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Acne Vulgaris

Gary I. Levine, MD Reviewed 04/2024
 


BASICS

DESCRIPTION

Acne vulgaris is a disorder of the pilosebaceous units, and a chronic inflammatory dermatosis notable for open/closed comedones, papules, pustules, nodules. 
Geriatric Considerations

F...

DIAGNOSIS

HISTORY

Ask about duration, relation to menses, medications, cleansing products, stress, smoking, exposures, diet, family history. 

PHYSICAL EXAM

  • Closed comedones (whiteheads), open comedones (...

TREATMENT

  • Comedonal (grade 1): keratinolytic agent

  • Mild inflammatory acne (grade 2): benzoyl peroxide +/- topical retinoid or benzoyl peroxide +/− topical antibiotic +/− topical retinoid

  • Moderate inflam...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Limit use of oral antibiotics to 3 months; taper topical antibiotic as lesions resolve (2). 

DIET

High-glycemic index foods, milk chocolate, skim milk may worsen a...

REFERENCES

1
Kolli SS, Pecone D, Pona A, et al. Topical retinoids in acne vulgaris: a systematic review. Am J Clin Dermatol. 2019;20(3):345–365. 
2
Marson JW, Baldwin HE. An overview of acne therapy, par...

SEE ALSO

Acne Rosacea, Algorithm: Acne 

CODES

ICD10

  • L70.0 Acne vulgaris

SNOMED

  • 403348008 Superficial inflammatory acne vulgaris

  • 403359004 Acne nodule

  • 238744006 Comedonal acne

  • 403347003 Superficial acne vulgaris

  • 403349000 Superficial mixed comedona...

CLINICAL PEARLS

Decrease topical frequency to every day or to every other day to lessen irritation. 

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