
- Pathogenesis involves multiple factors: follicular hyperkeratinization, Cutibacterium acnes bacteria, increased sebum production, androgens, and resultant inflammation.
Medications for Acne
- Medications are categorized as topical and oral agents.
Topical Agents
- Two main types: topical retinoids and topical antimicrobials.
Topical Retinoids
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Types:
- Adapalene (Differin)
- Tazarotene (Tazorac)
- Tretinoin (Retin-A, Retin-A Micro)
- Trifarotene (Aklief)
- Mechanism of Action (MOA):
- Bind to retinoic acid receptors (RAR-alpha, RAR-beta, RAR-gamma), reducing follicular occlusion.
- Down-regulate toll-like receptor (TLR)-2 expression.
- Enhances penetration of additional topical acne treatments.
- Tretinoin recognized as the most effective comedolytic agent and first-line for inflammatory and non-inflammatory acne.
Adverse Effects of Topical Retinoids
- Common side effects include photosensitivity, dry skin, scaling, erythema, burning, and pruritus.
- Variability in side effects based on formulation, concentration, and application frequency.
- Excluded for use in pregnancy (Category X).
Topical Antimicrobials
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Benzoyl Peroxide
- MOA: Exerts keratolytic effects and antibacterial activity.
- Considered a primary treatment for inflammatory acne (papules/pustules).
- Rapidly kills and inhibits growth of C. acnes without inducing bacterial resistance.
- Side effects include skin irritation and bleaching.
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Clindamycin and Erythromycin
- Clindamycin binds to the 50S ribosomal subunit, inhibiting protein synthesis.
- Erythromycin also targets the 50S ribosomal subunit, disrupting protein synthesis.
- Recommended for mild to moderate inflammatory acne; side effects include skin irritation.
- Monotherapy is not advised.
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Dapsone (Aczone)
- Competes with PABA to inhibit folic acid synthesis, effective for both inflammatory and non-inflammatory acne.
- Can cause yellow or orange discoloration when used with benzoyl peroxide.
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Azelainic Acid (Azelex)
- Inhibits protein synthesis, exhibits antibacterial properties, and normalizes keratinization.
- Causes less irritation compared to benzoyl peroxide, but may lead to hypopigmentation, especially in darker-skinned individuals.
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Salicylic Acid
- MOA: A keratolytic agent, well-tolerated as a comedolytic treatment.
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Description
This quiz explores the multifactorial pathogenesis of acne, focusing on the clogging of skin pores, inflammation, and associated bacteria. Learn about factors such as follicular hyperkeratinization, sebum production, and androgens that contribute to this common skin condition.
