Acne and Related Disorders — MCQs

Q: Rhinophyma is associated with which of the following?

Hypertrophy of sebaceous gland. ***Hypertrophy of sebaceous gland*** - **Rhinophyma** is a **chronic inflammatory skin condition** characterized by progressive enlargement and redness of the nose, primarily due to **hypertrophy of the sebaceous glands**. - It is considered a severe manifestation of **rosacea**, where the glandular and connective tissues become hyperplastic, leading to a bulbous, disfigured appearance. *Infection of hair follicles* - Infections of hair follicles, such as **folliculitis** or **furuncles (boils)**, are acute inflammatory conditions caused by bacteria or fungi. - While these can cause swelling and redness, they do not result in the chronic, progressive sebaceous gland hypertrophy seen in rhinophyma. *Congenital deformity of the nose* - **Congenital deformities** are structural abnormalities present at birth, often due to developmental errors during gestation. - Rhinophyma is an **acquired condition** that develops later in life, typically in adults, and is not present from birth. *Hypertrophy of sweat gland* - **Hypertrophy of sweat glands** (eccrine or apocrine) is not the characteristic feature of rhinophyma. - Conditions involving sweat gland overgrowth are rare and present differently, such as in certain forms of **hidradenitis** or **cystic fibrosis**, and do not lead to the specific nasal disfigurement of rhinophyma.

Q: Benzoyl peroxide acts in acne vulgaris by:

Decreasing bacterial count. ***Decreasing bacterial count*** - **Benzoyl peroxide** is a highly effective topical treatment for acne primarily due to its potent **antimicrobial activity** against *Cutibacterium acnes*, the bacterium implicated in acne pathogenesis. - It works by releasing **free radicals** that disrupt bacterial cell membranes and metabolism, thereby reducing the bacterial load in follicles. *Reduces sebum production* - While sebaceous gland activity is critical in acne, benzoyl peroxide does **not directly reduce sebum production**; retinoids like isotretinoin are known for this effect. - Its primary action is focused on combating bacteria and mildly promoting desquamation rather than affecting **lipid synthesis**. *Acts as a keratolytic agent* - Benzoyl peroxide does possess some **keratolytic activity**, aiding in the shedding of dead skin cells and preventing pore blockage. - However, its keratolytic action is **less pronounced** compared to agents like salicylic acid or tretinoin, and it is not its primary mechanism of action. *Increases epithelial turnover* - While benzoyl peroxide does promote a mild increase in **epithelial cell turnover**, helping to clear clogged pores, it is not its main mechanism of action or defining characteristic. - **Topical retinoids** (e.g., tretinoin, adapalene) are far more effective and primarily used to normalize follicular keratinization and increase cell turnover.

Practice by Chapter

Acne Vulgaris: Pathophysiology

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Acne Vulgaris: Clinical Types

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Acne Vulgaris: Management

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Acne in Special Populations

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Rosacea

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Perioral Dermatitis

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Hidradenitis Suppurativa

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Acne Keloidalis Nuchae

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Acne Scarring and Its Management

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Psychological Aspects of Acne

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Diet and Acne

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Newer Therapies in Acne Management

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