Jackie, a 16-year-old female, presents to your office with concerns about her acne. She has been dealing with acne on her face, neck,

Jackie, a 16-year-old female, presents to your office with concerns about her acne. She has been dealing with acne on her face, neck, and upper back for over a year. Nothing over the counter has seemed to help, including adapalene gel, benzoyl peroxide, and twice-daily facial washes. She reports she mainly has red pustules with a few cystic lesions. About a week prior to her menses, she does notice a slight increase in lesions, but it is bothersome all the time. She is embarrassed to wear tank tops because of the acne on her shoulders. PMH: Unremarkable Medications: Adapalene gel daily Allergies: Sulfa (rash) Upon exam, you find her shoulders have approximately 20 lesions with erythematous bases and pustules. Several on her neck and forehead. Black comedones on nose, forehead, and side of face. A couple pustule lesions noted on her upper arms. Questions 1. What would you recommend to Jackie for acne treatment? (2 points) 2. One treatment option for females with acne is a combined oral contraceptive (COC). What are some imperative health history questions you’d ask before starting a COC?

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