1. A 16-year-old male presents with comedonal acne on his forehead and cheeks.

He has been using over-the-counter benzoyl peroxide gel for two months

without improvement. What is the most appropriate next step in his

management?

a) Prescribe oral isotretinoin

b) Prescribe topical clindamycin

c) Prescribe oral doxycycline

d) Prescribe topical retinoid*

Rationale: Topical retinoids are the first-line treatment for comedonal acne, as

they unclog the pores and prevent new comedones from forming. Benzoyl

peroxide is effective for mild inflammatory acne, but not for comedonal acne.

Oral isotretinoin is reserved for severe or resistant cases of acne, and has

significant side effects. Topical clindamycin and oral doxycycline are

antibiotics that are used for moderate to severe inflammatory acne, but not for

comedonal acne.

2. A 22-year-old female presents with papulopustular acne on her chin and

jawline. She reports having irregular menstrual cycles and hirsutism. She has

tried several topical agents without success. What is the most likely

underlying cause of her acne?

a) Polycystic ovary syndrome (PCOS)*

b) Cushing's syndrome

c) Hypothyroidism

d) Acromegaly