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Acne Vulgaris

Gary I. Levine, MD Reviewed 06/2020
 


BASICS

DESCRIPTION

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

  • Systems affected: skin/e...

DIAGNOSIS

HISTORY

  • Ask about duration, medications, cleansing products, stress, smoking, exposures, diet, and family history.

  • Females may worsen 1 week prior to menses.

PHYSICAL EXAM

  • Closed comedones (whit...

TREATMENT

  • Comedonal (grade 1): keratinolytic agent (see as follows for specific agents)

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

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Limit use of oral to 3 months; taper topical antibiotic (6,7) as inflammatory lesions resolve. 

DIET

Data suggests that high-glycemic index foods and skim milk may ...

REFERENCES

1
Admani S, Barrio VR. Evaluation and treatment of acne from infancy to preadolescence. Dermatol Ther.  2013;26(6):462–466.
2
Picardo M, Eichenfield LF, Tan J. Acne and rosacea. Dermatol ...

ADDITIONAL READING

SEE ALSO

  • Acne Rosacea

  • Algorithm: Acne

CODES

ICD10

  • L70.0 Acne vulgaris

ICD9

  • 706.1 Other acne

  • 706.0 Acne varioliformis

SNOMED

  • 403348008 Superficial inflammatory acne vulgaris

  • 403359004 Acne nodule

  • 403349000 Superficial mixed comedonal and inflammat...

CLINICAL PEARLS

  • Full results for changes in therapy take 8 to 12 weeks.

  • Decrease topical frequency to every day or to every other day for irritation.

  • Use benzoyl peroxide every time a topical or oral an...

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