| • | bromides (e.g. Pro-Banthine = propantheline bromide) |
| • | iodides in vitamins with minerals |
| • | (and of course: hormones, glucocorticoids) |
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ddx: gram negative folliculitis, pityrosporum folliculitis, eosinophilic pustular folliculitis, rosacea, steroid acne, miliaria pustulosa, pseudofolliculitis, sycosis barbae, tinea barbae
Gram negative folliculitis
| • | can treat with Bactrim (or Augmentin) or with Accutane (treatment of choice) |
Treatment pearls:
| • | pearl - for patient with truncal acne, start Accutane with PO prednisone (20-40mg/day X two to four weeks) to avoid flare with keloids |
| • | alternative antibiotics: Azithromycin 500mg Qweek |
| • | Seborrheic distribution? Treat scalp for seborrheic dermatitis - Nizoral shampoo (supresses androgens and treats pityrosporum) |
| • | body acne - benzoyl peroxide 10% aqueous gel QHS works great |
| • | comedonal acne: have mom buy a comedone extractor (www.Delasco.com) and push out 5 to 10 per night |
| • | Nutmeg grater acne (kp-like?) = "Pityriasis folliculorum" - try soolantra, permethrin, or nizoral, or erythromycin |
Acne during pregnancy:
| • | azeleic acid cream is pregnancy category B |
| • | erythromycin 500 PO QD (if OBGYN approves) |
PO therapy for patient who doesn't want antibiotics:
| • | Zinc 200mg PO QD (and a MVI to get 1 to2mg of copper / day to prevent copper deficiency) without food |
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