Acne
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| show | Increased sebum production, Sloghing of keratinocytes, bacterial growth (P. acne), inflammation
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| show | Follecular canal widens and increase in cell production. Sebum mixes with excess loose cells in canal to form keratinous plug. Resulting lesion black head "open comedo (melanin). Inflammation or trauma may lead to white head "closed comedo". or pustle
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| show | black head, Composed of melanin pigment caused by sebum mixing with excess loose cells in the follicular canal to for a keratinous plug
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| show | If the plugged follicle stays below the surface of the skin, the lesion is called a closed comedo, or whitehead.
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| Nodule is | show 🗑
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| Papule | show 🗑
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| Pustule | show 🗑
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| Treatment goals of acne therapy | show 🗑
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| Tretinoin MOA (retinoid) | show 🗑
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| Alapalene MOA (retinoid) | show 🗑
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| show | Prodrug converted to active form tazarotenic, selectivly bind to RAR, comedolytic, keratolytic, and anti-inflammatory
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| Topical Antibiotics used in acne | show 🗑
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| show | 1st line Macrolides, tetracyclines ,minocycline, doxycycline, 2nd line-bactrim
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| show | Considered 2nd line: Ortho-tricyclen, Estrostep FDA indicated: but acceptable progesins :norgestimate, desogestrel, drosperinone
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| show | Decrease free testosterone thes decrease sebum production by inhibitin ovarian production of androgens
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| Systemic therapy: Spironolactone | show 🗑
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| Systemic 1st line for severe recalcitrant nodular/conglobata acne | show 🗑
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| Prior to RX of Isotretinoin female patients must | show 🗑
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| MOA of Isotrintnoin | show 🗑
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| show | Obtain from a registered whole saler, fill for max 30 days, not dispense if RX> 7 days, obtain risk management authorization, provide pt with isotretinoin med guide at each visit
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| Medications that contribute to acne | show 🗑
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| show | Gel> solution> cream> lotion
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| Creams are prefered for patients with | show 🗑
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| show | oily skin since they are the most drying and irrtating
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| Treatment effects begin | show 🗑
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| show | Comedones are main lesions. Papules and pustules may be present but are small and few <10
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| show | Moderate number of (10-40) papules and pustules. Moderate number of comedones (10-40)
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| show | Numerous papules and pustules (40-100) usually with many comedones (40-100) and the occassional larger (5) deeper nodular inflammed lesion. Usually face, neck, chest, back
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| Very severe acne characteristics | show 🗑
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| show | Bacteriacidal but watch clothes bleaching, and dry skin and irritation
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| show | Is a keratolytic (very potent at high concentrations) and comedolytic, watch dry skin due to ETOH carrier
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| Sulfer MOA | show 🗑
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