Elizabeth is a 22-year-old woman, who presents with severe nodular acne that has been resistant to topical treatments. She expresses frustration with the appearance of her skin and the negative impact it has on her self-esteem. After careful evaluation, including a pregnancy test and counseling on the potential side effects and risks, Elizabeth is prescribed isotretinoin, a highly effective medication for severe acne. She is enrolled in the iPLEDGE program, a risk management program designed to prevent birth defects. Elizabeth is educated about the importance of strict adherence to the medication regimen, regular follow-up appointments, and the need to use two forms of birth control to prevent pregnancy. She is also warned about the potential side effects of isotretinoin, such as dry skin, chapped lips, and mood changes. What are the primary congenital malformations associated with isotretinoin exposure during pregnancy?
