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Acne Related Conditions

Acne Related Conditions

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Published by Hassan.shehri
Acne Related Conditions
Acne Related Conditions

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Published by: Hassan.shehri on Jun 25, 2009
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05/11/2014

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ACNE RELATED CONDITIONS
-
It is a disorder affecting the pilosebaceous units of the skin
 A) Non-Inflammatory acne lesions (comedones)
1) Open comedones (black heads)2) Closed comedones (white heads)
Clinical presentation:
found in areas with numerous sebaceous glands.
 B) Inflammatory acne lesions
1) papules2) pustules3) nodules or cysts
CLINICAL FINDINGS
Scar, nodules & cyst
Type of acne:
Conglobata
Fulminans
 Neonatal
Steroid acne
Acne-form eruption
 Pathogenesis:
Androgens
Follicular obstruction
Propionobacterium acne
Therapy:
topical agents
systemic antibiotics
systemic retinoid
Topical agents:
Topical comedolytic agents are:
Tretinoin (Retin A) available in cream, gel and solution formulations.
Benzoyl peroxide available in 2.5%, 5% and 10% concentrations
Both can cause skin irritation (worse at first 1 to 2 weeks)
Topical antibiotics: Clendamycin and erythromycin.1
 
 Systemic antibiotics:
Tetracycline (500 mg twice/day) is the antibiotic of first choice because of itslow cost, efficacy and relative safety. Must be taken on an empty stomach.
Erythromycin (500 mg twice daily) the next most often used systemicantibiotics.
 Systemic retinoids:
Isotretinoin (Accutane)
Vitamin A analogue- Decreases follicular keratinization, sebum production and intrafollicular bacteriacount.
 Side effects:
Almost all patients experience chapped lips and dry skin
Increase liver enzymes
Increase lipids
Teratogenic* Special consent forms, strict birth control measures and monthly pregnancy test arerequired for female in the productive period.
ROSACEA
Chronic inflammatory disorder affecting the blood vessels and pilocebaceous units of the face.
CLINICAL FINDINGS
Papules and pustules are super imposed.
On a background of erythema and telangiectasia
On the central third of the face
 Differential Diagnosis:
-
Lupus erythematosus
-
Photodermatitis
-
Carcinoid syndrome
Complications:
-
Rhinophyma
-
Ocular complications- Blepharitis- Conjuctivitis- Keratosis (may lead to blindness)
Treatment:
-
Low dose tetracycline or erythromycin (250 mg twice daily)
-
Topical metronidazole 0.75% gel (metro gel) is effective in treating papules, pustules and erythema of rosacea.
-
Isotretinoin (Accutane) – for resistant cases.
-
Avoid stronger cortisone preparations and sun exposure.2

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