25. Acne vulgaris - Treatment Systemic therapy as oral antibiotics or cyproterone acetate should be given in conjunction with appropriate topical therapy. II) Moderate to severe acne Isotretinoin III) Severe acne
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33. Acne type Mild acne “Comedones” Initial therapy Maintenance Mild-to-moderate acne (papular / pustular) Moderate-to-severe acne (severe nodulocystic) T Adapalene or T retinoid or Bpo / T antibiotics T Adapalene + T / oral antibiotic or + Bpo antibiotic or ?? oral isotretinoin Oral isotretinoin or Cyproterone acetate T adapalene (Differin ® ) Failure Failure 3 ms Success After 3 ms success Success
34. Initial therapy Maintenance Acne type Modified from: Leyden, J Am Acad Dermatol, 2003 Oral isotretinoin or Hormonal therapy – women T. Retinoid + T./oral antibiotic or T. retinoid + BPO … antibiotic or fluid active (sebium AKN) BPO or ?? Oral isotretinoin Failure 3 ms Failure Mild acne “ comedones” Mild-to-moderate acne (papular/pustular) Moderate-to-severe acne (severe nodulocystic) Success T. Retinoid or T. Retinoid + BPO/T. antibiotics After 3 ms success T. Retinoid &/or BPO or Fluidactive (sebium AKN) Success
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55. Could acne be related to a change in skin lipid composition irrespective of the rate of sebum excretion ?
60. … and consider the possibility the patient is excoriating because of demodecideosis Crotamiton or Pyrethrin Acne Excori é e
61. Acne Excori é e Use topicals! … even if you don’t think they help … it gives the patient some way to touch the face without guilt – and without picking
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86. Perioral dermatitis Persistent erythematous eruption of tiny papules and pustules around the mouth, nose and may be eyes. A clear zone is often seen around the vermilion border of the lips.