ACNE test.txt

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Anonymous
ID:
98137
Filename:
ACNE test.txt
Updated:
2011-08-23 20:04:19
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OTC Acne
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Description:
OTC Acne
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  1. ACNE (Vulgaris)
  2. Pathophysiology
  3. Pathophysiology
    • Non-inflammatory Acne (Type I)
    • * White Head: Enlarged microcomedone w/ cells and sebum just beneath skin surface. Aka Closed comedone because follicle is completely blocked (no air exposure)
    • * Black Head: Plug protrudes from pore and is dark in color due to melanin and oxidation of lipids in sebum upon air exposure. Aka Open comedone because follicle is only partially blocked allowing air exposure and slow draining to surface (hangs around longer than whitehead)
    • Microcomedone White head 1 Black head 1
  4. White head 2 Black head 1
    • Pathophysiology
    • Sebum buildup (with non-inflammatory acne) allows propionibacterium acnes to proliferate-
    • -->Sebum breakdown releasing irritating free fatty acids and pro-inflammatory mediators-
    • --> Localized tissue destruction and inflammatory acne
    • Lesion
    • Note: Only type I (non-inflammatory) acne can be treated OTC
    • Pathophysiology
    • Inflammatory Acne
    • * Papules (Type II): Redness, Inflammation in and around follicular canal
    • * Pustules (Type III): Papules but w/ visible, purulent center.
    • * Nodules (Type IV): Ruptured follicle w/ contents released to surrounding
  5. Epidemiology/Etiology
    • * More severe in young men but more persistent in women
    • * Affects ~40% of adults >25y/o
    • * Increased risk if family history (parents) positive
    • * Could progress from face to neck and back with age, esp. in women (also jaw line/chin in women 30-40s y/o)
    • * Persistence/development in mid-20s may indicate Rosacea
    • Pathologic Factors
    • * Androgenic hormones
    • * Abnormal follicular desquamation
    • * Excess sebum production
    • * P.acne proliferation on skin
    • * Resultant inflammatory responses (severity)
  6. Exacerbating Factors
    • * Acne Mechanica: Local irritation/occlusion from clothing/ accessories; Excessive face/hand contact eg resting chin/cheek on hand
    • * Acne Cosmetica: Occlusion by oil-based products; Non-inflammatory, on face/chin/cheek
    • * Occupational: Exposure to dirt, oils, coal tar etc
    • * Medications: Phenytoin, Isoniazid, Moisturizers, Phenobarb, Lithium, Ethionamide, Steroids (PIMPLES)
    • Exacerbating Factors contd.
  7. * Stress: w/ Increased neuroendocrine modulators centrally or topically induced on sebaceous glands
    • * High humidity/Prolonged sweating: Decr in size of sebaceous gland duct. Also, hydration prevents loosening of comedone
    • * Hormonal Changes
  8. Complications
    * Post-inflammatory erythema/hyperpigmentation: Acute, Remnant of inflammation that fades w/ time. Sunscreen minimizes pigmentation
  9. * Scarring: Chronic, increased by picking and squeezing lesion
  10. Non-pharmacologic Therapy
    * Proper hydration; dehydration may increase inflammatory chemicals and affect normal cell desquamation
  11. * Avoid tight fitting clothes, accessories, helmets
  12. * Use water-based cosmetics, shampoos and cleansers
    • o Check for non-comedogenic label
    • Non-pharmacologic Therapy
    • * Mild- to non-soap cleanser wash ?BID
    • o Abrasives/Over cleansing may worsen acne
    • o Medicated soaps not really helpful as they leave very little active ingredient residue on skin
    • * Self applied acrylate glue-based strips (eg Biore� Strips) better option than picking/squeezing lesions
    • * Professional comedo extraction even better but scarring if not done right
    • Biore� Deep Cleansing Pore Strips
    • * Used for mechanical removal of black heads, available as nose and face strips (~$10 on drugstore.com)
    • o Wash area to be covered
    • o Apply strip to wet skin, leave on till dry/stiff (10-15mins), then peel off gently. Don�t force off.
    • o Avoid skin blemishes/ swollen, sunburnt or dry skin
    • o Use o Consult Dr first if on Acne Rx meds
  13. Pharmacologic Therapy
    *
  14. ACNE-3

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