Disorders of Sebaceous and Apocrine Glands
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What are the important characterisitcs (7) when describing a skin lesion?
- Type of skin lesion (macule, papule, comedo)
- Margination (well or ill defined)
- Consistency (soft, firm, indurated, lichenified)
- Arrangement (single or multiple, disseminated)
- Distribution of lesions (pattern and extent)
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
Acne Conglobata: (painful) nodules, cysts; can lead to scarring
- Chloracne: caused by dioxin poison
- Acne vulgaris mimic - NO inflammation!
- Steriod acne: monomorphic acneiform lesions cause by prolonged glucocorticoid use
- Acne vulgaris mimic
- NO comedos
Tx for acne vulgaris
- Remove follicular plugs
- Reduce sebum production
- Tx bacterial colonization
Acne vulgaris mimics:
- Steroid acne
- True acne (caused by hormonal drugs)
- Acneiform by drug: phenytoin, Li, isoniazid, iodides, bromides
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")
Erythematotelangiectatic (ETR) rosacea
Perioral dermatitis (can also be periorbital)
Perioral dermatitis tx
- Stop any topical glucocorticoids
- Metronidazole or erythromycin gel
- Systemic abx sometimes
Hallmark is exacerbation when treated with potent (fluorinated) corticosteroids
Where does Hidradenitis suppurativa occur?
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
Treatment for Hidradenitis suppurativa
Intralesional glucocorticoids, surgery, oral antibiotics, isotretinoin
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