A 22-year-old woman is evaluated in the office for acne on her face that has worsened over the past few weeks and includes inflammatory and small nodular lesions. The patient has a history of moderate-to-severe acne outbreaks occurring since she was 14 years old. Her parents and siblings also had acne. She has been using a topical retinoid and topical antibiotic preparations with no improvement. She is otherwise healthy. She takes combined (estrogen-progestin) oral contraceptives for birth control and has regular menses.
On physical examination, she has several papulonodular lesions on the face. The lesions are tender, and some have pustules.
Which of the following is the most appropriate next step in the management of this patient?
A Discontinue oral contraceptive
B Prescribe a course of oral corticosteroids
C Prescribe oral isotretinoin
D Prescribe oral tetracycline
On physical examination, she has several papulonodular lesions on the face. The lesions are tender, and some have pustules.
Which of the following is the most appropriate next step in the management of this patient?
A Discontinue oral contraceptive
B Prescribe a course of oral corticosteroids
C Prescribe oral isotretinoin
D Prescribe oral tetracycline