Pharmacologic
Therapy
For severe acne | 1.Antiandrogens
2.Isotretinoin
3.Topical and oral antibiotics |
Pharmacologic
Therapy
For severe acne | 1.Antiandrogens
2.Isotretinoin
3.Topical and oral antibiotics |
Pharmacologic
Therapy
For severe acne | 1.Antiandrogens
2.Isotretinoin
3.Topical and oral antibiotics |
formation of comedones, papules, pustules, nodules, and/or cysts as a result of obstruction and inflammation of pilosebaceous units
develops on the face and upper trunk
often affects adolescents | Acne Vulgaris |
The onset of acne vulgaris during puberty occurs at a younger chronologic age more in
a. girls
b. boys | a. girls |
In puberty, acne is often more severe in __ in about 15% of cases, which is tenfold greater
a. girls
b. boys | b. boys |
ACNE VULGARIS
FOUR MAJOR ETIOLOGICAL FACTORS | 1 Increased sebum production
2 Hormonal influences
3 Bacterial colonization of the
duct with Propionibacterium
acnes
4 Production of inflammation
in acne sites |
Increased glucocorticoid secretion => | potentiation of the
effects of androgens |
Foods that are perceived to exacerbate acne | 1 Chocolate
2 Cola drinks
3 Milk
4 Milk products |
THE PATHOGENESIS OF ACNE
4 stages | 1.Increased follicular keratinization
2.Increased sebum production
3.Bacterial lipolysis of sebum triglycerides to free fatty acids
4.Inflammation |
Acne results from this
primary lesion of both noninflammatory and
inflammatory acne | obstructed sebaceous follicle
aka microcomedone |
Acne Vulgaris Pathophysiology (step by step) | 1 Acne results from obstructed
sebaceous follicle (microcomedone)
2 Cells adhere to each other; forms dense keratinous plug
3 Sebum becomes trapped behind keratin plug
4 sebum solidifies; forms OPEN or CLOSED comedone
5 Pooling of sebum increases Anaerobic Bacterium
Propionibacterium acnes; generate T cell response; results to inflammation |
1 first clinically visible lesion of acne.
It takes 5 months to develop.
2 plug extends to upper canal and dilates opening;
either oxidized lipid and melanin (black color)
or to the impacted mass of horny cells | 1 Closed comedone, or whitehead
2 OPEN comedone or black head |
Acne that is characterized by open and closed
comedones is termed as? | Noninflammatory Acne |
Both recruitment of polymorphs into the follicle during the inflammatory process and release of P. acnes-generated chemokines lead to what formation?
Bursts into the Dermis | pus formation |
1 Propionibacterium acnes also produces enzymes which increase the permeability of the follicular wall, leading to:
2 Nodules, and cysts and may lead to __ | 1 Rupture, releasing keratin, hair, lipids and irritating free fatty acids into the dermis
2 scarring |
TYPES OF ACNE | 1 Blackheads
2 Whiteheads
3 Papules
4 Pustules
5 Nodules
6 Cysts |
ACNE VULGARIS
Nonpharmacologic
Therapy | 1.Cleansing
2.Proper shaving
3.Comedone extraction
4.Ultraviolet light
5.Prevention of Cosmetic Acne |
Pharmacologic
Therapy
For mild to moderate acne | 1.Topical retinoids
2.Salicylic acid
3.Benzoyl peroxide
4.Sulfur
5.Resorcinol |
Pharmacologic
Therapy
For moderate to severe acne | 1.Benzoyl peroxide
2 Topical antibiotics (Clindamycin/Clindamycin +
Benzoyl peroxide)
3 Oral antibiotics (erythromycin, tetracycline, or
minocycline)
4 Retinoids (tretinoin, adapalene, and tazarotene,
and azeleic acid). |
Pharmacologic
Therapy
For severe acne | 1.Antiandrogens
2.Isotretinoin
3.Topical and oral antibiotics |
Pharmacologic
Therapy
Anti-sebum agents | 1 Oral Contraceptives (norgestimate + ethinyl
estradiol or norethindrone acetate + ethinyl
estradiol)
2.Spironolactone
3.Cyproterone Acetate
4.Oral Corticosteroids
5.Oral Isotretinoin |
Pharmacologic
Therapy
Pharmacologic Cleansing Options: | 1.Medicated Soaps and Washes |