Acne is one of the most common disorders treated by dermatologists and other health care providers. While it most often affects adolescents, it is not uncommon in adults and can also be seen in children. This evidence-based guideline addresses important clinical questions that arise in its management. Issues from grading of acne to the topical and systemic management of the disease are reviewed. Suggestions on use are provided based on available evidence.

Oral lichenoid reactions represent a common end point in response to extrinsic agents (drugs, allergens), altered self-antigens, or superantigens. Oral lichen planus, a common and under-recognized inflammatory disorder, shares many clinical and histopathological features with oral lichenoid drug reaction and oral lichenoid contact reaction. Clinical presentation can vary from asymptomatic white reticular striae to painful erythema and erosions. Cutaneous and additional mucosal involvement is common. Delay in diagnosis of extraoral mucocutaneous lichen planus (LP) results in conjunctival scarring; vaginal stenosis; vulvar destruction; and stricture of the esophagus, urethra, and external auditory meatus. Although the etiology of LP is idiopathic, oral lichenoid reactions may be caused by medications or exogenous agents such as cinnamates and other flavorings. The clinical features, evaluation, and management of these oral lichenoid reactions are discussed.

This review focuses on the treatment options for adult female patients with acne. Acne in adult female patients may start during adolescence and persist or have an onset in adulthood. Acne has various psychosocial effects that impact patients’ quality of life. Treatment of acne in adult women specifically has its challenges due to the considerations of patient preferences, pregnancy, and lactation. Treatments vary widely and treatment should be tailored specifically for each individual woman. We review conventional therapies with high levels of evidence, additional treatments with support from cohort studies and case reports, complementary and/or alternative therapies, and new agents under development for the treatment of patients with acne.

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