title: Acne vulgaris in the context of complex medical co-morbities: the management of severe acne vulgaris in a female with retinitis pigmentosa - utilizing pulse dye laser in conjunction with medical therapy.
abstract: Acne vulgaris is a pervasive inflammatory disorder of the skin, with multiple etiologies and treatment options. Although first-line therapies exist, it is often the case that a patient will present with an underlying disorder that prohibits the use of most currently accepted treatment modalities. We present a patient with severe acne vulgaris and a history of retinitis pigmentosa who was treated with 595 nanometer pulsed dye laser therapy, in conjunction with therapeutic alternatives to first-line acne medications. Our patient exhibited a significant and sustained improvement with the combined use of 595 nanometer pulsed dye laser, Yaz (drospirenone-ethinyl estradiol), dapsone, topical metronidazole, sodium-sulfacetamide wash, and topical azelaic acid. The positive results in this case, suggest that this combined treatment modality may serve as an example of a safe and effective treatment alternative in the management of acne vulgaris complicated by medical co-morbidities that contraindicate the use of most first-line treatment options.
authors.affiliation: University of New Mexico School of Medicine. ashariff@salud.unm.edu.
authors.forename: Ayesha
authors.initials: A
authors.lastname: Shariff
authors.forename: Laura
authors.initials: L
authors.lastname: Keck
authors.forename: Barrett
authors.initials: B
authors.lastname: Zlotoff
mesh_terms: D000152:Acne Vulgaris / Q000150:complications / Q000532:radiotherapy*; D000279:Administration, Cutaneous; D000328:Adult; D000736:Androstenes / Q000627:therapeutic use; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage / Q000627:therapeutic use; D003131:Combined Modality Therapy; D000075202:Contraindications; D003622:Dapsone / Q000627:therapeutic use; D003998:Dicarboxylic Acids / Q000008:administration & dosage / Q000627:therapeutic use; D004997:Ethinyl Estradiol / Q000627:therapeutic use; D005260:Female; D006801:Humans; D054025:Lasers, Dye / Q000627:therapeutic use*; D008795:Metronidazole / Q000008:administration & dosage / Q000627:therapeutic use; D000451:Mineralocorticoid Receptor Antagonists / Q000008:administration & dosage / Q000627:therapeutic use; D017319:Photosensitizing Agents; D012163:Retinal Detachment / Q000517:prevention & control; D012174:Retinitis Pigmentosa / Q000150:complications*; D012393:Rosacea / Q000150:complications / Q000532:radiotherapy; D013409:Sulfacetamide / Q000627:therapeutic use; D013684:Telangiectasis / Q000209:etiology / Q000532:radiotherapy
chemical_list: D000736:Androstenes; D000891:Anti-Infective Agents, Local; D003998:Dicarboxylic Acids; D000451:Mineralocorticoid Receptor Antagonists; D017319:Photosensitizing Agents; C534342:drospirenone and ethinyl estradiol combination; D008795:Metronidazole; D004997:Ethinyl Estradiol; D013409:Sulfacetamide; D003622:Dapsone; C010038:azelaic acid