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(3) Nodules are larger inflamed lesions, which occur deeper within the dermal layer of the skin. Nodules are felt like hard, tender lumps beneath the skin. They occur as the follicular walls break and the contaminated debris empties deep within the skin, infecting the adjacent follicles. Nodules are severe acne lesions, which necessitates dermatologic consultation.
Some of the names are Lonicera, Tangkuei, Angelica, Fritillaria, Trichosanthes, Oolibanum, Myrrh, Gleditsia Spine, Aurantum, Paonia, Platycodon, Coix and Astragalus.
Oral antibiotics are indicated for moderate-to severe disease, for the treatment of acne on the chest, back, or shoulders, and in patients with inflammatory disease in whom topical combinations have failed or are not tolerated. After control of the acne is achieved and maintained for at least two months, a reduction in the dose can be attempted. Hormonal treatment is especially useful in women who desire contraception or have other manifestations of hyperandrogenism, such as irregular menstrual cycles or hirsute. Oral antibiotics and topical therapy may be used in combination with hormonal treatments.When the use of this agent is being considered, an assessment of the severity of disease should include the effect of the acne on the patient, such as the potential for scarring.
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