April Week 4

ARTICLE: Managing Adolescent Acne: PIR 2005.

Ronald is a 13 year old boy who comes into your office due to new skin lesions over the last couple of years. He has white and black papules on his face. He wonders if tee tree oil is the drug of choice for him.
1. What is acne a disorder of? What kind of acne does this patient have? How do you grade the severity of facial acne?
2. How can androgens play a role in acne?
3. Does bacteria play a role in acne and if so which type?
4. Ronald wonders what foods predispose you to acne and if washing his face multiple times a day prevent acne. What is your response to this?
5. What is your proposed treatment? Is tea tree oil a viable treatment?
6. What are some other disorders that mimic acne?
7. How long does it take for treatment for acne to be effective?
8. What would you give as advice for starting topical retinoid cream? What would you advise a patient in terms of adverse effects for retinoid cream and benzoyl peroxide?

Alice is a 17 year old girl who comes into your office with inflammatory erythemetous papules and comedones on ½ of her face. 
1. What kind of acne does Alice have in terms of severity?
2. What kind of treatment options are available for her?
3. Are OCPs, and if so what kind, are a suitable treatment adjunct for her?
4. She expresses interest in accutane (isotretinoin). What type of acne is this reserved for and what are some side effects?