Info
🌱 來自: Huppert’s Notes
Acneiform Eruptions🚧 施工中
Acneiform Eruptions
Acne vulgaris
• Pathophysiology: Inflammation of the hair follicle/sebaceous gland due to increased sebum production (androgen driven), abnormal keratinization, and proliferation of Cutibacterium acnes (formerly P. acnes)
• Clinical features: Open comedones (blackheads), closed comedones (whiteheads), inflammatory papules and pustules (can progress to nodulocystic lesions and scars) on the face, neck, chest, shoulders, and back
• Treatment:
- Mild: Topical antimicrobial (benzoyl peroxide, erythromycin, clindamycin) +/− topical retinoid
- Moderate: Topical combination therapy (antimicrobial + retinoid)
- Severe: Oral antibiotic (doxycycline, minocycline) or oral isoretinoin (requires birth control if woman of childbearing potential)
Rosacea
• Pathophysiology: Immune dysfunction, Demodex mites, and vascular hyperreactivity
• Epidemiology: Common in adults age 30–60 yr with light complexions (Celtic ancestry); much more common in females than males
• Clinical features: Centrofacial erythema (especially the nose and medial cheeks), papules and pustules, flushing, telangiectasias, and phymatous changes (e.g., skin thickening and sebaceous hyperplasia); frequently triggered by stress, alcohol, heat, spicy foods, or sunlight
• Treatment: Avoidance of triggers, topical metronidazole or azelaic acid, oral antibiotics (doxycycline, minocycline), laser therapy
Hidradenitis suppurativa
• Pathophysiology: Inflammatory skin disease of the apocrine glands
• Epidemiology: Begins after puberty, more commonly affects women and prevalence is disproportionately high among African Americans
• Clinical features: Tender inflammatory nodules, abscesses, draining sinuses, and scarring in the intertriginous areas (e.g., axilla, groin, under the breasts, vulva, perineal area)
• Treatment: Weight loss and tobacco cessation, skin decolonization (bleach baths, chlorhexidine), oral antibiotics (tetracyclines, clindamycin, rifampin), TNF-inhibitors (adalimumab, infliximab), surgical excision (although recurrence is common)