Alyssa is an 18-year-old who presents to clinic with a concern that her acne has worsened since she started college. She currently is using a benzoyl peroxide 5% wash once a day.

Question
Alyssa is an 18-year-old who presents to clinic with a concern that her acne has worsened since she started college. She currently is using a benzoyl peroxide 5% wash once a day.

This regimen has helped some, but she is still having breakouts of acne. She is healthy with no medical problems, and takes no medications.

In your examination, you notice open and closed comedones (white and black heads) and some inflammatory lesions (fewer than 10), but no cystic lesions.

What would you recommend? When should she follow-up? What education is given?

Case study #2 Emily is a 32-year-old nurse who presents to clinic with a 4 week history of worsening redness, dryness, and rash on her hands.

She recently graduated from nursing school and has started working on a medical-surgical unit. She washes her hands many times a day.

She tells you she had a similar problem a few years ago that persisted for months. She does not remember how that was treated. She did have eczema as a child.

The skin on Emily’s hands is red, dry, scaly, and excoriated, consistent with hand dermatitis.

How will you treat her hands? What education will you provide?

Case Study #3 Rob is a 48-year-old male with psoriasis for 4 years. It is confined to elbows, knees and buttocks.

He complains of itching, some discomfort, and significant embarrassment.

He currently is not using anything, and admits to getting frustrated in the past with treatment not working well.

What education will you provide? What will your recommended treatment be? Follow-up?

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