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Module 7 Current 15 ACNE
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What are the 4 primary factors in the pathogenesis of acne?
1) Plugging of sebaceous follicle
2) Increased sebum production
3) Proliferation of Propionibacterium acnes in the obstructed follicle
4) Inflammation
Many of the factors that cause acne are influenced by?
Androgen
What should be suspectd in teenagers if all lesions are in the same stage at the same time and if involvement extends to lower abd, lower back, arms, and legs?
Drug-induced acne
Drugs responsible for acne are?
-Corticosporin (ACTH)
-Glucocorticoids
-Androgens
-Hydantoins
-Isoniazid
***Increase plasma testosterone
What are the predominant clinical lesions in early adolescent acne?
-Open comedones
What is the black color in open comedones caused by
-Oxidized melanin within the stratum corneum cellular plug
Do open comedones progress to inflammatory lesions?
NO only closed comedones
What causes a closed comedone?
-Obstruction just beneath the follicular opening in the neck of the sebaceous follicle, which produces a cystic swelling of the follicular duct directly beneath the epidermis.
Most authorities believe that _____ ______ are precursors of inflammatory acne lesions.
Closed comedones
Why do adolescents with cystic acne require prompt medical attention?
Because ruptured cysts and sinus tracts result in severe scar formation
Recent data have indicated that _____ ______ that targets multiple pathogenic factors increases the efficacy of treatment and rate of improvement
combination therapy
What are treatments for acne?
1) Topical keratolytic agents
2) Topical antibiotics
3) Systemic antibiotics
4) Oral retinoids
5) Hormonal therapy
Comedonal acne treatment:
ONE OF THE FOLLOWING:
Retinoic acid
Microgel Adapalene
Papular inflammatory acne treatment:
ONE FROM COMEDONAL ACNE GROUPING PLUS ONE OF THE FOLLOWING:
-Benzoyl peroxide
Azelaic acid
Clindamycin (topical)
Pustular inflammatory acne treatment:
ONE FROM COMEDONAL ACNE GROUPING PLUS ONE OF THE FOLOWING ORAL ANTIBIOTICS:
-Tetracycline
Minocycline or Doxycycline
Nodulocystic acne treatment:
-Accutane
Acne therapy takes how long for improvement?
8-12 weeks
Acne follow up visits should be scheduled how frequently?
Every 12-16 weeks
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