J.S., age 16, comes to your office for a routine physical examination. You notice that she has facial acne that she is hiding with heavy makeup. She has tried Clearasil inconsistently without relief. She works at a fast food restaurant as a cook after school and on the weekends. Her mother has made her stop eating chocolates and greasy foods, but that has not seemed to help her. She is concerned because her prom is in 6 weeks and she wants her face clear. On physical examination, there are open and closed comedones as well as papules on her face and back. No scarring is evident. J.S. confides that she has recently become sexually active. Diagnosis: Acne Vulgaris.
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List specific treatment goals for J.S.
What drug therapy would you prescribe? Why?
What are the parameters for monitoring the success of the therapy?
Describe specific patient education based on the prescribed therapy.
List one or two adverse reactions for the selected agent that would cause you to change therapy.
What would be the choice for second-line therapy?
What over-the-counter or dietary supplement would you recommend to J.S.?
What dietary and lifestyle changes should be recommended for J.S.?
Describe one or two drug–drug or drug–food interactions for the selected agent.
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