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Acne
Acne

Acne

Introduction

Acne is a multifactorial disease primarily of teenagers with follicular plugging and inflammation. It presents with polymorphic lesions including, papules, and lesions involving the face, chest, shoulders and back.

Signs & symptoms

• Open and closed comedones
• Pustules
• Nodular and cystic lesions involving the face, chest, shoulder and the back

Diagnostic criteria

• Open and closed comedones
• Pustules
• Nodular and cystic lesions involving the face, chest, shoulder and the back

Investigation

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Treatment

  • Non-Pharmacological treatment

    • Avoid underlying precipitating factor e.g. stress, nuts, chocolate, overuse of ointments on skin, steroids, anticonvulsant drugs etc.
    • Encourage a healthy lifestyle – exercise, sunshine exposure, etc.
    • Use ordinary soap (harsh antibacterial cleansers or iodine-containing preparations may aggravate the acne)
  • Pharmacological

    Mild to moderate acne without scarring

    Apply

    • Benzoyl peroxide 2.5%–5% once nocte

    OR

    • Retinoid 0.05% once nocte

    Moderate acne with scarring-

    • Doxycycline 100mg daily for 1–3 month

    OR

    • Erythromycin 250mg 6 hourly for 1–3 month

    AND

    • Benzoyl peroxide or topical retinoid as above.

    Nodulocystic and/or conglobate acne

    • Isotretinoin (PO) 0.025–0.5mg/kg for at least 3–6 months

    Acne fulminans

    • Isotretinoin (PO) 0.025–0.5mg/kg for at least 4–6 months
    • Prednisolone (PO) 45mg start then 5mg reduction daily up to 0.

Prevention

• Avoid underlying precipitating factor e.g. stress, nuts, chocolate, overuse of ointments on skin, steroids, anticonvulsant drugs etc.
• Encourage a healthy lifestyle – exercise, sunshine exposure, etc.
• Use ordinary soap (harsh antibacterial cleansers or iodine-containing preparations may aggravate the acne)

Updated on,

3 Novemba 2020 12:32:28

References

    1.STG
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