Acne

Acne

Q. 1

Acid that is increased in acne comedones is?

 A Linolenic acid
 B

Palmitic acid

 C Acetic acid
 D

Linoleic acid

Q. 1

Acid that is increased in acne comedones is?

 A Linolenic acid
 B

Palmitic acid

 C Acetic acid
 D

Linoleic acid

Ans. B

Explanation:

Palmitic acid REF: Journal of Investigative Dermatology (1990) 95, 271-274; doi:10.1111/1523-1747. ep12484890, International Journal of Dermatology Volume 40, Issue 10, pages 640-643, October 2001.

“It has been shown that in acne comedones the proportion of linoleic acid is markedly decreased, while palmitic acid is significantly increased. We previously reported that the decreased proportion of linoleic acid, which markedly suppresses neutrophil reactive oxygen species (ROS) generation and phagocytosis, contribute to the worsening of acne inflammation.


Q. 2

A teenager girl with moderate acne is also complaining of irregular menses. Drug of choice will be:

 A

Oral isotretinon

 B

Oral acitretin

 C

Oral minocycline

 D

Cyproterone acetate

Q. 2

A teenager girl with moderate acne is also complaining of irregular menses. Drug of choice will be:

 A

Oral isotretinon

 B

Oral acitretin

 C

Oral minocycline

 D

Cyproterone acetate

Ans. D

Explanation:

Cyproterone acetate [Ref: Neena Khanna 3/c p. 102-103; Novak’s Gynae 14/e p. 1085; Shaw’s Gyna 14/c p. 287]

  • When cyproterone acetate is given along with estrogen as an oral contraceptive for 21 days, acne usually improves by 40- 50% by the third cycle and by 80-90% by the ninth cycle. This combination regularizes menstrual bleeding.
  • There are certain dermatological conditions of the skin in females that may be caused or aggravated by androgenic hormones.

These are:-

  • Acne
  • Seborrhoea
  • Hirsutisrn
  • Female pattern hair loss
  • Hidreadiniti.s suppurativa
  • Antiandrogens are believed to have beneficial effects on these conditions.
  • Antiandrogens of various types are used to treat these conditions.
  • Antiandrogenic or weakly androgenic progesterones are one among them.
  • Antiandrogenic progesterones include 😕

– Cyproterone acetate

– Drospirenone

– Dienogest

  • Cyproterone acetate is a progesterone which has powerful antiandrogenic properties

– It has been, foundto be quite effective in the treatment of androgenetic skin conditions especially acne. In acne the effect of cyproterone acetate includes

– Reduced sebum production

– Reduced comedone production

– Several different regimes are prescribed with dose ranging from 25-200 mg daily.

Prior to the menopause the medication is usually combined with ethinylestradeol or other oral contraceptive  agent to :-

“Regulate menstrual cycle irregularities” caused by the high dose of cyproterone

– Prevent pregnancy : there are concerns that cyproterone could harm a male .fetus by leminising” it.

  • In postmenopausal women it is not necessary to combine estrogen with cyproterone acetate.

Cyproterone is usually given as oral contraceptive where it is combined with ethinylestradiol.

-Antiandrogen medication suppress the release of pituitary hormone gonadotropin which is turn reduces androgen production by ovaries.

– The combination prevents pregnancy by preventing ovulation and changing cervical mucus.

  • The intercostals nerve passes through the space without a facial sheath where it can be reliabley blocked with local anaesthetic.

Intercostal nerve blocks

  • Quick and easy to perform, single injections are given for two or three intercostals spaces above and below the incision.
  • Has the advantage of localized analgesia without the risk of sympathetic nerve blockade.
  • Used alone this technique is short acting.
  • In this technique the posterior division is often missed which supplies the posterior ligaments and skin.

Interpleural analgesia

  • Also known as intrapleural analgesia
  • Local anaesthetics are injected b/w visceral and parietal pleura
  • The technique has been found to have some benefits but local anaesthetics tend to pool in dependent areas and is also lost through chest drains, limiting effectiveness.

Crvoprobe neurolysis

  • In this technique individual intercostal nerves are destroyed by application of low temperature probe.
  • The result may last for 3 months until the nerve grow back by axonal degeneration
  • In this technique the posterior division is often missed which supplies the posterior ligaments muscles and skins
  • Neuralgia and paraesthesia are also commonly seen. This technique is rarely used these days.

Q. 3

Oral retinoid is indicated in the treat­ment of:

 A Acne vulgaris
 B Pemphigus vulgaris
 C Lupus vulgaris
 D Erythema multiforme
Q. 3

Oral retinoid is indicated in the treat­ment of:

 A Acne vulgaris
 B Pemphigus vulgaris
 C Lupus vulgaris
 D Erythema multiforme
Ans. A

Explanation:

Acne vulgaris


Q. 4

Oral retinoid is indicated in the treatment of:

 A Acne vulgaris
 B Pemphigus vulgaris
 C Lupus vulgaris
 D Erythema multiforme
Q. 4

Oral retinoid is indicated in the treatment of:

 A Acne vulgaris
 B Pemphigus vulgaris
 C Lupus vulgaris
 D Erythema multiforme
Ans. A

Explanation:

Acne vulgaris


Q. 5

A 17 year old girl with acne has been taking a drug for the last two years. She now presents with blue black pigmentation of nails. The likely medication causing the above pigmentation is:

 A

Tetracycline

 B

Minocycline

 C

Doxycycline

 D

Azithromycin

Q. 5

A 17 year old girl with acne has been taking a drug for the last two years. She now presents with blue black pigmentation of nails. The likely medication causing the above pigmentation is:

 A

Tetracycline

 B

Minocycline

 C

Doxycycline

 D

Azithromycin

Ans. B

Explanation:

There may be diffuse blue-gray, muddy appearance in sun exposed areas and hyperpigmentation of mucous membranes, teeth, nails, bones and thyroid in patients taking minocycline for longer duration.
 
Ref: Skin Diseases and Sexually Transmitted Infection, Uday Khopkar, 6th Edition, Page 110; Handbook of Dermatologic Drug Therapy By Steven R. Feldman, Kathy C. Phelps, Kelly Campbell Verzino, Page 42; Harrison’s Principles of Internal Medicine, 16th Edition, Pages 303, 1229.

Q. 6

What is the treatment for nodulocystic acne vulgaris?

 A

Isotretiroin

 B

Clindamycine cream

 C

Topical steroids

 D

Benzoyl peroxide

Q. 6

What is the treatment for nodulocystic acne vulgaris?

 A

Isotretiroin

 B

Clindamycine cream

 C

Topical steroids

 D

Benzoyl peroxide

Ans. A

Explanation:

Nodulocystic acne is a severe form of acne which is very disfiguring.

Nodulocystic acne sufferers develop nodules as well as cysts.

Extensive scaring may result from this condition.

Oral or systemic Isotretinoin is used in treatment.

Oral antibiotics and contraceptives are also used.


Q. 7

Which of the following is the drug of choice in the treatment of nodulo cystic acne?

 A

Systemic steroids

 B

Isotretinoin

 C

Estrogen

 D

Benzoylperoxide

Q. 7

Which of the following is the drug of choice in the treatment of nodulo cystic acne?

 A

Systemic steroids

 B

Isotretinoin

 C

Estrogen

 D

Benzoylperoxide

Ans. B

Explanation:

Nodulocystic acne is a severe form of acne affecting face, chest and back.

It is characterised by multiple inflammed and uninflammed nodules with great tendency for scar formation.

Isotretinoin is the drug of choice of nodulocystic acne.

It is absolutely contraindicated in pregnancy due to its teratogenic effects.


Q. 8

The proportion of which of the acids are increased in acne comedones?

 A

Linolenic acid

 B

Palmitic acid

 C

Acetic acid

 D

Linoleic acid

Q. 8

The proportion of which of the acids are increased in acne comedones?

 A

Linolenic acid

 B

Palmitic acid

 C

Acetic acid

 D

Linoleic acid

Ans. B

Explanation:

In acne comedones the proportion of linoleic acid is markedly decreased, while palmitic acid is significantly increased. Decreased proportion of linoleic acid, markedly suppresses neutrophil reactive oxygen species (ROS) generation and phagocytosis and contribute to the worsening of acne inflammation.


Q. 9

All of the following are varients of Acne, EXCEPT:

 A

Acne conglobata

 B

Acne agminata

 C

Acne fulminans

 D

Pomade acne

Q. 9

All of the following are varients of Acne, EXCEPT:

 A

Acne conglobata

 B

Acne agminata

 C

Acne fulminans

 D

Pomade acne

Ans. B

Explanation:

Acne agminata also known as lupus miliaris disseminatus faciei or facial idiopathic granulomatous with regressive evolution is a disorder of uncertain etiology.

Ref: Rook Textbook of Dermatology, 8th Edition, Page 38.37.

Q. 10

Which of the following is the most common side effect of Isotretinoin used for acne vulgaris?

 A

Facial erythema

 B

Xerosis

 C

Hair loss

 D

Cheilitis

Q. 10

Which of the following is the most common side effect of Isotretinoin used for acne vulgaris?

 A

Facial erythema

 B

Xerosis

 C

Hair loss

 D

Cheilitis

Ans. D

Explanation:

Cheilitis is the most common side effect of isotretinoin. 

Ref: Rook Textbook of Dermatology, 8th edition, Page 42.64


Q. 11

Acne Vulgaris is due to involvement of:

 A

Sebaceous Gland

 B

Pilosebaceous Gland

 C

Eccrine Gland

 D

Apocrine Gland

Q. 11

Acne Vulgaris is due to involvement of:

 A

Sebaceous Gland

 B

Pilosebaceous Gland

 C

Eccrine Gland

 D

Apocrine Gland

Ans. B

Explanation:

Acne vulgaris is a common inflammatory disease of the pilosebaceous glands. It is a self-limited disorder primarily of teenagers and young adults.

The permissive factor for the expression of the disease in adolescence is the increase in sebum production by sebaceous glands after puberty. Small cysts, called comedones, form in hair follicles due to blockage of the follicular orifice by retention of keratinous material and sebum.

The activity of bacteria (Proprionobacterium acnes) within the comedones releases free fatty acids from sebum, causes inflammation within the cyst, and results in rupture of the cyst wall. An inflammatory foreign-body reaction develops as result of extrusion of oily and keratinous debris from the cyst.

The clinical hallmark of acne vulgaris is the comedone, which may be closed (whitehead) or open (blackhead). Comedones are usually accompanied by inflammatory lesions: papules, pustules, or nodules.

The earliest lesions seen in adolescence are generally mildly inflamed or non-inflammatory comedones on the forehead. Subsequently, more typical inflammatory lesions develop on the cheeks, nose, and chin. The most common location for acne is the face, but involvement of the chest and back is common. Most disease remains mild and does not lead to scarring.

Ref: 1) Harrison’s Internal Medicine; Part 2. Cardinal Manifestations and Presentation of Diseases ; Section 9. Alterations in the Skin ; Chapter 53. Eczema, Psoriasis, Cutaneous Infections, Acne, and Other Common Skin Disorders ; Eczema and Dermatitis. 
2) The Treatment of Modern Western Medical Diseases with Chinese Medicine: A Textbook & Clinical Manual by Bob Flaws, Philippe Sionneau.


Q. 12

Adapalene is used in treatment of:

 A

Acne vulgaris

 B

Atopic dermatitis

 C

Psoriasis

 D

All of the above

Q. 12

Adapalene is used in treatment of:

 A

Acne vulgaris

 B

Atopic dermatitis

 C

Psoriasis

 D

All of the above

Ans. A

Explanation:

Adapalene (Differin) is a derivative of naphthoic acid that resembles retinoic acid in structure and effects.

It is applied as a 0.1% gel once daily.

Unlike tretinoin, adapalene is photochemically stable and shows little decrease in efficacy when used in combination with benzoyl peroxide. Adapalene is less irritating than tretinoin and is most effective in patients with mild to moderate acnevulgaris

Ref: Katzung 11th edition Chapter 61.

Q. 13

Acne vulgaris is caused by-

 A

Staph aureus

 B

Diphtheroids

 C

Sweat gland hyperplasia

 D

Obstruction to pilosebaceous duct

Q. 13

Acne vulgaris is caused by-

 A

Staph aureus

 B

Diphtheroids

 C

Sweat gland hyperplasia

 D

Obstruction to pilosebaceous duct

Ans. D

Explanation:

D i.e. Obstruction to pilosebaceous duct


Q. 14

Causative factor for acne are all except.

 A

Androgen

 B

Only food

 C

Bacterial contamination

 D

Hypercornification of duct

Q. 14

Causative factor for acne are all except.

 A

Androgen

 B

Only food

 C

Bacterial contamination

 D

Hypercornification of duct

Ans. B

Explanation:

B i.e. Only food


Q. 15

Causative factor for acne are following except

 A

Androgen

 B

Only food

 C

Keratin

 D

Cell nucleus

Q. 15

Causative factor for acne are following except

 A

Androgen

 B

Only food

 C

Keratin

 D

Cell nucleus

Ans. B

Explanation:

B. i.e. Only food


Q. 16

Comedones are characteristics of –

 A

Acne vulgaris

 B

Acne rosasea

 C

SLE

 D

Adenoma sebaeceum

Q. 16

Comedones are characteristics of –

 A

Acne vulgaris

 B

Acne rosasea

 C

SLE

 D

Adenoma sebaeceum

Ans. A

Explanation:

A. i.e. Acne Vulgaris


Q. 17

19 years old girl has multiple papulo pustular erythe­matous lesions on face and neck, the likely diagnosis is

 A

Acne rosacae

 B

Acne Vulgaris

 C

Pityriasis Versicolour

 D

Lupus Vulgaris

Q. 17

19 years old girl has multiple papulo pustular erythe­matous lesions on face and neck, the likely diagnosis is

 A

Acne rosacae

 B

Acne Vulgaris

 C

Pityriasis Versicolour

 D

Lupus Vulgaris

Ans. B

Explanation:

B i.e. Acne Vulgaris


Q. 18

Treatment of acne-

 A

13 cis retionol

 B

Minocycline/Tetracycline

 C

Erytromycin

 D

All

Q. 18

Treatment of acne-

 A

13 cis retionol

 B

Minocycline/Tetracycline

 C

Erytromycin

 D

All

Ans. D

Explanation:

A i.e. 13 cis retionol; B i.e. Minocycline; C i.e. Erytromycin


Q. 19

Treatment of acne vulgaris may include all except‑

 A

Cryotherapy

 B

Oestrogens

 C

UV light

 D

Androgens

Q. 19

Treatment of acne vulgaris may include all except‑

 A

Cryotherapy

 B

Oestrogens

 C

UV light

 D

Androgens

Ans. D

Explanation:

D. i.e. Androgen


Q. 20

Treatment of nodulocystic acne is

 A

Erythromycin

 B

Tertacycline

 C

Isoretinonine (Retinoic acid)

 D

Steroids

Q. 20

Treatment of nodulocystic acne is

 A

Erythromycin

 B

Tertacycline

 C

Isoretinonine (Retinoic acid)

 D

Steroids

Ans. C

Explanation:

C i.e. Isoretinonine


Q. 21

Recalcitrant Pustular Acne is treated by

 A

Oral Erythromycin

 B

Oral tetracycline

 C

Steriod

 D

Retinoid

Q. 21

Recalcitrant Pustular Acne is treated by

 A

Oral Erythromycin

 B

Oral tetracycline

 C

Steriod

 D

Retinoid

Ans. D

Explanation:

D i.e. Retonoid 


Q. 22

Treatment of choice for Acne vulgaris

 A

Minocycline for inflammatory acne

 B

Retinoids for comedonal acne

 C

Etretinate

 D

a and b

Q. 22

Treatment of choice for Acne vulgaris

 A

Minocycline for inflammatory acne

 B

Retinoids for comedonal acne

 C

Etretinate

 D

a and b

Ans. D

Explanation:

A, B i.e Minocycline for inflammatory acne , Retinoids for 


Q. 23

A teenager girl with moderate acne is also complaining of irregular menses. Drug of choice will be:

 A

Oral isotretinon

 B

Oral acitretin

 C

Oral minocycline

 D

Cyproterone acetate

Q. 23

A teenager girl with moderate acne is also complaining of irregular menses. Drug of choice will be:

 A

Oral isotretinon

 B

Oral acitretin

 C

Oral minocycline

 D

Cyproterone acetate

Ans. D

Explanation:

D i.e. Cyproterone acetate

Cyproterone acetate is a progestin and a weak anti androgen by virtue of binding to the androgen receptor (i.e. progestational antiandrogen that blocks androgen receptor). Because of antiandrogen action, it is efective in conditions like acne seborrhoea, hirsutism, female pattern hair loss (androgenetic hair loss in females), hidreadinitis suppurativaQ -i.e. conditions caused or aggravated by androgenic hormones.

–        Cyproterone acetate (CPA) is effective in treatment of acne as it reduces sebum production (dose dependent) & comedogenesis. In premenopausal women it is usually combined with ethinyloestradiol (Dianette & estelle 35) or other oral contraceptive agents to regulate menstrual cycle irregularitiesQ (caused by high dose cyproterone) and prevent pregnancy (d/t concerns of feminising effects of cyproterone on male fetus). Whereas, in postmenopausal women, it is not necessary to combine ethinyl oestradiol (EOD) with CPA.

Reverse sequential regimen (CPA 100 mg / day on days 5 to 15, and EOD 30-50 mg /day on cycle days 5to 26) regulates menstrual bleeding, provides excellent contraception and is effective in treatment of even severe hirsutism and acneQ. Acne usually improves 40-50% by 3rd and 80-90% by 9th cycle.


Q. 24

A 17 year old girl with Acne has been taking a drug for the last two years. Show now presents with blue black pigmentation of nails. The likely medication causing the above pigmentation is

 A

Tetracycline

 B

Minocycline

 C

Doxycycline

 D

Azithromycin

Q. 24

A 17 year old girl with Acne has been taking a drug for the last two years. Show now presents with blue black pigmentation of nails. The likely medication causing the above pigmentation is

 A

Tetracycline

 B

Minocycline

 C

Doxycycline

 D

Azithromycin

Ans. B

Explanation:

B i.e. Minocycline

  • Amongst tetracyclines (tetracycline/ minocycline/ doxycycline) pigmentation is most commonly associated with minocyclineQ. A diffuse blue-black/blue- gray/ muddy hyper pigmentationQ is an uncommon but troublesome side effect of prolonged minocycline therapy. Sites of involvement include sun exposed skin, mucus membranes (eg conjunctiva), nails, teeth, sclera, thyroid & bonesQ.
  • Two side effects unique to minocycline are drug induced lupus & blue black pigmentation. Tetracycline induced nail discolouration is yellow.

Q. 25

Acne vulgaris is due to involvement of:

 A

Sebaceous glands

 B

Eccrine glands

 C

Pilosebaceous glands

 D

Apocrine glands

Q. 25

Acne vulgaris is due to involvement of:

 A

Sebaceous glands

 B

Eccrine glands

 C

Pilosebaceous glands

 D

Apocrine glands

Ans. C

Explanation:

C i.e. Pilosebaceous glands


Q. 26

Comedones are characteristic of:           

September 2004

 A

Psoriasis

 B

Acne vulgaris

 C

Lichen planus

 D

Pemphigus

Q. 26

Comedones are characteristic of:           

September 2004

 A

Psoriasis

 B

Acne vulgaris

 C

Lichen planus

 D

Pemphigus

Ans. B

Explanation:

Ans. B i.e. Acne vulgaris


Q. 27

A girl about to marry has comedonal acne. Drug to treat such a case is: 

March 2013

 A

Topical antibiotic

 B

Benzoyl peroxide

 C

Retinoids

 D

Estrogen

Q. 27

A girl about to marry has comedonal acne. Drug to treat such a case is: 

March 2013

 A

Topical antibiotic

 B

Benzoyl peroxide

 C

Retinoids

 D

Estrogen

Ans. C

Explanation:

Ans. C i.e. Retinoids

  • Retinoids are mainly comedolytic

Acne

  • Comedones are characteristic of: Acne vulgaris
  • Comedones are:

– Small cysts,

– formed in hair follicles,

– due to blockage of the follicular orifice

– by the retention of sebum and keratinous material

  • Acen vulgaris is caused by: Obstruction of pilosebaceous duct Nodulocystic acne (NA)
  • Treatment of NA: Isotretinonin (synthetic retinoic acid)

Q. 28

A 24-year-old girl presented with complains of acne. On examination, multiple nodules, cysts and intercommunicating sinuses were seen. How will you treat her?

 A

Acitretin

 B

Oral isotretinoin

 C

Doxycycline

 D

Tazorotene

Q. 28

A 24-year-old girl presented with complains of acne. On examination, multiple nodules, cysts and intercommunicating sinuses were seen. How will you treat her?

 A

Acitretin

 B

Oral isotretinoin

 C

Doxycycline

 D

Tazorotene

Ans. B

Explanation:

Ans. b. Oral isotretinoin

Oral isotretinoin is the preferred treatment option for acne in a 24-year old girl with multiple nodules, cysts and intercommunicating sinuses


Q. 29

Treatment options for acne vulgaris is/are ‑

 A

Topical erythromycin

 B

Oral Minocycline

 C

Isotretinoin

 D

All the above

Q. 29

Treatment options for acne vulgaris is/are ‑

 A

Topical erythromycin

 B

Oral Minocycline

 C

Isotretinoin

 D

All the above

Ans. D

Explanation:

Ans. is ‘d’ i.e., All the above 

Drugs used for treatment of Acne

  • Topical
  1. Comedolytics : – Act by removing follicular plug, thereby reopen pilosebaceous ostia. Comedolytics are ; Retinoic acid, Adapalene, Azelaic acid, Tazarotene.
  2. Antibiotics : – Decrease bacterial population and have anti-inflammatory effect. Topical antibiotics for acne are ; Erythromycin, clindamycin, Benzoyl peroxide.
  • Systemic
  1. Antibiotics : – Decrease bacterial population and have anti-inflammatory effect. Systemic antibiotics for Acne vulgaris are; Tetracycline, minocycline, doxycycline, Erythromycin, Roxithromycin, Cotrimoxazole, Dapsone.
  2. Retinoids [Isotretinoin (11-cis retinoic acid)J :- Removes follicular obstruction, and also suppresses sebum secretion (Sebostatic).
  3. Antiandrogens : – Decrease sebum secretion by decreasing androgens. Examples; Cyproterone, Ethinylestranol, Spironolactone. Cyproterone acetate (along with ethinylestranol) is particularly useful in teenage girls with mensural irregularities.

Q. 30

Treatment of nodulocystic acne ‑

 A

Erythromycin

 B

Isoretinonine

 C

Tetracycline

 D

Steroids

Q. 30

Treatment of nodulocystic acne ‑

 A

Erythromycin

 B

Isoretinonine

 C

Tetracycline

 D

Steroids

Ans. B

Explanation:

Ans. is ‘b’ i.e., Isoretinonine


Q. 31

SAPHO syndrome components are all except‑

 A

Acne

 B

Hyperostosis

 C

Osteitis

 D

Acantholysis

Q. 31

SAPHO syndrome components are all except‑

 A

Acne

 B

Hyperostosis

 C

Osteitis

 D

Acantholysis

Ans. D

Explanation:

Ans. is ‘d’ i.e., Acantholysis

SAPHO Syndrome

  • SAPHO syndrome is manifested by synovitis, acne, pustulosis, hyperostosis, and osteitis.
  • It is predominantly associated with hyperostosis of the anterior chest, palmoplantarpustulosis, hidradenitissuppurativa, and acne fulminans.
  • Its etiology is unknown.
  • Reported successful treatments for SAPHO syndrome are NSAIDS, sulfasalazine, and infliximab.The bisphosphonates are beneficial for treating the associated bone pain.

Q. 32

Difference in acne rosacea & acne vulgaris-

 A

Pustule

 B

Erythema

 C

Papule

 D

Absence of comedone

Q. 32

Difference in acne rosacea & acne vulgaris-

 A

Pustule

 B

Erythema

 C

Papule

 D

Absence of comedone

Ans. D

Explanation:

Ans. is ‘d’ i.e., Absence of comedone


Q. 33

Which hormone is responsible for acne ‑

 A

Estrogen

 B

Thyroid

 C

Testosterone

 D

Gonadotropins

Q. 33

Which hormone is responsible for acne ‑

 A

Estrogen

 B

Thyroid

 C

Testosterone

 D

Gonadotropins

Ans. C

Explanation:

Ans. is ‘c’ i.e., Testosterone

Predisposing factors for Acne vulgaris

  • Genetic factors
  • Hormones -4 Androgens, glucocorticoids.
  • Psychological stress and depression.
  • Environmental factors High temperature & humidity.
  • Cosmetics -3 Containing lenolin, petroleum, vegetable oils.
  • Infection –> Propionibacterium, Pityrosporum, Staph. epidermidis.
  • Menstural cycle -4 Premenstural aggravation.
  • Hyperkeratosis of pilosebaceous ostia.
  • Drugs Antepileptics (Carbamazepine, phenytoin, phenobarbitone), antitubercular (INH, rifampin, ethionamide), antidepressants, cyclosporine, Vitamin B12.Cough syrups containing halogens (Iodides, bromides).


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