PANCE Blueprint Dermatology - All Smarty PANCE
dermatology flashcard lesson sets combined
(Smarty PANCE)
Terms in this set (611)
A 14-year-old boy with dozens of Acne vulgaris
erythematous papules, pustules,
and cysts. On closer examination, he
also has atrophic scars on the lateral
forehead. What's the dx?
1. Increased sebum production (more androgens)
What are four main reasons that acne 2. Clogged sebaceous glands (d/t proliferation of the follicular keratinocytes)
happens? 3.Propionibacterium acne overgrowth
4. Inflammation
Bad bacteria that causes most acne? Cutibacterium acnes (formerly known as Propionibacterium acnes)
What medications can worsen or Lithium, steroids, OCPs, androgens
induce acne?
Acne vulgaris is diagnosed by a simple physical examination examining
How is acne vulgaris diagnosed?
the appearance of the skin.
Open comedones? Blackheads
Closed comedones? Whiteheads
Characterized by inflammatory hard lesions
found deeper in the skin at the point
What is nodular/cystic acne?
where the hair follicle becomes plugged w/
dead skin cells (usually PAINFUL/TENDER)
Mild: comedones, small amount of
Severity of acne? papules/pustules Mod: comedones, large# of
papules/pustules Severe: nodular (>5 mm) or
cystic acne
, 1. Salicylic acid
2. Benzoyl peroxide
Topical choices for acne?
3.Topical retinoids (typically these are 1st line)
4. Topical antibiotics (clindamycin common)
1. Systemic antibiotics (doxycycline, minocycline, clindamycin)
2. OCPs
Systemic choices for acne?
3.Spironolactone
4. Isotretinoin
First line treatment for mild acne is? First line treatment for mild acne is topical benzoyl peroxide.
What is the most effective topical Topical retinoids are the most effective topical agent for mild to
agent for mild to moderate moderate comedonal acne vulgaris.
comedonal acne vulgaris.
If mild acne is unresponsive to topical If mild acne is unresponsive to topical benzoyl peroxide, topical antibiotics such as
benzoyl peroxide, topical clindamycin or erythromycin may be added
antibiotics such as ________ and
_________________may be added.
With moderate to severe acne, oral With moderate to severe acne, oral antibiotics such as doxycycline or minocycline
antibiotics such as __________ and can be used in addition to topical treatment.
____________________________________
can
be used in addition to topical
treatment.
Last line for acne? Acutane (isotretinoin)
Inconvenient side effects of benzoyl Bleaches everything
peroxide?
Main MOA: COMEDOLYTIC. Vit A derivatives that bind to RAR or RXR
Method of action of topical retinoids? receptors found in keratinocytes. They help w normalization of
follicular keratinization and decreased cohesiveness of
keratinocytes.
- Decrease P. acne levels (antibacterial)
Method of action of benzoyl - Decreases inflammation from leukocytic and monocytic attraction to follicles
peroxide? - Comedolytic effect: increases epithelial cell turn over
Why are topical antibiotics often given To reduce resistance
w/ benzoyl peroxide?
Side effect of certain systemic acne Photosensitivity
medications, particularly tetracyclines?
What acne medications can cause All vitamin A derivatives and oral tetracyclines
photosensitivity?
With acne medications, what are the Inflammation, bacteria, oil, or actual cells
4 things we are targeting?
Should topical antibiotics be used Nope!
alone in acne?
Topical acids (salicylic and azelaic) Destroy the keratin/comedones
work how?
BEFORE STARTING: LFTs, LP, urine/serum pregnancy test in females
Isotretinoin unique things to know?
BIRTH CONTROL: Take 2 forms (1 month prior to initiation and 1 month after)
Chapped lips, cheilitis, dry skin/mucus membranes, epistaxis, photosensitivity,
Side effects of isotretinoin?
teratogenic, depression, increases lipids/TGs, bone pain, mood changes, GI issues
Mild: topical retinoids, BPO, topical
General mgmt of each type of acne? abx, OCPs Mod: add PO antibiotics or
spironolactone Severe: isotretinoins
dermatology flashcard lesson sets combined
(Smarty PANCE)
Terms in this set (611)
A 14-year-old boy with dozens of Acne vulgaris
erythematous papules, pustules,
and cysts. On closer examination, he
also has atrophic scars on the lateral
forehead. What's the dx?
1. Increased sebum production (more androgens)
What are four main reasons that acne 2. Clogged sebaceous glands (d/t proliferation of the follicular keratinocytes)
happens? 3.Propionibacterium acne overgrowth
4. Inflammation
Bad bacteria that causes most acne? Cutibacterium acnes (formerly known as Propionibacterium acnes)
What medications can worsen or Lithium, steroids, OCPs, androgens
induce acne?
Acne vulgaris is diagnosed by a simple physical examination examining
How is acne vulgaris diagnosed?
the appearance of the skin.
Open comedones? Blackheads
Closed comedones? Whiteheads
Characterized by inflammatory hard lesions
found deeper in the skin at the point
What is nodular/cystic acne?
where the hair follicle becomes plugged w/
dead skin cells (usually PAINFUL/TENDER)
Mild: comedones, small amount of
Severity of acne? papules/pustules Mod: comedones, large# of
papules/pustules Severe: nodular (>5 mm) or
cystic acne
, 1. Salicylic acid
2. Benzoyl peroxide
Topical choices for acne?
3.Topical retinoids (typically these are 1st line)
4. Topical antibiotics (clindamycin common)
1. Systemic antibiotics (doxycycline, minocycline, clindamycin)
2. OCPs
Systemic choices for acne?
3.Spironolactone
4. Isotretinoin
First line treatment for mild acne is? First line treatment for mild acne is topical benzoyl peroxide.
What is the most effective topical Topical retinoids are the most effective topical agent for mild to
agent for mild to moderate moderate comedonal acne vulgaris.
comedonal acne vulgaris.
If mild acne is unresponsive to topical If mild acne is unresponsive to topical benzoyl peroxide, topical antibiotics such as
benzoyl peroxide, topical clindamycin or erythromycin may be added
antibiotics such as ________ and
_________________may be added.
With moderate to severe acne, oral With moderate to severe acne, oral antibiotics such as doxycycline or minocycline
antibiotics such as __________ and can be used in addition to topical treatment.
____________________________________
can
be used in addition to topical
treatment.
Last line for acne? Acutane (isotretinoin)
Inconvenient side effects of benzoyl Bleaches everything
peroxide?
Main MOA: COMEDOLYTIC. Vit A derivatives that bind to RAR or RXR
Method of action of topical retinoids? receptors found in keratinocytes. They help w normalization of
follicular keratinization and decreased cohesiveness of
keratinocytes.
- Decrease P. acne levels (antibacterial)
Method of action of benzoyl - Decreases inflammation from leukocytic and monocytic attraction to follicles
peroxide? - Comedolytic effect: increases epithelial cell turn over
Why are topical antibiotics often given To reduce resistance
w/ benzoyl peroxide?
Side effect of certain systemic acne Photosensitivity
medications, particularly tetracyclines?
What acne medications can cause All vitamin A derivatives and oral tetracyclines
photosensitivity?
With acne medications, what are the Inflammation, bacteria, oil, or actual cells
4 things we are targeting?
Should topical antibiotics be used Nope!
alone in acne?
Topical acids (salicylic and azelaic) Destroy the keratin/comedones
work how?
BEFORE STARTING: LFTs, LP, urine/serum pregnancy test in females
Isotretinoin unique things to know?
BIRTH CONTROL: Take 2 forms (1 month prior to initiation and 1 month after)
Chapped lips, cheilitis, dry skin/mucus membranes, epistaxis, photosensitivity,
Side effects of isotretinoin?
teratogenic, depression, increases lipids/TGs, bone pain, mood changes, GI issues
Mild: topical retinoids, BPO, topical
General mgmt of each type of acne? abx, OCPs Mod: add PO antibiotics or
spironolactone Severe: isotretinoins
