Rosh Pediatrics Practice Exam

What is the most appropriate treatment for a 14-year-old girl with inflamed papules and pustules, considering the most likely diagnosis?

1. Combination oral contraceptive

2. Oral isotretinoin plus oral steroid

3. Oral minocycline with topical hydroquinone

4. Topical tretinoin, oral minocycline, and topical benzoyl peroxide

The correct answer is: Topical tretinoin, oral minocycline, and topical benzoyl peroxide

The most appropriate treatment for a 14-year-old girl with inflamed papules and pustules, likely indicative of moderate to severe acne, involves a combination of topical and oral therapies. Topical tretinoin helps to unclog pores and prevent the formation of new acne lesions, while oral minocycline, which is a systemic antibiotic, addresses the inflammatory aspect of the acne by reducing bacteria and inflammation associated with acne lesions. Topical benzoyl peroxide is also included in the regimen to further combat Propionibacterium acnes, the bacteria involved in acne formation, and it has additional comedolytic properties, assisting in the prevention of clogged pores. This multi-faceted approach effectively targets acne at different levels, making it appropriate for a teenager experiencing a significant amount of inflamed papules and pustules. In contrast to the other choices, this combined method provides a comprehensive treatment plan tailored to the severity of acne typically seen in adolescents. Other options may be less effective or not suitable for the condition presented, as they either do not address the inflammatory component or do not incorporate effective topical treatments.