vulgaris and Acne related disorders痤疮和痤疮相关疾病（PPT47）课件.ppt

Topical antibiotic ( anti-inflammatory anti-microbial) clindamycin Erythromycin Benzoyl peroxide Sodium Fusidic acid Systemic therapy Systemic Antibiotic : Tetracycline Doxycycline Minocycline Azithromycine Systemic Retinoids : Isotretinoin caps (Roaccutane): 0.5 – 1 mg/kg Indicated for severe forms (nodulocystic , fulminant and conglobate) but also for milder forms associated with scarring or with significant psychological impact. Relapse is minimal with cumulative dose of 120 – 150 mg/kg. Side effects include: cheilitis, dryness, alopecia , photosensitivity, xerophthalmia, decreased night vision, keratitis, benign intracranial hypertension (incresed risk with concomitant use of tetracyclines), photosensitivity, hypertriglyceridemia, hypercholesterolemia, elevated liver enzymes, depression (controversial), skeletal hyperostosis, myalgias. Teratogenicity (category X) so, Pregnancy must be prevented during treatment and for at least 1 month after discontinuing the drug. Other forms of therapy Oral steroid for acne fulminans and Intralesional steriods for cystic acne. Photodynamic therapy and Laser therapy (pulse dye laser) Hormonal therapy (Anti-androgen) e.g. OCP , flutamide and Spironolactone in treatment of acne associated with hyperandrogenism e.g. PCOS (Polycystic Ovary Syndrome). Rosacea A controversial topic in dermatology largely because of its uncertain pathophysiology and clinical variation. Primary features of rosacea is flushing, papules, pustules and telangiectasia that affect the central face sp. Convex areas like nose , cheek ,chin and forehead Epidemiology Common in Caucasian population womenmen Onset typically begins after age 30 Etiology and pathogenesis 1.Vascular reactivity: Which usually induced by chronic repeated exposure to certain triggers e.g.: Hot or cold temperature Sunlight Hot drinks, Spicy foods and Alcohol Emotional distress Certain medications and co