Treatment of nodulocystic acne -

Ans. is 'b' i.e., Isoretinonine o The DOC for nodulocystic acne is oral isotretinoin (13-Cis Retinoic acid).Guidlines of management of acneo Step 1 - For mild acne (< 10 lesions) : -# Topical therapy is used. Combination therapy is best. Benzoyl peroxide - erythromycin gel plus topical retinoids combination is used. Topical erythromycin-Benzoyl peroxide gels are applied during the day; topical retinoids are applied in the evening.o Step 2 - For moderate acne (10-25 lesions), and mild acne not responding to topical therapy : -Oral antibiotic is added to above topical regimen. Most effective antibiotic is minocycline or doxycycline.In females, moderate acne can be controlled with high doses of estrogens combined with progesterone or antiandrogens.o Step 3 - For severe acne, nodulocy Stic lesions, large nodular lesions, and moderate acne not responding to oral antibiotics (Recalcitrant acne) : -Isotretinoin is the drug of choice. Isotretinoin is the single most advance in the management of severe acne. It inhibits sebaceous gland function and keratinization and is very effective. Oral isotretinoin leads to complete remission in almost all cases. If patient cannot afford isotretinoin, dapsone is a useful alternative. Intralesional steroids can help in management of cysts and nodules. If there are signs of androgen excess, antiandrogens (cyproterone acetate) can be used with estrogen.