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Acne Vulgaris is a disease of the _______________ units of the skin.
PILOSEBACIOUS
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Where is acne most commonly presented on the body?
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Acne is a _________ disease and is linked to the onset of ______________.
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When does acne develop in males? And when does it resolve?
- Develops: 12-18
- Resolves: mid 20s
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When does acne develop in females? And when does it become problematic again?
- Develops: 15-17
- Problematic: 3rd or 4th decade
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Which hormone plays a role in acne?
Androgen
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What are the 3 layers of the skin?
- Epidermis
- Dermis
- Subcutaneous layer
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What layer of the skin provides protection (like a raincoat)?
Epidermis
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What 2 layers of the epidermis are most important in acne?
- Stratum Corneum
- Stratum Germinativum
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What is the role of the stratum corneum?
- outermost layer of epidermis
- sheds dead cells (q25-30days)
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What is the role of the stratum germinativum?
- Innermost layer of epidermis (next to dermis)
- formation of new cells
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Describe the process of new skin cell formation to cell death/shedding.
- New cells form (mitosis) in germin layer
- Move up thru layers (b/cm squished)
- Cells take in keratin/lose organelles
- Cell dies and sheds of in corneum layer
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What is the supportive layer of the skin, that prevents tearing?
Dermis
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What does the dermis mostly contain?
- connective tissue/collagen
- elastin
- blood vessels
- hair follicles
- sebaceous glands
- nerves
- sweat glands
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Which layer of the skin stores fat, provides insulation and provides protection?
Subcutaneous layer
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The subcutaneous layer consists of ____________ and is __________ to increase mobility over structures/organs.
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What do the pilosebaceous units consist of?
- hair follicle
- sebaceous gland
- (connected to skin surface by duct)
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What is the duct of the sebaceous unit surrounded by?
epithelial cells
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Where is the hair follicle located?
Epidermis and dermis
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What do sebaceous glands produce?
sebum
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Oil passes to the ____________ and spreads over _____________.
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What is the purpose of sebum/oil?
prevent water loss
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Where are sebaceous glands located?
next to hair follicle
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Explain 2 ways how dead cells are shed through hair follicles.
- Carried out by oil
- Conform in to hair follicle
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How do hair follicles become clogged (in respect to cells)?
An increase rate in turnover (clumps up and block)
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When does blocking of hair follicles become acne?
Bacteria (P. ances) gets stuck and thrive because of the presence of oil
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Which sweat glands open directly to the skin?
Eccrine
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What type of solution does eccrine sweat glands produce? Does it affect hair follicles?
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What type of sweat glands open into hair follicles?
Apocrine
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What type of solution does apocrine glands produce?
milky substance
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When are apocrine glands active?
puberty
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What reaction produces musky body ordor?
bacteria on skin and apocrine sweat
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What is the classification of a closed comedone?
- closed plug of sebaceous matter
- small, firm, elevation
- no white head (not near surface)
- no inflammation
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What is the classification of an open comedone?
- open plug of sebaceous matter
- blackened mass of epithelial debris (oxidation)
- non-inflammatory
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What is the classification of a papule?
- inflamed comedone
- small circumscrobed elevation of the skin
- expanded outside of hair follicle
- DONT POP
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What is the classification of a pustule?
- inflamed comedone
- small circumscibed elevation w/ purulent material (white head)
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Why dont you want to pop pimples?
- Only some pus escapes
- The rest is pushed down- which causes more problems
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What is the classification of a nodule?
- inflammatory
- large pus-filled deep seated painful lump
- will cause scarring
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What are the (8) proven contributing factors of acne?
- Disease- polycystic ovarian syndrome
- High humidity/profuse sweating
- Local irritation/friction
- Cosmetics (oil based)
- Hair products
- Stress
- Premenstrual
- Medications
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What are the unproven contributing factors of acne?
- sexual activity
- diet (chocolate, nuts, cola)
- dirty skin
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What are the (4) treatment goals of acne?
- relieve discomfort
- improve skin appearance
- prevent pitting & scarring
- prevent distress and social rejection
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What (2) things occur due to androgen production that cause acne?
- hyperkeratinization
- sebum production
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What (2) things cause pores to become clogged?
- increased keratin
- increased oil/fluid
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What is the bacterial component of acne?
Propionbacterium Acnes
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List characteristics of P. acnes.
- Normal Flora
- Gram +
- Anaerobic rods
- produce lipases---which form free fatty acids from sebum
- makes proprionic acid
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What is the inflammatory component of acne?
- response to irritation by fatty acids
- immune response to bacteria
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What are the exclusions of self care for acne?
- moderate/severe acne
- drug induced
- possible rosacea
- if acne does not improve in 8 weeks with self care
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Drugs that can induce acne?
- Phenytoin
- Isoniazid
- Moisturizers
- Phenobarbital
- Lithium
- Ethionamide
- Steroids
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What is the nickname for Rosacea?
Adult Acne
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When doe rosacea appear?
grater than 20yrs
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What causes rosacea?
genetics (not endocrine changes)
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What are the symptoms of rosacea?
- sensitive to touch
- red pustules/papules
- enlarged blood vessels
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Where does rosacea occur?
towards the center of the face (T-zone)
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What are the treatments for Rosacea?
- Metrogel, Finacea
- avoiding aggravating factors--anything that will flush the skin
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