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Must know skin conditions in family medicine

Acne vulgaris

  • Caused by follicular pores become blocked
  • Presentation
    • Closed comedones are whiteheads – closed round lesions that contain a white center
    • Open comedones are blackheads – exposure of sebum to causes oxidization making them appear dark
    • Inflammatory acne appears red and consists of papules, pustules and nodules that arise from comedones
  • Treatment
    • Mild
      • Topical salycylic acid
      • Topical benzoyl peroxide
      • Topical clindamycin
    • Moderate
      • Topical options above
      • Oral antibiotics from the tetracycline family
    • Severe
      • Oral isotretinoin (vitamin A derivative)
        • Highly teratogenic
      • High-dose oral antibiotics from tetracycline-class

Impetigo

Rosacea

  • Chronic inflammatory skin disease
  • Epidemiology: females, fair skin, middle age
  • Presentation: facial erythema, papules, pustules with NO comedones
  • Cause not well understood
    • Associated with increased body temperature and its associated triggers such as hot weather, spicy food
  • Treatment
    • Avoid behavioral triggers
    • Erythema, skin sensitivity, dry skin
      • Topical brimonidine (alpha adrenergic agonist)
      • Topical oxymetazoline (alpha-1 adrenergic receptor agonist)
    • Papules and pustules
      • Refer to dermatologist!
      • Mild
        • Topical metronidazole
        • Topical azelaic acid (dicarboxylic acid)
        • Topical ivermectin (anti-parasitic medication)
        • Topical sodium sulfacetamide (antibiotic)
      • Severe
        • Oral tetracycline or isotretinoin