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Acne Vulgaris

Gary I. Levine, MD Reviewed 06/2022
 


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 (5,6) as lesions resolve. 

DIET

High-glycemic index foods and skim milk may worsen acne (2)[B]...

REFERENCES

1
Dawson  AL, Dellavalle  RP. Acne vulgaris. BMJ.  2013;346:f2634. [View Abstract on OvidMedline]
2
Zaenglein  AL, Pathy...

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

  • May need 8 to 12 weeks to see the effect of therapy

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

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

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