Acne vlugaris (pumch)

A 21-year-old male patient with acne vulgaris before and after treatment. A. Multiple nodules and cysts were seen on the face. B. After taking 20 mg/d of oral isotretinoin and 1 g/d of erythromycin, the lesions improved significantly, and cysts and nodules were both disappeared. C. The most severe lesion before treatment was cyst, and the clinical grading was severe (Grade Ⅳ). D. The most severe lesion after treatment was inflammatory papule with a clinical grading of Grade Ⅱ. E. Pre-treatment ultrasound showed a pseudocyst of approximately 11 mm-sized in the dermis with poorly defined borders and uneven internal echogenicity (SSSA-Grade Ⅲ). F. Although the lesion had significantly reduction after treatment, ultrasound still showed a pseudocyst of about 6mm (SSSA-Grade Ⅲ). G.H. Schematic diagrams of the most severe lesion before and after treatment.