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Acne. High Fever, Severe Myalgia, Lymphedema, Have Scars. Developed A Nodulo-custic Patch. Treatment?
Dear sir, I had mild to moderate acne since the past two yrs. Recently I developed a nodulo-custic patch on my right cheek and was prescribed 20mg isotretinoin. Since then, all my problems have begun. 7 days after starting, i developed a combination of severe acne fulminans and conglobat. I had high fever, severe myalgia, lymphedema around eyes and many other symptoms. Isotetinoin was stopped. I was on antibiotics for 2 months. In between i was given short course of steroids(prednisolone40mg) for 5 days. Acne responded miraculously. After the course it returned. After cailure of treatment isotrwtinoin was again started on 15th march with steroid coverage ( prednisolone for 10 days in the begining followex by a shot of triamcinolone 40 IM ). Acne was resolving but of late has started to increase again. I am left with deep nodules and red scars all over my face. Please advise. I am a 18 yr old male, height 6 ft , wt. 80 kgs. Also, can I use cosmelite cream on the red patches on my forehead to clear the marks? That area is acne free.
Mon, 6 May 2013
ok dear ,i can understand ur problem.though i generally do the dental surgery,but um aslo my mbbs.every day i found many patient suffering from acne of ur age group at our derma opd.at your age acne doest not only afftect on ur skin by leaving scar marks but also it affects on ur mind.from ur history it is obvious that u had gone through a severe allergic reaction with isotretinoin wht vit a derivative ,
i will suggest u to use adapalene gel instead of tritinion although effect of adp and tretn almost same ,they act by changing the dna ,and try to exfoliate the keratinocyte ,but adp has its own selective receptor ,side effect is less , though before use skin test on forearm is must for u.
beside this u can also use clindamycin gel
systemically u can take doxt 100 mg od.but i will sugghest u to use topical antibiotic cream like clindamycin to use,because less chance of superinfection
before using adapln start with clindamycin gel..thn shift to the combination
i will suggest u to use adapalene gel instead of tritinion although effect of adp and tretn almost same ,they act by changing the dna ,and try to exfoliate the keratinocyte ,but adp has its own selective receptor ,side effect is less , though before use skin test on forearm is must for u.
beside this u can also use clindamycin gel
systemically u can take doxt 100 mg od.but i will sugghest u to use topical antibiotic cream like clindamycin to use,because less chance of superinfection
before using adapln start with clindamycin gel..thn shift to the combination
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