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Content Update

Feb. 19, 2019

Sarecycline (Seysara) Approved for Treatment of Acne Vulgaris: In October 2018, the FDA approved sarecycline (Seysara), a once-daily oral tablet for treatment of inflammatory lesions of non-nodular moderate to severe acne vulgaris in persons aged 9 years and older. Sarecycline is a tetracycline derivative with a narrower spectrum of activity than other tetracyclines, which may result in lower rates of bacterial resistance. Safety and efficacy of sarecycline were shown to be superior to placebo in two identical phase 3 clinical trials lasting 12 weeks. Adverse event rates were similar in nature to other tetracyclines and occurred at low rates. The high cost of the proprietary product may present a barrier to its adoption by health system formularies and widespread use by clinicians. Further research into the potential for reduced antimicrobial resistance is warranted.

LEARNING OBJECTIVES

LEARNING OBJECTIVES

Upon completion of the chapter, the reader will be able to:

  1. Describe the pathophysiology of common skin disorders.

  2. Assess the signs and symptoms of common skin disorders in a presenting patient.

  3. List the goals of treatment for patients with common skin disorders.

  4. Select appropriate nonpharmacologic and pharmacologic treatment regimens for patients presenting with common skin disorders.

  5. Identify adverse effects that may result from pharmacologic agents used in the treatment of common skin disorders.

  6. Develop a monitoring plan that will assess the safety and efficacy of the overall disease state management of common skin disorders.

  7. Create educational information for patients about common skin disorders, including appropriate self-management, available drug treatment options, and anticipated therapeutic responses.

INTRODUCTION

Several thousand skin disorders are currently documented, and many patients seek the assistance of a health care provider when a complication with their skin develops. Others will utilize self-care to effectively treat their symptoms.

This chapter discusses acne vulgaris, contact dermatitis (irritant and allergic), and diaper dermatitis; other common skin and soft tissue infections and superficial fungal infections are discussed in Chapters 73 and 83, respectively. Providing patients with appropriate therapy options, as well as patient education on treatment and prevention, will assist the successful management of many common skin disorders.

ACNE VULGARIS

Acne vulgaris is an inflammatory skin disorder of the pilosebaceous units of the skin. Although most commonly seen on the face, acne can also present on the chest, back, neck, and shoulders (Figure 65–1).1 Acne is not just a self-limiting disorder of teenagers. The clinical course of acne can be prolonged or recur, resulting in long-term physical complications, such as extensive scarring and psychological distress.2

FIGURE 65–1.

Twenty-year-old man. In this case of papulopustular acne, some inflammatory papules become nodular and thus represent early stages of nodulocystic acne. (From ...

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