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In: Nursing

J.S., age 16, comes to your office for a routine physical examination. You notice that she...

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

Answer the following questions. Include two references, cited in APA style.

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.

Solutions

Expert Solution

List specific treatment goals for J.S.

The goals of acne therapy include controlling acne lesions, preventing scarring, and minimizing psychological morbidity.

What drug therapy would you prescribe? Why?

Selection of topical therapy should be based on the severity and type of acne. In the case of J.s, it seems to be as mild type of acne. The mild acne is characterised by erythematous papules and occasional pustules mixed with comedones. Topical retinoids, benzoyl peroxide, and azelaic acid are effective treatments for mild acne.

Topical retinoids are versatile agents in the treatment of acne. They prevent the formation and reduce the number of comedones, making them useful against noninflammatory lesions. Topical retinoids also possess anti-inflammatory properties, making them somewhat useful in the treatment of inflammatory lesions. Adapalene (Differin) is the best tolerated topical retinoid.

Benzoyl peroxide is inexpensive and available over the counter. It has a stronger effect on papules.

Azelaic Acid is a dicarboxylic acid that has bacteriostatic and keratolytic properties. Azelaic acid (Azelex) may be particularly effective in the treatment of acne with postinflammatory hyperpigmentation.

Nightingale answered 2 years ago
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