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case: A 17 yo girl comes to the office that her skin is “breaking out”.She has not prior h/o skin problems but has noticed that during the week before each menstrual cycle she develops red pustules on her cheeks , chin, and back.These changes improve over the course of the month , only to return prior to her subsequent menses.she has no other significant past medical history and never taken OCPs.She is thin and in no acute distress.All of her VS are normal and her PE is unremarkable xcept for numerous comedons around the cheeks and chin and scattered erythematous pustules on her cheeks & upper back. Wat’s the appropriate treatment ………
2.topical corticosteroid tx.
3.topical benzoyl peroxide
topical benzyol peroxide and topical clindamycin both are first line agent against acne vulgaris......not sure of diagnosis but i think its acne...
YESSSSSS, DPS, U THOUGHT IT OUT GOOOOOD..........
ANSWER IS….4 , topical clindamycin
This pt. Clearly has acne vulgaris. If this pt. Had NO COMEDONS, it can be called a rosacea case.And out of the options listed here, 3,4,5,6 can be used in acne vulgaris, but when?????
For comedons ONLY-----benzoyl peroxide or Retin-A
When inflammatory lesions present----topical clindamycin and erythromycin
Oral antibiotics/tetracyclins r less preferred given the frequency of it’s s/es.
Oral isotretinoin is highly effective in severe cystic cases of acne.However this drug is highly teratogenic and shud be cautious in using it………
NOTE: ----------------.Females of child bearing age shud be instructed to use 2 forms of contraception 1 month prior to starting isotretinoin, while taking the medication, and for 1 month after isotretinoin has been stopped. Pregnancy tests must be negative before a prescription is given and monthly preganancy tests must be negative before prescriptions are renewed.
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