Disorders of Sebaceous and Apocrine Glands

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  1. What are the important characterisitcs (7) when describing a skin lesion?
    • Type of skin lesion (macule, papule, comedo)
    • Color
    • Margination (well or ill defined)
    • Consistency (soft, firm, indurated, lichenified)
    • Shape
    • Arrangement (single or multiple, disseminated)
    • Distribution of lesions (pattern and extent)
  2. Acne vulgaris hallmark
    • Comedo: follicular orifice blockd by keratinous material and sebum --> which becomes cysts then burts to cause INFLAMMATION
    • Many stages of lesions seen
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    Acne Conglobata: (painful) nodules, cysts; can lead to scarring
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    • Chloracne: caused by dioxin poison
    • Acne vulgaris mimic - NO inflammation!
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    • Steriod acne: monomorphic acneiform lesions cause by prolonged glucocorticoid use
    • Acne vulgaris mimic
    • NO comedos
  6. Tx for acne vulgaris
    • Remove follicular plugs
    • Reduce sebum production
    • Tx bacterial colonization
  7. Acne vulgaris mimics:
    • Steroid acne
    • Chloroacne
    • True acne (caused by hormonal drugs)
    • Acneiform by drug: phenytoin, Li, isoniazid, iodides, bromides
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  9. What is rosacea?
    • Chronic inflammatory disorder of pilosebaceous units
    • F>M, except rhinophyma
    • Episodes of increased capillary reactivity with increased skin temp - Rosacea diathesis ("flushing and blushing")
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    Erythematotelangiectatic (ETR) rosacea
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    Phymatous rosacea
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    Ocular rosacea
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    Perioral dermatitis (can also be periorbital)
  14. Perioral dermatitis tx
    • Stop any topical glucocorticoids
    • Metronidazole or erythromycin gel
    • Systemic abx sometimes
  15. Hallmark is exacerbation when treated with potent (fluorinated) corticosteroids
    Perioral dermatitis
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    Hidradenitis suppurativa
  17. Where does Hidradenitis suppurativa occur?
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  18. What is Hidradenitis suppurativa?
    • Chronic suppurative, cicatrical (scar forming) disease of apocrine gland-bearing skin
    • Disorder of the follicle
    • Some genetic features: motha-dauta, fm hx of nodulocystic acne
  19. Treatment for Hidradenitis suppurativa
    Intralesional glucocorticoids, surgery, oral antibiotics, isotretinoin
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Disorders of Sebaceous and Apocrine Glands
West's lecture
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