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Adnexal Diseases
Published in Ayşe Serap Karadağ, Lawrence Charles Parish, Jordan V. Wang, Roxburgh's Common Skin Diseases, 2022
Hasan Aksoy, Jordan V. Wang, Ayşe Serap Karadağ
Acne fulminans is a rare and severe variant of acne, which presents with painful, ulcerating, hemorrhagic, crusted, necrotizing, and destructive papules, pustules, and nodules that eventually heal with scarring (Figure 3.2). This variant primarily affects male adolescents. Unlike acne conglobata, it is typically accompanied by systemic symptoms, such as fever, arthralgia, myalgia, and weakness, and systemic findings, including leukocytosis, anemia, and osteolytic bone lesions of the sternum and clavicles.
Acne, rosacea, and similar disorders
Published in Rashmi Sarkar, Anupam Das, Sumit Sethi, Concise Dermatology, 2021
There is a very rare and severe type of cystic acne known as acne fulminans, in which the acne lesions quite suddenly become very inflamed. At the same time, the affected individual is unwell and develops fever and arthralgia. Laboratory investigation often reveals a polymorphonuclear leucocytosis and odd osteolytic lesions in the bony skeleton. The cause of this disorder is not clear, although it has been suggested that it is due to the presence of a vasculitis that is somehow precipitated as a result of the underlying acne. Rarely, Gram-negative folliculitis can develop in acne patients where topical antimicrobials are inadvertently used (Figures 10.10 and 10.11).
Acne, rosacea and similar disorders
Published in Ronald Marks, Richard Motley, Common Skin Diseases, 2019
There is a very rare and severe type of cystic acne known as acne fulminans in which the acne lesions quite suddenly become very inflamed. At the same time the affected individual is unwell and develops fever and arthralgia. Laboratory investigation often reveals a polymorphonuclear leucocytosis and odd osteolytic lesions in the bony skeleton. The cause of this disorder is not clear, although it has been suggested that it is due to the presence of a vasculitis that is somehow precipitated as a result of the underlying acne.
Treatment of Resistant Acne Vulgaris in Adolescents Using Dietary Supplementation with Magnesium, Phosphate and Fatty Acids (Omega 6 and 7): Comparison with 13-Cis-Retinoic Acid
Published in Journal of Dietary Supplements, 2023
Patients with hepatitis, cirrhosis, or other serious comorbidities were excluded from this study. Patients were excluded if they had only comedonal or papulo-pustular acne without nodules or very severe forms (acne fulminans), or if they had used oral/topical acne treatments within 8 weeks before the start of the study or systemic retinoids within 12 months before the start of treatment. Also excluded were: pregnant women or those who wished to become pregnant, breastfeeding mothers, patients with systemic or psychiatric diseases (including drug or alcohol abuse), patients with a dermatologic condition that could interfere with the acne evaluation or with acne due to secondary causes, patients enrolled in another clinical trial, and patients with hypersensitivity or allergy to the study medication. All patients gave written informed consent before participating in the study. Each patient was asked to return for a clinical interview at the end of treatment to assess adverse events and compliance.
The use of isotretinoin for acne – an update on optimal dosing, surveillance, and adverse effects
Published in Expert Review of Clinical Pharmacology, 2020
Edileia Bagatin, Caroline Sousa Costa
Severe inflammatory and extensive acne with macrocomedones and familial history can present an initial exacerbation of the disease, in the first 8 weeks. This acne flare is caused by intense sebocyte apoptosis, release of antigens and inflammatory response, with spontaneous resolution in 15–18% of patients. However, it might mimic acne fulminans, without systemic symptoms, but intense inflammation, ulceration, crusts and scars. In order to prevent the flare up, it is recommended to start isotretinoin with low daily dose (0.1–0.2 mg/kg), associated with oral prednisone (0.5−1.0 mg/kg/day), during 2–4 weeks; low dose should be maintained throughout the treatment or at least during 8 weeks, when it may be or not gradually increased along with fractional corticosteroid removal [102]. Controversial adverse events are discussed below.
Dapsone for the treatment of acne vulgaris: do the risks outweigh the benefits?
Published in Cutaneous and Ocular Toxicology, 2022
Selami Aykut Temiz, Munise Daye
In our own clinical experience, we achieved significant successful clinical results without any systemic side effects after 6–8 months of treatment in all five of our patients who received oral dapsone treatment (Figure 1). Three of our cases were patients who could not use systemic isotretinoin due to its side effects (severe hepatotoxicity), while the other two were patients with acne fulminans who were unresponsive to systemic isotretinoin alone. We checked the glucose-6-phosphate dehydrogenase (G6PD) levels of all our patients before treatment and obtained the consent form for treatment.