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Case CC: Padma Patil is a 16 yo female who presents to the clinic complaining of acne erupting on her cheeks, nose, and chin. She states that she has tried some over the counter products including salicylic acid but that has not seemed to work for her. She is distressed about her appearance and would like your advice. PMH: Allergic rhinitis FH: Non-Contributory Allergies: PCN (itching and rash) Physical Exam: Vitals: BP 110/66, HR- 65, RR- 12, Temp 98 F General: Well-appearing young female in her teens. Somewhat distressed over her appearance. CV: RRR Lungs: Clear to auscultation Integuement: Skin is warm and dry. Numerous closed comedones are apparent across her cheeks, nose, and chin. Papules are scattered on her cheeks. No hyperpigmentation or scarring is apparent. She has oily patches scattered on her face. Medications: Loratadine OTC 1. If Padma was also interested in starting birth control today what would you prescribe? 2. If Padma had severe cystic acne what would be a potential treatment options for her that decrease sebum production, gland size, and abnormal keratinization? 3. What would you need to perform before Padma started this therapy?
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