ACNE SCARS JAAD CME

1. A patient comes to the office as a follow-up for active acne and acne scarring. He has been on Doxycycline for 3 months and is transitioning back to topicals at this visit. What is the type of acne scarring being described and when is it appropriate for our patient to undergo a cosmetic procedure for his scarring?

• Boxcar- the patient can be scheduled for a procedure immediately

• Icepick-the patient can undergo a procedure once well maintained on topical therapy for at least 6 months without frequent breakouts

• 
  

  Boxcar-the patient should wait six months until undergoing a procedure for scarring

• Rolling- the patient can undergo a procedure once well maintained on topical therapy for at least 6 months without frequent breakouts

• Ice pick- the patient can be scheduled for a procedure immediately

. A patient comes to the office for evaluation of acne scarring. On exam he has hypopigmented, firm oval shaped papules along his jawline and oval to square “U shaped” depressions with sharp vertical edges on his bilateral cheeks. What type of scarring does this patient demonstrate?

• Boxcar and Icepick

• Rolling and Boxcar

• Papular and Rolling

• Icepick and Rolling

• Papular and Boxcar

A patient with Fitzpatrick IV skin presents to your surgical clinic for aggressive treatment of their acne scarring. Exam demonstrates rolling and icepick scars. She expresses that she has researched many options that she would like to discuss, but is willing to undergo whichever treatment is deemed clinically appropriate.

Which is not an important action to perform at this initial visit?Have the patient perform the SCARS and FASQoL self-assessments

• Have the patient perform the SCARS and FASQoL self-assessments

• Perform a quantitative assessment

• Discuss all clinically appropriate treatment options in addition to the treatments options the patient has researched

• Discuss pre-treatment topical therapies to prevent post-inflammatory hyperpigmentation

• Provide pricing at the end of the appointment

A patient with treatment-naïve moderate acne and associated scarring presents to your clinic to discuss acne scarring management. They are hesitant to pursue surgical treatment and would like to discuss non-surgical options. You consider options and determine that the patient may benefit from a topical treatment option.

Which of the following options would be an appropriate medication to start?

• Benzoyl peroxide 2.5%-clindamycin 1% combination applied daily

• Adapalene 0.1%-benzoyl peroxide 2.5% combination applied nightly

• Hydroquinone 0.1% applied nightly

• Topical epidermal growth factor applied twice daily

• Retinoic acid 0.025%-glycolic acid 12% applied nightly

Which of the following is an advantage of the Er:YAG laser over the Er:Glass laser in the treatment of acne scarring?

• More dramatic results after each treatment

• 
  

  Less risk of post-inflammatory hyperpigmentation

• Faster-resolving post-inflammatory hyperpigmentation

• 
  Less downtime after treatment

• 
  Less pain

A patient presents for treatment of the acne scar pictured in Figure 1. The scar has not been previously treated. What is the most appropriate first line treatment based on the clinical presentation?

• Pulsed dye laser

• Microdermabrasion

• Subcision with saline injection

• 
  TCA CROSS

• 
  Tretinoin 0.05% applied nightly

Which of the following is a safe and effective treatment for the treatment of rolling scars in a patient with Fitzpatrick skin type V?

• 
  TCA Cross

• 
  Phenol chemical peel

• 
  Punch elevation

• 
  Fractionated CO2 laser

• 
  Picosecond alexandrite laser

A patient presents for treatment of the scars pictured in Figure 1. You discuss treatment with TCA-CROSS. An important adverse event to discuss includes:

• 
  Enlargement of the scar

• Mycobacterial infection

• Cardiac events

• 
  Subcutaneous nodule

• Laryngeal edema