Acne

HISTORY:

‍AcneSkin rash for ‍ ‍hoursdays

Location: ‍faceneckchestback

Onset: ‍gradualsudden, following ‍

‍pimples

‍blackheads

‍whiteheads

‍cysts

‍redness

‍inflammation

‍pain

‍scarring

‍menstrual irregularities

‍weight gain, ‍ ‍lbskg over ‍ ‍weeksmonths

‍hirsutism

‍depressed mood

‍anxiety



Impact on daily life or mental health: ‍none

Treatments tried: ‍none, ‍effectiveineffective



EXAM:

Skin: ‍no rash



ASSESSMENT:

‍Acne vulgaris ‍likelysuspectedpossible

DDx: ‍



PLAN:

- Blood work: ‍Testosterone, ‍DHEAS, ‍LH, ‍FSH, ‍Prolactin, ‍17-OH Progesterone

- If oral isotretinoin: ‍CBC, ‍LFTs, ‍lipid profile, ‍β-HCG

- ‍Benzoyl peroxide

- ‍Topical antibiotics

- ‍Topical retinoids

- ‍Oral antibiotics

- ‍Oral contraceptives

- ‍Oral isotretinoin

- Avoidance of oil-based cosmetics and sunscreens

- Gentle skin cleansing

- If oral isotretinoin: Advise patient to avoid pregnancy and to use two forms of contraception because of teratogenicity

- Repeat blood work in ‍ ‍daysweeks if on oral isotretinoin

- Referral to dermatologist

- Follow-up in ‍ ‍daysweeks

- Return if symptoms worsen or if new symptoms develop such as severe redness, swelling, or pus-filled blisters