3rd treatment of accutane? If that's not curing your acne then you may want to look for other causes of your acne... Looks painful, can your doctor give you a cortisone shot into it to reduce the inflammation? Topicals don't work well against nodular acne so I would ice it to try to reduce the swelling if your doctor won't give a shot.
In the past 7 years I've pretty much exhausted every other option. The only thing that seems to work, although barely, is accutane. My skin has become much better than what it was a couple years back. These days I get 2-3 nodular acne per week, as opposed to getting 2-3 daily.
I did put some ice on that swelling and it did get a little better. It's not as hard as it was before, it has softened quite a bit. Now I'm hoping the antibiotics will do their job and make it subside completely