A 24 year old unmarried woman has multiple nodular,cystic,pustular and shoulders for 2 years. The drug of choice for her treatment would be -
High-Yield Explanation
Retinoids are comedolytic and anti inflammatory. They act by restoring the altered follicular keratinisation. Isotretinoin is a systemic retinoid highly effective in the Rx of severe, recalcitrant acne vulgaris Grade 1 acne - comedones, occasional papules Grade 2 acne - papules, comedones, few pustules Grade 3 acne - predominant pustules, nodules, abscesses Grade 4 acne- mainly pseudocysts, abscesses, widespread scarring Rx Grade 1- topical retinoids Grade 2 - depending on the type of predominant lesions present, combined use of topical benzyl peroxidase, retinoids, and antibacterials Grade 3- oral antibiotics Grade 4- oral retinoids according to history patient is suffering from grade 4 acne- drug of choice for nodulocystic grade 4 acne is isoteinoin. Reference Harrison20th edition pg 1209