Primary Care Dermatology: Isotretinoin, PCOS, and Rosacea

A complete set of vocabulary flashcards covering the indications, side effects, and clinical management of severe acne, Polycystic Ovarian Syndrome (PCOS), and Rosacea.

Oral Isotretinoin

A vitamin A derivative used for severe or resistant acne that shrinks the pilo-sebaceous unit and can offer a permanent cure for approximately $722\%$ of patients.

Teratogenic

The property of causing birth defects; oral isotretinoin requires all women of childbearing age to use effective contraception for a month before, during, and a month after treatment.

Pilo-sebaceous unit

The skin structure consisting of a hair follicle and sebaceous gland which oral isotretinoin shrinks to reduce oiliness and blackhead formation.

Cheilitis

Severe dryness of the lips, which is a universal side effect in patients taking oral isotretinoin.

Rotterdam criteria

Diagnostic guidelines for PCOS requiring two of three features: polycystic ovaries on ultrasound, menstrual irregularities, or clinical/biochemical androgen excess.

Hyperandrogenism

A condition defined by excess androgen production, often identified by an elevation of free testosterone and a low sex hormone binding globulin ($SHBG$).

Hirsutism

Excessive terminal hair growing in a male pattern (beard area, lower abdomen, and chest), commonly associated with PCOS.

Spironolactone

A non-hormonal anti-androgen medication used in PCOS context to treat acne, androgenic alopecia, and hirsutism.

Rosacea

An inflammatory disease most common in fair skin ($type\,1$ and $type\,2$) characterized by papules, pustules, and redness without comedones.

Telangiectasia

The presence of broken veins or permanent erythema on the face, which is a primary clinical feature of rosacea.

Blepharitis

Inflammation of the eyelids, a symptom of eye involvement that occurs in more than $50\%$ of patients with rosacea.

Rhinophyma

A condition in rosacea involving the thickening of skin on the nose and enlargement of sebaceous glands, leading to a bulbous appearance.

Demodex folliculorum

A hair follicle mite that is a normal skin inhabitant but often found in excessive amounts in rosacea patients.

Ivermectin $1\%$ cream

A topical antiparasitic agent ($Soolantra$) applied once daily for $6$ to $12$ weeks to treat rosacea.

Acne Fulminans

A severe, sudden-onset form of acne mentioned as a specific indication for oral isotretinoin therapy.

Eflornithine $11.5\%$ cream

A topical treatment ($Vaniqa$) used twice daily to slow down unwanted hair growth in patients with hirsutism.

Epistaxis

Nosebleeds, categorized as a predictable side effect of oral isotretinoin caused by mucous membrane dryness.

Phymatous rosacea

A subtype of rosacea characterized by thickening skin, irregular surface nodularities, and enlargement which can occur on the nose, chin, or forehead.

Lymecycline

An oral antibiotic with anti-inflammatory action often prescribed for inflammatory features of rosacea for $1$ to $3$ months.

Androgenic alopecia

Female pattern hair loss involving diffuse thinning of frontal and central scalp hair, occurring in approximately $22\%$ of women with PCOS.