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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).
Antibiotics Commonly Used for Skin Infections
Published in Sarah H. Wakelin, Howard I. Maibach, Clive B. Archer, Handbook of Systemic Drug Treatment in Dermatology, 2015
Hui Min Liew, Victoria J. Hogarth, Roderick J. Hay
Ciprofloxacin is used in the treatment of lower respiratory tract, GI, urinary tract and genital tract infections. In dermatology, it is used for Gram-negative infections of the skin and soft tissue and Gram-negative folliculitis.
Treatment challenges in adult female acne and future directions
Published in Expert Review of Clinical Pharmacology, 2021
Edileia Bagatin, Marco Alexandre Dias da Rocha, Thais Helena Proença Freitas, Caroline Sousa Costa
Oral antibiotics, mainly the tetracyclines, are recommended to treat moderate to severe inflammatory AFA by the inhibition of C. acnes proliferation, but mainly due to anti-inflammatory effects [80–82]. According to clinical guidelines and recommendations, with the aim of minimize the risk of emergent antibacterial resistance, their use should be limited to a maximum duration of 12 to 16 weeks; monotherapy or as maintenance treatment are contraindicated [62,65,82–85]. Therefore, oral antibiotics plus topical agents (except antibiotics) combined or not to systemic anti-androgens hormones (COCs and spironolactone) are useful for AFA when there is no desire to get pregnant. This regimen may be used as a first-line therapy for moderate to severe papular-pustular acne and secondary option for treating nodular-cystic acne when there is contraindication for oral isotretinoin [62,82,83]. It is a well-accepted current physician’s consensus, and also an evidence-based approach, to recommend the associated use of BP or BP plus adapalene when prescribing oral antibiotics [62,82,84,86]. This strategy allows either preventing treatment failure due to antibiotic-resistant acne as rising of resistant C. acnes strains in the communities [85–87]. Topical retinoids and azelaic acid may also be the therapeutic choice in association with oral antibiotics, especially if post-inflammatory hyperpigmentation is a concern [8]. Despite improvement in inflammatory lesions, post-therapy relapses are very frequent in AFA following one oral antibiotic course [88]. Serious adverse events are rare; the common events related to incorrect long-term treatment are gastrointestinal. Cutaneous eruptions, Candida vulvovaginitis, and Gram-negative folliculitis of the trunk and face are less frequent [82].