Acne Basics
Grab bag
Name that lesion
Consider this
100
This is the anatomical site where acne develops.
What is pilosebaceous gland?
100
A 42 year old African American man presents with concern for “pimples on my face and neck”. He’s been trying OTC acne washes but without relief. Name this condition. 
What is pseudofolliculitis barbae?
100
Name the skin lesion.
What are closed comedones (comedonal acne)?
100
A 21 year old male presents to your office as a new patient. He has no major health issues and hasn't been to a doctor since he aged out of his pediatrician's office at 18. He asks what you can do to treat his acne-- he's tried "everything-- benzoyl peroxide, adapalene, and I even took an antibiotic for a while last winter!" Nothing has worked. His exam shows many large erythematous papules and pustules over his entire face, and he says some are tender when they get really large. In hopes of minimizing scarring, you place an "intermediate consult" to dermatology to start this medication.
What is isotretinoin?
200
The causative bacteria of most acne
What is cutibacterium acne?
200
A 38 year old Caucasian woman presents with cc of “acne”. She describes facial flushing and persistant papulopustular acne that is evident on exam. Benzoyl peroxide and topical tretinoin have not been helpful, but her sister, who has the same thing, says she got a different topical medication that seems to help.
What is rosacea?
200
Name the skin lesion.
What are open comedones?
200
A 27 year old woman has recently established with dermatology after you tried to treat her acne for several months without success. She tells you she is going to start "accutane". She's been counseled to minimize alcohol while on this medication, as well as to see her PCP to start what additional class of medications prior to initiating accutane?
What are contraceptives?
300
This class of hormones made exclusively in the adrenals and the gonads, stimulate sebaceous glands, ultimately contributing to the pathogenesis of acne.
What are androgens?
300
This keratinolytic and antiinflammatory agent is the cornerstone of acne treatment from mild comedonal acne through moderate papulopustular acne.
What is a topical retinoid?
300
Name the skin lesion./acne-face-1-18-746455ebc4d34001bd57e3625be98cce.jpg)
What are papules in inflammatory acne?
300
You are reviewing labs that just returned for your colleague's patient in your RCT box. You note a couple abnormalities that don't seem to fit the clinical picture that your colleague so nicely documented in his last clinic note-- she is 21 years old, runs 15-20 miles per week, eats a healthy and robust vegetarian diet, and drinks alcohol maybe once or twice a month. After you finish reading the note, you realize she was seen by dermatology in the interim and started on isotretinoin for her severe acne. You are reassured and decide to repeat them in a month or so, while, messaging the dermatologist as an FYI. Which labs are elevated?
What are triglycerides and LFTs?
400
In addition to the presence of Cutibacterium acne, these two other substances are responsible for obstructing the pilosebaceous unit or "clogging pores".
What are sebum and keratin?
400
This class of antibiotics is a common choice for moderate papulopustular or inflammatory acne. We limits it's use to 3-4 months at a time in order to minimize resistance and side effects.
What are tetracyclines (doxycycline)?
400
Name the skin lesion.
What are pustules in inflammatory acne?
400
A 28 year old woman with h/o hypothyroid and GERD presents with concern for acne. She says it's embarrassing and she thought she was "supposed to grow out it by now!" She has tried benzoyl peroxide and a topical retinoids with mild improvement, but is still really frustrated by breakouts along her jawline and cheeks. After reassuring her that upwards of 50% of women her age struggle with acne, you suggest these two other options that may be helpful in her acne treatment plan.
What are combination hormonal contraceptives and spironolactone?