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ComPbms.Derm.13

Acne Vulgaris

QuestionAnswer
What Chronic disorder caused by abnormal desquamation of the follicular epithelium leading to obstruction of the pilosebaceous canal resulting in inflammation and formation of papules, pustules, nodules, and comedones.
The American Academy of Dermatology classifies acne at three levels: Mild acne Presence of comedones, few papules and pustules.
The American Academy of Dermatology classifies acne at three levels: Moderate Many pustules , papules(10-20) and >10 comedones.
The American Academy of Dermatology classifies acne at three levels: Severe Numerous extensive papules, pustules and nodular lesions.
Lab testing and work up: Careful history, include all meds, treatment hx, menses hx, previous meds tried for treatment. FMH. Cosmetic and cleansing hx. Oral contraceptive use. Lab tests not useful unless UCG needed prior to starting oral medications.
Lab testing and work up: Consider thyroid studies, blood glucose, testosterone levels in females with hyperandrogenism (think PCO).
Treatment Blue light therapy for inflammatory therapy. Genesis laser therapy, this is newer and available at certain Medical spas and dermatology offices.
Topical tx General topical abx such as erythromycin/clindamycin. Retinoids (differin 1% cream/gel) bid. Tazarotene .1% cream (tazorac) bid. Retin A or micronized Retin A cream ghs.
Oral Tx Doxycycline 100mg qd or erythromycin 1 gm in 2-3 doses daily. These are first line choices and cheaper for the patient. Minocycline 50-100mg bid initially which may be weaned to a daily dose. Estrogen containing OCP's for females. Accutane derm consult.
Created by: DianaB
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