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Acne Vulgaris — SCE Dermatology MCQ

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EasyInflammatory DermatosesAcne VulgarisSCE Dermatology

A 30-year-old woman with severe acne has completed a successful course of Isotretinoin. She achieved complete clearance. Her dermatologist advises maintenance therapy to prevent relapse. What is the recommended maintenance strategy after Isotretinoin?

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Correct answer: C — Topical retinoid (Adapalene or Tretinoin) as long-term maintenance to prevent relapse

After completing Isotretinoin, a topical retinoid (Adapalene 0.1-0.3% or Tretinoin 0.025-0.05%) is recommended as long-term maintenance therapy to prevent acne relapse. BAD guidelines emphasise that approximately 20-40% of patients relapse after a single Isotretinoin course, and maintenance topical retinoid reduces this risk by preventing microcomedone formation. The retinoid normalises follicular keratinisation. Addition of benzoyl peroxide to the retinoid provides additive benefit. Oral antibiotics should NOT be used for maintenance (resistance risk). A second course of Isotretinoin is appropriate if significant relapse occurs despite topical maintenance.

Reference: BAD 2023 Acne Guidelines; NICE CKS