Luther College BIO 116 Pediatric EOR Study Guide

Acne Vulgaris a. Inflammatory skin condition associated w/ papules & pustules involving the pilosebaceous units b. Pathophys: 4 main factors – follicular hyperkeratinization, increased sebum production, Propionibacterium acne overgrowth & inflammatory response c. S/S: common in areas w/ increased sebaceous glands (face, back, chest, upper arms i. Comedones – small, noninflammatory bumps from clogged pores 1. Open comedones = blackheads (INCOMPLETE blockage) 2. Closed comedones = whiteheads (COMPLETE blockage) ii. Inflammatory – papules or pustules surrounded by inflammation iii. Nodular/Cystic – often heals w/ scarring d. Diagnosis: i. Mild: comedones, small amounts of papules and/or pustules ii. Moderate: comedones, larger amounts of papules and/or pustules iii. Severe: nodular (> 5 mm) or cystic acne e. Management: i. Mild: topical azelaic acid/salicylic acid/benzoyl peroxide/retinoids, tretinoin or topical Abx (Clinda or Erythromycin) ii. Moderate: above + PO Minocycline or Doxycycline, can try Spironolactone iii. Severe (refractory nodular acne): PO Isotretinoin f. Isotretinoin: i. MOA: affects all 4 pathophysiologic mechanisms of acne (see above) ii. Most effective med for Acne Vulgaris iii. Usually reserved for severe or refractory acne iv. ADRs: dry skin & lips (MC), dry eyes, increased Tg & cholesterol 1. Highly teratogenic – must obtain at least 2 pregnancy tests prior to initiation of tx & monthly while on tx, must commit to 2 forms of contraception (used at least 1 month prior to initiation & 1 month after it is DC’d) 2. Arthralgias, myalgias, hepatitis, leukopenia, premature long bone closure 3. Photosen