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Severe Recalcitrant Nodular Acne

Severe recalcitrant nodular acne is another way of saying severe acne with large, painful bumps that don’t go away with other acne medicines. Patients with severe recalcitrant nodular acne are at higher risk of scarring.

Accutane is used to treat a type of severe acne (nodular acne) that has not been helped by other treatments, including antibiotics.

Important Safety Information

Accutane can harm your unborn baby, including birth defects (deformed babies), loss of a baby before birth (miscarriage), death of the baby, and early (premature) births. Patients who are pregnant or who plan to become pregnant must not take Accutane. Accutane can cause serious mental health problems, including depression, psychosis, and suicide.

Please see the Medication Guide and full Prescribing Information here for Boxed Warning, Contraindications, other important Warnings and Precautions, Drug Interactions, Use in Specific Populations, and other Adverse Reactions.

There are four main causes of the development of severe nodular acne: excess oils, slower skin cell turnover, bacterial growth and inflammation.

Excess oils: the oily substance that protects your skin can contribute to acne when too much is produced.

Slower skin cell turnover: dead skin cells that normally just fall off can get stuck in skin oils instead and clog your pores.

Bacterial growth: a specific bacteria that is normally harmless begins to multiply if it gets trapped in a clogged pore.

Inflammation: multiplying bacteria trigger inflammation that results in red, swollen, painful and pus-filled pimples.


Acne is the most common skin condition in the United States and can affect up to 50 million Americans every year. By the age of 21, more than 90% of males and 80% of females will have experienced acne, and the condition can continue into adulthood.

TARGADOX is a tetracycline-class antimicrobial indicated as adjunctive therapy for severe acne.

To reduce the development of drug-resistant bacteria as well as to maintain the effectiveness of TARGADOX and other antibacterial drugs, TARGADOX should be used only as indicated.

TARGADOX should not be used by persons who have shown hypersensitivity to any of the tetracyclines.

Important Safety Information

XIMINO is a tetracycline-class drug used to treat pimples and red bumps (non-nodular inflammatory lesions) that happen with moderate to severe acne vulgaris in people 12 years and older.

XIMINO is not effective for acne that is not red-looking (this means acne that is not inflammatory). It is not known whether Ximino is: safe for use longer than 12 weeks, safe and effective for the treatment of infections, or safe and effective in children under the age of 12 years

Do not take XIMINO if you are allergic to tetracycline class medicines. Ask your doctor or pharmacist for a list of these medicines if you are not sure.

Important Safety Information

Acne occurs when hair follicles are clogged with oils and dead skin cells. Hormones play a central role in the development of acne, which could be further aggravated by stress, environmental factors, over-washing or using harsh skin products, excessive touching of the face and diet. Acne can appear on the face, forehead, shoulders, back and chest in the form of whiteheads, blackheads or pimples and is often accompanied by oily skin.

Although lesions are temporary, acne can be progressive if not addressed, and permanent scarring can occur as a complication.

Fungal Skin Infections

Fungal skin infections are caused by pathogenic fungi, which affect structures such as the hair and skin, and are usually accompanied with itching.

EXELDERM Cream is an antifungal agent indicated for the treatment of tinea pedis, tinea cruris, tinea corporis, and tinea versicolor.

EXELDERM Solution is a broad-spectrum antifungal agent indicated for the treatment of tinea cruris, tinea corporis, and tinea versicolor. Effectiveness of EXELDERM Solution has not been proven in tinea pedis.

EXELDERM Cream and Solution are contraindicated in patients who have a history of hypersensitivity to any of its ingredients. Use EXELDERM Cream and Solution as directed by your physician only.

Important Safety Information

Athlete’s Foot
Athlete’s foot, also known as tinea pedis, is a common fungal infection affecting the superficial skin of the foot. Up to 25% of Americans are affected by this condition at any one time. The infection most often starts in the space between the toes and can be accompanied by redness, itching, cracked skin and bad odors. It can be spread through contact with infected skin flakes or contact with fungi in damp areas such as public showers, pool areas or locker rooms, and can be exacerbated by wearing restrictive footwear and/or sweaty socks.

Jock Itch
Jock itch, also known as tinea cruris, affects the skin of the groin, buttocks and upper thighs, especially in athletes. These areas are particularly susceptible to infection due to the presence of sweat and moisture, which creates perfect conditions for fungal growth. Jock itch presents as a highly visible, scaly plaque with a raised edge, with symptoms including an uncomfortable, itchy rash on the groin, which may be painful if the skin is breaking down due to excess moisture.

Ringworm, also known as tinea corporis, is a fungal infection affecting the trunk, neck, arms and legs, and does not have anything to do with worms. In the United States, 1 in 5 cases of these fungal skin infections are due to ringworm. Ringworm typically presents with a visible, itchy, red rash and single or multiple lesions with raised borders that spread from a core, giving it the characteristic ring shape.

Pityriasis, also known as tinea versicolor, is caused by yeasts, which are a type of fungi that causes the skin to appear lighter, darker or redder than surrounding unaffected skin. It most commonly occurs on the chest and back, but other affected areas include upper arms, neck and face. Pityriasis is most noticeable during the summer months, when the affected areas do not tan as easily as normal skin. Symptoms include patches of discolored skin, mild itching and scaling of skin. It is not contagious or painful.


Dermatitis is an inflammation of the skin caused by infections, allergies or irritating substances that results in skin rashes.The two most common types of dermatitis are atopic dermatitis and contact dermatitis.

Luxamend Wound Cream is indicated for use in radiation dermatitis.

Luxamend is contraindicated for use on bleeding wounds, skin rashes related to food or medicine allergies, and when an allergy to one of the ingredients is known.

Important Safety Information

Ceracade Skin Emulsion is to be used to treat dry skin conditions and to manage and relieve the burning and itching associated with various types of dermatitis, including atopic dermatitis, irritant contact dermatitis and radiation dermatitis.

Ceracade Skin Emulsion is contraindicated in persons with known hypersensitivity to any of the components of the formulation.

Important Safety Information

Atopic Dermatitis
Atopic dermatitis, also known as atopic eczema, is an inherited disorder that usually develops in the first five years of life and causes extremely itchy rashes. This condition is very common worldwide, and in the United States, 1 in 10 Americans has atopic dermatitis. It has a wide range of symptoms, from excessively dry, itchy skin to painful, itchy rashes.
Irritant Contact Dermatitis
Irritant contact dermatitis is a type of contact dermatitis that occurs when skin cells are damaged by exposure to irritants such as detergents, soaps, bleach, hair dye or makeup. This type of contact dermatitis does not involve an allergic reaction by the immune system and accounts for 80% of all contact dermatitis cases. Symptoms include burning or blistering of the skin, as well as itching.

Radiation Dermatitis
Radiation dermatitis is a common consequence of radiation therapy. Up to 85% of radiation therapy patients develop moderate-to-severe skin reactions. Often termed as skin “burns,” radiation skin reactions are not burns. Rather, they are caused when an imbalance between the normal production of skin cells and the basal cell layer of the skin occurs, damaging the cells at the skin surface.

While a patient undergoes radiotherapy, changes to the skin become noticeable. Early stages of the reaction appear as redness, as well as a mild tightness and itching of the skin. Irritation progresses to soreness, patchy redness and irritation, and pus-like drainage.

Wounds, Abrasions, Skin Ulcers, Sunburn & Donor Site Wounds

Minor cuts and scrapes, superficial wounds and abrasions are a common part of everyday life. It only takes one false move with a potato peeler to cut yourself or a stumble off of a curb to scrape your knee. Though these conditions may not seem very serious, they can cause redness, irritation, inflammation and pain, and become infected if left untreated. Proper wound care and application of topical treatments can reduce the risk of scarring. It takes three months for the wounded area to almost achieve pre-trauma strength; however, the entire healing process could take a few years.

Luxamend Wound Cream is indicated for the treatment of full thickness and superficial wounds, pressure sores, dermal ulcers, 1st and 2nd degree burns, dermal donor and graft site management, radiation dermatitis, and minor abrasions.

Luxamend is contraindicated for use on bleeding wounds, skin rashes related to food or medicine allergies, and when an allergy to one of the ingredients is known.

Important Safety Information

Sunburn remains one of the most common and preventable skin injuries. It is caused by overexposure to ultraviolet radiation (UVR) through indoor tanning beds or outdoor sunlight. Symptoms include mild to severe redness, skin warmth and tenderness, blistering, swelling and pain. Treatment of sunburn should begin as soon as you notice the symptoms.

Skin ulcers are caused by factors affecting the normal healing of the skin such as problems with blood circulation or injury/pressure. Some of the symptoms include pain, bleeding, discharge, bad odor and itching. With inadequate treatment, skin ulcers can deteriorate and develop complications such as infections, pain and sepsis.