Pharmacotherapy - Dermatology IV

Vocabulary flashcards covering acne treatments, medications, counseling points, and nonpharmacologic strategies as described in the video notes.

Adapalene

Topical retinoid with anti-inflammatory and comedolytic actions; used once daily at bedtime; improves dyspigmentation; may cause dryness, burning, or itching; takes 8–12 weeks for full effect; sunburn risk; pregnancy contraindication.

Benzoyl peroxide

Topical antiseptic/keratolytic that reduces Cutibacterium acnes, decreases oils; used 1–3 times daily; may bleach hair/clothes; can cause drying.

Salicylic acid

Beta-hydroxy acid that helps prevent clogged pores; used 1–3 times daily; may cause dryness and, in excess, salicylate toxicity.

Azelaic acid

Topical anti-inflammatory and depigmenting agent; helps prevent/treat dyspigmentation; apply thin layer twice daily; may cause burning, peeling, dryness.

Erythromycin

Topical antibiotic; antibacterial and anti-inflammatory; often combined with benzoyl peroxide.

Clindamycin

Topical antibiotic; antibacterial and anti-inflammatory; often combined with benzoyl peroxide.

Dapsone

Topical antibiotic with anti-inflammatory properties used in acne; often combined with other regimens.

Doxycycline

Systemic tetracycline antibiotic; antibacterial and anti-inflammatory; strongest prescription option; adverse effects include esophagitis and phototoxicity.

Minocycline

Systemic tetracycline antibiotic; antibacterial and anti-inflammatory; adverse effects include vertigo, hepatitis, hyperpigmentation, lupus-like symptoms, and hypersensitivity.

Sarecycline

Narrow-spectrum tetracycline derivative for acne; fewer side effects but higher cost; used for moderate to severe cases.

Combined oral contraceptives

Hormonal agents with anti-androgenic effects; can help acne; risks include VTE, myocardial infarction, stroke, breast cancer, and cervical cancer.

Spironolactone

Anti-androgenic medication that decreases testosterone; not FDA-approved for acne; adverse effects include menstrual irregularities, sweating, breast tenderness/enlargement, gynecomastia, fatigue, headache, dizziness; may increase potassium.

Intralesional corticosteroid

Corticosteroid injection for large papules or nodules; strongest local treatment; risk of skin atrophy.

Isotretinoin

Oral retinoid reducing sebaceous gland size and sebum production; decreases C. acnes; anti-inflammatory; significant risks including CV risk, bone mineralization concerns, scarring, mucosal dryness, headaches; requires strict iPLEDGE program.

IPLEDGE (iPLEDGE)

FDA-mandated REMS program to prevent isotretinoin pregnancy; requires enrollment of patient, prescriber, and pharmacy; mandatory pregnancy tests and specific timing for eligibility and dispensing.

C. acnes (Cutibacterium acnes)

Bacterium implicated in acne pathogenesis; targeted by benzoyl peroxide and antibiotics.

Phototoxicity

Light sensitivity as a adverse effect (noted with doxycycline and some retinoids); requires sun protection.

Esophagitis

Inflammation of the esophagus; potential adverse effect of doxycycline if not taken with enough water or lying down soon after taking the medication.

Hyperpigmentation (minocycline-related)

Darkening of the skin; a potential adverse effect of minocycline in some patients.

Nonpharmacologic therapy

Lifestyle and skincare measures to reduce acne: avoid irritants, cleanse twice daily, stay hydrated, don't pick, and follow dietary guidance (low glycemic index, limit high saturated/trans fats and dairy).