Question 1
A 14-year-old female presents with deep, painful erythematous nodules on her cheeks and chin. The focused physical exam also reveals depressed atrophic scars over previously healed lesions.
▸ Why D is the answer
The defining features of severe nodular acne include deep, painful nodules, cysts, and the presence of atrophic scars. Mild acne is primarily comedonal, and moderate acne involves papules and pustules but lacks deep nodules and extensive scarring. An acute acneiform eruption typically presents as monomorphic lesions without the chronic scarring seen in this patient. Recognizing severe acne is critical to initiate timely systemic therapy and prevent further permanent scarring.
🔑 Key takeaway
The presence of deep nodules and atrophic scarring categorizes acne vulgaris as severe, requiring aggressive systemic intervention.

