Name: Mallorca, Johanna Meryl H.

Date: 02/06/2021
Group #: Group IB Case # 1

17 year old PARIS came in due to recurrent lesions on the face. It started in November

The lesions would come and go. Sometimes, it will be big, sometimes small. Some have
scarred already. This time the lesions has become bigger for the last 3 weeks hence this
consult.

Salient Features:

▪ 17 y/o, Male
▪ History of preexisting acne vulgaris
▪ Recurring lesions on the face characterized as nodulocystic acne (Based on the
picture given)
▪ Scarring

IMPRESSION: Acne Conglobata

Basis: It occurs mainly in men and more commonly in white individuals and it may
begin during adolescence. Principal lesion is a nodule, mixture with comedones, pustules
and papules. Scarring is also present.

MANAGEMENT:

Combination of topical and oral medications:

▪ Benzoyl peroxide 10% Treatment gel – It reduces the amount of acne-causing
bacteria by peeling away the skin to get rid of dead skin cells and excessive oil
trapped underneath.
▪ Oral Isotretinoin 10mg capsule – It reduces sebaceous gland size and inhibits sebum
production
Counsel the patient: Avoid exposure to natural or artificial sunlight. Avoid blood
donation during therapy and for at least 1 month following drug discontinuation. This drug
may cause dizziness, drowsiness and visual disturbances.
▪ Oral prednisone 5mg tablet – To reduce inflammation.

PREVENTION:

▪ Regular washing of face (at least twice a day)

▪ Keep clean cut hair and avoid using oils and gels on hair
▪ Keep our hands off your face : Do not prick or pop it on your own
▪ Avoid eating oily foods
▪ Destress when you need to.
ANTICIPATORY GUIDANCE

▪ Topical adapalene, tretinoin, and benzoyl peroxide can be safely used to treat acne
in adolescent children.
▪ Isotretinoin is recommended for severe acne or moderate acne that does not respond
to other therapy.
▪ Monotherapy with systemic antibiotics is not recommended because of the risk of
bacterial resistance.

References: 2016, the American Academy of Dermatology (AAD)

Nelson’s Pediatrics 20E