Derm part 2

Question 1

Treatment of acne

Answer 1

• single topical therapy (topical retinoids, benzoyl peroxide)
• topical combination therapy (topical antibiotic, benzoyl peroxide, topical retinoid)
• oral antibiotics:
  
  • tetracyclines: lymecycline, oxytetracycline, doxycycline
  • erythromycin may be used in pregnancy
  • used for a maximum of three months
• combined oral contraceptives (COCP) are an alternative to oral antibiotics in women
  
  • in combination with topical agents
  • Dianette (co-cyprindiol) - VTE risk, 2nd line, use for 3 months
• oral isotretinoin: only under specialist supervision
  
  • pregnancy is a contraindication to topical and oral retinoid treatment

Question 2

How do you classify acne?

Answer 2

• mild: open and closed comedones with or without sparse inflammatory lesions
• moderate acne: widespread non-inflammatory lesions and numerous papules and pustules
• severe acne: extensive inflammatory lesions, which may include nodules, pitting, and scarring